ADI-R Child AuDHD Form

Details & Background

Clinician, child and respondent details, and background information.

Clinician Information

Clinician Name

Date of Interview

Clinic

Child Information

Child Name/ID * Please enter the child's name or ID

Child Date of Birth

Chronological Age

years months

Calculated from the date of birth and the interview date, or enter it by hand. Items 64, 65 and 68 are scored according to this age.

Gender

Respondent Information

Respondent Name

Relation to Subject

Second Respondent Name (Optional)

Relation to Subject

Algorithm

Algorithm Used

Background

Genogram and Family History

Notes:

Medical Conditions/Medication

Notes:

Report/Assessment History

Notes:

Current Concerns

Notes:

General Picture/Observations

Notes:

School/Nursery – general

Interview questions:

Children: How does your child find school? Any difficulties you’re aware of?
Adults: How do you find work? What are your main current difficulties?

Notes:

School/Nursery – tasks

Interview questions:

Children: How does your child find homework/academic tasks?
Adults: How do you find completion of work/administrative tasks?

Notes:

School/Nursery – social

Interview questions:

Children: Do you have any concerns about your child’s social development in school?
Adults: Do you have any concerns around how you engage socially with others? Have others ever expressed concern to you?

Notes:

Early Development

1Current (or past if adult) Concerns

Notes:

2Age (in months) when first noticed something was not quite right in Language, Relationships or BehaviourScored · D

Age in months:or, if no age can be given, choose a special code below

Special code

991: parents not concerned but child referred by professional992: parents worried since birth996: can’t recall but before 3 years997: can’t recall but after 3 years998: n/a999: n/k or not asked

Notes:

3First Symptoms to arouse to parental concern

Notes:

4Looking back with hindsight, when do you think s/he first showed any problems or difficulties in development or behaviour? Do you think everything was alright before then?

Notes:

Toilet Training

Interview questions:

How did they progress with toilet training? Able to hold overnight? Was skill lost and relearned at any stage?

Rating

993: Successfully toilet trained for period of 12 months, but relapsed and regularly has accidents994: Never Achieved995: Still not reached996: N/K but apparently normal997: N/K but apparently Delayed998: N/A999: N/K or not asked

Notes:

Sleeping/eating/dressing etc.

Notes:

Language

9Age of first single words (normal <24 months)Scored · D

Age in months:or, if no age can be given, choose a special code below

Special code

993: had some words, then ost and not yet regained994: milestone not reached996: N/K, but apparently normal997: N/K, but apparently delayed999: N/K, or not asked

Notes:

10Age (in months) first used phrasesScored · D

Interview questions:

Phrase must consist of 2 words, one of which must be a verb

Age in months:or, if no age can be given, choose a special code below

Special code

993: had some phrases, then lost and not yet regained994: milestone not reached996: N/K, but apparently normal997: N/K, but apparently delayed999: N/K, or not asked

Notes:

General Language

Interview questions:

Any loss of language skills?
How much language do they understand if you don’t gesture?
Overall level of language? Do people understand them? Use every day in different contexts?

Notes:

30Overall level of language (Item 30) *

Needed for scoring: verbal subjects (code 0) are scored on B1, B2, B3 and B4 and on Item 39; non-verbal subjects (code 1 or 2) on B1 and B4 only.

Social Interaction – Non-Verbal

50Direct gaze (thinking about 4-5 years old)Scored · A1

Interview questions:

Do/did they look you directly in the face when doing things with you or talking with you?
Is this sustained or briefly held?
Can/could you catch their eye?
Do/did they watch as you walk into the room? What about with other people?

Rating

0: normal reciprocal direct gaze used to communication across a range of situations and people1: definite direct gaze but only of brief duration or not consistent in social interactions2: uncertain/occasional direct gaze or gaze rarely used in social interactions3: unusual or odd use of gaze

8: n/a9: n/k or not asked

Notes:

51Social smilingScored · A1

Interview questions:

When approaching someone to get them to do something or talk to them, do they smile in greeting?
What about when they see someone they know or you return from somewhere?
If they are not smiling first, what do they do if someone smiles at them or says something nice to them? Would they smile back?
Is eye contact is consistently used with both familiar and unfamiliar people?
Is eye contact used across a range of pragmatic contexts for example; when talking, playing and when people enter a room What about when they were 4-5 years old??

