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The Adolescent Autism Spectrum Quotient

The Adolescent Autism Spectrum Quotient (AQ)

Ages 12-15 years

SPECIMEN‚ FOR RESEARCH USE ONLY.

For full details‚ please see:

S. Baron-Cohen‚ R. Hoekstra‚ R. Knickmeyer‚ S. Wheelwright‚ (2006)
The Autism Spectrum Quotient (AQ) – Adolescent Version
Journal of Autism and Developmental Disorders.

	Definitely Agree	Slightly Agree	Slightly Disagree	Definitely Disagree
1. S/he prefers to do things with others rather than on her/his own.
2. S/he prefers to do things the same way over and over again.
3. If s/he tries to imagine something‚ s/he finds it very easy to cr‎eate a picture in her/his mind.
4. S/he frequently gets so strongly absorbed in one thing that s/he loses sight of other things.
5. S/he often notices small sounds when others do not.
6. S/he usually notices car number plates or similar strings of information.
7. Other people frequently tell her/him that what s/he has said is impolite‚ even though s/he thinks it is polite.
8. When s/he is reading a story‚ s/he can easily imagine what the ch‎aracters might look like.
9. S/he is fascinated by dates.
10. In a social group‚ s/he can easily keep track of several different people’s conversations.
11. S/he finds social situations easy.
12. S/he tends to notice details that others do not.
13. S/he would rather go to a library than a party.
14. S/he finds making up stories easy.
15. S/he finds her/himself drawn more strongly to people than to things.
16. S/he tends to have very strong interests‚ which s/he gets upset about if s/he can’t pursue.
17. S/he enjoys social chit-chat.
18. When s/he talks‚ it isn’t always easy for others to get a word in edgeways.
19. S/he is fascinated by numbers.
20. When s/he is reading a story‚ s/he finds it difficult to work out the ch‎aracters’ intentions.
21. S/he doesn’t particularly enjoy reading fiction.
22. S/he finds it hard to make new friends.
23. S/he notices patterns in things all the time.
24. S/he would rather go to the theatre than a museum.
25. It does not upset him/her if his/her daily routine is disturbed.
26. S/he frequently finds that s/he doesn’t know how to keep a conversation going.
27. S/he finds it easy to “read between the lines” when someone is talking to her/him.
28. S/he usually concentrates more on the whole picture‚ rather than the small details.
29. S/he is not very good at remembering phone numbers.
30. S/he doesn’t usually notice small changes in a situation‚ or a person’s appearance.
31. S/he knows how to tell if someone listening to him/her is getting bored.
32. S/he finds it easy to do more than one thing at once.
33. When s/he talks on the phone‚ s/he is not sure when it’s her/his turn to speak.
34. S/he enjoys doing things spontaneously.
35. S/he is often the last to understand the point of a joke.
36. S/he finds it easy to work out what someone is thinking or feeling just by looking at their face.
37. If there is an interruption‚ s/he can switch back to what s/he was doing very quickly.
38. S/he is good at social chit-chat.
39. People often tell her/him that s/he keeps going on and on about the same thing.
40. When s/he was younger‚ s/he used to enjoy playing games involving pretending with other children.
41. S/he likes to collect information about categories of things (e.g. types of car‚ types of bird‚ types of train‚ types of plant‚ etc.).
42. S/he finds it difficult to imagine what it would be like to be someone else.
43. S/he likes to plan any activities s/he participates in carefully.
44. S/he enjoys social occasions.
45. S/he finds it difficult to work out people’s intentions.
46. New situations make him/her anxious.
47. S/he enjoys meeting new people.
48. S/he is a good diplomat.
49. S/he is not very good at remembering people’s date of birth.
50. S/he finds it very to easy to play games with children that involve pretending.

http://www.autismresearchcentre.com/arc_tests

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15 مهر 1391

The Empathy Quotient EQ 40

The Empathy Quotient (EQ) (40

The Cambridge Behaviour Scale

For full details‚ please see:

S. Baron-Cohen and S. Wheelwright‚ (2004)
The Empathy Quotient (EQ). An investigation of adults with Asperger Syndrome or High Functioning Autism‚ and normal sex differences
Journal of Autism and Developmental Disorders 34:163-175

Please note that this version for the questionnaire has 40 items as the 20 filler items discussed in the paper have been removed.

strongly

agree

slightly

agree

slightly

disagree

strongly

disagree

1.

I can easily tell if someone else wants to enter a conversation.

2.

I find it difficult to explain to others things that I understand easily‚ when they don’t understand it first time.

3.

I really enjoy caring for other people.

4.

I find it hard to know what to do in a social situation.

5.

People often tell me that I went too far in driving my point home in a discussion.

6.

It doesn’t bother me too much if I am late meeting a friend.

7.

Friendships and relationships are just too difficult‚ so I tend not to bother with them.

8.

I often find it difficult to judge if something is rude or polite.

9.

In a conversation‚ I tend to focus on my own thoughts rather than on what my listener might be thinking.

