Autism Spectrum Screening Questionnaire (ASSQ)

Please read the statement below and indicate by tapping, No, Somewhat, or Yes if this child stands out as different from other children of his/her age in the following ways:

Name *

First

Last

1. is old-fashioned or precocious *

• No
• Somewhat
• Yes

#1

2. is regarded as an "eccentric professor" by the other children *

• No
• Somewhat
• Yes

#2

3. lives somewhat in a world of his/her own with restricted idiosyncratic intellectual interests *

• No
• Somewhat
• Yes

#3

4. accumulates facts on certain subjects (good rote memory) but does not really understand the meaning *

• No
• Somewhat
• Yes

#4

5. has a literal understanding of ambiguous and metaphorical language *

• No
• Somewhat
• Yes

#5

6. has a deviant style of communication with a formal, fussy, old-fashioned or "robot like" language *

• No
• Somewhat
• Yes

#6

7. invents idiosyncratic words and expressions *

• No
• Somewhat
• Yes

#7

8. has a different voice or speech *

• No
• Somewhat
• Yes

#8

9. expresses sounds involuntarily; clears throat, grunts, smacks, cries or screams *

• No
• Somewhat
• Yes

#9

10. is surprisingly good at some things and surprisingly poor at others *

• No
• Somewhat
• Yes

#10

11. uses language freely but fails to make adjustment to fit social contexts or the needs of different listeners *

• No
• Somewhat
• Yes

#11

12. lacks empathy *

• No
• Somewhat
• Yes

#12

13. makes naive and embarrassing remarks *

• No
• Somewhat
• Yes

#13

14. has a deviant style of gaze *

• No
• Somewhat
• Yes

#14

15. wishes to be sociable but fails to make relationships with peers *

• No
• Somewhat
• Yes

#15

16. can be with other children but only on his/her terms *

• No
• Somewhat
• Yes

#16

17. lacks best friend *

• No
• Somewhat
• Yes

#17

18. lacks common sense *

• No
• Somewhat
• Yes

#18

19. is poor at games: no idea of cooperating in a team, scores "own goals" *

• No
• Somewhat
• Yes

#19

20. has clumsy, ill coordinated, ungainly, awkward movements or gestures *

• No
• Somewhat
• Yes

#20

21. has involuntary face or body movements *

• No
• Somewhat
• Yes

#21

22. has difficulties in completing simple daily activities because of compulsory repetition of certain actions or thoughts *

• No
• Somewhat
• Yes

#22

23. has special routines: insists on no change *

• No
• Somewhat
• Yes

#23

24. shows idiosyncratic attachment to objects *

• No
• Somewhat
• Yes

#24

25. is bullied by other children *

• No
• Somewhat
• Yes

#25

26. has markedly unusual facial expression *

• No
• Somewhat
• Yes

#26

27. has markedly unusual posture *

• No
• Somewhat
• Yes

#27

Scores

Submit

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