DASI English

DASI
Diagnostic Autism Spectrum Interview
English
Professor Susan Young
www.psychology-services.uk.com
Preface
I started working with young people with Autism Spectrum Disorder (ASD) and Attention Deficit
Hyperactivity Disorder (ADHD) over 25 years ago. In those days these two conditions were considered
to be independent of each other, in other words they were ‘differential diagnoses’. Since then,
advances in science have led to our understanding that the two disorders may co-exist and when they
do, they represent a condition of greater severity and complexity. In real terms this means that the
person with both disorders is suffering and has suffered greatly, often without the support they require.
Neurodevelopmental disorders, such as ASD and ADHD, require a comprehensive assessment spanning
the life of the individual. For ASD, one needs to assess and consider early developmental problems.
Over time, robust methods of assessment of ADHD have been developed and there are several rating
scales and clinical diagnostic assessments available that can be accessed free of charge. However for
ASD, this is not the case. As a Clinical and Forensic Psychologist, I found myself increasingly frustrated at
having to purchase assessment materials that did not easily map across to the criteria set within formal
diagnostic classifications. What I wanted was a ‘gold standard’ tool that would facilitate the clinical
diagnostic process and I set myself the task.
How did I do this? Well, I had already developed the ADHD Child Evaluation (ACE) and the ACE+ for
adults, both of which are free to download in multiple languages from the resources section of my
website (www.psychology-services.uk.com). They are also available to purchase in electronic format
(https://bgaze.com/en/ace) in English and Spanish. So, adopting the same methodology as before, I
commenced the journey to do the same for ASD; the one exception being the inclusion of a structured
observational record which aims to supplement the interview with objective information using a task-
based structured approach. Hence, the Diagnostic Autism Spectrum Interview (fondly referred to as
DASI) was born and, like ACE and ACE+, it is free to download from my website. I strongly advise
practitioners to access the introductory online training to use these tools (ACE, ACE+ and DASI) on my
website (www.psychology-services.uk.com). Accredited reliability training is also available by request.
I thank all of my colleagues for their optimism, encouragement and practical feedback on drafts of DASI,
in particular Anna Backman, Tobias Banaschewski, David Coghill, David Daley, Stephan Eliez, Gisli
Gudjonsson, Isabel Hernández Otero, Jack Hollingdale, Peter Mason, Denise McCartan, J. Antoni Ramos-
Quiroga, Bengi Semerci, Joseph Sergeant and Emma Woodhouse. Thanks also to the talented Benjamin
Wild (www.iBenWild.com) for producing the OR4 illustration. Special thanks go to Hannah Mullens for
her consistent motivation, support and skills in transforming my ideas into the practical steps required
to make them a reality. It is such a pleasure to collaborate with Hannah who has great patience and an
excellent eye for detail, especially when working with colleagues from other countries who have kindly
translated the tools into so many languages.
Professor Susan Young

London, 1st January 2020
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Contents
Page
Introduction to DASI 3
Diagnostic Criteria 3
Co-existing Problems and Disorders 4
DASI Administration 5
Assessor Qualifications 5
Interviewee and Sources of Information 5
Prior to the Appointment 5
Introducing the DASI Interview 6
Background Interview 6
Symptom Ratings 6
Chronological and Developmental Age 9
Non-Verbal Clients 9
Cultural Considerations 9
Accommodations and Camouflaging 10
Observational Record 10
Observational Record Summary 16
Scoring 17
Interview 18
Background 18
Symptom Ratings 26
Observational Record 74
Observational Record Summary 83
Scoring 84
Assessor Notes 87
Appendix 88
About the Author 94
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Introduction to DASI
DASI is a semi-structured clinical interview designed to support healthcare practitioners in assessing

ASD in children (age >2 years), young people and adults. DASI leads the assessor through the diagnostic
process by assessing the symptoms of ASD across the lifespan and the extent to which they impair
functioning. DASI sets out a series of questions and prompts to guide clinical judgement about the
presence of the core domains of (1) difficulties in social-communication and social interaction, and (2)
restricted, repetitive patterns of behaviour, interests or activities. DASI includes an observational
assessment, which aims to supplement the clinical interview with objective information using a
structured approach.
The assessor is guided to consider the onset of difficulties, their persistence over time, and
pervasiveness across settings. The impact of symptoms on daily life is considered in terms of functional
impairments, together with any accommodations made by the family and/or others in order to
minimise disruption to family life or everyday activities. The assessor is also guided to be mindful that
the client may mask symptoms by applying learned strategies and consider whether they are helpful
and successful. If the diagnosis is supported, the assessor is guided to consider the severity of the
presentation and the resultant level of support that may be required, and any known or possible
comorbid conditions.
Diagnostic Criteria
There are two diagnostic criteria in common use, the Diagnostic and Statistical Manual of Mental
Disorders 5th Edition (DSM-5: American Psychiatric Association, 2013) and the International Statistical
Classification of Diseases and Related Health Problems 11th Revision (ICD-11: World Health
Organisation, 2016). ICD-11 is currently being processed and it is anticipated it will align with DSM-5’s
diagnostic criteria being organised under the two categories described above. Other revisions include
Asperger’s Syndrome and other generalised developmental disorders falling within the broader
classification of the autism spectrum and the acceptance that ASD can co-occur with ADHD.
According to DSM-5, there are three core symptoms associated with the domain of social-
communication and social interaction (Criterion 1). These relate to (1) persistent deficits in social-
emotional reciprocity; (2) non-verbal communicative behaviours used for social interaction; and (3) the
ability to develop, maintain and understand relationships. The criterion is met if all three of these
symptoms are endorsed. There are four core symptoms associated with the domain of restricted,
repetitive patterns of behaviour, interests or activities (Criterion 2). These relate to (1) persistent
stereotyped or repetitive motor movements, use of objects, or speech; (2) insistence of sameness,
inflexible adherence to routines or ritualized patterns of verbal or non-verbal behaviour; (3) highly
restricted, fixated interests that are abnormal in intensity or focus; and (4) hyper-reactivity or hypo-
reactivity to sensory input or unusual interest in sensory aspects of the environment. The criterion is
met if at least two of the four symptoms are endorsed.
Individuals with ASD exhibit a range of intellectual and language functioning. Broadly, symptoms
typically present in early childhood (by 2-3 years of age) with or without language delay and may be
associated with early developmental delays and/or loss of social or language skills. However, many
people may not receive a diagnosis of ASD until adulthood. Symptoms must not be accounted for by
general developmental delays. Symptoms must be associated with clinically significant impairment in
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personal, family, social, educational, occupational, or other important areas of functioning. They are
relatively stable across the life span, although there may be some developmental gains in adolescence
and adulthood due to increased interest in social interaction, behavioural improvement associated with
interventions and/or compensations applied, and/or the environmental supports provided.
Co-existing Problems and Disorders

For a diagnosis of ASD, symptoms must not be better explained by general developmental delays (i.e.
intellectual disability) or another mental disorder (e.g. substance use, anxiety, depression), which
involves an assessment for differential diagnoses. However, individuals with ASD often present with co-
existing problems and disorders. Indeed, 70% of children with ASD will have at least one co-occurring
psychiatric condition and 41% will have two or more, the most common being social anxiety, ADHD and
oppositional defiant disorder (Simonoff et al., 2008). Adults also experience high rates of comorbidity,
the most common being mood disorders, anxiety disorder and ADHD (Hofvander et al., 2009). Hence,
the presentation of people with ASD may be complex from both a clinical and behavioural perspective
and the assessor must distinguish between primary (i.e. differential) and secondary (i.e. co-existing)
conditions. DASI includes a section that prompts the assessor to consider the presence of co-existing
problems and disorders, which will support them to make these decisions.
References
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.).
Arlington: American Psychiatric Association.
Hofvander, B., Delorme, R., Chaste, P., Nydén, A., Wentz, E., Ståhlberg, O., et al. (2009). Psychiatric and
psychosocial problems in adults with normal-intelligence autism spectrum disorders. BMC Psychiatry,
9(1), 35.
Simonoff, E., Pickles, A., Charman, T., Chandler, S., Loucas, T., & Baird, G. (2008). Psychiatric disorders in
children with autism spectrum disorders: prevalence, comorbidity, and associated factors in a
population-derived sample. J Am Acad Child Adolesc Psychiatry, 47(8), 921-929.
World Health Organization. (2016). International classification of diseases 11th ed (ICD-11).

http://www.who.int/classifications/icd/en/. Accessed 21/04/2019.
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DASI Administration
Assessor Qualifications
DASI should only be administered by healthcare practitioners who are very familiar with autism
spectrum disorder and the range of difficulties and impairments that are associated with the condition.
It is highly recommended that practitioners access the introductory online training to use DASI
(available at www.psychology-services.uk.com). Accredited reliability training is also available by
request.
Interviewee and Sources of Information

DASI is administered directly to the client and/or their family. When assessing children, the interview is
typically administered to parents/carers but it is essential for the assessor to meet and, if possible,
interview and conduct the observational assessment with the child. A wealth of useful information may
also be obtained from observing a child in school and speaking directly with teachers, if this can be
arranged.
When assessing adolescents and adults, a similar procedure is recommended (i.e. interviewing
parents/carers as well as interviewing and observing the client themselves) due to the need to obtain
reliable information about the client’s childhood functioning across settings.
In some cases, a parent/carer may not be available (especially when assessing adults), in which case
collateral information should be obtained from someone who is familiar with the client’s functioning in
different settings (e.g. a close family member or friend of the family). If a suitable informant cannot be
identified who knew (and can recall) the client well during their early childhood, it may be helpful to
obtain information from an informant who currently knows the client well (e.g. a close friend or
partner) in order to supplement self-reported information with an objective perspective.
For both child and adult clients, it is good practice to obtain corroborative information, whenever
possible, from appropriate informants and/or to obtain contemporaneous information about their
functioning across settings and across the lifespan. This may include completion of rating scales and
perusal of current and/or past reports (for example, educational, occupational appraisals/performance
reviews, social care, clinical reports). In the event that reliable and accurate clinical information about
the client’s functioning in childhood is unavailable, the assessor needs to make their best judgement as
to whether trait-like symptoms were present in childhood. This may present a difficulty for ‘borderline’
cases, i.e. clients presenting with symptoms of lower severity and requiring a lower level of support.
Prior to the Appointment

