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Interactive Symptom Checklist for Autism Spectrum Disorder with Printable Rating Scale

interactive autism symptom checklist and free rating scale for parents and teachers

When you scroll down you will find an interactive checklist for symptoms of autism spectrum disorder (ASD). You can go through each symptom and check off the ones that pertain to your child (or you). The symptoms in the checklist fall under two categories:

A. deficits in social communication or social interaction
B. restricted, repetitive patterns of behavior, interests, or activities.

Symptoms are based on the criteria indicated in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-V) , the tool used by medical and mental health practitioners to diagnose ASD. After completing the checklist you can print out the results and take them to your child’s doctor/mental health provider.

Disclaimer: This tool is not meant to diagnose anyone with autism spectrum disorder. It is simply a way to track your observations and a form to take along with you when meeting with your child’s doctor/mental health provider so you know exactly which symptoms to discuss.

Keep in mind: When a doctor or mental health provider evaluates a child for autism spectrum disorder, they must take the following into consideration in addition to the presenting symptoms:

  • Symptoms must be present in the early developmental period (but may not become fully manifest until social demands exceed limited capacities, or may be masked by learned strategies in later life).
  • Symptoms cause clinically significant impairment in social, occupational, or other important areas of current functioning.
  • Symptoms are not better explained by intellectual disability (intellectual developmental disorder) or global developmental delay. Intellectual disability and autism spectrum disorder frequently co-occur; to make comorbid diagnoses of autism spectrum disorder and intellectual disability, social communication should be below that expected for general developmental level.

Autism Spectrum Disorder Interactive Checklist

Directions: Please Review Parts A and B of the Interactive Autism Spectrum Checklist Below and Click Any Boxes Next to Symptoms You Currently Observe.

Date : Child’s Name :

A. Persistent deficits in social communication and social interaction across multiple contexts, as manifested by all of the following, currently or by history:

Deficits in social-emotional reciprocity. For example, abnormal social approach and trouble with normal back-and-forth conversation; reduced sharing of interests, emotions, or affect (an expressed or observed state of emotion); and/or failure to initiate or respond to social interactions.

Deficits in nonverbal communication used for social interaction. For example, poorly integrated verbal and nonverbal communication, abnormalities in eye contact and body language, deficits in understanding and using gestures; and/or total lack of facial expressions and nonverbal communication.

Deficits in developing, maintaining, and understanding relationships. For example, difficulties adjusting behavior to fit various social situations; difficulties in engaging in imaginative play with others, difficulties in making friends; and/or an apparent lack of interest in peers.

B. Restricted, repetitive patterns of behavior, interests, or activities, as manifested by at least two of the following, currently or by history (examples are illustrative, not exhaustive):

Stereotyped or repetitive motor movements, use of objects, or speech (e.g., simple motor stereotypies, lining up toys or flipping objects, meaningless repetition of words, unusual/quirky phrases).

Insistence on sameness, strict adherence to routines, or ritualized patterns of behavior (e.g., extreme distress at small changes, difficulties with transitions, rigid thinking patterns, greeting rituals, need to take same route or eat the same food every day).

Highly restricted, fixated interests that are abnormal in intensity or focus (e.g, strong attachment to or preoccupation with unusual objects, excessively limited interests).

Hyper- or hypo-reactivity to sensory input or unusual interests in sensory aspects of the environment (e.g., apparent indifference to pain/temperature, negative response to specific sounds or textures, excessive smelling or touching of objects, visual fascination with lights or movement).

Type Additional Concerns Here:

Autism Screening Using the Social Communication Questionnaire

You may also be interested in printing out and completing the Social Communication Questionnaire (SCQ) (see below), which can be given to a parent/guardian, teacher, or another individual who is regularly with the child.

A total of 15 points or higher on the SCQ indicates that symptoms of autism spectrum disorder may be present and an evaluation at your child’s school or in the community with a clinician is appropriate.

SCQ Scoring Guide: Numbers 1, 9, and 19-20 are given one point if the answer is marked NO and zero points if the answer is marked Yes.

Numbers 2-8, and 10-18 are given one point if the answer is marked Yes and zero points if the answer is marked No.

15 points = cut-off score

Related Articles About Autism Spectrum Disorder:

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