Autism Questionnaire For Parents and Commonly Asked Questions
Autism spectrum disorder (ASD) can look very diverse in different children. They have varied verbal abilities ranging from no speech at all to speech that is fluent but may sound awkward or inappropriate.
As early as infancy, children with ASD may manifest different symptoms. They may become extremely focused on one object, avoid eye contact, or fail to engage in typical babbling. On the other hand, some babies may develop normally until they reach their second or third year of life.
As parents, it’s normal to feel concerned about your child meeting their developmental milestones. Nonetheless, it is important to figure out how to spot autism early to get an evaluation from a healthcare professional.
In this blog, we’ve rounded up a list of the commonly used autism questionnaires for parents to help gather information on possible early signs of ASD. We also added the questions that are usually asked.
Common autism questionnaires for parents
The Centres for Disease Control and Prevention (CDC) reports that ASD can be detected at 18 months or younger. When a child has been diagnosed by age 2 by a healthcare professional, it can be considered very reliable. Children can undergo assessment during their well-baby visits at 9, 18, and 30 months, as recommended by the American Academy of Paediatrics (AAP).
There are screening tools and common autism questionnaires for parents to determine if their child is performing their expected developmental milestones. These tools will help you see whether your child’s symptoms resemble those of children diagnosed with ASD. Usually, a high score will suggest that an autism evaluation from a trained healthcare professional is necessary.
In Singapore, the following are the commonly-used screening tools for autism:
- Autism Diagnosis Interview-Revised (ADI-R) – ADI-R is an interview for caregivers of children that focuses on behaviours of children in three areas – communication and language, quality of social interaction, and repetitive, restricted and stereotyped behaviour and interests.
- Autism Diagnostic Observation Schedule (ADOS) – This tool is clinic-based play observation, wherein the physician will observe a child for about 40 minutes to one hour with activities that aim to assess a child’s social communication, play or imaginative use of materials, and social interaction.
- IQ Test: The WPPSI and WISC – These are clinical tools that are used to ascertain if the child may be on the autism spectrum. These tests have various components such as verbal comprehension, visual-spatial, fluid reasoning, working memory, and processing speed.
Worldwide, other tools are also used to evaluate if a child has ASD:
- Assessment of Basic Language and Learning Skills (ABLLS) – The ABLLS assessment is designed to determine critical learner and language skills in those with autism and other developmental disabilities. The test also assesses expressive language skills using the verbal behaviour method of behavioural analysis. It helps healthcare professionals assess academic, language, self-help, and motor skills deficiencies, and then implement and evaluate treatment interventions.
- Verbal Behaviour Milestones Assessment and Placement Program (VB-MAPP) – The VB-MAPP is an autism screening tool used to assess a child’s language and social skills. In addition, the tool also measures learning styles to develop the appropriate curriculum. Further, the system is designed to monitor and track improvement over time for those with language delays.
- Early Symptomatic Syndromes Eliciting Neurodevelopmental Clinical Examinations-Questionnaire (ESSENCE-Q) – The ESSENCE-Q, which was developed by Professor Christopher Gillberg in 2010, is a level-one questionnaire developed to focus on the various psychiatric and learning problems experienced by children in the first five years of life. It can help parents determine common developmental disorders in their children, before they can get a diagnosis.
- Autism Behaviour Checklist (ABC) – This level-two screening questionnaire highlights the signs and symptoms of ASD. It’s a 57-item behaviour rating scale to assess the behaviours and symptoms of autism for children 3 years old and above.
- The Autism Family Experience Questionnaire (AFEQ) – The AFEQ was developed through online consultations with parents. It was administered to parents of children enrolled in the Pre-school Autism Communication Trial.
- Autism Spectrum Screening Questionnaire (ASSQ) – The ASSQ is a screening questionnaire designed to determine the prevalence of Asperger’s Syndrome, and is now one of the most widely-used autism screening tools across the globe.
A pre-assessment test is also a good start for parents to see if their child is exhibiting symptoms of autism. This online test can provide a basis for parents to seek a more detailed screening tool provided by health professionals.
Questions that parents should ask before seeking diagnosis
1. Does your child look you or others in the eye?
Children with autism show deficits in nonverbal communicative behaviours used for social interaction, including the lack of eye contact.
Eye contact helps people communicate their attention and interest to a conversation partner. Often, we maintain eye contact to respond to important social cues from others. For children in the spectrum, however, making eye contact can be extremely stressful. Hence, they avoid eye contact, or they can’t maintain it for a long period of time.
