JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
ASSQ
Please answer these questions based on your student's typical behavior.
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Email
*
Your email
Student's Name:
*
Your answer
Student's Date of Birth:
Please use the name of the month instead of its number for less confusion.
e.g.: March 2nd 2019, or 2 March 2019
Your answer
Student's Gender:
*
Your answer
1-
is old-fashioned or precocious
*
No
Somewhat
Yes
2-
is regarded as an "eccentric
professor" by the other children
*
No
Somewhat
Yes
3-
lives somewhat in a world of his/her own
with restricted idiosyncratic intellectual
interests
*
No
Somewhat
Yes
4-
accumulates facts on certain subjects
(good rote memory) but does not really
understand the meaning
*
No
Somewhat
Yes
5-
has a literal understanding of
ambiguous and metaphorical language
*
No
Somewhat
Yes
6-
has a deviant style of communication
with a formal, fussy, old-fashioned or
"robot like" language
*
No
Somewhat
Yes
7-
invents idiosyncratic words and
expressions
*
No
Somewhat
Yes
8-
has a different voice or speech
*
No
Somewhat
Yes
9-
expresses sounds involuntarily; clears
throat, grunts, smacks, cries or screams
*
No
Somewhat
Yes
10-
is surprisingly good at some things
and surprisingly poor at others
*
No
Somewhat
Yes
11-
uses language freely but fails to make
adjustment to fit social contexts or the
needs of different listeners
*
No
Somewhat
Yes
12-
lacks empathy
*
No
Somewhat
Yes
13-
makes naive and embarrassing
remarks
*
No
Somewhat
Yes
14-
has a deviant style of gaze
*
No
Somewhat
Yes
15-
wishes to be sociable but fails to
make relationships with peers
*
No
Somewhat
Yes
16-
can be with other children but only
on his/her terms
*
No
Somewhat
Yes
17-
lacks best friend
*
No
Somewhat
Yes
18-
lacks common sense
*
No
Somewhat
Yes
19-
is poor at games: no idea of cooperating
in a team, scores "own goals"
*
No
Somewhat
Yes
20-
has clumsy, ill coordinated, ungainly,
awkward movements or gestures
*
No
Somewhat
Yes
21-
has involuntary face or body
movements
*
No
Somewhat
Yes
22-
has difficulties in completing simple daily
activities because of compulsory
repetition of certain actions or thoughts
*
No
Somewhat
Yes
23-
has special routines: insists on no
change
*
No
Somewhat
Yes
24-
shows idiosyncratic attachment to
objects
*
No
Somewhat
Yes
25-
is bullied by other children
*
No
Somewhat
Yes
26-
has markedly unusual facial
expression
*
No
Somewhat
Yes
27-
has markedly unusual posture
*
No
Somewhat
Yes
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. -
Terms of Service
-
Privacy Policy
Does this form look suspicious?
Report
Forms
Help and feedback
Contact form owner
Help Forms improve
Report