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ASDI Teenager Questionnaire English
Johnny Kerr
2024-09-18T13:24:28+01:00
ASDI Teenager Questionnaire English
"
*
" indicates required fields
Step
1
of
8
12%
ASPERGER SYNDROME DIAGNOSTIC INTERVIEW (ASDI)
The interview is intended for clinicians highly familiar with Asperger Syndrome, even if he/she does not need to be an expert on autism spectrum disorders. It is interviewer based, i.e. the evaluator scores every question only whenever he/she feels that sufficient information concerning a certain issue has been achieved in order to allow for scoring. This means that each of the 20 questions that the questionnaire includes must be covered in detail. When the questions are posed to teenagers, they are to be read exactly as they are, but may be expressed slightly differently to make sure that the relevant area of function is adequately examined.
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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Sex
*
Name of informant
*
Rater
*
Date of submission
*
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Major difficulties concerning mutual social interaction (extreme egocentricity)
1. Do you find it hard to interact or connect with people, expecially people your own age?
*
1 Does not apply
2 Probably applies/applies to some extent
3 Definitely applies
If 2 or 3; in what way?
*
2. Do you find it important to have a close relationship where you share your ideas and feelings or do you prefer to be on your own (do you e.g. have a boyfriend/girlfriend or "best friend")?
*
1 Does not apply
2 Probably applies/applies to some extent
3 Definitely applies
If 2 or 3; please specify
*
3. Do you have problems picking up on signals in social interactions? Do you e.g. find it hard to talk to people because you are uncertain of what they actually mean? Do you find it difficult to understand when or why the atmosphere in a certain situation changes?
*
1 Does not apply
2 Probably applies/applies to some extent
3 Definitely applies
If 2 or 3; please describe
*
4. Do other people sometimes point out that your behaviour or your emotional reactions are inappropriate or unsuitable?
*
1 Does not apply
2 Probably applies/applies to some extent
3 Definitely applies
If 2 or 3; please describe
*
Key to scores
Two or more scores of 3 (criterion met)
Two or more scores of 2 or one score of 3 and one score of 2 (criterion possibly met)
Monomaniacal narrow interests
5. Do you have a specific interest or hobby that takes up so much of your time that other activities suffer as a result?
*
1 Does not apply
2 Probably applies/applies to some extent
3 Definitely applies
If 2 or 3; please describe
*
6. Is there a sterotypical pattern or obsessive/compulsive element present in the patient's behaviour?
*
1 Does not apply
2 Probably applies/applies to some extent
3 Definitely applies
If 2 or 3; please describe
*
7. Is the patient's interests based more on learning facts than comprehending what they mean?
*
1 Does not apply
2 Probably applies/applies to some extent
3 Definitely applies
If 2 or 3; please give examples
*
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. Do you find that you have very fixed routines or that you are fixated on your interests? Do other people find that you have very fixed routines or that you are fixated on your interests?
*
1 Does not apply
2 Probably applies/applies to some extent
3 Definitely applies
If 2 or 3; please describe
*
9. Do you find that you force your routines or interests on other people/do other people point out that your force your routines or interests on them?
*
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 your language development delayed or different in any way?
*
1 Does not apply
2 Probably applies/applies to some extent
3 Definitely applies
If 2 or 3; please comment
*
11. Is the patient's ability to express themselves with language "superficially perfect" (regardless of whether he/she has problems with language comprehension or has other language and speech disorders)?
*
1 Does not apply
2 Probably applies/applies to some extent
3 Definitely applies
If 2 or 3; please specify
*
12. Is the patient's language overly formal or pedantic?
*
1 Does not apply
2 Probably applies/applies to some extent
3 Definitely applies
If 2 or 3; please specify
*
13. Is the patient's prosody abnormal with regard to pitch, volume, quality, intonation, stress?
*
1 Does not apply
2 Probably applies/applies to some extent
3 Definitely applies
If 2 or 3; please specify
*
14. Does the patient exhibit any problems with language comprehension especially with regard to perception of the words' implied meaning?
*
1 Does not apply
2 Probably applies/applies to some extent
3 Definitely applies
If 2 or 3; what kind of problem?
*
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. Is the patient's use of gestures limited?
*
1 Does not apply
2 Probably applies/applies to some extent
3 Definitely applies
If 2 or 3; please comment
*
16. Is the patient's body language awkward/clumsy/strange/unusual?
*
1 Does not apply
2 Probably applies/applies to some extent
3 Definitely applies
If 2 or 3; please comment
*
17. Is the patient limited to only a small number of facial expressions?
*
1 Does not apply
2 Probably applies/applies to some extent
3 Definitely applies
If 2 or 3; please describe
*
18. Is the patient's general physical posture (inclduing facial expressions) sometimes inappropriate?
*
1 Does not apply
2 Probably applies/applies to some extent
3 Definitely applies
If 2 or 3; please describe
*
19. Is the patients gaze stiff or abnormal in some other way?
*
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)
Motor clumsiness
20. Is there any previous note of the patient producing a poor result in a neurodevelopmental examination or do such difficulties emerge in conjunction with 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 diagnosis 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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