Rating

0: regularly predictable, reciprocal, social smiles in response to the smiles of a variety of people besides parent/caregiver1: some evidence of reciprocal social smiling but not enough for ‘0’2: some evidence of smiling while looking at people, code here if only smiles at parent/caregiver, only smiles on request or in odd situations or odd ways3: little or no smiling at people, although may smile at other things

8: n/a9: n/k or not asked

Notes:

57Range of facial expressions used to communicateScored · A1

Interview questions:

Do they show a normal range of facial expressions? Eg laughing, crying, pouting, embarrassed, guilty.
Can you tell by their face when they are scared or disgusted?
Are facial expressions typical, stilted or exaggerated?
Are facial expressions in context?
Do you think they have the same range of facial expressions as other children their age?
What about when they were 4-5 years old?

Rating

0: full range of facial expressions1: somewhat limited facial expression; may be stilted or exaggerated2: markedly limited range of facial expressions or tendency to have just one facial expression for all circumstances3: facial expression showing little or no indication of emotion of any kind

8: n/a9: n/k or not asked

Notes:

58Inappropriate facial expressionsScored · A4

Interview questions:

Does their facial expression usually seem appropriate to the situation?
Do they ever laugh/smile in situations most people wouldn’t find funny or when you don’t see what’s funny?
Did this ever occur in the past?

Rating refers to: Current Ever

Rating

0: Facial expression almost always appropriate to mood, situation, context1: Facial Expression slightly or occasionally inappropriate or odd2: Facial expressions obviously inappropriate in several different situations

8: n/a - almost not variation in facial expression - appropriate9: n/a or not asked

Notes:

49Imaginative play with peersScored · A2

Interview questions:

If 10 or over, only ask about 4-5 year period
Do they ever play imaginative games with anyone else? Contribute in ways that make sense?
Do they seem to understand what each other is pretending? How can you tell? Eg?
Do they take the lead in the play? Or do they tend to follow the other person’s ideas?
Is the play typically sustained, or does it break down?What about between 4-5 years old?

Rating refers to: Current (over 4 and under 10) Most abnormal 4-5

Rating

0: imaginative, co-operative play with older children in which they both take the lead and follow others in a spontaneous, pretend activities1: some participation in pretend play with another child, but not truly reciprcoal and/or pretending is limited3: no play with other children or no pretend play even on own

8: n/a9: n/k or not asked

Notes:

62Interest in other childrenScored · A2

Interview questions:

What do they think about other children around the same age who they don’t know? Do they show interest in them? How do you know?
What do they do when another child comes to your house, or they see another child in a familiar situation e.g. playgroup?
How do they try to get a child’s attention for example?
If it’s reported that their child does not approach other children always explore
“Do they do anything that would suggest that they are aware that other children are around them? Can you tell me about that?”
Do not code interest in babies here.

Rating refers to: Current (under 10) Most abnormal 4-5

Rating

0: often watches other children and sometimes makes a clear effort to approach them or get their attention1: usually watches other children or indicates interest in them to caregiver in some way (e.g. pointing, vocalising, trying to imitate what they are doing, but no attempt to seek them out), or approaches other children without trying to get their attentio2: occasionally watches other children but almost never tries to approach them, or direct parent/caregiver’s attention to them or copy them3: shows no, or almost no interest in other children

8: n/a9: n/k or not asked

Notes:

63Response to approaches of other childrenScored · A2

Interview questions:

Can you describe what they do if another child approaches them? Do they do anything to keep interaction going? Description…
Do they behave differently with sibling(s) or a familiar child? Describe…
Does the other child’s age make a difference?
Do they ever actively avoid other children?
Is their interaction something that came naturally, or did you have to teach them about how to interact with other children?
What about aged 4-5 years old?

Rating refers to: Current (under 10) Most abnormal 4-5

Rating

0: Generally responsive to other non-familial children's approaches even if hesitant initially. Sometimes makes clear effort to keep interaction going1: sometimes responsive to other non-familal children's approaches, but response limited or unpredictable2: rarely or never response to the approach of even familiar children, but may show interest3: consistently and persistently avoids approaches of others

8: n/a9: n/k or not asked

Notes:

64Group play with peersScored · A2

Interview questions:

If 10 or over, only ask about 4–5-year period
Can you tell me about any group games they might play with others their age when there are more than two together? (you need to get specific examples of the group games that are played - get a list)
Are they different with children outside the immediate family?
Can they play co-operatively in games that require joining in, such as hide and seek or ball games? How would they cope if the rules changed?
Would they initiate these games? Actively seek to join in?
Can they take different parts in these games e.g. being hider and seeker?
Do these games typically go well or do they break down?” If they break down “can you tell me about why this happens?

