ADI 4 So Interview Rua PSY3 ASD Case Study Report supvEcr Sam Brun _ _ ne BE | | [QOD cronstosiat ase: PY GOV conde: hate Fete Jo % Alex Prism _ Relation to Sub Parents __ intenviewen Asp Assesment SpedalestBACKGROUND —_—a——aeantSTOTeeeeeSSSSSSSSSSC“‘(‘ FAWILY MEMBERS/FAMILY MEDICAL AND SOCIAL HISTORY Nore PHROUGKOUT ANY DISCREPANCIES BETWEEN INFORMANT’ DESCRIPTION AND OBSERVER'S ENOWLEDGE FROM OTHER SOURCES, AND SUMMARIZE AT END OF INTERVIEW. ASK QUESTIONS AS APPROPRIATE FOR RELATIONSHIP PEWWEEN ‘FoRwawT Nb soaIEc, ‘To begin, perhaps you could give me an ea of who's who in [subject's family. ‘Does s/he have any brothers or sisters? Could you tell me their names and ages? De al of them have the same birth parents? Are any of them adopted or fostered? (Jf ether parent previously mtd) Ate any from a previous marriage? Does anyone ele live in (sje) Have any of the brothers or sisters been delayed in their development? or had any special problems in evelopment for which treatment was sought? Did either of [subject's parents have any developmental difficulties (or late walking or talking)? oF special problems in development for which treatment was given? Ie there anyone in [subject|s extended family who has difficulties similar to thore of [subject]? Biologie ot tla cance Bicoycal father © _ recvng mother i rt bith wether Caregiving ater (fr basal ate):GROUND (CONTHUED) ‘SUBDECT'S EDUCATION (SCHOOL AND PRESCHOOL) [THE PUREOSE OF THESE QUESTIONS 18 TO PROVIDE A FRAME OF REFERINCE FOR THE TENS THAT FOLLOW. ow 1d tke to ask about what sort of programs, playgroups, and schools (subject) has attended ins ths regular playgroup ot schoo How lng 6d s/he atend?Dié s/he need any special hep/renedial hep? Did she have any special problems with reading or speling? (GO TARDUGH SCHOOLS AS APPROPRIATE FOR AGE AND DsTAIN DETAILS OF ATTATNMENTS IF APPROPRIATE.) What has s/he doe since leaving school? a 1 Ceaereh cole, ly Gace Wm PERSONALIZED TIMING tater on in the interview, Lam going to need to ask you to focus particularly on the 12-month period between [unie’s fowsth and fifth bisthdaye. What Sa going tobe the easlest way for you to think abost that age petiod? ouve just mentlone tat [ebject] was attending [school at that ine stat right? Where were you ivng then? {Go THEOUGH OFWER POSSIRLE PERSONALIZED TIMINGS, SUCH AS THE BATH OF SIBLINGS, MOVES OF HOUSE, EITHER PARENT STARTING OR FINISHING JOBS, FAMILY DEATHS, ETC.) a [DIAGNOSIS (ne cso nese here) Did anyone ever say that (sject] had a medical problem or give you a medical diagnosis for her/him? t hearing? (GET OCIAILS AND WAITE BELOW) NIP MEDICATION (no otng needed here) Dees {subject take any regular pills or medicines now? (GET OTAILS AN WRITE SELON.) Wo -INTRODUCTORY QUESTIONS "HE FURFOSE OF THESE FIRST QUESTIONS 1S TO PROVIDE A FRAME OF REFERENCE FOR THE ITEMS BILOW. ‘4 uke to start off by just getting a genera picture of (subject. Let me just brlefty atk you some questions ‘and then we can then come ack fo seme things in more detail once {have some tense of what Insect} ie Uke; Can you tell me a litle about [subject]? How weuld you describe eubjects) behavior to me It foa rosie heim out na iat Kinds of things does s/he do when lef to fiat? What is (subject's language Uke? ibe Wechovode _ SO wy new peayhe dialer he deem thane & ed ck heme ge dryj core oy Sol 4 leds he bres Fons wands | rh wd yore yeh Some Belewour cepebhue He Tainan Wet oh Sane one Loves bbe omecle_ Hoes Bey) s ew eh ag | feats «fygiationg HOSS “es Ae pretend ay buh ee “ry olen -wrRoDUCTORY QUESTIONS (COTW) © corre cones est mee) ‘bo you have any concerns about sues Behavior or development nov? What are hey? {Gotan oescathion ano Hore SELON) Spear dow * declen Dgenous Woe Wren pe same gee ens Seriengy 27plereben— PF papirey op eos (YD A paoud nan PomeEARLY DEVELOPMENT Can we now go back to talk about [subject's early years? Onset of Symptoms Tre © Ace cv mowTas) when paReNTs RST NOTICED cae apie mse hoe ‘THAT SOMETHING WAS NOT QUITE RIGHT IN ithe Br ole code me LANGUAGE, RELATIONSHIPS, O8 BEHAVIOR i ‘ Rew aca nea a a pun ay barren development. ‘ctu age rather than 990, ee How old wat [subject] when you first wondered if 1991 = patents ot concer ‘there might be something not quite right with sigh hao her/his development? by pfesiona Eee it ee premature oy Sih) Slow te bed Ne words oe pownbng