10.

When I was a child‚ I enjoyed cutting up worms to see what would happen.

11.

I can pick up quickly if someone says one thing but means another.

12.

It is hard for me to see why some things upset people so much.

13.

I find it easy to put myself in somebody else’s shoes.

14.

I am good at predicting how someone will feel.

15.

I am quick to spot when someone in a group is feeling awkward or uncomfortable.

16.

If I say something that someone else is offended by‚ I think that that’s their problem‚ not mine.

17.

If anyone asked me if I like their haricut‚ I would reply truthfully‚ even if I didn’t like it.

18.

I can’t always see why someone should have felt offended by a remark.

19.

Seeing people cry doesn’t really upset me.

20.

I am very blunt‚ which some people take to be rudeness‚ even though this is unintentional.

21.

I don’t tend to find social situations confusing.

22.

Other people tell me I am good at understanding how they are feeling and what they are thinking.

23.

When I talk to people‚ I tend to talk about their experiences rather than my own.

24.

It upsets me to see animals in pain.

25.

I am able to make decisions without being influenced by people’s feelings.

26.

I can easily tell if someone else is interested or bored with what I am saying.

27.

I get upset if I see people suffering on news programmes.

28.

Friends usually talk to me about their problems as they say I am very understanding.

29.

I can sense if I am intruding‚ even if the other person doesn’t tell me.

30.

People sometimes tell me that I have gone too far with teasing.

31.

Other people often say that I am insensitive‚ though I don’t always see why.

32.

If I see a stranger in a group‚ I think that it is up to them to make an effort to join in.

33.

I usually stay emotionally detached when watching a film.

34.

I can tune into how someone else feels rapidly and intuitively.

35.

I can easily work out what another person might want to talk about.

36.

I can tell if someone is masking their true emotion.

37.

I don’t consciously work out the rules of social situations.

38.

I am good at predicting what someone will do.

39.

I tend to get emotionally involved with a friend’s problems.

40.

I can usually appreciate the other person’s viewpoint‚ even if I don’t agree with it.

©SBC/SJW Apr 2007

سایت روان سنجی : ابزار از منبع زیر اخذ شده است ، جهت کسب اطلاعات بیشتربه مرکز پژوهشی اوتیسم به نشانی زیر مراجعه کنید:

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15 مهر 1391

The Autism-Spectrum Quotient- CHILD

Cambridge University Behaviour and Personality Questionnaire For Children

NOTE: This questionnaire is to be completed by the parent/guardian of each child aged 4 and above. Please complete all three pages.

Name ………………………………………………

Date of Birth (Month in words) ………………… Today's date (Month in words)……………….

Address………………………………………………………………………………………………….

Please answer each of the following questions about your child or the person who is under your care by ticking a box that reflects your answer to the question most appropriately. If there is any question that you feel not able to comment‚ please ask your son‚ daughter‚ partner or the person to answer.

	Definitely Agree	Slightly Agree	Slightly Disagree	Definitely Disagree
1. S/he prefers to do things with others rather than on her/his own.
2. S/he prefers to do things the same way over and over again.
3. If s/he tries to imagine something‚ s/he finds it very easy to cr‎eate a picture in her/his mind.
4. S/he frequently gets so strongly absorbed in one thing that s/he loses sight of other things.
5. S/he often notices small sounds when others do not.
6. S/he usually notices house numbers or similar strings of information.
7. S/he has difficulty understanding rules for polite behaviour.
8. When s/he is read a story‚ s/he can easily imagine what the ch‎aracters might look like.
9. S/he is fascinated by dates.
10. In a social group‚ s/he can easily keep track of several different people’s conversations.
11. S/he finds social situations easy.
12. S/he tends to notice details that others do not.
13. S/he would rather go to a library than a birthday party.

14. S/he finds making up stories easy.
15. S/he is drawn more strongly to people than to things.
16. S/he tends to have very strong interests‚ which s/he gets upset about if s/he can’t pursue.
17. S/he enjoys social chit-chat.
18. When s/he talks‚ it isn’t always easy for others to get a word in edgeways.
19. S/he is fascinated by numbers.
20. When s/he is read a story‚ s/he finds it difficult to work out the ch‎aracters’ intentions or feelings.
21. S/he doesn’t particularly enjoy fictional stories.
22. S/he finds it hard to make new friends.
23. S/he notices patterns in things all the time.
24. S/he would rather go to the cinema than a museum.
25. It does not upset him/her if his/her daily routine is disturbed.
26. S/he doesn’t know how to keep a conversation going with her/his peers.
27. S/he finds it easy to “read between the lines” when someone is talking to her/him.
28. S/he usually concentrates more on the whole picture‚ rather than the small details.
29. S/he is not very good at remembering phone numbers.
30. S/he doesn’t usually notice small changes in a situation‚ or a person’s appearance.
31. S/he knows how to tell if someone listening to him/her is getting bored.
32. S/he finds it easy to go back and forth between different activities.
33. When s/he talk on the phone‚ s/he is not sure when it’s her/his turn to speak.