Rating refers to: Current (Over 4 and under 10) Most abnormal 4-5

Rating

0: actively seeks and plays co-operatively in several different groups in a variet of activities1: Some Co-Op play but insufficient initiative, flexibility, frequency or variety to score 02: Enjoys parallel active play but little or no co-op play3: seeks no play that involves participation in groups of children, although may play chase and catch

8: n/a9: n/k or not asked

Notes:

65Friendships (for those aged 5 and older)Scored · A2

Interview questions:

Do they have any particular friends or a best friend? How do you know they are friends?
Always ask about whether the child seeks out this person and is the relationship reciprocal?
Do they see them outside of school?
What do they play together? Do they share interests or do any other activities together?
Are their relationships with others normal for their age?
Was it the same in the past or did they have more/less friends when they were younger?

Rating refers to: Current (5 or older) Most abnormal 10-15

Rating

0: one or more relationships w/ person in aprox own age group. non-stereotyped activites outside of pre-arranged group w/ definite reciprocity.1: one or more rx that involve some personal shared activities outside prearranged groups, some initiative taken by child but limited.2: people w/ whom they have some kind of personal relationship involving seeking of contact but only in group situation or in school/work3: no peer rx that involve selectivity and sharing

8: n/a (outside age range or sig lack of oppo for peer contact)9: n/k or not asked

Notes:

Shared Enjoyment

52Showing and directing attention (differentiate showing and requesting)Scored · A3

Interview questions:

Do they ever show you things that interest them? E.g. a new toy or something they are making?
When would this most likely happen and does it happen across a range of things?
Would your child ever bring you anything to show?
What kinds of things would they show you?
Would your child ever point to something just to show you it?
Does this ever happen for things that aren’t part of their special interests or things they need you for?
Would your child ever show you things like; a new toy or something that they’ve found?
What about when they were 4-5 years old?

Rating refers to: Current Most abnormal 4-5

Rating

0: regular showing of objects by bringing things to parent/caregiver and directing their attention with no motive other than sharing1: possible showing as in 0, but not sufficient to meet 02: some bringing things to parent/caregiver, and/or showing, but associated w/ preoccupations, food or need for help3: rare or no social approaches of this type

8: n/a9: n/k or not asked

Notes:

53Offering to share (unprompted, nonroutine offers to share range of objects to different people)Scored · A3

Interview questions:

Do they ever offer to share things? E.g. Food, toys, objects, space on the sofa?
Who with? What about other children? How often?
Do they do this on their own or do you need to suggest it?
What about when they were 4-5?

Rating refers to: Current Most abnormal 4-5

Rating

0: frequent, spontaneous, and varied offers to share different sorts of objects, with different people1: some spontaneous offers to share, but limited in frequency or contexts (more than food)2: will sometimes share if requested but not spontaneously, or spontaneous sharing of food3: no sharing

8: n/a9: n/k or not asked

Notes:

54Seeking to share enjoyment with others.Scored · A3

Interview questions:

What kinds of things do they enjoy doing or makes them happy?
Can you describe what your child does when their feeling happy and excited? /How do they show these feelings?
Do they ever seem to want you to share in their enjoyment of something?
Have they tried to share these feeling with you? What are they doing that makes you feel they are sharing enjoyments with you? (more for selves or others)
What about when they were younger?

Rating refers to: Current Most abnormal 4-5

Rating

0: frequent attempts across a variety of contexts to direct several other people’s attention to things that they enjoy or have done well (must be with more than one parent)1: some attempts to share enjoyment, but limited in number or variety or spontaneity or lackign clear quality of shared pleasure2: few or no attempts to share enjoyments

8: n/a9: n/k or not asked

Notes:

Social-Emotional Reciprocity

Can also include appropriateness of facial expression here.