te 7 @ rst srmrrons To AROUse PARETAL CONCERN ca mt et) ‘What was it that gave you concern at that time? {(ELICTT DETAILS OF SYMPTOMS FIRST CAUSING PARENTAL CONCERN AND NOTE BELOW.)any DevELorment (comrTueD) @ pwser as encerveo with HINDSIGHT ‘rue PURPOSE oF Tis 174 16 To RECORD THE EARLIEST FOUNT INTHE CHILDS DEVELOPMENT THAT [ANYTHING UNUSUAL MAY HAVE OCCURRED, ACCORDING 70 THE INFORMANTS BEST JUDGMENT WITH HINDSIGHT. ut trans bet B LAL a ereen ra) Yoetine shaved anyprotiems or ittentiesin =| °7 gatyrug'™ eee ‘Do you think that everything was alright before ee day at 7 ioe etry bai 2 probes nt preset before ‘cod th, but we ote Moroeoe ted hy sep eines ‘or bee but thoy 4 probes at een blate eal we ae Sh hry So mere ted stor le Stn Soy ens nt preset bre ‘tne ted 2 = il ata ae peceedby prs a sind of snort 4 go prolene wee noted bron = n/or na aedne (contac) Motor Milestones @ Hest wacked unatoeD What about walking? ‘At what age did [subject] walk without holding on? (IF NOT WALKING BY 18 MONTHS ~ OR IF APPARENTLY DELAYED OR DEVIANT ~ ASK ABOUT OTHER MOTOR MILESTONES, SUCH AS AGE WHEN FIRST SAT UNATDED ‘OW A FLAT SURFACE. WRITE DETAILS BELOWL) Br slower Ho ected beh rot ted coksy delepocl Oa Note: Remember to take mlaplat rd oun po the neces oath iar yt eose ect rather than ay (Cote n mnt, Smal Te motihe) 097 = Wb apparently dled ome Wa 989 = W/o a aanu DEVELOPMENT (CoTWED) Toilet Training ‘wont FoR THE POSSITLITY THAT EACH SEY OF HABITS MAY HAVE BEEN SUBSEQUENTLY LOST AND RELEARNED [OTE AGES FOR SOTH, BUT CODE RELEARNING OMIY.DO NDT CODE ISOLATED ACCIDENTS WITH AM UNDERSTANDABLE Tevianavion (c-0, SURJECT UNWELL, HAD A HIGH TEMPERATURE, RESPONDING TO A CHANGE OF ENVIRONMENT rene ots) ow ba let ting gone? @ ‘courstr10 oF avaoee cone: pavime Is (subject] dry during the day? ow old was s/he when this was first achieved? ‘When was s/he first dry for 12 months without accidents? Argan, bit ego ov © pede ade be ae a mnt) of st ‘vine sae eezentbetare Sh noch pri Ele ‘owe one of 196 = w/e, betEARLY DEVELOPMENT (CONE) @ scaursmos o aao0ee connor: curone tt yan Shamans, Tay) How twas se when s/t fat remind dat ela sone : ‘ther ro tee When was s/he first dry for 12 months without an accident? Aagpies ob wfhs Ea 68 = n/axnUy DEVELOPAENE (coHTTUED) @ -cousson oF Bower conrrou ‘Does (subject) soil himself/herself at all (with her/his bowel movements)? How old was s/he when s/he first got fall control of her/his bowels? ‘When was s/he first continent for 12 months without an accident? Gee pie cot agen mx) when | Sine teed fe, oe lal) Sen items pret nea eta otha oe inl a Sent fnvtvng eoling ov Sth etn al. reer heed continence 986» Wt bu ppatety norma 997 = 7b apparent dled eanACQUISITION AND LOSS OF LANGUAGE/OTHER SKILLS How I'd like to talk about [subject's language development and the kinds of things children do before they learm to talk. ‘What is (subjects language like now? Has s/he learned to talk yet? {ADAPT INITIAL PROBES 10 WHAT 15 ALREADY KNOWN ABOUT SUBJECTS LEVEL OF LANGUAGE, AND OBTAIN DESCRIPTIONS To AID THE WORDING OF LATER QUESTIONS.) @ Ace oF ranst sinste words, “MEANINGFULLY REFERS To WORDS USED REPEATEDLY AND CONSISTENTLY FOR THE PURPOSE OF COMMUNICATION WITH REFERENCE TO A FARTICULAR CONCEP, OBIECT, OR EVEN. DO NOT COME MOM AND “DADDY INCLUDE ANY OTHER ‘SPONTANEOUS, FHOWOLOGICALLY CONSISTENT SOUNDS THAT APPROXIMATE REAL WORDS IN LANGUAGE OF TANILY AND ow old was s/he when s/he first used words feictmiereemonecretitse — [ [210] meaningfully spar from "mama" and cS aT What mere her/his Fist words? How id s/he show that s/he knew thr mening? (GET EXAMPLES.) 354» milestone nt reached Did (subject) ever use these words to refer to anything 996 = 47, be apparent sara ‘else or as sounds that didn’t seem to have any specific 97 = but apparent delayed eae $99 = w/e ornot ated ~ Co Se — bell‘Ako LOSS OF LANGUAGE/ OTHER SHILS (contin) © 2ce 0F ast eheases (Fever UseD) {on THz PURPOSES OFTHIS CODE, A PHRASE MUST CONSIST oF TWO WORDS, ONE OF WHICH NUST BE A VERB. DO NOP {abe ATTRIBUTE NOUN COMBINATIONS OR ECHOLALICSPEBCH OR PHRASES THAT MIGHT HAVE BEEN LEARNED AS SINGLE twoRD T0 CONVEY A stNGLE MEANING (2.6, “SEE YOU" [MEANING GOOD-BYE). NOTE THAT THIS DEFINITION DIFFERS FRO WrHAT Is REGARDED AS VERBAL TOR TIEN 3, “OVERALL LEVEL OF LANGUAGE.” ade aye in ont) St sed How old was s/he when s/he first said something at lone ane af bee that involved putting words together meaningfully! (es! <)¥ mons) (Ge. using two or three-word phrases)? 