In advance of the appointment it is helpful to provide those attending with information about the
assessment process (duration, breaks etc.). It may also be helpful to send out parts of the background
interview (which includes information about developmental milestones) for completion ahead of the
appointment.
It is helpful to ask the client and/or parents/carers to peruse and send, ahead of the appointment,
copies of relevant childhood documents (e.g. developmental health records, school reports) and/or to
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look through any photographs they have of when the client was a young child (i.e. special occasions,
with family, with peers, holidays). This might jog their memory about the presentation and specific
characteristics of the client across situations and settings. It is often very helpful to ask the interviewee
to bring these photographs with them to the assessment. Prompting the client and/or parents/carers to
think about key transitions in the client’s life (such as moving home, change of school) can also help to
jog their memory ahead of the appointment.
Introducing the DASI Interview

Prior to administering the interview, the assessor should try to establish rapport with the interviewee(s)
in order to make them feel comfortable, settled and at ease. This may be challenging when conducting
the interview directly with a client with autism as their preference may be to embark directly on the
semi-structured interview rather than engage in social ‘chit chat’. To some extent, this may be
circumvented by reiterating practical information about the assessment process (i.e. its anticipated
duration, to take breaks when needed, where to go when taking breaks, arrangements about
refreshments). When interviewing an informant, it is helpful to tell them that they will be asked about
the client’s functioning across their lifespan (including their young childhood/toddler years) and that
you are interested in the client’s interests, play/hobbies, engagement, communication and
interpersonal style with others. A helpful ‘ice breaker’ is to look through the photographs they bring
with them.
Background Interview
Commence the interview by completing the 'Background' section. If this has been sent out and
completed in advance of the appointment, the assessor should check through the responses for
omissions, clarifications and/or further details that may be required.
In addition to demographic information, the background section enquires about the presentation and
early development of the client, their educational and occupational history, medical history, family and
relationships.
Symptom Ratings
Before embarking on the symptom ratings, it may be helpful for the assessor to briefly revise the
symptom ratings guidance. This guidance is located at the beginning of the Symptom Ratings section,
and provides a one-page reminder of the important diagnostic factors that the assessor should be
bearing in mind throughout the assessment. For each item, it is important to enquire whether
symptoms were present at a very young age (e.g. as a toddler) and if any developmental differences
were observed/reported. It is also important to enquire about frequency, severity, impairment and
mediating factors, in addition to considering each symptom across the entire lifespan of the client.
The assessor needs to be mindful of the need for symptoms to be consistent and pervasive over time
and across settings; difficulties should not be better explained by a situation-specific event that
required them to adapt to substantial change in their life (such as moving home or school). The assessor
should also consider whether difficulties are being masked by compensatory strategies and/or
‘accommodations’ (i.e. adjustments) made by others. Contextual influences need to be kept in mind.
For example, the purpose of verbal and/or behavioural rituals may be to provide comfort (ego-syntonic)
or to neutralise feelings of distress (ego-dystonic).
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The symptom ratings section assesses social-communication and social interaction (three items) and
restricted, repetitive patterns of behaviour, interests or activities (four items).
The three items relating to social-communication and social-interaction (Criterion 1) are organised
under nine core symptoms as follows:
1a. Abnormal social approach

1b. Initiation of social interactions and response to those of others
1c. Engagement in two-way conversations (NB. Not applicable for non-verbal clients)
1d. Sharing of interests, emotions and/or affect
2a. Integration of verbal and non-verbal communication
2b. Facial expressions and body language
3a. Forming and maintaining friendships
3b. Sharing in imaginative play
3c. Adjusting behaviour according to social context
The four items relating to restricted, repetitive patterns of behaviour, interests or activities (Criterion 2)
are organised under eleven core symptoms as follows:
4a. Stereotyped or repetitive motor movements

4b. Stereotyped or repetitive use of objects
4c. Stereotyped or repetitive speech
5a. Insistence on sameness and inflexible adherence to routines
5b. Ritualized patterns of verbal or non-verbal behaviour
6a. Preoccupations or attachments to unusual objects
6b. Restricted or perseverative interests
7a. Unusual response to pain or changes in temperature
7b. Unusual response to specific sounds
7c. Unusual response to specific textures, tastes and/or smells
7d. Unusual response to lights or movement
Each symptom consists of a series of questions. It may not be necessary to put every question to the
interviewee; they are there solely to assist the assessor in determining the appropriate rating and the
assessor should continue to administer the prompts until they are satisfied they have sufficient
information to reach a decision.
Each symptom has four text boxes that prompt the assessor to record notes as follows:
 As a toddler/child does/did the client differ from other children of the same age? As a child,
do/did other people (e.g. teachers, peers, fellow parents) make comments about the client?
 How do/did these characteristics impact on daily activities? Are/were accommodations made to
reduce disruption to family life? Does/did the client use camouflaging or strategies to mask their
symptoms?
 How do/did these characteristics manifest at home and outside of the home (i.e. school,
occupation, leisure activities)?
 How do these characteristics currently cause concern or impairment?
It is recommended that these notes are written in sufficient depth to guide and support the assessor’s
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decision about the symptom. The assessor should prompt the interviewee to describe specific situations
and/or to give specific examples about when, how and where the difficulty presents across settings and
whether it has changed over time (and if so why). Given the high estimates of heritability of
neurodevelopmental conditions in families, it is important to be mindful that informants may have an
(undiagnosed) condition, which in turn may impact on their judgment of ‘typical’ behaviour. It is
therefore important for the assessor to obtain very specific examples of behaviour from the informant
and use these examples to make clinically informed judgments, rather than relying upon the
informants’ perception of what is ‘typical’ or ‘atypical’.
From this in-depth exploration of each symptom, the assessor will judge and record at the bottom of
the page whether each symptom is (1) absent, (2) partially present without impairment, (3) partially
present with impairment, and (4) present.
Impairment is defined as a diminishment or loss of function or ability, either physical or mental. It refers
to a severe limitation that people experience in carrying out functions in their daily lives at home, in
school or at work, and in the community, that falls outside a range of considered ‘normal’. To assist in
differentiating between the ratings, the following guidance is provided:
Absent: This is endorsed when a symptom is determined not to be present.
Partially present: Partially present is applicable if a symptom is present across settings and situations,
but not consistently (i.e. it is only sometimes present). One reason for this may be when the client is
able to moderate their presentation in some situations due to camouflaging and/or applying
compensatory strategies. These methods enable the client to maintain their presentation for a brief
period and/or in some contextual situations, but it cannot be sustained across all situations or for
extended periods of time. Sometimes it is others who make the modifications or provide ‘scaffolding’ to
support the client. We have subdivided this category based on associated impairment as follows:
 Partially present without impairment: Partially present without impairment refers to a symptom
which does not cause impairment to the client’s personal, social, or educational/occupational
functioning. An example relating to symptom 1c (engagement in two-way conversations) is a
client who appears to communicate relatively well with their immediate family but struggles with
others who know him/her less well. This may be because the client’s family is used to the client’s
interpersonal style, can understand and anticipate their needs, is well acquainted with their
specific interests and is skilled at facilitating conversation. When interacting with people they
know less well however, the client is able to engage in two-way conversation but communication
is more stilted and difficult to maintain. In this case, a partially present symptom may be rated
because the client is able to successfully use a conversation strategy that allows them to engage
in minimal, scripted small talk that is sufficient for small social encounters, and/or they avoid any
scenarios where extended conversations would be required (i.e. happily chooses to play alone at
school or successfully pursues a career with minimal social contact). This would not be associated
with impairment if the client does not report any distress or frustration at their limited
conversational abilities and is happy and able to successfully participate in limited social
engagement (outside of the immediate family).
 Partially present with impairment: In the example above, a partially present symptom may be
rated to be with impairment if the client is able to communicate relatively well with their
immediate family but is unable to successfully adopt strategies that they can consistently apply
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across a variety of social encounters and social settings and/or their communication difficulties
cause him/her to feel frustration and/or distress. As a result, the client suffers impaired personal
and social functioning because they are unable to successfully socialise beyond their immediate
family.
Present: This is selected when a symptom is determined to be consistently present (with impairment)
across settings and situations.
The qualifiers that determine this decision, especially with regards to the level of impairment and any
accommodations made, should be included when writing a clinical assessment report based on DASI.
Chronological and Developmental Age

It is important to consider the extent to which the client’s functioning is both age and developmentally
appropriate. A child’s chronological age relates to their date of birth, which may differ substantially
from their developmental age. Their developmental age is the age at which they function emotionally,
physically, cognitively and socially. For example, a child may be 12 years of age but developmentally
they display emotions or behaviours that make them seem much younger. Hence, it is important not to
focus solely on a child’s intellectual limitations or chronological age but to be mindful of a child’s
developmental limitations more broadly. For example, a child of 12 years may have an IQ that falls
within normal limits, but their emotional and social functioning may be highly discrepant with other
areas of functioning and therefore developmentally inappropriate. Hence, one has to consider the
broader developmental functioning of the child.
Non-Verbal Clients
Some items and questions are not relevant when conducting an assessment about a client who is non-
verbal. For consistency across interviews, DASI has adopted the definition of ‘verbal’ applied in the
Autism Diagnostic Interview – Revised (ADI-R; Rutter, Le Couteur & Lord, 2003, p81) “the functional use
of spontaneous, echoed, or stereotyped language that, on a daily basis, involves phrases of three words
or more that at least sometimes include a verb and are comprehensible to other people”.
Hence item (1c) ‘Engagement in two-way conversations’ is not applicable for clients who do not meet
this definition of verbal ability.
In item (2a) ‘Integration of verbal and non-verbal communication’ a prompt has been added to indicate
that for non-verbal clients this item might involve integrating one or more of the following: eye contact,
gestures, facial expressions and/or sounds/vocalisations (rather than verbalisations).
With respect to the Observational Record, only OR5: General Presentation can be completed for non-
verbal clients.
Cultural Considerations
Cultural issues may impact on the assessment; for example, expectations regarding the use of eye
contact vary in different parts of the world. Style of interaction may also differ; for example, language
1
Rutter, M., Le Couteur, A., & Lord, C. (2003). ADI-R. Autism Diagnostic Interview Revised. Manual. Los Angeles: Western Psychological Services.
[9]
use is typically more formal in Russian and ex-soviet cultures and in Mediterranean cultures people
often speak more loudly and with greater gesticulation. Play activities may also be culturally sensitive.
For this reason, the assessor should place greater emphasis on the interpersonal style children adopt in
their play (e.g. whether they follow or impose strict rules, whether they dominate and delegate as
opposed to engage in reciprocal activities) rather than the type of play activities in which they engage.
Accommodations and Camouflaging

There may be diagnostic challenges when diagnosing client’s with subtle or ’mild’ presentations. This
may be due to difficulties being ‘masked’ by comorbid conditions and/or environmental
accommodations being applied at home such as avoiding family outings, social events and school trips.
The individual may also ‘camouflage’ their difficulties by acquiring compensatory strategies or ‘surface
skills’ that they are able to sustain for a limited time, which make them appear more socially able than
they really are.