34. S/he enjoys doing things spontaneously.
35. S/he is often the last to understand the point of a joke.
36. S/he finds it easy to work out what someone is thinking or feeling just by looking at their face.
37. If there is an interruption‚ s/he can switch back to what s/he was doing very quickly.
38. S/he is good at social chit-chat.
39. People often tell her/him that s/he keeps going on and on about the same thing.
40. When s/he was in preschool‚ s/he used to enjoy playing games involving pretending with other children.
41. S/he likes to collect information about categories of things (e.g. types of car‚ types of bird‚ types of train‚ types of plant‚ etc.).
42. S/he finds it difficult to imagine what it would be like to be someone else.
43. S/he likes to plan any activities s/he participates in carefully.
44. S/he enjoys social occasions.
45. S/he finds it difficult to work out people’s intentions.
46. New situations make him/her anxious.
47. S/he enjoys meeting new people.
48. S/he is good at taking care not to hurt other people’s feelings.
49. S/he is not very good at remembering people’s date of birth.
50. S/he finds it very to easy to play games with children that involve pretending.

ÓBA-SBC-SW-CA

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15 مهر 1391

The Empathy Quotient EQ 60

The Empathy Quotient (EQ) (60 item version)

For full details‚ please see:

S. Baron-Cohen and S. Wheelwright‚ (2004). The Empathy Quotient (EQ). An investigation of adults with Asperger Syndrome or High Functioning Autism‚ and normal sex differences. Journal of Autism and Developmental Disorders 34:163-175

		strongly agree	slightly agree	slightly disagree	strongly disagree
1	I can easily tell if someone else wants to enter a conversation.
2	I prefer animals to humans.
3	I try to keep up with the current trends and fashions.
4	I find it difficult to explain to others things that I understand easily‚ when they don't understand it first time.
5	I dream most nights.
6	I really enjoy caring for other people.
7	I try to solve my own problems rather than discussing them with others.
8	I find it hard to know what to do in a social situation.
9	I am at my best first thing in the morning.
10	People often tell me that I went too far in driving my point home in a discussion.
11	It doesn't bother me too much if I am late meeting a friend.
12	Friendships and relationships are just too difficult‚ so I tend not to bother with them.
13	I would never break a law‚ no matter how minor.
14	I often find it difficult to judge if something is rude or polite.
15	In a conversation‚ I tend to focus on my own thoughts rather than on what my listener might be thinking.
16	I prefer practical jokes to verbal humour.
17	I live life for today rather than the future.
18	When I was a child‚ I enjoyed cutting up worms to see what would happen.
19	I can pick up quickly if someone says one thing but means another.
20	I tend to have very strong opinions about morality
21	It is hard for me to see why some things upset people so much.
22	I find it easy to put myself in somebody else's shoes.
23	I think that good manners are the most important thing a parent can teach their child.
24	I like to do things on the spur of the moment.
25	I am good at predicting how someone will feel.
26	I am quick to spot when someone in a group is feeling awkward or uncomfortable.
27	If I say something that someone else is offended by‚ I think that that's their problem‚ not mine.
28	If anyone asked me if I like their haircut‚ I would reply truthfully‚ even if I didn't like it.
29	I can't always see why someone should have felt offended by a remark.
30	People often tell me that I am very unpredictable.
31	I enjoy being the centre of attention at any social gathering.
32	Seeing people cry doesn't really upset me.
33	I enjoy ha‎ving discussions about politics.
34	I am very blunt‚ which some people take to be rudeness‚ even though this is unintentional.
35	I don't tend to find social situations confusing
36	Other people tell me I am good at understanding how they are feeling and what they are thinking.
37	When I talk to people‚ I tend to talk about their experiences rather than my own.
38	It upsets me to see animals in pain.
39	I am able to make decisions without being influenced by people's feelings.
40	I can't relax until I have done everything I had planned to do that day.
41	I can easily tell if someone else is interested or bored with what I am saying.
42	I get upset if I see people suffering on news programmes.
43	Friends usually talk to me about their problems as they say I am very understanding.
44	I can sense if I am intruding‚ even if the other person doesn't tell me.
45	I often start new hobbies but quickly become bored with them and move on to something else.
46	People sometimes tell me that I have gone too far with teasing.
47	I would be too nervous to go on a big rollercoaster.
48	Other people often say that I am insensitive‚ though I don't always see why.
49	If I see a stranger in a group‚ I think that it is up to them to make an effort to join in.
50	I usually stay emotionally detached when watching a film.
51	I like to be very organised in day to day life and often make lists of the chores I have to do.
52	I can tune into how someone else feels rapidly and intuitively.
53	I don't like to take risks.
54	I can easily work out what another person might want to talk about.
55	I can tell if someone is masking their true emotion.
56	Before making a decisions I always weigh up the pros and cons.
57	I don't consciously work out the rules of social situations.
58	I am good at predicting what someone will do.
59	I tend to get emotionally involved with a friend's problems.
60	I can usually appreciate the other person's viewpoint‚ even if I don't agree with it.

