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center-742950SYA? Unofficial autism checklistUnofficial SYA? Autism questionnaire ? This is an unofficial?questionnaire checklist for Autistics, which is a?version of a checklist in a blog?by Samantha Craft.?? ? It is recommended?that you work your way through the questions/items to identify how many closely match your experiences. You may find that some items lead you to have questions (e.g. "why do I do that?"), and there are short open forms at the end of each section so you can note these questions and ask about them with/at SYA? ? Please note that this is quite a long questionnaire, so make sure you have time to complete it as there are 166 questions. This will, however, give you a good idea as to whether you are Autistic, as well as help provide you with questions to bring to the SYA? sessions.? There are 11?sections to this questionnaire (which is much more detailed than some of the official checklists). The sections cover: Deep Thinkers Innocence Escape and Friendship Co-occurring Attributes Social Interaction Finding Refuge when Alone Sensitive Sense of Self Confusion Words and Patterns Executive Functioning? If you find yourself closely matching 75 - 80% in each section then it is reasonable to consider asking for an assessment to see if you are Autistic.(This Autistic?checklist questionnaire is based very closely on?Samantha Craft's blog: Everyday Asperger’s, March 2012,?Females with Aspergers?Non-Official?Checklist,?retrieved from?)Ethical consideration:?the original checklist asks about e.g. being abused or taken advantage of, and these questions are contained in this questionnaire. You do not have to answer these questions, and if these are likely to cause discomfort you can opt not to take the questionnaire at all. So, You're Autistic (SYA)??note:?Some of the language is slightly dated in the original checklist i.e. Asperger's has been removed from the latest diagnostic manuals.?However, this unofficial checklist contains a good guide to experiences you may have as an Autistic person). ?Section A: Deep Thinkers Please indicate on the scale how strongly you feel that the statements apply to you:? Strongly disagree1Somewhat disagree2Neither agree nor disagree0Somewhat agree3Strongly agree4I consider myself to be a deep thinker I consider myself to be a prolific writer drawn to poetry I consider myself to be highly intelligent I consider myself to see things at multiple levels including thinking processes I consider myself to analyse existence, the meaning of life, and everything continually I consider myself to be serious and mater-of-fact in nature I DO NOT consider myself to simplify things I DO NOT take things for granted I feel that everything is complex I often get lost in my own thoughts and “check out” (blank stare) Deep Thinkers score: _________ (max score 40, min score 10)? Please use this space to make any notes or questions that this section raises for you:________________________________________________________________________________________________________________________________________________________________________________________________Section B: InnocentPlease indicate on the scale how strongly you feel that the statements apply to you:?Strongly disagree1Somewhat disagree2Neither agree nor disagree0Somewhat agree3Strongly agree4I consider myself to be na?ve I consider myself to be honest I consider myself to have trouble with lying I find it difficult to understand manipulation and disloyalty I find it difficult to understand vindictive behaviour and retaliation I can be easily fooled and conned I often have feelings of confusion and being overwhelmed I often have feelings of being misplaced and/or form another planet I often have feelings of isolation I have been abused or taken advantage of as a child, but didn't think to tell anyone Innocence?score______ (max score 40, min score 10)?Please use this space to make any notes or questions that this section raises for you:________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________Section C: Escape and FriendshipPlease indicate on the scale how strongly you feel that the statements apply to you:?Strongly disagree1Somewhat disagree2Neither agree nor disagree0Somewhat agree3Strongly agree4I survive overwhelming emotions and senses by escaping in thought or action I escape regularly through fixations, obsessions, and over-interest in subjects I escape routinely through imagination, fantasy, and daydreaming I escape through mental processing I escape through the rhythm of words I philosophise continually I had imaginary friends in youth I imitate people on television or in movies I have treated friends as “pawns” in youth, e.g., friends were “students,” “consumers,” “soldiers” Section C: Escape and FriendshipStrongly disagree1Somewhat disagree2Neither agree nor disagree0Somewhat agree3Strongly agree4I tend to make friends with older or younger females I tend to imitate friends or peers in style, dress, and manner I obsessively collect and organise objects I have mastered imitation I tend to escape by playing the same music over and over I escape through a relationship (imagined or real) Numbers can bring me feelings of ease I escape through counting, categorising, organising, and rearranging I tend to escape into other rooms at parties I cannot relax or rest without many thoughts Everything has a purpose Escape and Friendship?score: ________ (max score 80, min score 20)?Please use this space to make any notes or questions that this section raises for you:________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________Section D: Co-occurring?Attributes ? Please indicate on the scale how strongly you feel that the statements apply to you:?Strongly disagree1Somewhat disagree2Neither agree nor disagree0Somewhat agree3Strongly agree4I consider myself to have OCD (Obsessive Compulsive Disorder) I have sensory issues/differences (sight, sound, texture, smells, taste) I consider myself/have been diagnosed with Generalised Anxiety I often have a sense of impending danger or doom I have feelings of polar extremes (depressed/over-joyed; inconsiderate/over-sensitive) I have poor muscle tone, double-jointed, and/or lack coordination I have/have had eating disorders, food obsessions, and/or worry about what I eat Section D: Co-occurring?AttributesStrongly disagree1Somewhat disagree2Neither agree nor disagree0Somewhat agree3Strongly agree4I have irritable bowel and/or intestinal issues I have issues with chronic fatigue and/or immune challenges I have been misdiagnosed or diagnosed with other mental illness/es