Observation for ASD Assessment
Observation For ASD Assessment
Observer ______Date ______
Child’s Name ______Grade ______Age ______
School Name ______Teacher Name ______
Description of Setting ______
Description of Activity ______
Description of Child ______
- Qualitative Impairment in Social Interaction
Limited Joint Attention ______
Limited Use of Facial Expressions Directed Toward Others ______
Absence of Bringing This to Others to Indicate an Interest in the Activity ______
Demonstrates difficulties in relating to people, objects, and events ______
Gross Impairment in Ability to Make and Keep Friends ______
Significant Vulnerability and Safety Issues Due to Social Naivete ______
May Appear to Prefer Isolated or Solitary Activities ______
Misinterprets Others’ Behaviors and Social Cues ______
- Qualitative Impairment in Communication
Not Using finger to Point or Request ______
Using Others’ Hand or Body As a Tool ______
Showing Lack of Spontaneous Imitation or Lack of Varied Imaginative Play ______
Absence or Delay of Spoken Language ______
Limited Understanding and Use of Nonverbal Communication Skills such as Gestures, Facial Expressions, or Voice Tone ______
Odd Production of Speech Including Intonation, Volume, Rhythm, or Rate ______
Repetitive or Idiosyncratic Language or Inability to Initiate or Maintain a Conversation When Speech is Present ______
- Restricted, Repetitive, or Stereotyped Patterns of Behavior, Interest, and Activities
Insistence on Following Routines or Rituals ______
Demonstrating Distress or Resistance to Changes in Activity ______
Repetitive Hand or Finger Mannerism ______
Lack of True Imaginative Play Versus Reenactment ______
Overreaction or Under-Reaction to Sensory Stimuli ______
Rigid or Rule-bound Thinking ______
Intense, Focused Preoccupation with a Limited Range of Play, Interests, or Conversation Topics ______
Summary:
Minnesota Eligibility Criteria for Special Education states that “The team shall verify than an ASD adversely affects a pupil’s present level of performance and that the student is in need of special education instruction and related services.”
Identify observational areas in which the child exhibits a pattern of behaviors that indicates eligibility for an ASD identification--
- Qualitative Impairment in Social Interaction
______Limited Joint Attention
______Limited Use of Facial Expressions Directed Toward Others
______Absence of Bringing This to Others to Indicate an Interest in the Activity
______Demonstrates difficulties in relating to people, objects, and events Gross
Impairment in Ability to Make and Keep Friends
______Significant Vulnerability and Safety Issues Due to Social Naivete
______May Appear to Prefer Isolated or Solitary Activities
______Misinterprets Others’ Behaviors and Social Cues
2. Qualitative Impairment in Communication
______Not Using finger to Point or Request
______Using Others’ Hand or Body As a Tool
______Showing Lack of Spontaneous Imitation or Lack of Varied Imaginative Play
______Absence or Delay of Spoken Language
______Limited Understanding and Use of Nonverbal Communication Skills such
as Gestures, Facial Expressions, or Voice Tone
______Odd Production of Speech Including Intonation, Volume, Rhythm, or Rate
______Repetitive or Idiosyncratic Language or Inability to Initiate or Maintain a
Conversation When Speech is Present
3. Restricted, Repetitive, or Stereotyped Patterns of Behavior, Interest, and Activities
______Insistence on Following Routines or Rituals
______Demonstrating Distress or Resistance to Changes in Activity
______Repetitive Hand or Finger Mannerism
______Lack of True Imaginative Play Versus Reenactment
______Overreaction or Under-Reaction to Sensory Stimuli
______Rigid or Rule-bound Thinking
______Intense, Focused Preoccupation with a Limited Range of Play, Interests, or
Conversation Topics