In this section the assessor is steered to consider the issue of differential or co-occurring presentations
by referring to a list of alternative and/or common co-existing problems. These include
neurodevelopmental/cognitive, behavioural, emotional, physical and medical disorders, and each
includes a brief description that aims to prompt the assessor to consider the presentation of the client
from a different perspective. The section is not intended to be presented sequentially to the client; the
items serve only as a prompt from which the assessor selects co-existing conditions that may have been
indicated during the interview.
It is not recommended that the problems and disorders are disclosed (as labelled) to the interviewee.
Preferably, the assessor should lead with general questions that relate to the condition before focusing
on specific symptoms. A space is provided to make notes and classify whether the condition has been
previously diagnosed or whether further investigation is required. This section is not intended to make
a diagnosis; rather it aims to identify symptoms that should be considered as potential differential or
co-existing conditions that require further investigation. Any known co-existing and suspected inherited
or acquired conditions are also recorded here (i.e. medical, psychiatric and genetic). If in the course of
this assessment a client has disclosed that they have had a condition diagnosed in the past that is no
longer a problem, this should also be recorded (including the duration of the episode).
Observational Record
The aim of this section is simply to provide a structure to observe and record the client in order to
obtain objective information that might supplement the clinical interview. It is not a ‘test’ and it should
not be presented in that way to the client. The section consists of five items, OR1-OR5, as follows:
OR1: Communication Task

OR2: Emotions Task
OR3: Picture Task
OR4: Story Task
OR5: General Presentation
Only the OR5: General Presentation can be completed for non-verbal clients.
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The materials required for OR3 and OR4 can be found in the Appendix. OR3 should be printed in colour.
Although presented as an independent section, the items can be split up and administered at any point
during the assessment. This means that the assessor can take advantage of an opportunity that may
naturally present in the flow of the assessment rather than commencing the section independently,
which may cause anxiety.
The recording process requires that, for each item, the assessor rates a qualitative description of any
observed difficulty and/or the client’s response in the sections provided. Based on their clinical
judgement and bearing in mind the age, developmental level and/or expressive language level of the
client, the assessor is invited to consider and rate the level of difficulty, insight or understanding. These
ratings aim to guide the assessor to reflect on the client’s response and to categorise it from a
subjective clinical perspective (as opposed to any objectively imposed criteria that has been obtained
from empirical research). Guidance for each observational record item and its corresponding rating can
be found below.
If a discrepancy arises between information given during the interview and the observed behaviour,
priority should be given to observed difficulties (even if these are not reported or played down by
informants). However, in the reverse situation (if difficulties are reported by informants but not
observed), the assessor should prioritise the informant account if they are able to provide supporting
examples.
OR1: Communication Task
OR1 aims to assess social communication and conversation style, noting reciprocity and use of gesture,
based on objective observation by the assessor. The record is based on what is directly observed (i.e.
not based on the report of others). The assessor is guided to record a qualitative description of any
observed difficulty in the following categories:
 General level and style of language (intonation, volume, rhythm, rate, hyper-formality)
 Conversation flow (spontaneity, reciprocal social interchange, domination)
 General direction of conversation (initiation of topics, building on topic, switching topic, excessive
interest in a topic, flexibility within conversation)
 Unusual use of language (stereotyped/idiosyncratic use of words, echolalia, neologisms)
 Non-verbal communication (spontaneous emphasis, gesture, eye contact, smiling, gesture/speech
integration)
OR1 may be administered at any point during the assessment if an unstructured interaction has
occurred that has extended beyond a general social greeting or overture. The conversation should not
be limited to a general (and often rehearsed) social interchange (i.e. ‘how are you today?’, discussion
about the weather, how they got to the appointment and questions about the journey). This may be a
good ‘icebreaker’ when first meeting but a simple ‘question and answer’ format is not going to provide
the opportunity to meaningfully observe social communication difficulties. Indeed, many people with
ASD are able to engage in a brief and/or superficial social interchange of this nature.
Difficulties may not be observed until a conversation advances in duration and complexity. This may be
achieved by introducing various age-appropriate topics (e.g. talking about pets, plans to move house,
academic subjects the client liked/didn’t like at school, public speaking, holiday plans), intentionally
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interrupting the client, offering an alternative opinion, as well as deliberately switching topics in the
course of the conversation. The aim is to assess the extent to which the client can be flexible and
adaptive in their response.
If there is no opportunity to integrate OR1 into the interview and it is administered independently (e.g.
at a separate meeting with the client), the assessor should introduce and structure a conversation as
described above, taking care that this does not seem unnatural and stilted. It might be helpful to go
back to the OR1 task after OR5 has been completed (and when the assessor has had the opportunity to
further observe and discern difficulties). In this case, the assessor may wish to review the OR1
qualitative notes and ratings awarded. It may also be helpful for the assessor to note their observations
as a passive observer of the client’s interaction with others, should an appropriate opportunity arise.
The assessor should note in the record whether OR1 has been completed from observations made from
(1) an unstructured interaction/conversation that arose in the course of the appointment/interview
(but drawing on the guidance provided); (2) a more structured ‘stand alone’ interaction/conversation;
and/or (3) an observation of the client’s interaction/conversation with others. In the latter case, the
assessor is not a participant in the conversation and the assessor should record the context of the
observation by noting the situation and persons present. The duration of the interaction/conversation
should also be recorded.
Aside from making qualitative notes, based on their clinical judgement and bearing in mind the age,
developmental level and/or expressive language level of the client, the assessor is invited to consider
and circle the overall level of difficulty from four options (no difficulty, some/limited difficulty, difficulty,
marked difficulty). To assist in differentiating between the ratings the following guidance is provided:
 No Difficulty – at least typical and consistent for developmental age (functioning that is advanced
for developmental age should also be included in this rating).
 Some/Limited Difficulty – despite some difficulties being present, the client is able to apply and
communicate the element adequately.
 Difficulty – some difficulties are present but the client struggles to apply and communicate the
element adequately.
 Marked Difficulty – atypical and not consistent for developmental age.
OR2: Emotions Task
OR2 aims to define and establish insight into how emotions may relate to social behaviour and/or
consequences. The client is asked to describe a time they felt happy, sad, angry, sorry, excited, worried,
guilty and surprised. The client should be allowed sufficient time to respond but if they do not respond
and/or they appear to struggle with the task, the assessor can give an example prompt (selecting the
prompt for the respective emotion) as follows:
 I felt happy on Saturday because I went skating with my friend