99) = ad me pss What did s/he say? soe repsines What abot phrases ining a verb? (GET EXAMPLES.) ein tec m7 = bu apetety laed Nok oh 499 Nk cot ake (aly)‘ACQUISITION AND LOSS OF LANGUAGE,OTNER SKILLS (C¥rINED) Loss of Language Skills (Items 11-19) ls ITEM Is To DETERMINE WHETHER. ONCE THE SUBJECT HAS DEVELOPED COMMUNICATIVE LANGUAGE, THERE WAS A DEFINITE PERIOD OF LOSS OF SKILLS THaT LASTED AT LEAST 2 MONTHS. USE THE FoLLOwine oaruuneam {LANGUAGE BEFORE LOSS: COMMUNICATIVE USE OF AT LEAST FIVE DIFFERENT WORDS (OTHER THAN “KAMA” AND DADA") ON A DAILY BASIS FOR A LEAST 3 MONTHS [LANGUAGE LOSS: LOSS FOR AT LEAST 3 MONTHS OF A LANGUAGE SKILL PREVIOUSLY ESTABLISHED, AS SPECIFIED ABOVE Were you ever concerned that (subject) might have lost language skills daring tl her/his Ue? ‘Was there ever a time that s/he stopped speaking for tome months after having learned to talk? (HF ¥E5) How much language did s/he have before stopping? Was s/he using atleast five different words (other than “mama” or “dada") on a daily bass for as long as 3 months? first years of @ 1055 oF Lancuace seis AFTER ACQUISITION 0 =m ie mr pend ent sin te 1 No - jes yew Slows Prmashiogseenreen-rstin 7 God goedlung ae bea nh wed’ Ste Mer‘AcQUISITION AND LOSS OF LANGUAGE/OTHERSHILLS (CONTINUED) @ tee oF conmUNtCATIVE LANGUAGE BEFORE Loss = ty nen ng How much language did [svject] have before losing ie? usin se yet aq hat was s/he abet say before the change occurred? Ses eee nt FOR NUMBER OF MEANINGFUL WORD, EXTENT OF Sin eat SFonvaNeous UsACE, AND LEVELOF COMMUNICATIVE USE.) “NESS 1 = cal teen see etal {i cmaurtey alone ‘conanton with itor ite 2 padaced speech or ods foe ret ma ora ot ee‘ACQUISITION AND LOSS OF LANGUAGE/OTHER SKULLS (cNTTUED) ‘Type of Language Skills Lost (Items 13-16) "FOR THE FOLLOWING ITEMS, L0SS" REFERS To ABILITIES THAT THE SURDEGT HAD MD THEN LOSE FOR AT LEAST 5 WonTHS What aspects of language did [subject lose? eae oe Did s/he stop using meaningful words spontaneously? 4 + probable of pec kat Did s/he stop using words to communicate wit other people? 2» dette of pectin kt What about use of grammar? + instcient ngage t show Masher onc of ods atc? eae © 1055 oF sronraneous use oF ar east FIVE neamwcruL woros ne @ 10055 0¢ conmunacarive rent en Am. 19) Ai © 10055 oF srwracrican states cRannany en @ @ 1055 oF aescutaTion PronunctatonAcQUISTTOW AND L055 OF LANGUAGE/OTWER SKILLS (CH7TUED) @ Ace wien matn Loss OF LANGUAGE SKILLS FIRST APPARENT ow old was [subject] when s/he first began to lose ‘her/his language? seatieldlowss et 31919) 998 = 0 a se @ ‘ssoctarton oF L0S5 OF LANGUAGE WITH PHYSICAL ILLNESS ‘i [subject] have any serious physical iliness at the ‘time that e/he began to lose language? (JF VES, OBTAIN DETAILS.) / itr - @ ovrvrt0n oF Loss oF cancuace sxaues How long was it before hhad been at before the loss took place? .gan to come back? How tong was it before s/he reached the Level s/he Sorat te erect BE ‘eit Se eat te ts tomemgued wins aetateitowe | C2) (Caper ante Seti eat snes 2+ lsd wth aed ‘SoS ce Sry hes eg Spite erovenee = role a le 92 W/E ot adGeneral Loss of Skills (Items 20-28) © 1055 oF sats (Fo a east 3 Mowry SKILL LOSS: SKILL THAT HAD BEEN ESTABLISHED AND USED ON & DAIL BASIS FOR ATLEAST 3 MONTHS, AND WAS ‘HEY LOST SUBSTANTIALLY OR COMPLETELY FOR ATLEAST 3 MONTHS. DO NOT IMGLUDE. A Lost oF aLADUER oe Bonet CONTROL IF NOT PART OF A MORE GENERAL LOSS OF SKILLS; OR VARIATIONS IN USE OF SRLS AY MES OF wonsenee BEHAVIOR If SUBIECT CLEARLY RECOVERS (LE. F “LOSS” 1 PART OFA MORE GENERAL PATTERN OF UPS AN0 DOWNS 08S MUST BE CONSISTENT OVER A PERIOD OF At LEAST 3 MONTHS We've just talked about posible loss of language Geir ‘ile ake fo go Seed newts sok soos = ie) ie in other ite ae : os when [subject] seemed to get mi 1 — mba of bat ‘dropped further behind in her/hi ae When was ths? oer ene What skills did [subject] lose? shila over a pesiod of time (i LSS OF LANGUAGE ILS) Did [subject lose these °~ W/E mt sae er skills at the same time as losing language? een im ie, pte guint 2). 