Autism Spectrum Disorder Checklist

Name: __________________________________________ Grade: _______________ Date: _______________

Teacher: ________________________________________ School: ___________________________________

Difficulties with both verbal and nonverbal communication, expressive and receptive communication

Communication Limited / no language

Lengthy monologues
Unusual language e.g. echolalia (repetition of language heard),
modulation
Recurring questioning
Unusual and speech volume control
Undeveloped conversation skills
Attention, eye contact
Following instructions, sequencing
Literal interpretations of humor / sarcasm / idioms
Gestures; absent to exaggerated
Unaware of body language / facial expressions of others
Lack of response to questions, both verbal and written
Interest in facts / information

Social Skills Appears naïve, socially immature

Lacks an awareness of their own and other emotions
Misunderstands social situations
Unaware of the effect their behavior has on others
Insensitive to needs and feelings of others
At risk of harassment
Perseverates on injustices
Limited / no initiation of social interaction
Reluctant or averse to risk taking for fear of failure

Motor Skills Poor motor planning skills e.g. judgment of space

Poor gross and fine motor skills
Avoids physical activities
Poor fine motor skills – writing legibility
Immature grasp / pencil grip
Reluctant to start work
Moves with an unusual gait
Transitions Becomes upset when interrupted or asked to stop
Starts again if interrupted
Becomes upset when activity finishes
Refuses to stop
Is anxious if there is a change in routine
Reacts poorly to the unexpected
Behaves poorly around strangers
Demands things be done in a particular way

Organization Skills Messy work area

Frequently unable to find items
Easily distracted from the task
Assignments late, not finished (or started)
Forgetting to give notes to parents
Forgetting to return notes, bring gear
Written work erratic

Sensory Issues Limited diet

Reactions to smells
Negative responses to dirt, paint, glue
Adverse reactions in noisy situations e.g covering ears – assembly, music
Removes clothes
Leaves clothes on for inappropriate weather
Appears frightened
Reacts to touching
Parent reports afraid of hairdresser, dentist
Distracted by the sensory input
Becomes upset when sensory input is stopped
Doesn’t seem aware of or indicate injury
Over reacts to minor scrape, bump

Comment / Action When

No Limits: Teachers including learners with disabilities in regular classrooms