 I felt sad when my sister fell off her bike and broke her leg
 I felt angry when a teacher told me off at school
 I felt sorry after I said nasty things to a friend
 I felt excited when I saw all of my Birthday presents
 I felt worried when I thought I lost my mum in the store
[12]
 I felt guilty when I sat on my friend’s glasses and they broke
 I was surprised when my dad came home early from work
The assessor records whether an example prompt was given, or not. If it is, the client should be guided
to give a response of their own, rather than repeating or making a minor adaptation to the example
prompt given by the assessor. It is important the assessor enquires why the client associated the
emotion with the event or situation in order to ensure their understanding of the concept. The assessor
makes a verbatim note of the response for each emotion together with any observations of non-verbal
communication (intonation, facial expression). If the client appears to be making an effort but is unable
to attempt the task, or if there is a clear refusal and/or disengagement from the task, this should be
recorded.
and circle the overall level of insight displayed from four options (good insight, some/limited insight,
poor insight, inability/refusal to attempt task). To assist in differentiating between the ratings the
following guidance is provided:
 Good Insight – no prompt required, an appropriate response is given, and a clear rationale is
provided for why the client experienced the target emotion.
 Some/Limited Insight – required prompting (i.e. an example given), following which an
appropriate response is given which markedly differs from the prompt and with a clear rationale
for why the client experienced the target emotion.
 Poor Insight – client provided an inappropriate response and/or an unclear rationale for why the
client experienced the target emotion, regardless of whether a prompt was provided.
 Inability/Refusal to Attempt Task – the client is unable to produce a response at all (despite
prompting) or refuses to attempt task.
OR3: Picture Task
OR3 aims to (1) assess items of interest to the client and (2) assess the client’s ability to understand and
interpret social situations. The OR3 task sheet can be found in the appendix and should be printed in
colour in advance of the interview.
This is a picture of a ‘fancy dress’ birthday party. Seven children are present. One is dressed as an
astronaut; this is the birthday girl and she is wearing a birthday badge indicating she is 7 years old. The
other children are dressed as a wizard, a pirate, a karate kid, a woodland character, and a clown. One
child is not wearing fancy dress and one female adult is present. The clown is wearing the wrong hat; he
is wearing a king’s crown.
The people in the picture are standing in groups. Three children are talking together; they are playing a
game ‘pin the tail on the donkey’ with the karate kid, who is blindfolded. He is pinning the tail in the
wrong place. In the middle of the room a child is sitting on a rug playing alone with a train. He is not
wearing fancy dress. He is sitting with his hands over his ears. In the corner of the room an adult is
looking angrily at two children (the woodland character and the clown) who are fighting. One of them
has chocolate on his hand (and there is a chocolate handprint on the wall next to him). There is a
chocolate birthday cake on a table with a piece missing. There are only six candles on the cake (the
[13]
birthday girl is 7 years old) and one of them isn’t alight. There are birthday presents in gift wrapping in
the room.
A fish and several animals feature in the picture. There is a fish swimming in a fishbowl on the table.
There is also a cat on the table who is watching the fish. The fish seems aware of the cat’s interest. A
giraffe and squirrel are outside looking in through the window at the party. There is a spider near the
ceiling in the corner, by a crack in the wall. There are five decorative ducks in the picture, two to the left
of the window and three to the right. There is a picture of a donkey on an easel for the ‘pin the tail on
the donkey’ game.
The décor in the room includes things that are ‘odd’, misaligned or lopsided and/or that can be
counted. This includes a picture on the wall of an elderly man; the picture is not hanging straight. The
wallpaper has countable patterns but with irregularities. The curtains hanging around the window are
different lengths on each side. The flowers on the table are all the same (yellow with four petals) with
the exception of one, which is red and has eight petals. The wall clock is lopsided and shows the time to
be 3.22pm and 50 seconds. The digital clock that is diagonally opposite, on the table, is faster; the time
is 15:25 (i.e. 3.25pm). It is ‘odd’ to have a giraffe in the garden looking through the window. Some
earphones are dangling from the ceiling. There are three balloons in the picture, each differing in their
colour, size and/or pattern.
The assessor places the picture in front of the client. The assessor directs the client to look at the
picture and asks the client to tell them what they notice about it. The assessor should not direct the
client’s attention towards specific parts of the picture (either verbally or by pointing). A space is
provided for the assessor to qualitatively record the client’s response. If the client does not respond
verbally, the assessor may give general prompts (What are you looking at? What are you thinking?
What are you doing? What do you find interesting? Is there anything that bothers you?). In some cases
the assessor may notice that the client is engaged in some kind of activity (e.g. counting items, staring
at a particular part of the picture), in which case the assessor should prompt the client to tell them what
it is they are doing or what has taken their interest. Supplementary information from non-verbal
responses and observations should also be recorded.
Following this, the assessor is guided to give specific prompts to assess the client’s understanding of the
social groupings, context, activities, and their ability to take the perspective of others. The assessor may
use both specific verbal and visual prompts (such as pointing) for these sections. If the client does not
spontaneously attempt to identify the thoughts and feelings of others (including the animals), the
assessor should give prompts by pointing to specific people/animals in the picture and asking how they
feel and why. For each category, the assessor records a qualitative description of any observed
difficulties in the client’s comprehension of the setting, the social groupings, and their ability to take the
perspective of others (e.g. their thoughts and feelings). If the client appears to be making an effort but
is unable to attempt the task, or if there is a clear refusal and/or disengagement from the task, this
should be recorded.
and circle the level of social understanding displayed from four options (good understanding,
some/limited understanding, poor understanding, inability/refusal to attempt task). To assist in
differentiating between the ratings the following guidance is provided:
[14]
 Good Understanding – at least typical and consistent for developmental age (functioning that is
advanced for developmental age should also be included in this rating).
 Some/Limited Understanding – an incomplete understanding of the item, even with prompting
(e.g. an understanding of some, but not all, aspects of the item).
 Poor Understanding – despite being given multiple prompts, the client displays only a basic
and/or superficial understanding of the item.
 Inability/Refusal to Attempt Task – the client is unable to produce responses at all (despite
prompting) or refuses to attempt task.
OR4: Story Task
OR4 aims to assess the client’s ability to spontaneously engage in an activity that requires imagination
and creativity. The OR4 task sheet contains images of an apple, a question mark, a cat, a tree and a
triangle. The OR4 task sheet can be found in the appendix and should be printed in advance of the
interview.
The assessor should place the task sheet in front of the client and ask them to make up a story that
incorporates each of the five items and tell the assessor when they are finished. If the client seems
unsure how to proceed, the assessor may give the client some encouragement to get started by
discussing the items with them (e.g. what is this, what is it used for, where might you see it?) before
repeating the instructions. However the assessor should not guide or lead the client by selecting the
first or any other items in the task to generate a sequential imaginative story. Furthermore, the assessor
should not model the procedure by providing an example story.
If the client completes the task having omitted one or more of the items the assessor may remind the
client to include all five items in the story, but this prompt should only be given once.
The assessor makes a verbatim note of the client’s story. For example (not to be read out to the client):
“a cat runs up a tree and an apple falls from the tree into a hole shaped like a triangle in the ground.
The cat is curious (the question mark) and wonders where the apple’s gone”.
The items can be incorporated into the story in any order and the items do not have to be specifically
named but it must be clear when they are including each item. The client may choose to point out items
instead of naming them, for example, the client might state the apple fell into a hole in the ground and
indicate the triangle is the hole by pointing at it.
Aside from the story content, the assessor notes whether a prompt had to be given to include all five
items and records the number of items included in the story before and after the prompt (if this is
given). If the client appears to be making an effort but is unable to attempt the task, or if there is a clear
refusal and/or disengagement from the task, this should be recorded.
and circle the overall level of imaginative effort from four options (spontaneous creativity/imagination,
good creativity/imagination, some/limited creativity/imagination, or inability/refusal to attempt task).
To do this, there are three aspects to be considered:
[15]
A. The number of items used to create the story.
B. The client’s use of abstraction from the ‘triangle’ and ‘question mark’ items (if used). Have these
been applied to the story in a literal or a non-literal manner? Examples of abstract application are
the ‘triangle’ being used to represent a mountain, rocket, hat, person, piece of cheese. For the
‘question mark’ these might be a snake, river, necklace, earring, coat hanger. The question mark
might also be used abstractly to represent a cognitive or emotional state (e.g. thinking, pondering,
curious, confused). An example of literal use of these items might be the inclusion of a picture or
card with a ‘triangle’ or ‘question mark’ in the story. In the previous example this might be ‘the
apple fell onto a card on the ground that had the shape of a triangle on it’.
C. The narrative generated by the client. To what extent has the client provided a ‘rich’ story that
links some or all of the items together? Even if the client has not incorporated all of the items and
those that have been used have been incorporated in a literal way, the client may have generated
a creative story that involves a level of complexity and imaginative material.
To assist in differentiating between the ratings the following guidance is provided:
 Spontaneous Creativity/Imagination – credit for each of the following three aspects (A, B and C):
A. Number of items: without prompting, the client generated a story incorporating all of the items
B. Abstraction: abstract use of at least one of the ‘triangle’ and ‘question mark’ items
C. Narrative: an imaginative and creative story was generated
 Good Creativity/Imagination – credit for two of the three aspects (A, B or C):
A. Number of items: with prompting, the client generated a story incorporating all of the items
B. Abstraction: abstract use of at least one of the ‘triangle’ and ‘question mark’ items
 Some/Limited Creativity/Imagination – credit for one of the three aspects (A, B or C):
A. Number of items: the client is able to produce a story using some, but not all of the items (even
with prompting)
B. Abstraction: no abstract use the ‘triangle’ and ‘question mark’ items but the client used one or
both of the two items literally (if used)
 Inability/Refusal to Attempt Task - the client is unable to produce a story at all (despite
prompting) or refuses to attempt task
OR5 is a qualitative record of behaviours that the assessor has observed in the course of the DASI
assessment. OR5 can be completed for both verbal and non-verbal clients, noting observations relating
to complex mannerisms (hand/finger movements, flapping); intense interest, dislike or reference to
sensory stimuli; compulsions and/or ritualised behaviours; excessive interest or preoccupation with
unusual or highly specific topics, objects or repetitive behaviours; and self-injurious behaviour. There is
a category called ‘other’ where the assessor might capture atypical and/or other difficulties that were
noted during the assessment (such as rigid thinking patterns, hyperactivity, oppositional behaviours).
OR5 is a qualitative record only, and no ratings are made for these observations.
Observational Record Summary

The Observational Record Summary is a section where the assessor copies across the ratings awarded
for OR1, OR2, OR3 and OR4 of the observational record. A notes box is provided at the end where the
[16]
assessor can summarise pertinent observations from OR5 (which has no ratings). The Observational
Record Summary will support the assessor to reflect upon the pattern of difficulties across the domains
that have been objectively assessed.
Scoring
The scoring section is organised under Criterion 1, Criterion 2, Diagnosis and Notes.
For ease of scoring, the assessor should transfer the rating for each symptom to the corresponding
boxes on the scoring sheets. The assessor then records whether the required number of symptoms
have been endorsed (Yes) or not endorsed (No). Endorsement (Yes) is achieved if at least 1 item per
category has been rated as ‘present’ or ‘partially present with impairment’.
For Criterion 1, the assessor records (a) if all three categories of Criterion 1 have been endorsed, (b) if
they present across multiple settings and contexts and (c) are not better accounted for by general
developmental delays.
For Criterion 2, the assessor records (a) if at least two out of the four categories of Criterion 2 have
been endorsed, (b) if they are present across multiple settings and contexts and (c) are not better
accounted for by general developmental delays.
Assessors are guided to consider whether the client has a diagnosis of ASD by completing the Diagnosis
section. This asks them to record in a Yes/No format:
A. Whether all three categories of Criterion 1 have been endorsed (Yes) across multiple settings and
not better accounted for by general developmental delay (as shown on the Criterion 1 scoring
sheet)
B. Whether at least two of the four categories of Criterion 2 have been endorsed (Yes) across
multiple settings and not better accounted for by general developmental delay (as shown on the
Criterion 2 scoring sheet)
C. Whether symptoms have been present since early childhood.
D. Whether symptoms cause clinically significant impairment in social, occupational or other
important areas of functioning.
A diagnosis of ASD is present if each of the above (i.e. A, B, C and D) are all endorsed (Yes). A diagnosis
of Social Communication Disorder is present if A, C and D are endorsed (Yes) but not B (No).
The Notes section collates further information and context for the diagnosis. The assessor is guided to
consider the presence of intellectual impairment in addition to any current language impairment. If
intellectual impairment or an uneven cognitive profile is suspected (but not known), the assessor should
consider obtaining a comprehensive intellectual assessment.
The assessor is then invited to rate the severity of the client’s presentation, determined by circling the
one level of support option that best reflects the client’s requirements (mild to moderate, substantial,
or very substantial). DSM-5 provides guidance on making this decision. Finally, a space is provided for
additional notes including the presence of possible or known comorbid conditions.
[17]
INTERVIEW - Background
Client’s name:
Date of birth: ___ /___ /___
Gender: Male Female Other - please specify:
Date of interview: ___ /___ /___
Name of assessor:
Informant's name(s):
Relationship to client:
Initial Presentation
How would you describe the client when they were a toddler/child?
Did you feel the client was different from other children in any way?
[18]
At what age did you first become concerned about the presentation of the client? ____ yrs ____mths
What specifically caused you to be concerned?
Has anyone else raised a concern about the presentation of the client? Yes* No
* If ‘Yes’:
Who raised the concern?
At what age?
What was their concern?
Early Development
Were there any complications during the pregnancy or birth of the client?
Problems during pregnancy* Problems during the birth*
Premature birth* Low birth weight (<2.5kgs or 5.5lbs)*
*Please provide further details of all those selected:
Was the client able to walk by 18 months? Yes No*
*If ‘No’: At what age was this achieved?
Was the client able to say single words by 18 months? Yes No*
[19]
Was the client able to form short sentences by 24 months?
Yes No*
(i.e. put at least 2 different words together, not simply repeating other people)
Please provide any further information about the client’s developmental milestones, including whether
any concerns were raised about these and by whom:
For children who were not meeting language milestones, how did they make their needs known?
Were any of these skills achieved but subsequently lost/declined? Yes* No
*If ‘Yes’: Please detail -
As a child, has/did the client receive speech and language therapy support? Yes* No
* If ‘Yes’:
Who referred the client?
At what age?
How often and over what time frame was the support provided?
What was the aim of the intervention?
[20]
As a child, has/did the client ever have contact with external agencies Yes* No
e.g. social and/or health services?
As a child, has/did the client have their cognitive ability assessed? Yes* No
Education and Occupation

