Autism Symptom Dimensions Questionnaire

We're glad you're here!

Completing this free evaluation will provide you with enough information to help make an informed decision about seeking the appropriate care for your child. You'll receive a free report that you can share with your pediatrician, along with recommendations on next steps.

We're Glad You're Here!

Instructions: Please indicate how frequently the person you are rating engages in each of the following behaviors. Please consider expectations for behavior given the person's age when responding to each question.

1. Start interactions with others without prompting? *

Never

Rarely

Sometimes

Often

Very Often

N/A

2. Prefer to be with family or friends rather than alone? *

Never

Rarely

Sometimes

Often

Very Often

N/A

3. Try to be physically and emotionally-connected to family and friends? *

Never

Rarely

Sometimes

Often

Very Often

N/A

4. Make expected eye contact? *

Never

Rarely

Sometimes

Often

Very Often

N/A

5. Use gestures to communicate? *

Never

Rarely

Sometimes

Often

Very Often

N/A

6. Communicate clearly so that other people know how they feel? *

Never

Rarely

Sometimes

Often

Very Often

N/A

7. Offer comfort to others when they are upset or sick? *

Never

Rarely

Sometimes

Often

Very Often

N/A

8. Share enjoyment about interests or activities with other people? *

Never

Rarely

Sometimes

Often

Very Often

N/A

9. Engage in back and forth play with same-age peers? *

Never

Rarely

Sometimes

Often

Very Often

N/A

10. Respond appropriately when others approach them? *

Never

Rarely

Sometimes

Often

Very Often

N/A

11. Have a back and forth conversation about another person’s interests and activities, not just their own? *

Never

Rarely

Sometimes

Often

Very Often

N/A

12. Read social cues? *

Never

Rarely

Sometimes

Often

Very Often

N/A

13. Understand that expected behavior varies by social situation? *

Never

Rarely

Sometimes

Often

Very Often

N/A

14. Seem to understand what others are thinking or feeling? *

Never

Rarely

Sometimes

Often

Very Often

N/A

15. Show that relationships are important to them? *

Never

Rarely

Sometimes

Often

Very Often

N/A

16. Seek out playful interactions, playmates, or friendships? *

Never

Rarely

Sometimes

Often

Very Often

N/A

17. Engage with two or more close friends? *

Never

Rarely

Sometimes

Often

Very Often

N/A

18. Flap or move their hands in an unusual way? *

Never

Rarely

Sometimes

Often

Very Often

N/A

19. Repetitively jump, rock their body, spin in circles, or do other whole-body motions? *

Never

Rarely

Sometimes

Often

Very Often

N/A

20. Repeat sounds, words, or lines from videos? *

Never

Rarely

Sometimes

Often

Very Often

N/A

21. Repetitively play with objects or repeat actions without a purpose? *

Never

Rarely

Sometimes

Often

Very Often

N/A

22. Insist on keeping a consistent daily schedule? *

Never

Rarely

Sometimes

Often

Very Often

N/A

23. Have difficulty transitioning from one activity to another? *

Never

Rarely

Sometimes

Often

Very Often

N/A

24. Want to follow strict rules, rituals, or sequences? *

Never

Rarely

Sometimes

Often

Very Often

N\A

25. Have trouble changing their mind and being flexible? *

Never

Rarely

Sometimes

Often

Very Often

N/A

26. Appear overly sensitive to loud noises? *

Never

Rarely

Sometimes

Often

Very Often

N/A

27. Get upset in crowded or busy places? *

Never

Rarely

Sometimes

Often

Very Often

N/A

28. Dislike certain lights, sounds, textures, foods, or smells? *

Never

Rarely

Sometimes

Often

Very Often

N/A

29. Prefer to engage with specific parts of objects rather than the whole object? *

Never

Rarely

Sometimes

Often

Very Often

N/A

30. Appear fascinated by sensory experiences? *

Never

Rarely

Sometimes

Often

Very Often

N/A

31. Become preoccupied with visual patterns or sounds? *

Never

Rarely

Sometimes

Often

Very Often

N/A

32. Think or talk about the same topic over and over? *

Never

Rarely

Sometimes

Often

Very Often

N/A

33. Seem overly fixated on one interest or activity? *

Never

Rarely

Sometimes

Often

Very Often

N/A

34. Spend too much time on a game or subject that is not interesting to others? *

Never

Rarely

Sometimes

Often

Very Often

N/A

35. Seem too focused on an interest that is highly specific or narrow in scope? *

Never

Rarely

Sometimes

Often

Very Often

N/A

36. Prefer to make lists, memorize facts, or learn about technical subjects? *

Never

Rarely

Sometimes

Often

Very Often

N/A

37. Stand too close or show unexpected body language when interacting with others? *

Never

Rarely

Sometimes

Often

Very Often

N/A

38. Take things too literally? *

Never

Rarely

Sometimes

Often

Very Often

N/A

39. Speak with an unusual volume, tone, rhythm, or rate of speech? *

Never

Rarely

Sometimes

Often

Very Often

N/A

Nice Job! You're almost there.

Let's get your child set up in our system.

First Name *

Last Name *

Gender Assigned At Birth *

Male

Female

Date of Birth *

State where child will reside at time of service

AL
AK
AZ
AR
AS
CA
CO
CT
DE
DC
FL
GA
HI
ID
IL
IN
IA
KS
KY
LA
ME
MD
MA
MI
MN
MS
MO
MT
NE
NV
NH
NJ
NM
NY
NC
ND
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VT
VA
WA
WV
WI
WY
No elements found. Consider changing the search query.
List is empty.

Race

optional

White
Black or African American
American Indian or Alaska Native
Asian
Native Hawaiian or Other Pacific Islander
Other Race
No elements found. Consider changing the search query.
List is empty.

Ethnicity

optional

Hispanic or Latino
Not Hispanic or Latino
No elements found. Consider changing the search query.
List is empty.

Ethnic Origin

White

Asian

African American

Hispanic or Latino

Native Hawaiian or Other Pacific Islander

American Indian or Alaska Native

Prefer not to say

Last Step!

Just a few more questions, then on to your evaluation results.

Your First Name *

Your Last Name *

Your Email *

Your Phone *

Your Zipcode *

What is your relationship with the child *

It can take up to 20 seconds to complete processing, please be patient.

HIAA Compliance and Privacy Statement: At Online Autism Testing, we take our responsibilities towards client & patient confidentiality very seriously and have dedicated both resources and time to train our workforce and develop and implement all of the components of our HIPAA Compliance Program.

Disclaimer: This web site is provided for educational and informational purposes only and does not constitute providing medical advice or professional services. The information provided should not be used for diagnosing or treating a health problem or disease, and those seeking personal medical advice should consult with a licensed physician..