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ASDI Parent Questionnaire English
Johnny Kerr
2024-09-18T12:39:41+01:00
ASDI Parent Questionnaire English
"
*
" indicates required fields
Step
1
of
8
12%
ASPERGER SYNDROME DIAGNOSTIC INTERVIEW (ASDI)
This interview is intended for completion by a clinician well acquainted with Asperger Syndrome, although not necessarily an expert in the field of autism spectrum disorders. It is investigator-based, i.e. the clinician should score each item only after he/she feels that enough information pertaining to a particular item has been elicited to allow scoring. This means that each of the 20 items covered by the pro forma has to be covered in detail. The questions listed when directed to the proband should be phrased as they read, but may be slightly rephrased in order to assure that the relevant area of functioning be adequately covered and probed into.
Name of child/adolescent
*
Age of child/adolescent
*
Please enter a number greater than or equal to
0
.
Child's/adolescent's date of birth
*
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Year
Year
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Sex
*
Name of informant
*
Rater
*
Date of submission
*
Day
Day
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Month
Month
1
2
3
4
5
6
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8
9
10
11
12
Year
Year
2027
2026
2025
2024
2023
2022
2021
2020
2019
2018
2017
2016
2015
2014
2013
2012
2011
2010
2009
2008
2007
2006
2005
2004
2003
2002
2001
2000
1999
1998
1997
1996
1995
1994
1993
1992
1991
1990
1989
1988
1987
1986
1985
1984
1983
1982
1981
1980
1979
1978
1977
1976
1975
1974
1973
1972
1971
1970
1969
1968
1967
1966
1965
1964
1963
1962
1961
1960
1959
1958
1957
1956
1955
1954
1953
1952
1951
1950
1949
1948
1947
1946
1945
1944
1943
1942
1941
1940
1939
1938
1937
1936
1935
1934
1933
1932
1931
1930
1929
1928
1927
1926
1925
1924
1923
1922
1921
1920
Severe impairment in reciprocal social interaction (extreme egocentricity)
1. Does he/she exhibit considerable difficulties interacting with peers?
*
1 Does not apply
2 Probably applies/applies to some extent
3 Definitely applies
If 2 or 3; in what way?
*
2. Does he/she exhibit a low degree of concern about not making friends/a lack of interest in making friends and/or interacting with peers?
*
1 Does not apply
2 Probably applies/applies to some extent
3 Definitely applies
If 2 or 3; please specify
*
3. Does he/she have problems appreciating social cues, i.e. does he/she fail to note changes in the social conversation/interaction or to take account of such changes in his/her ongoing interaction with other people?
*
1 Does not apply
2 Probably applies/applies to some extent
3 Definitely applies
If 2 or 3; please describe
*
4. Does he/she exhibit socially/emotionally inappropriate behaviour?
*
1 Does not apply
2 Probably applies/applies to some extent
3 Definitely applies
If 2 or 3; in what way(s)?
*
Key to scores
2 or more scores of 3 (criterion met)
2 or more scores of 2 or one score of 3 and one score of 2 (criterion possibly met)
All absorbing narrow interest
5. Is there a pattern of interest or a specific interest which takes up so much of his/her time that time for other activities is clearly restricted?
*
1 Does not apply
2 Probably applies/applies to some extent
3 Definitely applies
If 2 or 3; please comment
*
6. Is there a repetitive quality to his/her interest patterns/specific interest?
*
1 Does not apply
2 Probably applies/applies to some extent
3 Definitely applies
If 2 or 3; please specify
*
7. Are his/her interests/specific interest(s) based more on rote memory than on true meaning?
*
1 Does not apply
2 Probably applies/applies to some extent
3 Definitely applies
If 2 or 3; please comment
*
Key to scores
One or more scores of 3 (criterion met)
One or more scores of 2 (criterion possibly met)
Imposition of routines and interests
8. Does he/she try to introduce and impose routines and interests on himself/herself in such a way as to produce problems for himself/herself or other people?
*
1 Does not apply
2 Probably applies/applies to some extent
3 Definitely applies
If 2 or 3; in what way?
*
9. Does he/she try to impose routines and interests on other people in such a way as to produce problems for these other people or for himself/herself or others still?
*
1 Does not apply
2 Probably applies/applies to some extent
3 Definitely applies
If 2 or 3; please describe
*
Key to scores
One or more scores of 3 (criterion met)
One or more scores of 2 (criterion possibly met)
Speech and language problems
10. Was his/her language development delayed?
*
1 Does not apply
2 Probably applies/applies to some extent
3 Definitely applies
If 2 or 3; please comment
*
11. Is his/her language "superficially perfect" regardless of whether there are comprehension problems or other speech-language problems?
*
1 Does not apply
2 Probably applies/applies to some extent
3 Definitely applies
If 2 or 3; please comment
*
12. Is his/her language formal, pedantic or "overly adult"?
1 Does not apply
2 Probably applies/applies to some extent
3 Definitely applies
If 2 or 3; please describe
*
13. Is there any characteristic about his/her voice (pitch, volume, quality, intonation, word stress, "prosody" etc.) which you find peculiar or unusual?
1 Does not apply
2 Probably applies/applies to some extent
3 Definitely applies
If 2 or 3; in what way?
*
14. Are there any comprehension problems, including misinterpretations of literal/implied meanings?
*
1 Does not apply
2 Probably applies/applies to some extent
3 Definitely applies
If 2 or 3; what kind of problems?
*
Key to scores
Three or more scores of 3 (criterion met)
Three or more scores of 2 or two scores of 2/3 and one of 3/2 (criterion possibly met)
Non-verbal communication problems
15. Does he/she make limited use of gesture(s)?
*
1 Does not apply
2 Probably applies/applies to some extent
3 Definitely applies
If 2 or 3; please comment
*
16. Is his/her body language awkward/gauche/clumsy/strange/unusual?
*
1 Does not apply
2 Probably applies/applies to some extent
3 Definitely applies
If 2 or 3; please comment
*
17. Are his/her facial expressions limited to a rather small repertoire?
*
1 Does not apply
2 Probably applies/applies to some extent
3 Definitely applies
If 2 or 3; please describe
*
18. Is his/her general expression (including facial) sometimes inappropriate?
*
1 Does not apply
2 Probably applies/applies to some extent
3 Definitely applies
If 2 or 3; please describe
*
19. Is his/her gaze stiff/strange/peculiar/abnormal/odd?
*
1 Does not apply
2 Probably applies/applies to some extent
3 Definitely applies
If 2 or 3; please characterise
*
Key to scores
One or more scores of 3 (criterion met)
One or more scores of 2 (criterion possibly met)
Motor clumsiness
20. Has he/she been noted to perform poorly on neurodevelopmental examinations either in the past or in connection with present interview?
*
1 Does not apply
2 Probably applies/applies to some extent
3 Definitely applies
If 2 or 3; please comment
*
Key to scores
Score of 3 (criterion met)
Score of 2 (criterion possibly met)
FINAL ASSESSMENT
(A)
ALL
criteria met at interview:
ASPERGER SYNDROME
(B)
If not ALL
criteria are met but all are at least possibly met:
REVIEW
all clinical indices under every symptom heading to determine whether the 2s cannot be assessed as 3s: then reevaluate and either diagnose as
SUSPECTED ASPERGER SYNDROME or ASPERGER SYNDROME
(C) In clinical practice a diagnosis of ASPERGER SYNDROME can sometimes also be given when “only” criteria for (B) are met.
Comments
(such as all criteria except motor clumsiness met):
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