Please provide the following information regarding the client’s education:
Dates of Age of Type of Reason for moving on

Name of school (e.g. expelled, family
attendance client school
relocation, end of schooling)
[21]
If in mainstream education, does/did the client receive extra support or
Yes* No
help at school?
Has the client left school? Yes* No
*If ‘Yes’:
At what age did they leave school?
Why did the client leave school? (i.e. reached end of compulsory education; expelled; to be
homeschooled)
For those who have left school, please detail any further education the client has undertaken (i.e.
homeschooling, college, university, vocational study, apprenticeships, other training):
Please list all qualifications and grades achieved by the client:
For those who have left school, please detail the client’s occupational history including paid/unpaid
work, number of jobs, duration of employment, reasons for a change in occupation and periods of
unemployment:
[22]
Medical History
Has the client been previously clinically diagnosed with ASD Yes* No
(including Asperger’s Syndrome)?
*If ‘Yes’: Please detail –
At what age?
Who provided the diagnosis?
Does the client have a history of any medical/psychiatric conditions? Yes* No
Is the client currently taking any medication? Yes* No
Does/has the client used alcohol or non-prescription drugs? Yes* No
*If ‘Yes’:
What substances have they used in the past?
With what frequency did they use these?
What substances do they use currently?
With what frequency do they use these?
[23]
Family and Relationships
For young people and adults, does the client currently have an Yes* No
intimate partner?
*If ‘Yes’: For how long have they been with this intimate partner?
Describe the number and quality of the client’s intimate relationships (including duration and reasons
for ending of relationships). Note whether there is a substantial age difference:
Does the client have any children? Yes* No
Do any family members (e.g. parents, children) have diagnosed or suspected neurodevelopmental
conditions such as ASD, ADHD and/or intellectual disability?
Yes – diagnosed* Yes – suspected* No
Do any family members (e.g. parents, children) have a specific learning difficulty (e.g. dyslexia,
dyscalculia, dysgraphia, processing deficits)?
Yes* No
[24]
Do any family members (e.g. parents, children) have a diagnosed or suspected psychiatric condition such
as anxiety disorder, depression, bipolar disorder or psychosis?
Yes – diagnosed* Yes – suspected* No
Notes
Please use the space below to expand upon any of the background information included here, or to
record further information you feel may be relevant:
[25]
Symptom
Symptom Ratings
Ratings
Items 1-3 relate to CRITERION 1: Persistent deficits in social-communication and social interaction
Items 4-7 relate to CRITERION 2: Restricted, repetitive patterns of behaviour, interests, or activities
Each symptom item consists of a series of questions and prompts. It may not be necessary to put every
question to the interviewee, the prompts are there solely to assist the assessor to determine whether a
symptom item is (1) absent, (2) partially present without impairment, (3) partially present with
impairment, or (4) present. It is important to enquire whether symptoms were present at a very young
age, e.g. as a toddler. Please refer to the DASI Administration section for further details. When
conducting the interview bear in mind and/or note the following points:
 Onset: When did this symptom first appear? Symptoms are typically recognised by 24 months,
but may be earlier if developmental delays are severe or later if symptom presentation is more
subtle. In some cases there may be a loss of skills (typically between 12 and 24 months) which
may be a gradual or rapid deterioration in social behaviours and/or language skills. In some cases
loss of skills may be transient.
 Persistence: Has the symptom persisted over time? Does/did it occur more frequently than
that typically expected for the child’s age and development level? Note, the symptom may persist
but change in nature or character.
 Pervasiveness: Does/did the symptom present in more than one context (e.g.
school/occupation, home and leisure activities)?
 Developmental Difference: Does/did the client differ from other children of the same
age? In what way? Do/did other people make comments about this?
 Impairment: To what extent (1) does this symptom impair the client’s current functioning and
(2) did it impair the client’s functioning and development as a toddler/child? Note that initially,
symptoms may not appear to cause impairment. For example a young child may play alone for
long periods of time which, although not typical behaviour, may not have been perceived as
problematic or impairing at that time.
 Masking: In childhood, to what extent are/have symptoms been masked by accommodations

made by the family and/or others in order to minimise disruption to family life or everyday
activities? In later years, to what extent are symptoms masked by learned strategies (sometimes
symptoms may be camouflaged for a limited duration in certain settings or situations)?
 Severity: Consider the level of support required to accommodate impairments associated with
Criterion 1 and Criterion 2 symptoms (i.e. requiring support, substantial support or very
substantial support).
[26]
1a. Abnormal social approach
 Does the client’s approach to others differ from that of their peers?
 What is the purpose or quality of the client’s approach to others? Is it solely motivated to meet a
specific need (to get something or find out something) or is it motivated to initiate a social
interaction?
 As a toddler/child, how does/did the client behave if you are/were in a waiting room at the
doctor or dentist? What if other children are/were there?
 Does the client respect the personal boundaries of others (e.g. barging into bedrooms
unannounced, taking/using items that belong to others, invading personal space)?
 Would you describe the client as being socially naïve?
 Would you describe the client as being socially disinhibited (in the way they approach others
socially)?
As a toddler/child does/did the client differ from other children of the same age? As a child, do/did
other people (e.g. teachers, peers, fellow parents) make comments about the client?
How do/did these characteristics impact on daily activities? Are/were accommodations made to reduce
disruption to family life? Does/did the client use camouflaging or strategies to mask their symptoms?
[27]
How do/did these characteristics manifest at home and outside of the home (i.e. school, occupation,
leisure activities)?
How do these characteristics currently cause concern or impairment?
1a. Absent
Partially present
without impairment
Partially present
with impairment
Present
[28]
1b. Initiation of social interactions and response to those of others
 Does the client initiate social interactions of any kind (i.e. not just verbal) with adults, children,
friends, family, acquaintances, strangers?
 Does the client respond to social interactions of any kind (i.e. not just verbal) with adults,
children, friends, family, acquaintances, strangers?
 Does the client repeatedly make inappropriate ‘embarrassing’ statements or ask inappropriate
questions? Is the client ever cheeky or rude to people?
 Does the client realise the social impact of his/her comments or behaviour?
 For non-verbal clients this item might involve attempts to initiate/respond to social contact
through use of eye gaze, facial expressions, gestures and sounds/vocalisations
[29]
1b. Absent
Partially present
without impairment
Partially present
with impairment
Present
[30]
Engagement in two-way conversations
1c. (N.B. not applicable for non-verbal clients)
 What is the purpose of the client’s speech? What proportion of their speech is to make a request
or get their needs met? What proportion is to be social/chatty?
 If you said nothing to the client, would he/she make conversation?
 Can the client maintain a conversation by taking turns in speaking? Does the client wait for a
person to respond?
 Can the client sustain a conversation by building on other people’s comments?
 When making conversation, is it one-sided? Does the client dominate the conversation?
 Does the client respond to social cues (indicating someone is busy or trying to close down a
conversation)?
 Can the client have a conversation about topics you or others have introduced (unrelated to
special interests of their own)?
 How do people outside of the family experience conversations with the client? Do they report a
sense of unease or that they do not fully understand what is being communicated?
[31]
1c. Absent
Partially present
without impairment
Partially present
with impairment
Present
[32]
1d. Sharing of interests, emotions and/or affect
 How does the client express their feelings and emotions?

 If the client is watching something wondrous (magician, fireworks) will the client turn to you to
share this wonder/excitement?
 Does the client spontaneously draw attention to things of interest (e.g. when on a journey,
YouTube clips, TV shows)?
 Does the client keep things to him/herself unless explicitly asked about something?
 Does the client show favourite objects (e.g. toys, hobby items) without being prompted to do so?
 How does the client respond to another person’s distress or discomfort?
 Would the client ask why they are distressed (e.g. crying, angry)? Would the client understand the
emotion being expressed and what might have caused this?
 Does the client spontaneously give comfort to others (verbal expression of concern, and/or
touch/gesture)?
Failure to engage and/or limited ability

to engage in two-way conversations
[33]
1d. Absent
Partially present
without impairment
Partially present
with impairment
Present
[34]
2a. Integration of verbal and non-verbal communication
 Does the client integrate both verbal and non-verbal methods to gain your attention and/or to
communicate their needs?
 When speaking, does the client use hand movements, gestures and/or facial expressions to
communicate?
 How would you describe the client’s use of eye-contact? Does the client look at you when talking
to you? Does the client lack eye-contact, even when you are trying to catch their eye?
 Does the client seem to rest his/her eyes on the bridge of your nose or on your mouth, instead of
making eye contact?
 Does the client ever turn away from the person they are speaking to or who is speaking to them?
 If the client needs help, does the client point to something and/or come and get you as well as
communicating the need verbally?
 For non-verbal clients this item might involve integrating one or more of the following: eye
contact, gestures, facial expressions, sounds/vocalisations (rather than verbalisations)
Failure to engage and/or limited ability