2. Does your child respond to their name?
Infants as young as 4 to 6 months old usually perk up and become attentive when they hear their names. This hints that the sound patterns of their names are internalised early in life. Children with autism often fail to consistently respond to their names by their first birthday. It’s also one of the most consistent early signs of ASD and other developmental delays.
A study also found that at 9 months old, infants developing autism were more likely to fail to orient to their names, which persists through 24 months of age.
3. How does your child communicate with you non-verbally?
Nonverbal communication is important as it improves one’s ability to engage, relate, and establish meaningful communication. It provides valuable information about a situation, including how we feel, receive information, and approach another person.
People with autism, however, find it difficult to use words to express what they need and want. They often speak in single words or short phrases and struggle in understanding language. They have a hard time recognising nonverbal cues, or their gestures or expressions do not match the situation.
You may be asked if your child uses your hand if they want something, or if they can point to an object and say they want it. Also, an autism questionnaire for parents may include queries about your child’s facial expressions, such as smiling, pouting, and frowning, in response to situations.
In turn, it’s also important to note if your child understands or responds to the expressions of other people. For instance, when you frown or exhibit an angry face, will they know that you’re sad or upset?
4. Does your child repeat sounds and words they hear?
Echolalia is when children with autism repeat words without regard for meaning. No one knows the cause of echolalia, but it’s common in autism. They repeat the phrases or words of familiar people, like their parents or caregivers, or they might repeat words or songs from their favourite video.
There are two types of echolalia – immediate and delayed. Immediate echolalia happens when the child repeats words or sentences right after they’ve heard them. In delayed echolalia, the words are repeated at a later time.
Children often develop echolalia because of prolonged hours of screen time and repeat-watching the same video or the same video segments over and over again. As a result, they become obsessed with it. Thus, even when they are not watching the video, it replays in their head, causing delayed echolalia. In immediate echolalia, the child does not understand the question asked but is aware that they are expected to answer. So, they repeat after you.
5. Does your child have sensory needs?
When we talk about sensory input, we think of our five senses – sight, smell, taste, hearing, and touch. In ASD, children can experience both hyposensitivity (under-responsiveness) and hypersensitivity (over-responsiveness) to a broad range of stimuli. In some cases, they might have a combination of both.
Children may react strongly to bright lights or loud noises. Certain sounds, smells, tastes, and textures can be overwhelming for them, which leads to a meltdown. Often, they resort to sensory avoidance wherein they try to get away from stimuli. This may look like covering their ears to avoid loud noises, pulling away from physical touch, and avoiding certain clothing or food.
6. How well does your child communicate verbally?
Delayed speech is a classic sign of ASD. Some children with autism have very limited speaking skills, while others may not be able to communicate using speech or language. This question is usually asked in autism assessment tools. Some follow-up questions include topics about conversations with others, how well they express their thoughts, and if they use words or phrases that only you can understand.
7. What Activities Does Your Child Like?
One important aspect of an autism evaluation is knowing what activities they like. Most often, they are fixated on certain objects, like spinning a toy car’s wheel.
Lining up toys in a row and arranging things symmetrically are also common in children with autism. However, experts say that these are usually seen among toddlers as they are in a stage of mastering things in their environment. Parents should be concerned when these behaviours have become habitual or obsessive.
It’s also common for children with autism to get upset when their routine becomes interrupted. Autistic children also play differently than those who do not have autism. They often prefer repeated actions over and over, rather than playing pretend. They prefer to play alone and struggle with playing with other kids.
8. Does your child engage in odd movements?
Stimming is a typical symptom in children on the spectrum. It refers to self-stimulating behaviours involving repetitive sounds or movements. When they feel anxious, stressed or even when they’re happy, they resort to movements like rocking, hand flapping, flicking their fingers, waving their arms.
Next steps
An autism questionnaire for parents provides an overview of the questions your healthcare professional will ask during an evaluation. If your child’s scores are worrisome, you need to contact a multidisciplinary team for an autism assessment, including a paediatrician, a psychologist, a psychiatrist, a speech pathologist, and a therapist.
Remember, there’s no single test for autism. An ASD diagnosis is based on observing how children interact and play with others, reviewing their developmental history, and interviewing parents or caregivers.
At AutismSTEP, we are a team of certified and experienced BCBAs and RBTs. We conduct autism assessments and provide a tailored treatment plan for your child. To ensure that your child is in good hands during the therapy sessions, all our therapists are RBT-certified.
To help you make an informed decision on the type of therapy your child needs, please schedule a consultation with us today, or call +65 6456 9950.