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15 مهر 1391

The Childhood Autism Spectrum Test

The Childhood Autism Spectrum Test (CAST)

Child’s Name: .................................. Age: ......................... Sex: Male / Female

Birth Order: ..................................... Twin or Single Birth: ..................................

Parent/Guardian: .....................................................................................................

Parent(s) occupation: ............................................................................................

Age parent(s) left full-time education: ....................................................................

Address: .................................................................................................................

................................................................................................................. .................................................................................................................

Tel.No: .................................. School: ........................................................

-‎--‎--‎--‎--‎--‎--‎--‎--‎--‎--‎--‎--‎--‎--‎--‎--‎--‎--‎--‎--‎--‎--‎--‎--‎--‎--‎--‎--‎--‎--‎--‎--‎--‎--‎--‎--‎--‎--‎--‎--‎--‎--‎--‎--‎--‎--‎--‎--‎--‎-

Please read the following questions carefully‚ and circle the appropriate answer. All responses are confidential.

1. Does s/he join in playing games with other children easily? Yes No

2. Does s/he come up to you spontaneously for a chat? Yes No

3. Was s/he speaking by 2 years old? Yes No

4. Does s/he enjoy sports? Yes No

5. Is it important to him/her to fit in with the peer group? Yes No

6. Does s/he appear to notice unusual details that others miss? Yes No

7. Does s/he tend to take things literally? Yes No

8. When s/he was 3 years old‚ did s/he spend a lot of time pretending (e.g.‚ play-acting being a superhero‚ or

holding teddy’s tea parties)? Yes No

9. Does s/he like to do things over and over again‚ in the same way all the time? Yes No

10. Does s/he find it easy to interact with other children? Yes No

11. Can s/he keep a two-way conversation going? Yes No

12. Can s/he read appropriately for his/her age? Yes No

13. Does s/he mostly have the same interests as his/her peers? Yes No

14. Does s/he have an interest which takes up so much time that s/he does little else? Yes No

15. Does s/he have friends‚ rather than just acquaintances? Yes No

16. Does s/he often bring you things s/he is interested in to show you? Yes No

17. Does s/he enjoy joking around? Yes No

18. Does s/he have difficulty understanding the rules for polite behaviour? Yes No

19. Does s/he appear to have an unusual memory for details? Yes No

20. Is his/her voice unusual (e.g.‚ overly adult‚ flat‚ or very monotonous)? Yes No

21. Are people important to him/her? Yes No

22. Can s/he dress him/herself? Yes No

23. Is s/he good at turn-taking in conversation? Yes No

24. Does s/he play imaginatively with other children‚ and engage in role-play? Yes No

25. Does s/he often do or say things that are tactless or socially inappropriate? Yes No

26. Can s/he count to 50 without leaving out any numbers? Yes No

27. Does s/he make normal eye-contact? Yes No

28. Does s/he have any unusual and repetitive movements? Yes No

29. Is his/her social behaviour very one-sided and always on his/her own terms? Yes No

30. Does s/he sometimes say “you” or “s/he” when s/he means “I”? Yes No

31. Does s/he prefer imaginative activities such as play-acting or story-telling‚ rather than numbers

or lists of facts? Yes No

32. Does s/he sometimes lose the listener because of not explaining what s/he is talking about? Yes No

33. Can s/he ride a bicycle (even if with stabilisers)? Yes No

34. Does s/he try to impose routines on him/herself‚ or on others‚ in such a way that it causes problems? Yes No

35. Does s/he care how s/he is perceived by the rest of the group? Yes No

36. Does s/he often turn conversations to his/her favourite subject rather than following what the other

person wants to talk about? Yes No

37. Does s/he have odd or unusual phrases? Yes No

SPECIAL NEEDS SECTION

Please complete as appropriate

38. Have teachers/health visitors ever expressed any concerns about his/her development? Yes No

If Yes‚ please specify..................................................................................................

39. Has s/he ever been diagnosed with any of the following?:

Language delay Yes No

Hyperactivity/Attention Deficit Disorder (ADHD) Yes No

Hearing or visual difficulties Yes No

Autism Spectrum Condition‚ incl. Asperger’s Syndrome Yes No

A physical disability Yes No

Other (please specify) Yes No

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15 مهر 1391

the Systemizing Quotient-Revised

the Systemizing Quotient-Revised (SQ-R)

Revised Cambridge Personality Questionnaire

For full details‚ please see:

S. Wheelwright‚ S. Baron-Cohen‚ N. Goldenfeld‚ J. Delaney‚ D. Fine‚ R. Smith‚ L. Weil and A. Wakabayashi‚ (2006)
Predicting Autism Spectrum Quotient (AQ) from the Systemizing Quotient-Revised (SQ-R) and Empathy Quotient (EQ)
Brain Research 1079:47-56

		strongly agree	slightly agree	slightly disagree	strongly disagree
1.	I find it very easy to use train timetables‚ even if this involves several connections.
2.	I like music or book shops because they are clearly organised.
3.	I would not enjoy organising events e.g. fundraising evenings‚ fetes‚ conferences.
4.	When I read something‚ I always notice whether it is grammatically correct.
5.	I find myself categorising people into types (in my own mind).
6.	I find it difficult to read and understand maps.
7.	When I look at a mountain‚ I think about how precisely it was formed.
8.	I am not interested in the details of exchange rates‚ interest rates‚ stocks and shares.
9.	If I were buying a car‚ I would want to obtain specific information about its engine capacity.
10.	I find it difficult to learn how to programme video recorders.
11.	When I like something I like to collect a lot of different examples of that type of object‚ so I can see how they differ from each other.
12.	When I learn a language‚ I become intrigued by its grammatical rules.
13.	I like to know how committees are structured in terms of who the different committee members represent or what their functions are.
14.	If I had a collection (e.g. CDs‚ coins‚ stamps)‚ it would be highly organised.
15.	I find it difficult to understand instruction manuals for putting appliances together.
16.	When I look at a building‚ I am curious about the precise way it was constructed.
17.	I am not interested in understanding how wireless communication works (e.g. mobile phones).
18.	When travelling by train‚ I often wonder exactly how the rail networks are coordinated.
19.	I enjoy looking through catalogues of products to see the details of each product and how it compares to others.
20.	Whenever I run out of something at home‚ I always add it to a shopping list.
21.	I know‚ with reasonable accuracy‚ how much money has come in and gone out of my bank account this month.
22.	When I was young I did not enjoy collecting sets of things e.g. stickers‚ football cards etc.
23.	I am interested in my family tree and in understanding how everyone is related to each other in the family.
24.	When I learn about historical events‚ I do not focus on exact dates.
25.	I find it easy to grasp exactly how odds work in betting.
26.	I do not enjoy games that involve a high degree of strategy (e.g. chess‚ Risk‚ Games Workshop).
27.	When I learn about a new category I like to go into detail to understand the small differences between different members of that category.
28.	I do not find it distressing if people who live with me upset my routines.
29.	When I look at an animal‚ I like to know the precise species it belongs to.
30.	I can remember large amounts of information about a topic that interests me e.g. flags of the world‚ airline logos.
31.	At home‚ I do not carefully file all important documents e.g. guarantees‚ insurance policies
32.	I am fascinated by how machines work.
33.	When I look at a piece of furniture‚ I do not notice the details of how it was constructed.
34.	I know very little about the different stages of the legislation process in my country.
35.	I do not tend to watch science documentaries on television or read articles about science and nature.
36.	If someone stops to ask me the way‚ I'd be able to give directions to any part of my home town.
37.	When I look at a painting‚ I do not usually think about the technique involved in making it.
38.	I prefer social interactions that are structured around a clear activity‚ e.g. a hobby.
39.	I do not always check off receipts etc. against my bank statement.
40.	I am not interested in how the government is organised into different ministries and departments.
41.	I am interested in knowing the path a river takes from its source to the sea.
42.	I have a large collection e.g. of books‚ CDs‚ videos etc.
43.	If there was a problem with the electrical wiring in my home‚ I’d be able to fix it myself.
44.	My clothes are not carefully organised into different types in my wardrobe.
45.	I rarely read articles or webpages about new technology.
46.	I can easily visualise how the motorways in my region link up.
47.	When an election is being held‚ I am not interested in the results for each constituency.
48.	I do not particularly enjoy learning about facts and figures in history.
49.	I do not tend to remember people's birthdays (in terms of which day and month this falls).
50.	When I am walking in the country‚ I am curious about how the various kinds of trees differ.
51.	I find it difficult to understand information the bank sends me on different investment and saving systems.
52.	If I were buying a camera‚ I would not look carefully into the quality of the lens.
53.	If I were buying a computer‚ I would want to know exact details about its hard drive capacity and processor speed.
54.	I do not read legal documents very carefully.
55.	When I get to the checkout at a supermarket I pack different categories of goods into separate bags.
56.	I do not follow any particular system when I'm cleaning at home.
57.	I do not enjoy in-depth political discussions.
58.	I am not very meticulous when I carry out D.I.Y or home improvements.
59.	I would not enjoy planning a business from scratch to completion.
60.	If I were buying a stereo‚ I would want to know about its precise technical features.
61.	I tend to keep things that other people might throw away‚ in case they might be useful for something in the future.
62.	I avoid situations which I can not control.
63.	I do not care to know the names of the plants I see.
64.	When I hear the weather forecast‚ I am not very interested in the meteorological patterns.
65.	It does not bother me if things in the house are not in their proper place.
66.	In maths‚ I am intrigued by the rules and patterns governing numbers.
67.	I find it difficult to learn my way around a new city.
68.	I could list my favourite 10 books‚ recalling titles and authors' names from memory.
69.	When I read the newspaper‚ I am drawn to tables of information‚ such as football league scores or stock market indices.
70.	When I’m in a plane‚ I do not think about the aerodynamics.
71.	I do not keep careful records of my household bills.
72.	When I have a lot of shopping to do‚ I like to plan which shops I am going to visit and in what order.
73.	When I cook‚ I do not think about exactly how different methods and ingredients contribute to the final product.
74.	When I listen to a piece of music‚ I always notice the way it’s structured.
75.	I could generate a list of my favourite 10 songs from memory‚ including the title and the artist's name who performed each song.

