Form 1.5 LOI2 QUEX-8 Parent Video-Guided Self Report (VGPR)

Neuropsychosocial Measures Formative Research Methodology Studies for the National Childrens Study (NICHD)

Attach 5 LOI2-QUEX-8 - Parent Video-Guided Self Report (VGPR)

LOI2 QUEX 8 Development and Validation of an Autism Case Confirmation Approach for Use in the National Children's Study

OMB: 0925-0661

Document [pdf]

Download: pdf | pdf

OMB#: 0925-0661
Expiration Date: 06/30/2015

Attachment 5 - LOI2-QUEX-8 - Early Detection of Autism
and Social Communication Delays

Early Detection of Autism
and Social Communication Delays
Rebecca Landa, Ph.D., CCC-SLP
Kennedy Krieger Institute
Baltimore, MD

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Send comments regarding this burden estimate or any other aspect of this collection of
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6705 Rockledge Drive, MSC 7974, Bethesda, MD 20892-7974, ATTN: PRA (0925-0661).

Patent pending
copyright Rebecca Landa

Giving Your Child the Best Opportunity for Healthy
Development.
•Purpose of this web-based questionnaire is to help parents know
if their child is developing as expected in:
•Social,
•Communication, and
•Play abilities.
•Some children who have social and communication delays have
autism.

•There are many ways to help children with
autism and social and communication
delays, especially while they are young.

What can I expect?
•Takes about 30 minutes.
•Videos of children with typical
development and children
with autism.
•Answer questions about your
child.

What is autism?
Children with autism have:
•Difficulty with the give-and-take of social interaction
•Trouble connecting with people
•Difficulty communicating their
ideas to others
•Not playing in creative ways

What is autism?
Children with autism also:
•Have strong interests in certain things
•Repeat certain behaviors over and over
•Are bothered by certain smells, sounds, sights
•Stiffen the body in unusual ways

How would I know if my child has autism?
•Unusual or absent social connection to others.
•Consistent child characteristic.
•Usually clear signs by 3 years of age.
•Watch how the children in the videos:
•Connect to others.
•Communicate with others.
•Play with toys.
•Move their bodies.
•To have autism, a child must show several signs.
•Do not have to show all the signs.
•Important to detect delays early so that you can help your
child achieve their best.
Let’s begin

Imagination and Play

Imagination and Play: Typical Development

Imagination and Play: Autism

Next, you will see some questions about your child.

Please answer them as accurately as possible.

Imagination and Play Questions:
1. My child pretends in lots of different ways with toys.

2. My child is flexible in his play, easily adding new ideas to other people’s ideas.

3. My child tries to get other people involved in his play.

Submit
copyright Rebecca Landa

4. My child joins in the play of other children his age.

5. My child plays with a wide variety of toys.

6. My child has certain toys that he likes to play with almost exclusively.

Submit
copyright Rebecca Landa

7. My child imitates movements and activities of other children in a way that helps him
connect and join in their play.

8. My child shows lots of imagination while playing, like pretending that a block is a
car or food.

Submit

Being Flexible with Toys and
Routines

Being Flexible with Toys and Routines:
Typical Development

Being Flexible with Toys and Routines:
Autism

Being Flexible with Toys and Routines Questions:
9. My child gets fixated or stuck on certain toys or things.

10. It seems like my child is more interested in the movement, light,
or sound a toy makes than in playing with the object itself.

11. My child rejects others’ attempts to join in his play unless they
join in what he is doing.

Submit
copyright Rebecca Landa

12. My child becomes upset when his routines are changed.

13. My child becomes upset when it is time to switch to a new
activity.

14. My child insists on finishing what he is doing even when it is time
to stop.

Submit

Sharing Enjoyment

Sharing Enjoyment: Typical Development

Sharing Enjoyment: Autism

Sharing Enjoyment Questions:
15. My child points using his index finger to show me what he is
interested in.

16. My child only points when he wants me to get something for
him.

17. My child makes eye contact when communicating with people.

Submit

18. I have to go out of my way to get my child to look and smile at
me, like playing tickle and chasing games.

19. When I point or look to something out of reach, my child looks there to share my interest.

Submit

Using Face and Gestures to
Communicate

Using Face and Gestures to Communicate:
Typical Development

Using Face and Gestures to Communicate:
Autism

Using Face and Gestures to Communicate:
Typical Development

Using Face and Gestures to Communicate:
Autism

Using Face and Gestures to Communicate Questions:
20. My child’s face shows lots of different emotions that are appropriate to the situation,
including surprise, guilt, disappointment, and concern.

21. My child uses gestures with her hands to communicate with other people.

22. My child uses my hand as a tool to communicate with me.

Submit
copyright Rebecca Landa

23. My child shows that he is connected with me by looking at my
eyes and smiling at the same time that he is talking to me.

24. My child shows that he shares other people’s emotions by the look on his face.

Submit

Unusual Body Movements and
Repetitive Behaviors

Unusual Body Movements and Repetitive
Behaviors: Typical Development

Unusual Body Movements and Repetitive
Behaviors: Autism

Unusual Body Movements and Repetitive Behaviors
Questions:
25. My child moves his arms, legs, hands, or body in an odd or repetitive way.

26. When my child jumps up and down, flaps or claps his hands, or makes a squealing sound, it
can last a long time.

27. My child’s speech has an unusual rhythm, either very flat or sing songy.

Submit
copyright Rebecca Landa

28. My child repeats back what other people say like a parrot or echo.
Or she repeats what she hears on the television.

29. When someone calls my child’s name, she responds by answering
or looking at the person.

Submit

Please tell your level of concern about your child’s
development:
No concern at all. I think my child is developing normally for
his or her age.

Somewhat concerned.
Concerned.
Very concerned.

Submit

You have completed the web-based questionnaire.
Thank you for answering these questions about your child.

File Type	application/pdf
File Title	Dimension 1: Social interaction and communication
Author	kobak
File Modified	2012-08-28
File Created	2012-05-11