1 tena ede 0°87 8 fr "am 2028 anthem ite 2 (ge 2). ah = och swt acquae stellt‘AcausrT10N AND L055 OF LANGUAGE/OTMER SKILL (CONTE) ‘Type of Skills Lost (Items 21-25) ‘What skills did [subject lose? ni ‘id it affect her/his blity to look after hex/himsl Di it affect her/his play? What about coordination? walking? ability to arip or hold objects? what about using the bathroom? schoo-type skis? ade none, (GFLOSS OF LANGUAGE SKUs) Dt [subject] xe ese others atthe same tinea sng angunge/ ‘tite lon PURPOSIVE HAND MOVEMENTS. / wee {ABILITY TO GRIP/HOLD OBJECTS) {fo MOTOR SKILLS (oSTURE, GAT, COOROINATION) SELF-HELP SKILLS / vee (FEEDING, DRESS, USING HE BATHROOM ET.) / 5 CONSTRUCTIVE OR IMAGINATIVE PLAY wee (PULRES, GAMES, MAKE-BELIEVE EC.) al SOCIAL ENGAGEMENT AND RESPONSIVENESS (SOCIAL RELATEDNESS, IWPEREST AND INVOLVEMENT) / (laACQUISITION AND L055 oF LANGUAGE/OTH seas connec (© ce when wate Loss o eas sr appaRent How old was s/he when the loss of this skill first became apparent? ade age in months, or chose neo te Yt @ ‘ssoctarrow oF Loss oF skaLis WITH PHYSICAL ILLNESS Did (subject) have any serious physical iliness at the ‘time this change occurred? (IF YES, OBTAIN DETAILS.) aie © vwrarion oF Loss oF sxruis sit before s/he reached the level s/he had been at before wy of hs, tno psy er a 1 ma th ay cota Se cena ‘mena reat 2 once inp sei Senmnol tcp pee snot as In monte the neon fo ate tine peas {et an oct one of 294 = pein dteation 980 = N/K or a ad (Gs15LANGUAGE AND COMMUNICATION FUNCTIONING ow let's come back to [subject's language and communication. Let me begin with what her/his ‘understanding of language is like now. © cowrrcnension oF inpue ancuace ‘Son tan seepecte. ‘She ov el place a tet ‘ls 15 A SUMMARY CODE THAT DEALS WITH THE SUBIECYS ‘ONDERSTANDING OF SPOKEN LANGUAGE WHEN THERE 1S 4M ‘fhe han someting fo eed [ABSENCE OF OTHER CUES SUCH AS THOSE THAT HIGHT BE Sra tearm ah PROVIDED BY GESTURE, POINTING, OR COWTEXT rete theirs a) ‘How much language do you think [subject] ndcrtande iyo don't gesture? copmeumis SE What sbont when a/te can't tl frm the sitnation i what is going to happen? For example, can you send SEES mote “GB eee eee SS tig ‘her/his shoes or blanket? «a ‘carry out a new action vl What about your purse or a book? we! Fe Melati | 2 - mimetnay mninme ‘the usual place? Could s/he deliver a simple message? Could se follow an instruction with an IF” and a “the deca foe han Does s/he understand if you say “no” without gesturing or Ears: bt ome i : ompeheson 9 raising your voice? Senpetnon How about “ves” or “olay”? Tee ne mr How about names of favorite foods or toys or people in ce eee arent 4 tit orm compiabenion of Do you think s/he understands 10 words? 50? 8 WA(oa. det) What about at age 4 t0 5? A//A 9 wykoc nt aed Cmegense — Seems” opeclMING (OWEN) @ ovenace cever oF Lancunce {HHS 15 & SUMMARY CODE conCERNING WHETHER SUBDECT USES AT LEAST THREE WORD PiRAst "THIS INCLUDES SPONTANEOUS SPEECH OR ECHDED OR STEREOTYPED SPEECH [F THEY ARE USED PoMc ONALLY, How much speech does (subject) have now? oes s/he ave pases with at at re words that s/he uses every day? Do they ever include verbs? Do other people understand? If nat, does s/he have single words hat ar sed ona dally base? How many? ~)o? cae on™ + © fnetinal ae of spontaneoss, cunsor ia] Itetade sw and ace oapehon te her people Seve pec bt ass tat ive diferente 2 feet ha ve wor total ot ‘eect ed on day Ss etnanictmbaarebtestear,, (Sesh em (Page 31) nde" ante Mec siete Fee adept fra yo ottLANGUAGE AND COMMUNICATION FUNCTIONING (COTW @ 05e oF omnes 00% to communscare ‘nut eniasis 15 ON THE ABNORMAL USE OF ANOTIER PERSON AS KIND OF EXTENSION OF THE SUBIECTS ARH OR aera AMPLE, THE USE OF ANOTHER PEISON'S HAND 70 POI, TOUCH AN OBDECT, OR PERFORM A TASK SUCH AS aoe fot gon KNOB TO OPEN ADOOR, UNSCREWING A BOTTLE TOP OR MANIPULATING A ZIPPER OR BUTTONS, 135 saan ai FROBABLY TAKE PLACE WITHOUT ANY PRIOR ATPEMPT TO COMMUNICATE THE NEED OR REQUEST. BY BEM atte oTHeR SOUNDS OR GESTURES. THUS, THE PHYSICAL CONTACT 1 NOT 90 INITIATE A SOCIAL APPROACH, SUT RATHER TO FACILITATE TE COMPLETION OFTHE TASK. nue 8 Saeco? o Title spect cea fl How ai /he let you know s/he wanted something ea oar Soomre at s/he ver show sou what [he wanted by taking g}, Sey ins ae Sor anit araame ther part of your boast h” ‘Sinden sue om ‘What exactly did s/he do? eznalgacmen foc i “What did s/he do when you were brought to the objéct ers band ae too tt ae ee re i ih aber moses oh Did s/he ever use your hand as iit were a tol or an Saucon txtension of her/his