31Use of other’s body to communicate.Scored · A4

Interview questions:

When they had very little speech, how did they let you know that they wanted something?
How often does this behaviour occurs and does the child also use other methods of communication, or it is their primary method?
Did they ever show you what they wanted by taking your hand, wrist or another part of your body?
Do they ever do this now?
Did they ever use your hand as if it were a tool or an extension of their arm?
Did they look at you when doing this?
Did they combine this with trying to communicate with sounds/words too?
Get specific examples of when the child would use hand placement instead of pointing a vocalisation

Rating refers to: Current Ever

Rating

0: No use of other's body to communicate - except where other strategies didn't work (e.g. couldn't get parents attn during conv), or leading someone somewhere1: occasional placement of the other's hand on objects or use of other's hand as a tool, but in combo with other modes of comms2: occasional placement of other's hand or use of ohter's hand as a tool or to demonstrate "for" the child w/o integration of other modes3: regular use of other's hand as a tool or to gesture "for" the child

8: little or no spontaneous comms9: n/k or not asked

Notes:

55Offering SupportScored · A4

Interview questions:

Do they ever try and comfort you if you are upset, hurt or ill?
What would they do if they saw you in tears? Would their facial expression change?
What about with their brother or sister?
Do they show comfort in more than one situation?
If a child does not offer comfort always ask “what if you pretended to cry or you were exaggerated?
What about when they were 4-5 years old?

Rating refers to: Current Most Abnormal 4-5

Rating

0: flexibly & Spont offers comfort in range of situations and ways + facial expression1: has a partial response (stands nearby) or indirect physical approach (sits on lap but doesn't give comfort)2: rarely offers comfort or only in odd ways3: never offers comfort to others

8: n/a9: n/k or not asked

Notes:

56Quality of social overtures (quality of majority, rather than best ones)Scored · A4

Interview questions:

How do they get your attention when they want something or want help?
Do they point, give objects to you or come and get you when they need help? Do they ever use gestures or movements with sounds or words to get your attention?
Do they look at the object or you?
What about when they were 4-5? Did they show interest in others?
would I be right in saying that to communicate social intention your child would typically use vocalisation and gesture, and that these would be weakly integrated with eye contact?
Would I be right in saying that to communicate their social intention/make a request your child would verbalise and gesture with some eye contact? Yes / No

Rating refers to: Current Most Abnormal 4-5

Rating

0: consistently uses co-ordinated eye gaze w/ accompanying vocalisation in typical situations when motivataed to communicate1: may use eye gaze or vocaliation but these are weakly integrated2: rarely shows well co-ord focused, social intentionality involving eye gaze or vocalissation (or shows in odd ways)3: shows no co-ordination of eye gaze and vocalisation

8: n/a9: n/k or not asked

Notes:

59Appropriateness of social responsesScored · A4

Interview questions:

Do they consistently respond to the approaches of others in familiar situations? Can you describe what they would do if someone walked into the house?
Is anybody that your child would have a consistent positive response to? can you describe that?
What about it a friend of yours who they don’t know well approaches them and speaks to them?
What about someone they really like? How do they respond?
How do they respond if someone who they don’t know (e.g. cashier in a shop) tries to speak to them appropriately? o they look at them? Do they smile? Do they show other reactions?
What about when they were 4-5 years old?

Rating refers to: Current Most Abnormal 4-5

Rating

0: appropriate response to overtures from familiar and unfamiliar adults1: some clear positive responses and interactions, but not consistent2: responds to parent/caregiver and others in familiar settings but responses stereotyped, inappropriate or limited3: little or no interest in or response to people except caregiver/familiar sig others

8: n/a

Notes:

Spoken Language and Gestures

42Point to express interestScored · B1

Interview questions:

Do they ever spontaneously point at things around them? E.g. a plane in the sky?
When? In a car? On a street? To show or to request? What sort of things?
Would they ever point out things when you’re walking down the road to show?
Is this just to show you things to share or would it be to request?
Do they also look at you when pointing? Is it a well formed point?
When your child points to something do they look back at you before looking back to the item, or do they just keep looking at the item?
What about when they were 4-5?

Rating refers to: Current Most Abnormal 4-5

Rating

0: spont points at objects at a distance w/ finger to express interest using co-ordinated eye gaze1: makes limited attempt to express interest by pointing but limited in flexibility and/or lack of co-ordination with other cues2: little or no spontaneous unprompted attempts to point to express interest in objects at a distance

8: n/a9: n/k or not asked

Notes:

43NoddingScored · B1

Interview questions:

Do they nod their head to indicate “yes”? How often?
What about when they were 4-5 years old?

Rating refers to: Current Most Abnormal 4-5

Notes:

44Head ShakingScored · B1

Interview questions:

Do they shake their head to indicate “no”? How Often?
What about when they were 4-5 years old?

