SECTION A: Ask Parent
YES | NO | Does your child enjoy being swung, bounced on your knee? |
YES | NO | Does your child take an interest in other children? |
YES | NO | Does your child like climbing on things, such as upstairs? |
YES | NO | Does your child enjoy planning peek-a-boo/hide-and-seek? |
YES | NO | *Does your child
ever pretend, for example, to make a cup of tea using a toy cup and teapot, or pretend other things (e.g. pouring juice)? |
YES | NO | Does your child ever use his index finger to point, to ask for something? |
YES | NO | *Does your child ever use his index finger to point, to indicate interest in something? |
YES | NO | Can your child play properly with small toys (e.g., cars or blocks) without just mouthing, fiddling or dropping them? |
YES | NO | Does your child ever bring objects over to you (parent). To show you something? |
SECTION B: Doctor Observation
YES | NO | During the appointment, has the child made eye contact with you? |
YES | NO | *Get the child's attention,
then point across the room at an interesting object and say, "Oh, look! There's a [toy]!" Watch the child's face. Does the child look across to see what you are pointing at?' |
YES | NO | *Get the child's attention,
then give child a miniature toy cup and teapot and say, "Can you make a cup of tea?" Does the child pretend to pour out tea, drink it, etc.? |
YES | NO | *Say to the child, "Where's
the light?", or "Show me the light." Does the child point with his index finger at the light?' |
YES | NO | Can the child build
a tower of blocks? If so, how many? (Indicate the number of blocks) |
*
Indicates critical questions that are most indicative of autistic characteristics
¹ To record yes on this item, ensure the child has not simply looked at your hand,
but has actually looked at the object you are pointing at.
² If you can elicit an example of pretending in some other game, score a yes
on this item.
³ Repeat this with, "Where's the Teddy?" or some other unreachable object
if
child does not understand the word "light". To record a yes on this item,
the child must have looked up at your face around the time of pointing.
The British Journal of Psychiatry (1996), 168, pp. 158-16,
The British Journal of Psychiatry (1992), 161, pp. 839-843.
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