own arm (Such as pointing with your hhand or getting your hand to turn a door knob)? Sarre aaa bes) Oi s/h oak t you when ding thst cee Did s/he combine taking your hand with trying to wither aot of {Dnmuscate nh sund rns? hen di she doe? someon gmenuee ‘Did s/he try to communicate first by sounds or gesture? — Does s/he ever take your hand or wrist lke this now? 7 Sus Cigovt (GET DETAILS SUFFICIENT FOR CODING.) Soe tried b tale sods Souls ote op you Tprhe Pl pe YY boul A tbe ga Siwer > Sire seu thong he cer v C pice bx ) prevly 4 chow sow ey! AssLANGUAGE AND COMMUNICATION FUNETONING (cONEKUED) ‘tems 42 onwards apply to both verbal and nonverbal subjects, @ rovwrns 10 exons aareesr Tuts ITE 1s STRICTLY CONCERNED WITH UNPROM.PTED POINTING THAT IS USED AS SPONTANEOUS COMMUNICATION 10, }PRESS INTEREST OR TO SHOW SOMETHING AT A DISTANCE RATHER THAW AS A MEANS OF OBTAINING SOME ono FOUMTING MUST BE SOcAL AND TT MUST BE IMTLATED BY THE SUBIECT. FURTHERMORE, THE POINTING HUST ae 2 GRDECTS {THAT ARE WITHIN SIGHT BOT THAT ARE SOME DISTANCE AMA POINTING AT BOOKS. OK POI Ke a ea ie eee 70 QUESTIONS, 15 EXPLICITY EXCLUDED FROM THIS ITEN, ALSO ERELUDED s POINTING TdT Is Uasd Ne dear Does subject] ever spontaneously point at things = getty a, comet cae feet eet ir] Wiha finger or ort of «hand extended he aching? ietetoconeanl a what cumstances? te se eaten ost naan epeeteet anki Doe s/he ever pont at things at distance, such aout psec ee re ac ens eh 1 wanted to ge you to look a something, might Fst Pe look at it then look at you, then pont and lok a the Sree Siege) cbjec agai, then look back at you to see you ceeeeee Understood Can fubject) do th? et as What about when s/he was 4 to 5 years old? Bajecu ces dtace A ge besp = W/L or ot ed + Show mnbeveh cars / duels — plres Somehire checks eck yt bak rh ales - CO rey pl rink reyeok. U Jar] Jee feowf Ohl gor chin tecloeLANGUAGE ANO COMMUNICATION FUNCTIONING (COTTHUED) @ wo0one ss rrem 18 tsTeNDED 10 DETERMINE 1 THE SURUECT CURRENTLY USES OR HAS EVER USED THE CONVENTIONAL GESTURE ran ppbaNe TO cONMUNICATE YES” NoDDING SHOULD HAVE OCCURRED IX SEVERAL DIFFERENT SITUATIONS BUT Sunt HAVE DECREASED IN FREQUENCY AS TAE SUBJECT LEARNED TO SPEAK ‘oes {subject mod her/his head to mean “yes”? cone aT What about when s/he was 4 to 5 years old? jometines nots spontaneously (GET DETAILS.) 2 = ere nods spontaneously aakonma. ws seas (8) SowerneS 1 ern td @ reno seman Sot chases mages sme! wen SE Does [subject] shake her/his head to mean “no”? Oe et ae aa wat about when s/he was 4to 5 years od? 1 matin aa ba coat (GET DETAILS.) 2 nee sala ad 9 nye eat asad Someh we SING owe) © conventionaransteumentac Gestures INSTRUMENTAL GESTURES ARE SPONTANEOL US, CULTURALLY APPROPRIATE. DELIBERATE HAND OR ARM MOVEMENTS THAT CONVEY A MESSAGE BY THER FORM As 50 IAL STONALS. EXCLUDE PURELY EMOTIONAL SIGNALS (SUCH AS BANDS 10 TACE Dee mv abt eo se a her om When des this happen? fmmcmcrntetag Beas s/he ever ue thr common gestures, sch ag it Sno Mowing Hes ping fer aieb wl done ating Zeya hy a finger to her/his lips to mean “be quiet.” or {netrmana perp, end“ meee Rohan *- wnupaiesnd poner [BI] Does s/h ever te gestures, othe han pointing or Site Tamaes hholding arms up to be lifted, to let you know what s/he eee uns? 1+ emma Docs s/he we sstres when s/he suing to gt you to vane halo her/im ort ge our tention (tor ean, aeaceee bechoning to someone, or puting ous han et pan cules ‘xtended to ask that you give beth something)? feces ‘What about when s/he was 4 to 5 years od? ewe Wes rhe beans 9 = Nort aed chy car 7d L hese vithes beame Woke oobern eo alo Mh Reger — be gute a hovel ahem s ee ” Come hve” 4 here 16h © ty"@ wrevmov 1 01 For subjects aged 5.0 years or older, prot ‘only forthe 4.0- to 5.0-year per ‘nie roc 1s ON WHETAER THE SUBDECT SHOWS AK ORIENTING RESPONSE WHEN SPOKEN 1O AND NOT WHETHER /HE ee a i carb Tie ORTENTING RESPONSE SHOULD CONSIST OF AN AUTOMATIC LOOKING TO THE SOUND roe oir aa ArPROPALATE FACIAL EXPRESSION Ts SHOULD OCCUR WITHOUT THE NEED FOR EXTRA STEPS SUCH 1s cALLInG THE SUBDEETS HAME OR STANDING VERY CLOSE £0 HIM/HER 0 = uly nts and pn coms 1f you come into a room and start talking to [subject] Suet glcetcin DELS) without ealting her/his name, what does s/he do? Sele hae icone Lana “aber than od ometig Tmean when you say something neutral rather the athe tan ose ‘when