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No
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Resolved
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Mild
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Moderate
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Severe
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SOCIAL INTERACTION DIFFICULTIES (with same age peer) [how to rate]
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1. Poor eye contact, or staring from unusual angle
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2. Ignores when called, pervasive ignoring, not turning head to voice
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3. Excessive fear of noises (vacuum cleaner); covers ears frequently
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4. In his/her own world (aloof)
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5. Lack of curiosity about the environment
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6. Facial expressions don't fit situations
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7. Inappropriate crying or laughing
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8. Temper tantrums, overreacting when not getting his/her way
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9. Ignores pain (bumps head accidentally without reacting)
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10. Doesn't like to be touched or held (body, head)
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11. Hates crowds, difficulties in restaurants and supermarkets
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12. Inappropriately anxious, scared
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13. Inappropriate emotional response (not reaching to be picked up)
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14. Abnormal joy expression when seeing parents
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15. Lack of ability to imitate
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SPEECH AND LANGUAGE DELAY [how to rate]
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1. Loss of acquired speech
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2. Produces unusual noises or infantile squeals
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3. Voice louder than required
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4. Frequent gibberish or jargon
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5. Difficulty understanding basic things ("just can't get it")
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6. Pulls parents around when wants something
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7. Difficulty expressing needs or desires, using gestures
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8. No spontaneous initiation of speech and communication
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9. Repeats heard words, parts of words or TV commercials [Grading tips for #9-14]
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10. Repetitive language (same word or phrase over and over)
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11. Can't sustain conversation
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12. Monotonous speech, wrong pausing
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13. Speaks same to kids, adults, objects (can't differentiate)
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14. Uses language inappropriately (wrong words or phrases)
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ABNORMAL SYMBOLIC OR IMAGINARY PLAY [how to rate]
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1. Hand or finer flapping; self stimulation
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2. Head banging
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3. Self mutilation, inflicting pain or injury
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4. Toe walking, clumsy body posture
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5. Arranging toys in rows
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6. Smelling, banging, licking or other inappropriate use of toys
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7. Interest in toy parts, such as car wheels
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8. Obsessed with objects or topics (trains, weather, numbers, dates)
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9. Spinning objects, self, or fascination with spinning objects
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10. Restricted interest, (watching the same video over and over)
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11. Difficulty stopping repetitive "boring" activity or conversation
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12. Attachment to unusual objects, (sticks, stones, strings, or hair)
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13. Stubborn about rituals and routines; resists to change
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14. Restricted taste by consistency, shape or form (refuses solids)
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15. Savant ability, restricted skill superior to age group (reads early, memorizes books)
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BEHAVIORAL DIFFICULTIES [how to rate]
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LEVEL OF DYSFUNCTION
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TOTAL SCORE
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