Rating refers to: Current Most Abnormal 4-5

Rating

Notes:

45Conventional / instrumental gesturesScored · B1

Interview questions:

Do they wave goodbye?
When does this happen?
Do you need to prompt them? Who will they wave to?
Did they naturally acquired the use of gestures or did you have to teach them?
Do they use any other common gestures such as blowing a kiss, thumbs up, beckoning over etc?
Would they be typical or exaggerated? out of context? Stilted in any way?
What about when they were 4-5 years old?

Rating

0: appropriate and spontaneous use of a variety of conventional or instrumental gesture1: spotaneous use of conventional or instrumental gestures but limited in range or contexts2: inconsistent spontaneous use or use of elicited or well-rehearsed simple conventional or instrumental gestures only3: no use of conventional or instrumental gestures

8: n/a9: n/k or not asked

Notes:

Social Development and Play

47Spontaneous imitation of actions (do not code vocal or elicited imitation here)Scored · B4

Interview questions:

If 10 or over, only ask about 4–5-year period
Do they imitate you or others in the family? How often? What kinds of things?
Have they ever copied something you have done using a pretend object? (e.g. banana as telephone)
What about if your child didn’t have a miniature, would they use something else and pretend that is the item?
How varied are the things they imitate? Would they incorporate them into their own play?
What about when they were 4-5 years old?

Rating refers to: Current (under 10) Most Abnormal 4-5

Rating

0: spontaneous imitation of a varied range of non-taught actions, w/ some incorporated into play outside context of observed bh of imitated person1: some indication of spont.imitation that goes beyond copying a frequent use of an object, non sufficient for 02: spontaneous imitation limited to a few familiar routines not incorp into play, incl freq approp use of obj.3: very rare or no spontaneous imitation

8: n/a9: n/k or not asked

Notes:

48Imaginative playScored · B4

Interview questions:

If 10 or over, only ask about 4-5 year period
Do they play any pretend games? E.g. toy tea sets, action figures GET EXAMPLES
Has she ever given the doll/figure a drink or ride in a car?
Do they ever talk to them or make them make noises? Are they directing or acting in play?
Does their play vary from day to day? Do they use objects beyond their purpose? E.g. shoe as cup
Have they ever made up a story or sequence? Does the narrative expand?
What about between 4-5 years old?

Rating refers to: Current (under 10) Most Abnormal 4-5

Rating

0: variety of pretend play, incl use of dolls/animals/toys as self-initiating agents1: some pretend play, including actions directed to dolls, cars etc but limited in variety or frequency2: occasional spont pretend actions or highly repetitive pretend play (may be frquent) or only play taught by others3: no pretend play

8: n/a9: n/k or not asked

Notes:

61Imitative social playScored · B4

Interview questions:

As a young child, did/do they join in social games such as ring a’ring o’roses?
Did they spontaneously join in and do the actions?
Does your child initiate these games, if so how?
What about teasing games? “I’m going to get you!” or fingers walking towards them
With familiar adults? How would they join in the game?
Peekaboo? Did they initiate? Hide back?
Are you able to naturally end these games or does your child find it difficult when they end?

Rating refers to: Current (under 10) Most Abnormal 4-5

Rating

0: normal social play, including clear evidence of child initiating and responding to simple social games1: some to and fro social play but limited in amount, duration or context2: little to and fro social play, may not be reciprocal3: no evidence of to and fro social play

8: n/a9: n/k or not asked

Notes:

Social Communication

Thinking more broadly about social communication: how they chit chat, use language and make small talk.

34Social Verbalisation/chatScored · B2

Interview questions:

Do they ever make small talk or chat just to be with someone without it being about their needs/wants? Just talking to be social?
What would happen if you started mundane chit chat with your child, how do you think they would respond? Would they make an attempt to keep the interaction going?
How often would your child initiate small talk/chitchat with you?
What about when they were younger?

Rating refers to: Current Ever

Rating

0: verbalises or chats w/ clear social quality of talking to be friendly or to express interest, rather than just to make needs known1: some social use of speech in response to caregiver or to get attention with no obvious motivation, but limited in freqency/range2: uses some speech to alter caregiver to immediate needs or wants, but little or no purelys ocial use of verbalisation

8: n/a9: not asked

Notes:

35Reciprocal conversation within person’s level of languageScored · B2

Interview questions:

Can you have a conversation with them? Not just asking/answering questions?
Do conversations typically go back-and-forth or does your child like to lead?
If you say something without asking a direct question – what will they do?
Will they ever ask you a question and/or build on what you have said in a way that adds something new to the conversation and so it will continue?