©SBC/SJW Apr 2007

http://www.autismresearchcentre.com/arc_tests

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15 مهر 1391

Checklist for Autism in Toddlers

Checklist for Autism in Toddlers- CHAT

THE CHAT

To be used by GPs or Health Visitors during the 18 month developmental check-up.

Child’s name:................................. Date of birth:............... Age:................

Child’s address:................................................. Phone number: ................

SECTION A: ASK PARENT:

1. Does your child enjoy being swung‚ bounced on your knee‚ etc?	YES	NO
2. Does your child take an interest in other children?	YES	NO
3. Does your child like climbing on things‚ such as up stairs?	YES	NO
4. Does your child enjoy playing peek-a-boo/hide-and-seek?	YES	NO
5. Does your child ever PRETEND‚ for example‚ to make a cup of tea using a toy cup and teapot‚ or pretend other things?	YES	NO
6. Does your child ever use his/her index finger to point‚ to ASK for something?	YES	NO
7. Does your child ever use his/her index finger to point‚ to indicate INTEREST in something?	YES	NO
8. Can your child play properly with small toys (eg. cars or bricks) without just mouthing‚ fiddling or dr‎opping them?	YES	NO
9. Does your child ever bring objects over to you (parent) to SHOW you something?	YES	NO

SECTION B: GP OR HV OBSERVATION:

i. During the appointment‚ has the child made eye contact with you?	YES	NO
ii. Get child’s attention‚ then point across the room at an interesting object and say “Oh look! There’s a (name of toy)!” Watch child’s face. Does the child look across to see what you are pointing at?	YES	NO*
iii. 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**
iv. Say to the child “Where’s the light?”‚ or “Show me the light”. Does the child POINT with his/her index finger at the light?	YES	NO***
v. Can the child build a tower of bricks? (If so how many?) (Number of bricks:.............)	YES	NO

* (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.)

** (If you can elicit an example of pretending in some other game‚ score a YES on this item.)

*** (Repeat this with “Where’s the teddy?” or some other unreachable object‚ if child does not understand the word “light”. To record YES on this item‚ the child must have looked up at your face around the time of pointing.)

http://www.autismresearchcentre.com/arc_tests

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15 مهر 1391

The Adult Autism Spectrum Quotient

The Adult Autism Spectrum Quotient (AQ)

Ages 16+

SPECIMEN‚ FOR RESEARCH USE ONLY.

For full details‚ please see:

S. Baron-Cohen‚ S. Wheelwright‚ R. Skinner‚ J. Martin and E. Clubley‚ (2001)
The Autism Spectrum Quotient (AQ) : Evidence from Asperger Syndrome/High Functioning Autism‚ Males and Females‚ Scientists and Mathematicians
Journal of Autism and Developmental Disorders 31:5-17

Name:........................................... Sex:...........................................

Date of birth:................................... Today’s Date.................................

How to fill out the questionnaire

Below are a list of statements. Please read each statement very carefully and rate how strongly you agree or disagree with it by circling your answer.

DO NOT MISS ANY STATEMENT OUT.

Examples

E1. I am willing to take risks.	definitely agree	slightly agree	slightly disagree	definitely disagree
E2. I like playing board games.	definitely agree	slightly agree	slightly disagree	definitely disagree
E3. I find learning to play musical instruments easy.	definitely agree	slightly agree	slightly disagree	definitely disagree
E4. I am fascinated by other cultures.	definitely agree	slightly agree	slightly disagree	definitely disagree

