Preliminary Autism Screening (ASD)

20 Yes/No questions for children (Primary Check)

Please answer all questions:

1. Does the child avoid eye contact?

Yes No

2. Does the child have difficulty making friends?

Yes No

3. Does the child repeat words or sentences often (echolalia)?

Yes No

4. Does the child show repetitive movements (e.g., hand flapping)?

Yes No

5. Does the child get upset by small changes in routine?

Yes No

6. Does the child prefer to play alone?

Yes No

7. Does the child have unusual reactions to sounds or lights?

Yes No

8. Does the child speak less than other children their age?

Yes No

9. Does the child have trouble expressing feelings?

Yes No

10. Does the child have trouble understanding others’ feelings?

Yes No

11. Does the child not respond when their name is called?

Yes No

12. Does the child repeat certain activities for long periods?

Yes No

13. Does the child get overly focused on specific interests?

Yes No

14. Does the child find it hard to join group games?

Yes No

15. Does the child avoid physical affection (hugs, cuddles)?

Yes No

16. Does the child use objects in unusual ways?

Yes No

17. Does the child have delayed language development?

Yes No

18. Does the child have difficulty following instructions?

Yes No

19. Does the child prefer routine and resist changes?

Yes No

20. Does the child show unusual emotional reactions?

Yes No