you'te trying to get her/him to do something. Teas lax ap et ay eteaton tye? ‘seemless ow does s/he respond? How about to other people? Spey ailgwetaned MSY Do you need to say her/his name or catch her/his eye ‘een wat a & fst o could you jst ay someting that s/he might nat mradtas even be that interested in, such a5 70h no, it's raining” ootanunat ee ‘or “My goodness, what a lot of toys!” bay sention when spoken to, ns Dwr not epost ‘What did {subject} do when s/he was 6 to 5 years old? sponse oer (GET DETAILS.) serene nieuw? ann mostyy wil sep whet imcheanete 7 cheing + loom soma er gee whe To hapa Jarinmey Cc@ srowrancous noraron oF aris For subject’s aged 10.0 years or older, probs nly forthe 4.0- to 5.0-year periot "EMPHASIS 15 OM TEE SPONTANEOUS IMITATION OF A VARIED RANGE OF NONTAUT, INDIVIDUAL BERAYIORS, ACTIONS, 8 CHARACTERISTICS OF ANOTHER PERSON. EXCLUDE InITATION OF T¥/FILM CHaRACTENS oes [subject] imitate you or other people in the family? 92° He ced or oa iat RRR ier ey How about when you are not trying to get her/him to 5» sputzeunteion ss ant Salou tin ee gf hic Aces s/he copy something you have done, but using 3 iia rate “pretend” object such as mowing the lawn with some toy cutest shamed °° tae he 11 = some indication of spontaneous: cae 2th mation oy atten you ate dig whatever, nn a (3) ‘F does the copying form part of ers play at other times? ye ivi e ape ur of How vred are the things she imitates? Does te iitation fsbo are trite som perl hoa suchas thewny NAT ‘you walk or gesture or the way you fold something? owen ee, (2 ee oun et (GET EXAMPLES.) eet nara ns py ‘What about when s/he was 4 to 5 years old? ta ec ry en yn meee — gpuclen ty Whores 9 glean woh + be Vookwel, — oloes Auburn ype le Crek tebe mm rleey ) Besa beapg pporored mrannerins get — only achetr( 7dLANGUAGE AND COMMUNICATION FUNCTIONING (CONTRUED) @ mcrae ry 1 subjects aged 10.0 years or older, probe only for the 4.0- to 5.0-year riod. | MAGINATION 18 DEFINED AS FRETEND PLAY THAT IMPLIES THE FORMATION OF MENTAL IKAGES OF THINGS ‘Totamasent, Ta Focus HERE 15 ON THe CHILO'S CREATIVE AND YARIED USE OF ACTIONS OR OBDECT IN FLAT {To REPRESENT HER/IS OWN IDEAS, Does (subject lay any pretend games? Does s/he play with toy tea sets or dolls or action figures or es? (GET EXAMPLES.) Does s/he dink the tea/push the cari the stuffed animal? Ha s/he ever given the dll a drink or the action figure 3 tide inthe car? Has s/he ever used the doll/ation figure asthe initiator- so thatthe doll pours and serves the tea o the action Figure walks tothe car and gets in it? Does s/he ever talk to her/his dolls ora Does s/he ever make them talk or make noises? Does this type of play vary from day to day? ‘as s/he ever made up a sort of story or sequence (eau mith the toy cas racing each other, being parked in 2 Serage, or going to Granny house)? What about at age 4 to 5? (GET EXAMPLES.) CUS ~ ASL + mredre Serol) = ore hang 7 cuddles bis Holly oi reln nea axoerit0) SSeldateg sem 2) 1+ sme pretend a. cog Mow aeete Ser fe ‘ey er eeguen anon 2 Sted crt hy fg esr ten ay {ahien may be Reoe), (romp hasbeen ‘api byes 23 = nopeted ay wa Cc bt ot |, oh bool eh. Cbd mony ees P eoluh olees Huey{LANGUAGE AND COMMUNICATION FUNCTIONING (omHUsD) © wacavarive rea wth eens For subjects je 10.0 years or older, probe only forthe 4.0- to 5.0- "HE FOCUS HERE 1s OW THE SPONTANEOUS, CREATIVE SHARING OF IMAGINATION AMONG CHILDREN, INCORPORATING OTH! {HE SUBJECTS IDEAS AND THOSE OF OTHER CHILDREN. THE LEVEL OF IMAGINATION MAY BE SINGLE CO Late ae SOCIALLY INTERACTIVE, SPONTANEOUS, AND VARIED. 1 THE SUBDECTS ONLY PAY I WITH sIBLENGS. BE PavecoeAaLY (CAREFUL 10 DEFERENTIATE WELL-PRACISED ROUTINES FROM SPONTANEOUS, FLEXIBLE PLAY. aisd itTBbewooe ey "THAT 1S HIGHLY STRUCTURED FOR" THE SUBJECT BY THE SGLING FON PLAT IN WH Ste slows SOME Tec tees a eens on) someone ese? Sececcatehete” (mata lead and follows another — Do they seem to understand what eachother ie Setigenn Pretending? How can you tell? Can you give me an anions net + at os, Does [subject] eve tae the lad in ths ply? 0 does oy a sata sive most follow the other prsors Wea? Peed ite fe What about at age 4to 52 2 ont th ote Nie ee CH prsS)SOCIAL DEVELOPMENT AND PLAY SOCIAL DEVELOPMENT AND PLAY ‘thank you, That has given me a clear idea about her/his communication and imaginative play. ow can we talk about how ¢/he got on with people when s/he was tittle? @ vurecr cae INCLUDES BOTH THE SUBDECT'S USE OF DIRECT EYE GAZE TO COMMUNICATE AND HER/IHIS RESPONSE TO OTHERS’ [ATTEMPTS TO CATCH HER/HS EYE. For subjects UNDER 5.0 years: Dees subject look you diretl inthe face when doing things with you or talking with you? (Can you catch her/his eye? Does s/he sometimes watch you as you walk nt the oom? Does she lookback and forth o your face as other chien would? ‘hat about with others? ees (bi eur be sy’) For subjects OVER 5.0 years: When [subject was 4 to 5 years of age, did s/he lok at you ‘rectly in the face when doing things with you ox talking with you? Could you catch her/his eye? Did s/he sometimes watch you 35 you walked into the room? ‘ould s/he have looked back an frth to you face as other children would? ‘What about with others? ‘Sop sation a pene 1 definite dst ao bat ny of Wie austin co content 2 srcnain/ocaina iret Sheer gun aay ed Sng ema rts) Poi (3@ socrat smruinc DEFINED AS SPONTANEOUS SMILING DIRECTED ATA VARIETY OF PEOPLE, INCLUDING SMILING RACK. AT SOMEONE SMILING ‘A HER/HOM, SMILING DURING AN APPROACH, AND SMILING IN RESPONSE TO HAT SOMEONE DOES OR SAYS TO HEB/HIM. When {subject} {s approaching someone to get her/ ‘him to do something or to talk to her/him, does [subject] smite in greeting? What about when s/he sees you fot the firs time when you've been cut? Or when meeting someone s/he knows? If s/he is not smiling first, what does s/he do if someone else smiles at her/him? Or when someone says something nice to her/him? What about at age 4 to 5 years old? Lovely sale 7 geek io 2 hee png, ama ace” =) Soe “marae: lal otwcpeca cde hf ‘ses ot tpn 4 = ee on ling t pape, ‘ough may al at ter ws aie Rab oly cw chon Raw coms t hese Ret ahs ing a‘SOCIAL DEVELOPMENT AND PLAY (CONTINUED) @ svone ano oneecrne arrenrzon ‘HE PURPOSE OF THI 1724 1 TO DETERMINE WHETHER, HOW, AND IN WHAT CIRCUMSTANCES THE SUBIECT DIRECTS (OTHERS AUTENTION To TOYs on OBJECT IN WHICH se IS INTERESTED. THE FOCUS 1S ON SPONTANEOUS DIRECTING (OF ATTENTION PURELY 10 SHARE (HTEREST snag tgee ca tem [0 tera Sera = es oeacmeret ist Saas 2 sone ring things plein a speceatony ed. cedtiaiay “this ape aes = nyteorsot aedINTERESTS AND BEHAVIORS (ournueo) @ conruisions tunis ‘Hie ewasis OF THs TEM 15 ON FKED StQUENCES THAT ARE PERFORMED ASIF THE SuBDECT FEEL PRESSURE To COMPLETE ‘HEIN PARTICULAR ORDER. COMULSOWS MAY ALSO INCLUDE ING 10 PLACE PARTICULAR UoDees Ih Gee "POSITIONS oR RELATIONSHIPS I SPACE, SUCH AS OPENING ALL DOORS 70 A CERTALN ANGLE OF TURING Bil LAG OF. ‘A Gonunsion wit ors DUeFERS Fkom REPErnive Use oF osaEETs (CODED I TEN 69) IN THAT THE SUBS MALTS "HAT SEVERAL LIGHTS MUST REMAIM OF, RATHER THAN CARRYING OUT A EPERITVE ACTON OFFIC Ls OF AND ON, RITUALS DIFFER FZOM DUFICULTES WITH CHANGES AS DESCRIBED IN ITEM 7419 THAT THEY Have SEOUENCE, 10 ADDITION. mA RITUAL oR COMPULSION Te SUBDECT Is IMPOSING AN ORDER ON EVENTS, RAGHER Sia AESFONDING TO.A PERCEIVED CHANGE, THUS, a SUaIECT MO NEEDS 10 LAY HER/ Hs MAPKIN OUT LAT AND Plats Han/Ais SpooN (ON T BEFORE Sie WILL EA, COULD Be COORD AS HAVING A RITUAL, WHEREAS A SUaiter mio“ str G Si OVEN DIFFERENT NAPKIN WOULD BE CODED ONLY UNDER “DIFTICHLRES WITH MANOR CHANGES In SUBSECTS Cats OUTS OF PERSONAL ENVIRONMENT” (TED 75), BEDTIME ROUTINES ARE EXPLICITLY EXCLUDED FROM TIS ITEM BECAUSE THEY OCCUR $0 COMMONLY IX NORMALLY DEVELOPING Complsionrituat mast have sone on CURRENT ferat iene smoot to be code tt 0 no compalsiony/ situate ‘Are there things that (subject) seems to have to in a very particular way or order; that is, rituals that s/he has to do or has to have you di 3 Bree Like touching particular things or putting things in ‘Sguenes bt ho acy ha appears special places before going on to do something else? empl n qulty = How does s/he reat if s/he is unable to complete Suan ism” [T) the whole Sequence of her/his activity or is one spc coer Aisrapted daring the course of her/ns ations? sas acy eed ay {GET DETAILS Ano EXAMPLES.) ceeriegiee niet Was this ever a problem in the past? Inept hen eau uy (PROBE AS APPROPRIATE, USING PROMPTS OR ca leech AE ea 5 = one marae tat ajc as Derm pei aya Seems b news hu Tama See Sy nar Spondees wn catenin Altces Geena lat er sae = WM oret et — teddy on bos eel — aon a shel in fot TE mods No\ Ato bilaced bibseanst ereler its a aehavIORS (CONTNLED) @ wws0A: sensowr nenests UNUSUAL SENSORY INTERESTS ARE DEFINED AS UNUSUALLY STRONG SEEKING OF STIMULATIONS FROK THE [ust SENSATIONS OF SIGHT, TOUCH, SOUND, TASTE, OR SMELL THAT ARE DISSOCLATE FROM MEARING ‘heroes sur xtEn TO WHICH THE ABNORMAL HERESY DISTURDS OR REPLACES "NORMAL USE" OFTHE OBIE. Does s/he seem particularly interested in the sight, fel, ‘sound, tate, or smell of things or people? For example, ‘does s/he tend to sniff toys, objects, or people inappropriately? (rs s/me unusually concerned withthe fel or texture of things? ‘r des s/t tend to pee ator Look at things for long periods of ‘ine? (Or does s/he touch things to her/his ips or tongue to see how they fel? How long has s/he been interested inthis? (GET EXAMPLES, ‘SPECIFYING THE SENSE AND CIRCUMSTANCES WHERE SHOWN.) as there ever been a time when s/he showed an unusual Anterest in sensations? onde pre Recling terres & Ueuesl sensory ntererte mse CURRENT See tatier serie TT) “fetes fees Sania El See ce Sine aoe = nyrer eet asad. ohan ashing ate cinder gpg on + do ay enper , lakes, speck Gree M18 m alelPSYBAD = (ase Stud vk AD Comprehensive Algorithm Form * oe Subject. Eee ure Nameesabecrnos Say PxDLdIV Date ofits QS LO | /L | ehronoogia oS mame Alex % Jo Blown rastiontosaiece Prver dS tame ASD Assessment Specialist stele - . due ottnenion 5 | 10 OD Z ” Tk earth we ore or Raion Dts tin 2 vt 3 ea at 1 veneers et 46 te 9 eno an oe 10 Yeas 0 Months or der (eral Sbjes ory em 30 =) [ye fe Up) ft ett oe ty sn nm Zee 3 a Ore] nic gi at "peer Bt tine on ae‘A: Qualitative Abnormalities in Reciprocal Social Interaction. Copy each code ito the box fo on es subject age Level, iH * thooth lie fi ee) Nee a Ee 51 Sac Siting. CMSs head, oS ml 57 it resin knee (es oes Edi yh zeae to develop peer aonsips CC). C) 49 Imaginative Play With Peers (oc). ee 63 ean Apacs fer nts —-(—}-} (64 Group Piay With Pe ape (Gro 40 009.11 yous) = 0 (ae tha 4 or 65, een op te) 6 Fienie Free wor oie [A3: Lack of shared enjoyment E @ (Oo000 , O00 52 Showing nd acting Attn ().).C. 1 tis ado epee) oS 5 ‘4 Sotng to Share Enjoyment wth Oh } Pasian visions to eee ‘A Lack of sctoemetlonlrcprocty 1 te ars tty Commute Alnre.(_}-{ 5 feng confor Lod worried as ea gre 58 npc pens brah) 158 Arpoptenss of Sc Resposts oe rd Sak Giteatolls onby so ty B: Qualitative Abnormalities in Communication + Scor Bi, Bs B(V). and 83) fo eral subject (tem 20 0) + Scote only Bt and B¢ for nonverbal subject (Item 30» 202. Copy each code int the box for algo eo oe Boa Lack of or dly in, apoken language nd flee compensate tveagh getare ene os 42 Paiming to peste Cortastenbee (9). J v 0 Woks tecmesshack S aes) 6 text tng OO.E ——— coer Row semen) ae $s bck of varied pontanens make leo ai inate pay (G4 ote n Gent Seta ee or 100 or older) ed QO0U o 1 Sears tation tion pe 4 tmagiative Pay V roe ie tS em) 11 ne ea ty onroaes ra 2O ‘Ba Wh; Relative falure to initiate or sustain conversational interchange : 24 Socal Vrain peat oO 7 35 Repeal Convention oO. rout 207) ae 000 i Q \ OU nH tf) \ 13 (V): Stereotyped, repetitive, or idiosyncratic pees 2 Straypd teres and Delayed cae 36 Inapoprate Question or Statens. cleme) 37 Prono eve... (ea) (ae CO 138 Nesey ost Language QO) QUUU (HOO ‘oral B3(v) (eH puis, barter URLS [See meaning (Eo Brea ‘abet ee} Toate? dagnet BSRestricted, Repetitive, and Stereotyped Patterns of Behavior Copy each code into the box for slgorithe type and subject age level omy ret ee tn oe hath gh ae sing peoceapton eum ater of inset sn om eee ee = 68 Cheung Its (ere f ye or oe) nD 2: Apparently compulsive adherence to nonfunct 39 bal uals (eon tem 300) 70 compusios/Riuals asks rhe eg SS routines (5: Stereotyped and repetitive en 78 othe Compe Manrrioms ‘Stereayped Boe Movements ..%. tor mannerioms és Preceeupation with parts of objects er nonfunctional elements of material omens oy So —_... teaheres, (nae Gare) 71 Uns Snsory interests Serato ates fier cana Deeeecta tins rats sete ee enced Ds Abnormality of Development Evident at or Before 36 Months Diagnostic Algorithms only. ole a 2 Ag Parents Fit Noticed (36 months scar). Ft soy cacncneerts( TH1Z)-—Cf 9) Age oF Fist Single Words (f>26 months, score 1)... 22 pads 2le Fit Phases (i 3 months sare 3) abt gtk. Mls, CLO. 5 Ages mat Fit et ed 8061) Ea oar 2). 157 nerves gman on Age When Aormales Fst Manet «36 mons, eet)... [ 2] A} ) Oye ino