to engage in two-way conversations
[35]
2a. Absent
Partially present
without impairment
Partially present
with impairment
Present
[36]
2b. Facial expressions and body language
 Does the client show a range of feelings through facial expressions (including subtle expressions
such as curiosity)?
 What makes the client excited or happy? How do you know? How does the client show feelings?
If given a present, how does the client respond?
 Does the client spontaneously use gestures when communicating, such as pointing, waving,
nodding, shaking head? Is it always a functional gesture (e.g. rub tummy to show hungry)?
 Does the client use hand or arm movements to convey emotional signals (e.g. hand over face to
convey embarrassment or shock, shrinking with fear)?
 Does the client shake his finger to indicate ‘bad’ or ‘naughty’, clapping hands to applaud or praise,
blow a kiss, finger to mouth for ‘shushhh’?
[37]
2b. Absent
Partially present
without impairment
Partially present
with impairment
Present
[38]
3a. Forming and maintaining friendships
 Does/did the client initiate friendships or does/did the client lack interest in peers? Does/did the
client want to have friends? Does/did the client prefer to be alone?
 As a toddler/child, if the client saw a group of same-age children he/she didn’t know at a
park/beach/swimming pool, what would the client do? Would the client go over and approach
them? How? What would the client do if one of them approached him/her?
 As a toddler/child did the client engage in parallel play (playing next to a child but not playing
with the child)?
 Does/did the client actively avoid interacting with peers and/or social situations? Does/did this
happen even if the client is familiar with the person and setting?
 Does/did the client have friends in school? Outside of school? How does/did the client spend
break time at school? How old are/were the client’s friends compared to the client?
 Does/did the client meet up with friends outside of school? How often? Who initiates/initiated
this? What do/did they do together?
 If the client has left school, how many friends does the client have that he/she makes an effort to
speak to or meet up with (i.e. not organised by someone else)?
 Are/were the client’s friendships circumstantial (neighbours, children of family friends, friends of
partner/housemate)?
 Are/were the client’s friendships mutual and equal in terms of reciprocity?
 Does/did the client have online friends? How many? What percentage of time does the client
interact with online friends?
[39]
3a. Absent
Partially present
without impairment
Partially present
with impairment
Present
[40]
3b. Sharing in imaginative play
 As a child, did the client organise play on his/her own without the help or direction of others?
 Does/did the client spontaneously engage in imaginative ‘pretend play’ or games as a child (e.g.
playing doctors, soldiers, teachers, dolls tea parties, space adventures, shopping)?
 Does/did the client talk to toys/dolls/stuffed animals or make them talk or make noises?
 Does/did the client play co-operatively with peers? How flexible is/was the client’s play?
 Does/did the client engage in group games and social activities such as charades or hide and seek?
 Does/did the client make up or create stories? Does/did the client do this with others and
incorporate their ideas? If so, was this spontaneous?
 Does/did the client copy the things people do but using a pretend object or toy (e.g. making tea,
mowing lawn) as part of their play? Is/was this spontaneous (i.e. not initiated or prompted by
others)?
 Does/did the client imitate other people (e.g. how they sit or walk - NOTE: not as a joke). Is/was
this spontaneous (i.e. not initiated or prompted by others)?
 Does/did the client make the effort to keep the interaction/play going?
 Does/did the client take an authoritarian role (e.g. not actually engaging in the game but creating
order and rule by bossing others around)?
[41]
3b. Absent
Partially present
without impairment
Partially present
with impairment
Present
[42]
3c. Adjusting behaviour according to social context
 Is the client’s behaviour appropriate to that expected in the setting/environment (church,

restaurant, shopping)?
 Does the client’s behaviour vary according to who is present?
 Does the client display inappropriate facial expressions?
 How does the client respond to strangers, teachers, adults, children (reserved, shy, disinhibited,
cheeky)?
 Is the client able to moderate their behaviour according to context or setting?
[43]
3c. Absent
Partially present
without impairment
Partially present
with impairment
Present
[44]
4a. Stereotyped or repetitive motor movements
 Does the client have any stereotyped behaviours, repetitive mannerisms or odd hand movements
(flapping, finger flicking, twisting)? [NOTE: not nail biting, twisting hair, sucking thumb, clapping
for applause]
 Does the client engage in repetitive complex body movements (swaying, spinning, walking on
toes, bouncing, head rolling, rocking)?
 Does this happen at particular times (anxiety, distress, anger, frustration)?
 Do these movements interfere with the client’s functioning (i.e. their ability to do things)? How?
What happens if you ask the client to stop?
[45]
4a. Absent
Partially present
without impairment
Partially present
with impairment
Present
[46]
4b. Stereotyped or repetitive use of objects
 Does the client repeatedly interact with objects in a manner that is excessive and/or unnecessary
(e.g. opening/shutting a door, flipping objects, switching lights on/off)?
 Does the client ever change or adapt these activities or are they always the same?
 As a toddler/child, did the client play with a whole toy or just a part of it (e.g. spinning the wheels
of a car rather than its intended use)?
 Does/did the client do the same thing over and over again with toys/items (e.g. by lining them up
rather than playing with them, dropping them from a distance)?
[47]
4b. Absent
Partially present
without impairment
Partially present
with impairment
Present
[48]
4c. Stereotyped or repetitive speech
 Does the client engage in a repetitive speech pattern (repeating words, sentences or questions;
talking to him/herself, giving a running commentary of what he/she is doing or thinking and
repeating the commentary)?
 Does the client ever use odd phrases or say something over and over again in exactly the same
way (other than when asking for something they want)?
 Does the client have routine phrases that he/she repeats out of context (e.g. must not pull
eyelashes)?
 Does the client repeatedly use phrases from a TV programme or from songs?
 Does the client ever use words he/she’s invented or made up (neologisms)?
 Does the client use idiosyncratic language, e.g. real words/combined phrases in an odd way to
convey specific meanings such as ‘raw toast’ for bread? [NOTE: Not as part of a game or joke and
not conventional metaphors, such as rhyming slang]
 Would someone outside the family understand what the client is communicating?
 Does the client speak in a high-pitched, sing-song, flat or robotic-like manner?
 If stereotyped speech is used, is this functional (i.e. a child saying “by gosh, I don’t even know
your name” in order to find out someone’s name)?
[49]
4c. Absent
Partially present
without impairment
Partially present
with impairment
Present
[50]
5a. Insistence on sameness and inflexible adherence to routines
 How does the client react to change? [NOTE: marked negative reaction to minor change required;
not associated with major transitions such as moving house, changing school]
 Do routines need to be consistently specific and rigidly followed (e.g. same route taken for
familiar journeys, same time each day)?
 Is the client bothered by minor changes to personal routines and arrangements (switching mittens
to gloves, long sleeves to short sleeves, bathing 15 minutes earlier/later than usual, dressing after
breakfast instead of before, where food is placed on a plate)?
 How does the client react to change in someone else’s routine (e.g. if a family member/teacher is
away or late) or to changes in another person’s appearance (e.g. if a family member has a
haircut)?
 How does the client react to items being moved (e.g. how furniture is arranged, position of
ornaments, place settings at mealtime)?
[51]
5a. Absent
Partially present
without impairment
Partially present
with impairment
Present
[52]
5b. Ritualized patterns of verbal or non-verbal behaviour
 Does the client engage in any compulsive behaviours they are compelled to repeatedly perform,
such as needing to clap hands 5 times before entering a room, checking things, hand washing?
 Must the client do things in a fixed sequence or specific order (e.g. a ritual of touching or putting
things in a specific place before leaving home or going to bed, placing cutlery and folding napkins
in a specific way before eating)?
 What happens if the client can’t complete the whole sequence and/or the client is disrupted
before it is completed? Does the client have to re-start the sequence?
 Does the client have rigid thinking patterns (e.g. can’t understand humour, irony, sarcasm)?
 Does the client engage in verbal rituals (e.g. they repeat fixed word or number sequences that
must be said in a particular order. This can also involve insistence that another person responds in
a highly specific way)? [NOTE: excludes bedtime routines to say goodnight unless they are
markedly unusual]
 What happens if the client is interrupted or you refuse to comply? Does the disruption of routine
lead to distress? How is this expressed (pacing, motor movements, flapping, tantrums)?
[53]
5b. Absent
Partially present
without impairment
Partially present
with impairment
Present
[54]
6a. Preoccupations or attachments to unusual objects
 Does the client have any unusual, narrow and/or peculiar interests in objects that intensely
preoccupy him/her that might seem odd to others (e.g. barcodes, street lamps, metal pegs, pipes,
colours, numbers)? [For each interest record age and duration of phase. NOTE: Interest should be
present for at least 3 months]
 Does the client become fixated on unusual objects (e.g. vegetables, batteries, a piece of string)?
 Does the client carry these objects around with him/her until a new object attachment is formed?
 What percentage of time does/did the client spend on these objects/interests, including talking
about them (0-100%)?
[55]
6a. Absent
Partially present
without impairment
Partially present
with impairment
Present
[56]
6b. Restricted or perseverative interests
 Has the client gone through phases when he/she had a special interest or hobby that was unusual
in intensity? [NOTE: Not solely a collection – it must involve a strong interest or preoccupation
that is present for at least 3 months. For each interest, record age, duration of phase and level of
intensity (0–100%)]
 How did the client show that they were interested in this topic/hobby?
 What percentage of time does/did the client spend on these interests, including talking about
them (0 – 100%)?
 Does/did the client collect items associated with the interest? What does/did the client do with
these items? Were they kept in boxes? Does/did the client catalogue items and/or associated
information?
 Does/did the client undertake research about the special interest (e.g. internet searches on the
history/associated facts, making detailed notes, logging information/timetables)?
 Does/did the client actively seek out these interests, even when they are absent (e.g. internet
search) or is the client just interested in them when he/she sees them?
 When the client has moved onto a new interest, what did he/she do with items and paraphernalia
relating to these interests?
[57]
6b. Absent
Partially present
without impairment
Partially present
with impairment
Present
[58]
7a. Unusual response to pain or changes in temperature
 Does the client show an unusual response to pain (e.g. a high or very low tolerance to pain)?
 Is the client unaware if he/she has cut themself (e.g. when falling over)?
 Does the client engage in self-injurious behaviour (head banging, eye poking, scratching, biting)?
 Does the client show an unusual response to changes in temperature (e.g. a high or very low
tolerance for heat/cold, wearing multiple layers of clothing on a hot day)?
 How does the client respond (e.g. crying, tantrums, indifference)?
 Does the client seek out comfort?
[59]
7a. Absent
Partially present
without impairment
Partially present
with impairment
Present
[60]
7b. Unusual response to specific sounds
 Does the client show an intense aversion or fascination for certain ordinary sounds (e.g.
ringtones, household appliances, traffic noise)? [NOTE: excludes reaction to sudden, harsh
unexpected noise, startle or fearful reaction].
 How does the client respond (e.g. screaming, covering their ears, tantrums)?
 Is the response predictable?
[61]
7b. Absent
Partially present
without impairment
Partially present
with impairment
Present
[62]
7c. Unusual response to specific textures, tastes and/or smells
 Does the client show an intense aversion or fascination for the texture of some items (e.g.
stroking velvet, wood, bristles rubber, silk, sand, earth, chalk)?
 Does the client touch things with their lips to see how they feel or taste?
 Does the client inspect some items closely by licking or smelling them inappropriately?
 How does the client respond, e.g. does he/she refuse foods due to their smell or texture?
[63]
7c. Absent
Partially present
without impairment
Partially present
with impairment
Present
[64]
7d. Unusual response to lights or movement
 Does the client seem to look at or stare at some things for a long time?
 Have you noticed the client watching things out of the corner of his/her eye, or by squinting?
 Does the client show an intense aversion or fascination for visual stimuli such as lights (street
lights, car headlights, chandeliers)?
 Does the client show an intense aversion or fascination for moving objects (e.g. appears
transfixed by spinning fans, wheels on toys)?
 Does the client appear to have an intense aversion or fascination for opening and closing doors,
switching lights on/off or watching dust particles?
 How does the client respond?
[65]
7d. Absent
Partially present
without impairment
Partially present
with impairment
Present
[66]
Common differential and co-existing conditions are presented below. The assessor should consider each
in turn and decide whether it is a primary (i.e. differential diagnosis) or secondary (i.e. co-existing)
condition. It is important to establish whether the presenting problem is chronic or whether it has a
recent onset. When applying ICD-10 criteria, note that this classification system does not recognise
comorbid conditions. It is recommended that the assessor DOES NOT disclose (as labelled) the disorder
being discussed. Preferably, the assessor should lead with general questions that relate to the condition
before focusing on specific symptoms. In the scoring section, known or suspected inherited or acquired
conditions should be noted.
Cognitive and Learning Impairments