1.	I prefer to do things with others rather than on my own.	definitely agree	slightly agree	slightly disagree	definitely disagree
2.	I prefer to do things the same way over and over again.	definitely agree	slightly agree	slightly disagree	definitely disagree
3.	If I try to imagine something‚ I find it very easy to cr‎eate a picture in my mind.	definitely agree	slightly agree	slightly disagree	definitely disagree
4.	I frequently get so strongly absorbed in one thing that I lose sight of other things.	definitely agree	slightly agree	slightly disagree	definitely disagree
5.	I often notice small sounds when others do not.	definitely agree	slightly agree	slightly disagree	definitely disagree
6.	I usually notice car number plates or similar strings of information.	definitely agree	slightly agree	slightly disagree	definitely disagree
7.	Other people frequently tell me that what I’ve said is impolite‚ even though I think it is polite.	definitely agree	slightly agree	slightly disagree	definitely disagree
8.	When I’m reading a story‚ I can easily imagine what the ch‎aracters might look like.	definitely agree	slightly agree	slightly disagree	definitely disagree
9.	I am fascinated by dates.	definitely agree	slightly agree	slightly disagree	definitely disagree
10.	In a social group‚ I can easily keep track of several different people’s conversations.	definitely agree	slightly agree	slightly disagree	definitely disagree
11.	I find social situations easy.	definitely agree	slightly agree	slightly disagree	definitely disagree
12.	I tend to notice details that others do not.	definitely agree	slightly agree	slightly disagree	definitely disagree
13.	I would rather go to a library than a party.	definitely agree	slightly agree	slightly disagree	definitely disagree
14.	I find making up stories easy.	definitely agree	slightly agree	slightly disagree	definitely disagree
15.	I find myself drawn more strongly to people than to things.	definitely agree	slightly agree	slightly disagree	definitely disagree
16.	I tend to have very strong interests which I get upset about if I can’t pursue.	definitely agree	slightly agree	slightly disagree	definitely disagree
17.	I enjoy social chit-chat.	definitely agree	slightly agree	slightly disagree	definitely disagree
18.	When I talk‚ it isn’t always easy for others to get a word in edgeways.	definitely agree	slightly agree	slightly disagree	definitely disagree
19.	I am fascinated by numbers.	definitely agree	slightly agree	slightly disagree	definitely disagree
20.	When I’m reading a story‚ I find it difficult to work out the ch‎aracters’ intentions.	definitely agree	slightly agree	slightly disagree	definitely disagree
21.	I don’t particularly enjoy reading fiction.	definitely agree	slightly agree	slightly disagree	definitely disagree
22.	I find it hard to make new friends.	definitely agree	slightly agree	slightly disagree	definitely disagree
23.	I notice patterns in things all the time.	definitely agree	slightly agree	slightly disagree	definitely disagree
24.	I would rather go to the theatre than a museum.	definitely agree	slightly agree	slightly disagree	definitely disagree
25.	It does not upset me if my daily routine is disturbed.	definitely agree	slightly agree	slightly disagree	definitely disagree
26.	I frequently find that I don’t know how to keep a conversation going.	definitely agree	slightly agree	slightly disagree	definitely disagree
27.	I find it easy to “read between the lines” when someone is talking to me.	definitely agree	slightly agree	slightly disagree	definitely disagree
28.	I usually concentrate more on the whole picture‚ rather than the small details.	definitely agree	slightly agree	slightly disagree	definitely disagree
29.	I am not very good at remembering phone numbers.	definitely agree	slightly agree	slightly disagree	definitely disagree
30.	I don’t usually notice small changes in a situation‚ or a person’s appearance.	definitely agree	slightly agree	slightly disagree	definitely disagree
31.	I know how to tell if someone listening to me is getting bored.	definitely agree	slightly agree	slightly disagree	definitely disagree
32.	I find it easy to do more than one thing at once.	definitely agree	slightly agree	slightly disagree	definitely disagree
33.	When I talk on the phone‚ I’m not sure when it’s my turn to speak.	definitely agree	slightly agree	slightly disagree	definitely disagree
34.	I enjoy doing things spontaneously.	definitely agree	slightly agree	slightly disagree	definitely disagree
35.	I am often the last to understand the point of a joke.	definitely agree	slightly agree	slightly disagree	definitely disagree
36.	I find it easy to work out what someone is thinking or feeling just by looking at their face.	definitely agree	slightly agree	slightly disagree	definitely disagree
37.	If there is an interruption‚ I can switch back to what I was doing very quickly.	definitely agree	slightly agree	slightly disagree	definitely disagree
38.	I am good at social chit-chat.	definitely agree	slightly agree	slightly disagree	definitely disagree
39.	People often tell me that I keep going on and on about the same thing.	definitely agree	slightly agree	slightly disagree	definitely disagree
40.	When I was young‚ I used to enjoy playing games involving pretending with other children.	definitely agree	slightly agree	slightly disagree	definitely disagree
41.	I like to collect information about categories of things (e.g. types of car‚ types of bird‚ types of train‚ types of plant‚ etc.).	definitely agree	slightly agree	slightly disagree	definitely disagree
42.	I find it difficult to imagine what it would be like to be someone else.	definitely agree	slightly agree	slightly disagree	definitely disagree
43.	I like to plan any activities I participate in carefully.	definitely agree	slightly agree	slightly disagree	definitely disagree
44.	I enjoy social occasions.	definitely agree	slightly agree	slightly disagree	definitely disagree
45.	I find it difficult to work out people’s intentions.	definitely agree	slightly agree	slightly disagree	definitely disagree
46.	New situations make me anxious.	definitely agree	slightly agree	slightly disagree	definitely disagree
47.	I enjoy meeting new people.	definitely agree	slightly agree	slightly disagree	definitely disagree
48.	I am a good diplomat.	definitely agree	slightly agree	slightly disagree	definitely disagree
49.	I am not very good at remembering people’s date of birth.	definitely agree	slightly agree	slightly disagree	definitely disagree
50.	I find it very easy to play games with children that involve pretending.	definitely agree	slightly agree	slightly disagree	definitely disagree

Developed by:

The Autism Research Centre

University of Cambridge

http://www.autismresearchcentre.com/arc_tests

[1] Pouretemad‚ H.R.