Rating refers to: Current Ever

Rating

0: conversation flows, including both offering information and building on other person's response in a way that leads to ongoing dialogue1: occasional reciprocal conversation, but less frequent than normal or limited in flexibility or topics2: little or no reciprocal conversation; others find it hard to build a conversation even if there is apparently positive or social talk; doesn't follow anyone else's topic3: very little spontaneous speech

8: n/a9: nk or not asked

Notes:

33Stereotyped utterances (routine phrases used out of context) and delayed echolaliaScored · B3

Interview questions:

Have they ever tended to use odd phrases or say the same thing over and over in almost exactly the same way? E.g. quotes from cartoons or “say - ‘it’s alright’” maybe something they have made up themselves?
Do they use other language to communicate as well or is most of their communication stereotyped or echoed?
Do they tend to talk to themselves in this way when doing something on their own?
Do they ever give a running commentary on what they are doing?
Do they ever use an accent?
Did they ever use odd or repetitive phrases more often than they do now?

Rating refers to: Current Ever

Rating

0: Rarey or never uses stereotyped phrases1: Speech tends/tended to be more repetitive than most children at the same level of complexity, but not stereotyped in an odd or unusual way; or occasional stereotyped utterances but consistent productive lanaguage as well.2: Often uses/used stereotyped utterances with productive language as well3: Phrases are almost exclusively stereotyped utterances

8: n/a; no phrases9: n/k or not asked

Notes:

36Inappropriate questions or statementsScored · B3

Interview questions:

Are there times when they uses socially inappropriate questions or statements? Where you would wish the ground would swallow you up?
Do they ask personal questions or make personal comments at awkward times?
Ask about frequency and specific examples.
Was this ever an issue when they were younger?

Rating refers to: Current Ever

Rating

0: No or very rare use of questions/statements inappropriate to conversation or setting1: use of some questions/statements regardless of situation, questions, or statements are slightly inappropriate and may be repetitious but are not usually very odd or highly embarassing2: frequent use of questions/statements that are odd or obviously inappropriate to the situation

8: n/a9: n/k or not asked

Notes:

37Pronominal reversalScored · B3

Interview questions:

Have they ever got their personal pronouns mixed up or the wrong way round? Say ‘I’ when they mean ‘you’ or ‘he/she’ instead of ‘1’?
Ask about frequency and specific examples.
What about when they were younger?

Rating refers to: Current Ever

Rating

0: no confusion between 1st, 2nd, 3rd person after phrase speech with pronoun established1: refers/referred to self by name instead of "i" after phrase speech established, but no persistent you'll or he/she confusion2: you'll or he/she confusion after phrase speech established but "you" or "he/she" not used with intonation of a question3: pronominal confusion when asking a question in which "you" or "he/she" is used for "i

7: other types of pronominal confusion (other than I/Me) such as he/you8: n/a9: n/k or not asked

Notes:

38Neologisms / Idiosyncratic languageScored · B3

Interview questions:

Do they ever use words that they seem to have invented or made up?
Do they ever put things in odd indirect ways (e.g. ‘hot rain’ for ‘steam or “white wet day” for fog’)
Ask about frequency and specific examples.
Did they ever use odd phrases in the past?

Rating refers to: Current Ever

Rating

0: No use of neologisms or idiosyncratic language1: occasional use of neologisms and/or idiosyncratic words and phrases used consistently2: Regular use of neologisms and/or idiosynratic ways of saying things

8: n/a9: n/k or not asked

Notes:

39Verbal rituals: where they are saying things in a particular order or in a particular way and/or need you to do the same (exclude those from bedtime routine)Scored · C2

Interview questions:

Do they ever say the same thing over and over in exactly the same way or insist on you doing so?
What happens if you interrupt or refuse to comply?
Was this ever a problem when they were younger?

Rating refers to: Current Ever

Rating

0: no verbal rituals1: tendency to say things in ritualised way or require others, but not compulsive. stopped if asked2: says one or more things in special way, may intrude on family life. Distress at interruption.3: as for 2, but with marked difficulty to control and marked intrusiveness on family life to a degree that causes social impairment or serious distress if interrupted.