Is there evidence of generalised intellectual disability or specific learning difficulties such as reading,
writing or arithmetic difficulties?
Notes:
Previously Further investigation

Yes No Yes No
diagnosed: required:
Speech and Language Impairments

Is there evidence of specific expressive and receptive language delay?
Notes:

Yes No Yes No
[67]
Attention Deficit Hyperactivity Disorder
Is there evidence of problems with sustaining attention, poor impulse control and hyperactive
behaviour (in adults hyperactive behaviour may present more as inner restlessness)?
Notes:

Yes No Yes No
Tics Disorder (Including Tourette’s)

Is there evidence of motor and/or vocal tics?
Notes:

Yes No Yes No
Other Developmental Disorders

Is there evidence of gross motor or fine motor developmental difficulties?
Notes:

Yes No Yes No
[68]
Oppositional Defiant Disorder or Conduct Disorder
In childhood, is there evidence of oppositional behaviour and refusal to comply with authority, or more
serious antisocial behaviours?
Notes:

Yes No Yes No
Excessive Irritability (Including Disruptive Mood Dysregulation Disorder)

In childhood, is there evidence of excessive irritability and/or anger, either in intensity, frequency,
and/or ease of provocation?
Notes:

Yes No Yes No
Emotional Instability/Dysregulation
In adulthood, is there evidence of changeable and volatile mood including anger, frustration and
irritability?
Notes:

Yes No Yes No
[69]
Substance Misuse
Is there evidence of the client using or misusing substances including alcohol, cigarettes, prescription
medication and/or illicit drugs? (Note also the severity of and the reasons for using drugs).
Notes:

Yes No Yes No
Traumatic Brain Injury

Is there evidence of a history of severe head trauma or recurrent head injuries (e.g. falls, sport
accidents, motor vehicle related injuries)? Note any loss of consciousness.
Notes:

Yes No Yes No
Anxiety Disorders
Is there evidence of phobia, panic, social and/or generalised anxiety?
Notes:

Yes No Yes No
[70]
Obsessive Compulsive Disorder
Is there evidence of obsessions, compulsions or other ritualistic or stereotyped behaviour?
Notes:

Yes No Yes No
Post-Traumatic Stress Disorder

Has the client experienced any significant physical, sexual or emotional trauma?
Notes:

Yes No Yes No
Depression
Is there evidence of low mood, negative thinking, low self-esteem, fluctuating mood, and irritability?
(Note if there has ever been suicidal ideation or behaviour).
Notes:

Yes No Yes No
[71]
Bipolar Disorder
Is there evidence of an episodic disorder, including mania or hypomania?
Notes:

Yes No Yes No
Psychosis
Is there evidence of thought disorder, delusions or hallucinations?
Notes:

Yes No Yes No
Personality Disorders
Is there evidence of social and behavioural problems that may indicate a personality disorder (such as
antisocial or borderline disorders)?
Notes:

Yes No Yes No
[72]
Other Mental Health Problems
Does the client have any other mental health problems (e.g. eating disorder, sleep-wake disorders)?
Notes:

Yes No Yes No
Other Medical Conditions

Does the client have any other diagnoses or suspected inherited or acquired conditions (e.g. Rett
syndrome, Fragile X syndrome, Downs syndrome, epilepsy, fetal valproate syndrome, fetal alcohol
syndrome)?
Notes:

Yes No Yes No
[73]
Observational Record
Detailed guidance on the administration of the Observational Record is provided in the DASI
Administration section.
The materials to administer the OR3: Picture Task and the OR4: Story Task can be located in the
Appendix of this document.
It is essential that the OR3: Picture Task is printed in colour.
Only the OR5: General Presentation can be completed for non-verbal clients.
The assessor records a qualitative description of any observed difficulty in the sections provided. Based
on their clinical judgement and bearing in mind the age, developmental level and/or expressive
language level of the client, the assessor is invited to consider and rate the client’s functioning from one
of four options.
OR5 is a qualitative record only, and no ratings are made for these observations.
[74]
OR1 Communication Task
Interaction/Conversational style observed from (tick the method applied and note duration):
Unstructured interaction/conversation with the assessor during appointment/interview
Duration: ___ hours ___ minutes
Structured ‘stand alone’ interaction/conversation with the assessor
Observation of interaction/conversation with other(s)
Details of situation and person(s) present:
Circle the client’s difficulty for each communication element below and provide details/examples
(see DASI Administration for guidance):
Some/
General level and style of language No
Limited Difficulty
Marked
(intonation, volume, rhythm, rate, hyper-formality) Difficulty Difficulty
Difficulty
If any difficulty is present, please detail:
Some/
Conversation flow No
Limited Difficulty
Marked
(spontaneity, reciprocal social interchange, domination) Difficulty Difficulty
Difficulty
[75]
Circle the client’s difficulty for each communication element below and provide details/examples
General direction of conversation No

Some/
Marked
(initiation of topics, building on topic, switching topic, Limited Difficulty
Difficulty Difficulty
excessive interest in a topic, flexibility within conversation) Difficulty
Unusual use of language No

Some/
Marked
(stereotyped/idiosyncratic use of words, echolalia, Limited Difficulty
neologisms) Difficulty
Non-verbal communication No
Some/
Marked
(spontaneous emphasis, gesture, eye contact, smiling, Limited Difficulty
gesture/speech integration) Difficulty
[76]
OR2 Emotions Task
Tell me about a time when you felt ….. ?

Record verbatim response and circle the client’s level of insight for each emotion (see DASI Administration for guidance):
Some/ Inability/Refusal
Happy Good Insight
Limited Insight
Poor Insight
to Attempt Task
Detail response:
Why?
Unable to attempt? No Yes
Prompt given? No Yes Refusal to attempt? No Yes
Sad Good Insight
Limited Insight
Poor Insight
to Attempt Task
Detail response:
Why?
Angry Good Insight
Limited Insight
Poor Insight
to Attempt Task
Detail response:
Why?
Sorry Good Insight
Limited Insight
Poor Insight
to Attempt Task
Detail response:
Why?
[77]
Tell me about a time when you felt ….. ?
Record verbatim response and circle the client’s level of insight for each emotion (see DASI Administration for guidance):
Excited Good Insight
Limited Insight
Poor Insight
to Attempt Task
Detail response:
Why?
Worried Good Insight
Limited Insight
Poor Insight
to Attempt Task
Detail response:
Why?
Guilty Good Insight
Limited Insight
Poor Insight
to Attempt Task
Detail response:
Why?
Surprised Good Insight
Limited Insight
Poor Insight
to Attempt Task
Detail response:
Why?
No Yes Unable to attempt? No Yes
Prompt given? No No Yes Yes Refusal to

Noattempt?
Yes No Yes
[78]
OR3 Picture Task
Look at the picture. Tell me what you notice about it? (Do not draw attention towards specific parts of the
picture, either verbally or by pointing. If the client does not verbally respond, general prompts may be given, as guided
in the DASI Administration). Record their description of the picture and specify areas of particular interest or dislike.
What do you think is happening here? (Prompt: Specifically ask about the social groupings, the context, and
the activities occurring in the picture. Assessor may use verbal and visual prompts, such as pointing). Record their
response.
If the client has not spontaneously attempted to identify the thoughts and feelings of others, prompt:
How do you think this person feels? Why? What might this person be thinking? What about the
animals? (Assessor may use verbal and visual prompts, such as pointing). Record their response.
[79]
For each of the categories below, circle the client’s level of understanding and provide details
Good Some/Limited Poor Inability/Refusal

General understanding of setting Understanding Understanding Understanding to Attempt Task
Refusal to attempt? No Yes
Understanding of social Good Some/Limited Poor Inability/Refusal

groupings Understanding Understanding Understanding to Attempt Task
Understanding what others

might be thinking and feeling Understanding Understanding Understanding to Attempt Task
(social-perspective taking)
[80]
OR4 Story Task
Look at these 5 items. There is an apple, a triangle, a tree, a cat face, and a question mark. Make
up a story using all five of these items. (Record their story verbatim)
How many items did the client include in their story without prompting?
Did the client require a prompt to use all five items in their story? No Yes*
* Total number of items used after prompting?
Did the client seem unable to complete the task? No Yes
Did the client refuse to engage in the task? No Yes
From the story, circle the client’s level of creativity/imagination

Spontaneous Good Some/Limited

Inability/Refusal
Creativity/ Creativity/ Creativity/
to Attempt Task
Imagination Imagination Imagination
[81]
OR5 General Presentation
Please make qualitative notes relating to the following observed behaviours in the course of the
interview/assessment (there are no ratings for OR5):
Complex mannerisms: (hand/finger movements, flapping)
Intense interest, dislike, or reference to, sensory stimuli:
Compulsions and/or ritualised behaviours:
Excessive interest or preoccupation with unusual or highly specific topics, objects or repetitive
behaviours:
Self-injurious behaviour:
Other: (may include verbal observations, such as rigid thinking patterns)
[82]
Observational Record Summary
Some/Limited
OR1: Communication Task No Difficulty
Difficulty
Difficulty Marked Difficulty
General level and style of language

Conversation flow
General direction of conversation
Unusual use of language
Non-verbal communication
Some/Limited Inability/Refusal
OR2: Emotions Task Good Insight
Insight
Poor Insight
to Attempt Task
Happy
Sad
Angry
Sorry
Excited
Worried
Guilty
Surprised

OR3: Picture Task Understanding Understanding Understanding to Attempt Task
General understanding of setting
Understanding of social groupings
Understanding what other may be
thinking and feeling
Spontaneous Good Some/Limited

OR4: Story Task Creativity/ Creativity/ Creativity/
Inability/Refusal
to Attempt Task
Imagination Imagination Imagination
Imaginative effort

Notes: (Summary of observed behaviours)
[83]
Scoring
CRITERION 1 - Persistent deficits in social-communication and social interaction

1. Partially present Partially present
Absent Present
Are persistent deficits in social-emotional without impairment with impairment
reciprocity endorsed by at least 1 item 1a.
rated as ‘present’ or ‘partially present with 1b.
impairment’?
1c.*
Yes No
1d.
* not applicable for non-verbal clients
2.
Are persistent deficits in non-verbal Partially present Partially present
Absent Present
without impairment with impairment
communicative behaviours used for social
interaction endorsed by at least 1 item 2a.
rated as ‘present’ or ‘partially present with
impairment’? 2b.
Yes No
3.
Partially present Partially present
Are persistent deficits in the ability to Absent Present
develop, maintain and understand
relationships endorsed by at least 1 item 3a.
rated as ‘present’ or ‘partially present with
3b.
impairment’?
3c.
Yes No
Are all 3 categories of Criterion 1 endorsed?

