ASD Assessment Scale
Grading and Scoring

Grading for Assessment Questions in General:
(Bolded questions are graded differently. See detailed descriptions below.)

Grading for Social Interaction Difficulties

Social impairments are a fundamental aspect of autism, Asperger's syndrome or PDD NOS.

  1. Poor eye contact, or staring from unusual angle
  2. Ignores when called, pervasive ignoring, not turning head to voice
  3. Excessive fear of noises (vacuum cleaner); covers ears frequently
  4. In his/her own world (aloof)
  5. Lack of curiosity about the environment
  6. Facial expressions don't fit situations
  7. Inappropriate crying or laughing
  8. Temper tantrums, overreacting when not getting his/her way
  9. Ignores pain (bumps head accidentally without reacting)
  10. Doesn't like to be touched or held (body, head)
  11. Hates crowds, difficulties in restaurants and supermarkets
  12. Inappropriately anxious, scared
  13. Inappropriate emotional response (not reaching to be picked up)
  14. Abnormal joy expression when seeing parents
  15. Lack of ability to imitate

Grading for Speech and Language Delay

  1. Loss of acquired speech
  2. Produces unusual noises or infantile squeals
  3. Voice louder than required
  4. Frequent gibberish or jargon
  5. Difficulty understanding basic things ("just can't get it")
  6. Pulls parents around when wants something
  7. Difficulty expressing needs or desires, using gestures
  8. No spontaneous initiation of speech and communication
  9. Repeats heard words, parts of words or TV commercials
  10. Repetitive language (same word or phrase over and over)
  11. Can't sustain conversation
  12. Monotonous speech, wrong pausing
  13. Speaks same to kids, adults, objects (can't differentiate)
  14. Uses language inappropriately (wrong words or phrases)

Grading of Speech Related Skills (features 9-14 in the Speech and Language questions)

When no language is present, these questions 9-14 must all be graded severe if ASD is diagnosed based on the entire assessment. When language delay is moderate or mild, features 9-14 must be graded accordingly, if the language impairment prevents these features from being manifested.

Grading for Abnormal Symbolic or Imaginary Play

  1. Hand or finger flapping; self stimulation
  2. Head banging
  3. Self mutilation, inflicting pain or injury
  4. Toe walking, clumsy body posture
  5. Arranging toys in rows
  6. Smelling, banging, licking or other inappropriate use of toys
  7. Interest in toy parts, such as car wheels
  8. Obsessed with objects or topics (trains, weather, numbers, dates)
  9. Spinning objects, self, or fascination with spinning objects
  10. Restricted interest, (watching the same video over and over)
  11. Difficulty stopping repetitive "boring" activity or conversation
  12. Attachment to unusual objects, (sticks, stones, strings, or hair)
  13. Stubborn about rituals and routines; resists to change
  14. Restricted taste by consistency, shape or form (refuses solids)
  15. Savant ability, restricted skill superior to age group (reads early, memorizes books)

Grading for Behavioral Difficulties


To diagnose infantile autism based on the DSM IV criteria, one must have features from each group, associated with a significant level of dysfunction, indicated by a score of at least "moderate" or "severe."

The DSM IV criteria requires onset before 3 years of age, the associated autistic features as above and a significant impairment observed, involving one of the following:

  1. Social interaction
  2. Language
  3. Symbolic or imaginative play

If the above requirements are met then the following scores may be suggestive of the corresponding definitions:

0 - 49 = no ASD
50-100 = Mild ASD
100-150 = Moderate ASD
> 150 = Severe ASD

The above numbers are arbitrary estimates and must be confirmed with a large scale population study that hasn't been performed yet.

The total score may not indicate ASD unless there is a feature present in each of the 3 sections. However, if there are no features present in the second section, Speech and Language Delay, but the overall score is above 60, consider Asperger's Syndrome.

Interpretation of the ASD Assessment scale questionnaire: Best performed by an experienced physician with both parents present during the information intake. Interpretation of data acquired by parents filling the forms without proper instructions and explanation of the features, may lead to diagnostic errors.

Final diagnostic determination: Must take into account the examiner's clinical experience in conjunction with the above collected data.

For the diagnosis of specific syndromes, such as Asperger's or Rett, one has to apply the collected data to the specific DSM IV criteria.

© 2000-2014 Rami Grossmann, M.D. - All rights reserved.