[2] Ziaei‚ M.

[3] Ganjavi‚ A.

توسط: کارشناس ندای مهر

15 مهر 1391

Childrens Empathy Quotient and Systemizing Quotient

Children's Empathy Quotient and Systemizing Quotient

Child EQ-SQ Questionnaire

Please complete by ticking the appropriate box for each statement

		Definitely Agree	Slightly Agree	Slightly Disagree	Definitely Disagree
1.	My child likes to look after other people.
2.	My child often doesn’t understand why some things upset other people so much.
3.	My child doesn’t mind if things in the house are not in their proper place.
4.	My child would not cry or get upset if a ch‎aracter in a film died.
5.	My child enjoys arranging things precisely (e.g. flowers‚ books‚ music collections).
6.	My child is quick to notice when people are joking.
7.	My child enjoys cutting up worms‚ or pulling the legs off insects.
8.	My child is interested in the different members of a specific animal category (e.g. dinosaurs‚ insects‚ etc).
9.	My child has stolen something they wanted from their sibling or friend.
10.	My child is interested in different types of vehicles (e.g. types of trains‚ cars‚ planes‚ etc).
11.	My child does not spend large amounts of time lining things up in a particular order (e.g. toy soldiers‚ animals‚ cars).
12.	If they had to build a Lego or Meccano model‚ my child would follow an instruction sheet rather than "ploughing straight in".
13.	My child has trouble forming friendships.
14.	When playing with other children‚ my child spontaneously takes turns and shares toys.
15.	My child prefers to read or listen to fiction rather than non-fiction.
16.	My child’s bedroom is usually messy rather than organised.
17.	My child can be blunt giving their opinions‚ even when these may upset someone.
18.	My child would enjoy looking after a pet.
19.	My child likes to collect things (e.g. stickers‚ trading cards‚ etc).
20.	My child is often rude or impolite without realising it.
		Definitely Agree	Slightly Agree	Slightly Disagree	Definitely Disagree
21.	My child knows how to mix paints to produce different colours.
22.	My child would not notice if something in the house had been moved or changed.
23.	My child has been in trouble for physical bullying.
24.	My child enjoys physical activities with set rules (e.g. martial arts‚ gymnastics‚ ballet‚ etc).
25.	My child can easily figure out the controls of the video or DVD player.
26.	At school‚ when my child understands something they can easily explain it clearly to others.
27.	My child would find it difficult to list their top 5 songs or films in order.
28.	My child has one or two close friends‚ as well as several other friends.
29.	My child quickly grasps patterns in numbers in maths.
30.	My child listens to others’ opinions‚ even when different from their own.
31.	My child shows concern when others are upset.
32.	My child is not interested in understanding the workings of machines (e.g. cameras‚ traffic lights‚ the TV‚ etc).
33.	My child can seem so preoccupied with their own thoughts that they don’t notice others getting bored.
34.	My child enjoys games that have strict rules (e.g. chess‚ dominos‚ etc).
35.	My child gets annoyed when things aren't done on time.
36.	My child blames other children for things that they themselves have done.
37.	My child gets very upset if they see an animal in pain.
38.	My child knows the differences between the latest models of games-consoles (e.g. X-box‚ Playstation‚ etc.‚) or other gadgets.
39.	My child remembers large amounts of information about a topic that interests them (e.g. flags of the world‚ football teams‚ pop groups‚ etc).
40.	My child sometimes pushes or pinches someone if they are annoying them.

		Definitely Agree	Slightly Agree	Slightly Disagree	Definitely Disagree
41.	My child is interested in following the route on a map on a journey.
42.	My child can easily tell when another person wants to enter into conversation with them.
43.	My child is good at negotiating for what they want.
44.	My child likes to cr‎eate lists of things (e.g. favourite toys‚ TV programmes‚ etc).
45.	My child would worry about how another child would feel if they weren’t invited to a party.
46.	My child likes to spend time ma‎stering particular aspects of their favourite activities (e.g. skate-board or yo-yo tricks‚ football or ballet moves).
47.	My child finds using computers difficult.
48.	My child gets upset at seeing others crying or in pain.
49.	If they had a sticker album‚ my child would not be satisfied until it was completed.
50.	My child enjoys events with organised routines (e.g. brownies‚ cubs‚ beavers‚ etc).
51.	My child is not bothered about knowing the exact timings of the day’s plans.
52.	My child likes to help new children integrate in class.
53.	My child has been in trouble for name-calling or teasing.
54.	My child would not enjoy working to complete a puzzle (e.g. crossword‚ jigsaw‚ word-search).
55.	My child tends to resort to physical aggression to get what they want.