Yes No
(i.e. ‘Yes’ selected for items 1, 2, and 3)
Are these symptoms present across multiple settings and contexts? Yes No
Are these symptoms not better accounted for by general developmental

Yes No
delays?
[84]
CRITERION 2 - Restricted, repetitive patterns of behaviour, interests, or activities
4.
Are persistent stereotyped or repetitive Absent Present
motor movements, use of objects, or
4a.
speech, endorsed by at least 1 item rated as
‘present’ or ‘partially present with 4b.
impairment’?
4c.
Yes No
5.
Is an insistence on sameness, inflexible Partially present Partially present
Absent Present
adherence to routines, or ritualized patterns without impairment with impairment
of verbal or non-verbal behaviour endorsed 5a.
by at least 1 item rated as ‘present’ or
5b.
‘partially present with impairment’?
Yes No
6.
Are highly restricted, fixated interests that Absent Present
are abnormal in intensity or focus endorsed
6a.
by at least 1 item rated as ‘present’ or
‘partially present with impairment’? 6b.
Yes No
7. Absent
Present
Is hyper-reactivity or hypo-reactivity to
sensory input or unusual interest in sensory 7a.
aspects of the environment endorsed by at 7b.
least 1 item rated as ‘present’ or ‘partially
7c.
present with impairment’?
7d.
Yes No
Are at least 2 categories of Criterion 2 endorsed? Yes No

(i.e. ‘Yes’ selected for 2 or more of items 4, 5, 6, or 7)
Are these symptoms present across multiple settings and contexts? Yes No
Are these symptoms not better accounted for by general developmental

Yes No
delays?
[85]
DIAGNOSIS
A. Are all 3 categories of Criterion 1 endorsed across multiple settings

and not better accounted for by general developmental delay? Yes No
B. Are at least 2 categories of Criterion 2 endorsed across multiple Yes No

settings and not better accounted for by general developmental delay?
Yes No
C. Have the symptoms been present since early childhood?
D. Do the symptoms cause clinically significant impairment in social, Yes No

occupational, or other important areas of function?
ASD Diagnosis
A, B, C, and D are all endorsed (Yes)
Social Communication Disorder Diagnosis

A, C, and D are endorsed (Yes) but B is not endorsed (No)
NOTES
Is intellectual impairment present? Yes No
Is current language impairment present?

Yes No
(no intelligible speech, single words only, phrase speech)
Level of severity:
Based on the evidence gathered and your clinical judgement, please circle the level of support the
client requires:
Requires Requires Requires

mild to moderate support substantial support very substantial support
Notes (e.g. record possible or known comorbid conditions):
[86]
Assessor Notes
[87]
APPENDIX
[88]
OR3 Picture Task
The OR3: Picture Task is part of the Diagnostic Autism Spectrum Interview [DASI] (www.psychology-
services.uk.com).
It is essential that the OR3: Picture Task is printed in colour for its use as part of the DASI assessment.
Instructions for the administration of the OR3: Picture Task are provided in the DASI Administration
section.
Young, S. (2020). OR3: Picture Task. Diagnostic Autism Spectrum Interview (www.psychology-services.uk.com)
OR4 Story Task
The OR4: Story Task is part of the Diagnostic Autism Spectrum Interview [DASI] (www.psychology-
services.uk.com).
Instructions for the administration of the OR4: Story Task are provided in the DASI Administration
section.
Young, S. (2020). OR4: Story Task. Diagnostic Autism Spectrum Interview (www.psychology-services.uk.com)
Young, S. (2020). OR4: Story Task. Diagnostic Autism Spectrum Interview (www.psychology-services.uk.com)
About the Author
Professor Susan Young has a BSc Honours first class degree in Applied Psychology and Sociology from
University of Surrey, a Doctorate in Clinical Psychology from University College London and a PhD from
King’s College London. She is a Registered Psychologist (clinical and forensic) with the Health and Care
Professions Council and registered with the British Psychological Society as a Chartered Clinical
Psychologist, Chartered Forensic Psychologist and Chartered Scientist. She is a practitioner member of
the Division of Neuropsychology and an Associate Fellow of the British Psychological Society.
Susan is the director of Psychology Services Limited (http://psychology-services.uk.com/) providing

clinical and forensic psychology services and consultation, including assessment and treatment to
children, adolescents and adults with mental health and/or neurodevelopmental problems. She has
over 25 years experience working in clinical academia, including prestigious employment at the
Maudsley Hospital; Broadmoor Hospital; the Institute of Psychiatry, Psychology and Neuroscience
(King’s College London); and Imperial College London. Currently Susan has honorary contracts as a
consultant at the Maudsley Hospital and an honorary professorship at Reykjavik University.
In the NHS Susan worked at the Maudsley Hospital in their brain injury, neurodevelopmental and
clinical services. After gaining experience of working in primary, secondary and tertiary healthcare
services, Susan worked in forensic services for many years. She has worked at every level of security
(community outreach, open rehabilitation, low, medium and high secure services), in addition to
providing specialist advice and consultation at various youth and adult correctional/prison
establishments. For 11 years, Susan’s clinical academic post was as an Honorary Consultant Clinical and
Forensic Psychologist based at Broadmoor Hospital and for 4 years she was the Director of Forensic
Research and Development in the West London Mental Health Trust.
Susan has continued to be involved in international research collaborations and has over 150
publications in peer reviewed scientific journals. Susan has also written and published clinical treatment
programmes for children, adolescents and adults and these are published in six books. These
programmes are delivered in English speaking countries (including North America, Ireland, Canada,
Singapore, Australia) and translated for use in Iceland, Sweden, Norway, Denmark, China and Japan.
Susan has developed the ADHD Child Evaluation (ACE), which is translated into 20 languages, and ACE+
for use with adults, which has been translated into 12 languages at the present time (see Resources
Section for Healthcare Practitioners of her website). ACE and ACE+ have been developed in electronic
format and are available in English and Spanish (https://bgaze.com/en/ace). More recently, Susan has
launched a comprehensive clinical tool to assess autism in children, young people and adults; the
Diagnostic Autism Spectrum Interview (DASI).
Susan regularly receives requests for medio-legal assessments. Aside from civil, family and tribunal
cases, she has been engaged in over 150 legal cases referred by Defence solicitors, the Crown
Prosecution Service, Customs Prosecution Service, the Police, the Criminal Cases Review Commission,
the Home Office National Offender Management Service and directly by the Court.
[94]
www.psychology-services.uk.com

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DASI

Diagnostic Autism Spectrum Interview

Professor Susan Young

DASI is a semi-structured clinical interview designed to support healthcare practitioners in assessing

Co-existing Problems and Disorders

World Health Organization. (2016). International classification of diseases 11th ed (ICD-11).

Interviewee and Sources of Information

Prior to the Appointment

Introducing the DASI Interview

1a. Abnormal social approach

4a. Stereotyped or repetitive motor movements

Absent: This is endorsed when a symptom is determined not to be present.

Chronological and Developmental Age

Accommodations and Camouflaging

Co-existing Problems and Disorders

OR1: Communication Task

OR1: Communication Task

OR2: Emotions Task

 I felt happy on Saturday because I went skating with my friend

OR3: Picture Task

OR4: Story Task

To assist in differentiating between the ratings the following guidance is provided:

OR5: General Presentation

Observational Record Summary

Date of birth: ___ /___ /___

Gender: Male Female Other - please specify:

Date of interview: ___ /___ /___

What specifically caused you to be concerned?

Who raised the concern?

What was their concern?

Problems during pregnancy* Problems during the birth*

Premature birth* Low birth weight (<2.5kgs or 5.5lbs)*

*Please provide further details of all those selected:

Was the client able to walk by 18 months? Yes No*

*If ‘No’: At what age was this achieved?

*If ‘No’: At what age was this achieved?

*If ‘No’: At what age was this achieved?

Were any of these skills achieved but subsequently lost/declined? Yes* No

*If ‘Yes’: Please detail -

Who referred the client?

What was the aim of the intervention?

*If ‘Yes’: Please detail -

Education and Occupation

Dates of Age of Type of Reason for moving on

Has the client left school? Yes* No

At what age did they leave school?

Please list all qualifications and grades achieved by the client:

*If ‘Yes’: Please detail –

Who provided the diagnosis?

Does the client have a history of any medical/psychiatric conditions? Yes* No

*If ‘Yes’: Please detail -

Is the client currently taking any medication? Yes* No

*If ‘Yes’: Please detail -

Does/has the client used alcohol or non-prescription drugs? Yes* No

What substances have they used in the past?

With what frequency did they use these?

What substances do they use currently?

With what frequency do they use these?

Does the client have any children? Yes* No

*If ‘Yes’: Please detail -

Yes – diagnosed* Yes – suspected* No

*If ‘Yes’: Please detail -

*If ‘Yes’: Please detail -

Date of birth: _ /_ /___

Date of interview: _ /_ /___

Duration: _ hours _ minutes

Duration: _ hours _ minutes

Duration: _ hours _ minutes