8: n/a9: n/k or not asked

Notes:

Restricted and Repetitive Interests and Behaviours

67Unusual preoccupations (odd or peculiar in quality, unusual in its intensity and lack of social features, repetitive or stereotyped in its features, for at least 3 months)Scored · C1

Interview questions:

Do they have any interests that are unusual or peculiar in themselves for their age? Eg street signs, brass objects, etc
Does this interest interfere with family life or family activities and if so, how?
How much do they talk about them?
Does the interest influence how they behave?
How long has it lasted?
Does it interfere with other activities or family life? Describe……
Do you think that this interest impacts on your child’s communication or social interaction with others?
When did this interest first emerged and how often would you see this interest?
What about when they were younger?

Rating refers to: Current Ever

Rating

0: No unusual preoccupations1: unusual preoccupation that does not interfere with significant actiities of family life or does not cause social impairment2: definite. repetitive preoccupation that intrudes into family life but doesn't disrupt it significantly; or does not cause substantial interference with social functioning but does constrain/intrude on other activities.3: definite preoccupation that causes substantial interference or social impairment and severely limits other activities.

9: n/k or not asked

Notes:

68Circumscribed interests (for those aged 3 and older; not unusual in itself but differs in its intensity and circumscribed nature eg unusually focused)Scored · C1

Interview questions:

Do they have any hobbies or interests that are unusual in their intensity? For how long?
What makes you feel that this interest is intense?
Do they share the interest with other people? How?
Does it seem all encompassing in its intensity? Does it interfere with them doing things or family life?
What would happen if you asked them not to talk about?
Have there been any special interests in the past?

Rating refers to: Current (3 or older) Ever (3 or older)

Rating

0: No circumscribed interests1: special interest of unusual degree, but not definitely intrusive or constraining of family activities2: definite circumscribed interest that does not cause substantial intereference with social functioning but constrains/intrudes on family life or other activities3: definite circumscribed interest that causes clear-cut social impairment

8: n/a (age below 3 years)9: n/k or not asked

Notes:

69Repetitive use of objects or interest in parts of objects (for at least 3 months)Scored · C4

Interview questions:

How do/did they play with toys/things round the house?
Do/did they play with the whole toy or do/did they seem to be more focused on particular parts eg. Spinning the wheels, opening and shutting doors?
Are there particular kinds of toys/objects they really like?
Do they ever collect or gather certain objects?
Do they ever line things up or do things in the same way over and over?
Do they sort toys by colour, category or size
Do they drop things to watch them fall
Do they enjoy setting up the scene but not actually playing with toys
Do they play with the wheels instead of the car as a whole or enjoy watching the wheels
Do they play with any part of a toy instead of playing with the whole toy as it’s intended to be played with
Do they like a toy due to a sound it makes and only playing with the sound repetitively

Rating refers to: Current Ever

Rating

0: Little or not repetitive use of objects1: some repetitive use of objects (e.g. shaking, spinning, tapping things) or interest in parts (turning wheels), or very specific types of objects (collecting bits of paper) but not causing social impairment.2: Play linked to highly stereotypic use of objects or attention to specific parts or types of objects, does not constrain or intrude on other activities.3: play linked to highly stereotypic use of objects to extent that prevents/seriously interferes with other activities

7: interest in "infant" toys such as music or rattles, but play is with a ariety of objects adn not in a highly stereotypical fashion8: n/a (no play with objects)9: N/K or not asked

Notes:

70Compulsions / rituals (compulsion is when person feels pressure to do things in a specific way; rituals have sequence, involve imposing order on events rather than responding to change). Bedtime routines are excluded as they commonly occur in typically developing childrenScored · C2

Interview questions:

Are there things that they seem to have to do in a very particular way or order? Or things they make you do in a specific way/order? Eg touching particular things or putting things in special places.
When did you first notice this behaviour and how often does this behaviour occur?
How do they react if they are unable to complete the whole sequence or if they are disrupted?
Do you feel that this has a compulsive quality?
Was this ever an issue in the past?

Rating refers to: Current Ever

Rating

0: no compulsions/rituals1: some activities w/ unusually fixed sequences, but no activity that appears compulsive in quality.2: one or more activities that they have to do in a special way, person appears under pressure or gets anxious if disrupted. Family avoid interupting rituals. Compulsive quality present, little interference with family life or social impairment.3: one or more activities that they have to perform in a special way, under marked pressure or gets extremely anxious if disrupted, compuslive quality, intrudes on family life or causes definite social impairment.

9: N/K or not asked

Notes:

77Hand and finger mannerisms (for at least 3 months)Scored · C3

Interview questions:

Do they have any mannerisms or odd ways of moving their hands/fingers? Eg twiddling or twisting fingers or flicking in front of eyes?
When did you first notice these mannerisms? Can you describe them to me
Do they interfere with them doing other things? What happens if you try and get them to stop?
Are there any particular circumstances where they do it more?
When would you be most likely to see them?
Did they ever do this in the past?

Rating refers to: Current Ever

Rating

0: No hand or finger mannerisms1: occasional hand or finger mannerisms only or not as clearly specified as rating for 22: definite, frequent hand mannerisms or finger twisting/flicking, but no interference in other activities and no distress if disrupted.3: marked manerisms of type specified, associated with social impairment or distress when interrupted, or infrequent interruption due to concern about person's reaction.

8: n/a (e.g. physically disabled)9: N/K or not asked

Notes:

78Other complex mannerisms or stereotyped body movements (do not include isolated rocking; for at least 3 months)Scored · C3

Interview questions:

Do they have any (voluntary) complicated movements of their body such as spinning repeatedly, rocking or bouncing up and down?
When did you first notice these mannerisms? Can you describe them to me
How often does this behaviour occur?
Does this interfere at all with getting them to do other things?
What happens if you try and get them to stop?
When would you be most likely to see them?
Did they ever do this in the past?

Rating refers to: Current Ever

Rating

0: no complex mannerisms or sterotyped body movements1: only occasional complex mannerisms or stereotyped body movements2: definite frequent, other mannerisms or stereotypies, but will stop without distress if interrupted.3: marked mannerisms associated w/ social impairment

8: n/a (e.g. physically disabled)9: N/K or not asked

Notes:

71Unusual sensory interests (for at least 3 months)Scored · C4

Interview questions:

Do they seem particularly interested in the sight, feel, sound, taste, or smell of things or people?
Do they sniff toys, objects, or people inappropriately?
Do they tend to peer at or look at things in a strange way or out of the side of their eyes?
Does your child ever look at things for long periods of time or at different angles?
Has there ever been a time when they showed an unusual interest in sensations, eg seeking them out?

Rating refers to: Current Ever

Rating

0: no unusual sensory interests.1: shows one or two unusual interests regularly2: has unusual sensory interest that takes up major amount of time or prevents or limits alternative use of that material in its ordinary form

9: N/K or not asked

Notes:

Age of Onset & Closing

86Age when abnormality first evident __Scored · D

Interview questions:

Just to check back on the early years that we have talked about, having discussed their development in detail, when did you first start to think that their development wasn’t normal?
What was their talking / play / looking after themselves / relationships like?

Rating

0: development in first 3 years clearly normal in quality and within normal limits for social, adaptational, language, self-help and motor milestones; no behavioural problems of a type that might indicate development delay or disorder1: development possibly within normal limits during first 3 years but uncertainty because of either the quality of behaviour or the level of skills2: development probably abnormal by the age of 3 years as indicated by developmental delay or disorder but not of a degree or type that is definitely incompatible with normality3: development definitely abnormal in the first 3 years but quality of behaviour, social relationships or communication not unambiguously autistic at that age4: development definitely abnormal in the first 3 years and quality of behaviour, social relationships and communication strongly indicative of autism at that age

9: n/k or not asked

Notes:

87Interviewers judgement on age when developmental abnormalities probably first manifested.Scored · D

Age in months:

Notes:

Strengths or special skills

Interview questions:

Any strengths or special skills? (e.g. shapes, puzzles, memory, musical/artistic skills, reading, computers, etc)

Notes:

Self-injury, risk and mental health

Interview questions:

Any self-injury, risk of harm to self or others? MH Issues?

Notes:

Anything else

Interview questions:

Anything else we have missed or not covered that you wanted to mention or that concerns you?

Notes:

ADI-R Child AuDHD Form

Details & Background

Clinician Information

Child Information

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Algorithm

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Early Development

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Language

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Social Interaction – Non-Verbal

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Shared Enjoyment

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Social-Emotional Reciprocity

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Spoken Language and Gestures

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Social Development and Play

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Social Communication

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Restricted and Repetitive Interests and Behaviours

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Age of Onset & Closing

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