and/or labelled a hypochondriac I often question my place in the world I often drop small objects I often wonder who I am and what is expected of me I search for right and wrong Since puberty, I have had bouts of depression I tend to flick/rub my fingernails, flap hands, rub hands together, tuck hands under or between legs, keep closed fists, and/or clear throat often Co-occurring Attributes score: ______ (max score 64, min score 16)Please use this space to make any notes or questions that this section raises for you:________________________________________________________________________________________________________________________________________________________________________________________________Section E: Social Interaction? Please indicate on the scale how strongly you feel that the statements apply to you:?Strongly disagree1Somewhat disagree2Neither agree nor disagree0Somewhat agree3Strongly agree4Friends have ended friendship suddenly and without me understanding why I have a tendency to over-share I have a tendency to spill intimate details to strangers When in class, I tend/tended to raise my hand too much or didn’t participate at all I have/had little impulse control when speaking I have a tendency to monopolise conversations at times I tend to bring the subject back to myself I can/have come across at times as narcissistic and controlling (I am not narcissistic) I share in order to reach out I can sound eager and over-zealous at times Section E: Social Interaction?Strongly disagree1Somewhat disagree2Neither agree nor disagree0Somewhat agree3Strongly agree4I hold a lot of thoughts, ideas, and feelings inside I feels as if I am attempting to communicate “correctly” I tend to obsess about the potentiality of a relationship with someone, particularly a love interest I can be confused by the rules of accurate eye contact, tone of voice, proximity of body, stance, and posture in conversation Conversation can be exhausting I question the actions and behaviours of myself and others, continually It feels as if I am missing a conversation “gene” or thought-“filter” I have trained myself for social interactions through readings and studying of other people I visualise and practice how I will act around others I tend to practice in my mind what I will say to another before entering the room I find it difficult to filter out background noise when talking to others I tend to have a continuous dialogue in mind that tells me what to say and how to act when in a social situations I have a sense of humour which sometimes seems quirky, odd, or different from others I find it hard to know when it is my turn to talk - now and/or when I was younger I find norms of conversation confusing Social Interaction?score: _____ (max score 100, min score 25) Please use this space to make any notes or questions that this section raises for you:________________________________________________________________________________________________________________________________________________________________________________________________Section F: Find Refuge when Alone? Please indicate on the scale how strongly you feel that the statements apply to you:?Section F: Find Refuge when Alone?Strongly disagree1Somewhat disagree2Neither agree nor disagree0Somewhat agree3Strongly agree4I feel extreme relief when I don't have to go anywhere, talk to anyone, answer calls, or leave the house I can perceive one visitor in my home as a threat Even if I know logically a house visitor is not a threat, this doesn’t relieve the anxiety I can have feelings of dread about upcoming events and appointments on the calendar Knowing I have to leave the house causes anxiety from the moment I wake up I find the thought of all the steps involved in leaving the house overwhelming and exhausting to think about. I have to prepare myself mentally for outings, excursions, meetings, and appointments Section F: Find Refuge when Alone?Strongly disagree1Somewhat disagree2Neither agree nor disagree0Somewhat agree3Strongly agree4I question next steps and movements continually Telling myself the “right” words and/or positive self-talk doesn’t often alleviate anxiety Knowing I am staying home all day brings great peace of mind I require a large amount of down time or alone time I feel guilty after spending a lot of time on a special interest I am uncomfortable in public locker rooms, bathrooms, and/or dressing rooms I dislike being in a crowded shopping centre/mall, crowded gym, or crowded theatre Finding Refuge when Alone?score: _________?(max score 56, min score 14)? Please use this space to make any notes or questions that this section raises for you:________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________Section G: Sensitivities? Please indicate on the scale how strongly you feel that the statements apply to you:?Strongly disagree1Somewhat disagree2Neither agree nor disagree0Somewhat agree3Strongly agree4I am sensitive to sounds, textures, temperature, and/or smells I often have to adjust bedclothes, bedding, and/or environment in an attempt to find comfort I have dreams that are anxiety-ridden, vivid, complex, and/or precognitive in nature I am highly intuitive to others’ feelings I take criticism to heart I longs to be seen, heard, and understood I question if I am a “normal” person I am highly susceptible to outsiders’ viewpoints and opinions At times I adapt my view of life or actions based on others’ opinions or words I recognise my own limitations in many areas daily I become hurt when others question or doubt my work I view many things as an extension of self Section G: Sensitivities?Strongly disagree1Somewhat disagree2Neither agree nor disagree0Somewhat agree3Strongly agree4I fear others opinions, criticism, and judgment I dislike words and events that hurt animals and people I collect or rescue animals (often in childhood) I have a huge compassion for suffering. I am sensitive to substances (environmental toxins, foods, alcohol, etc.) I try to help, offer unsolicited advice, or formalise plans of action I question life purpose and how to be a “better” person. I seek to understand abilities, skills, and/or gifts. Sensitive?score: _________?(max score 80, min score 20)? Please use this space to make any notes or questions that this section raises for you:________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________Section H: Sense of Self? Please indicate on the scale how strongly you feel that the statements apply to you:?Strongly disagree1Somewhat disagree2Neither agree nor disagree0Somewhat agree3Strongly agree4I feel trapped between wanting to be myself and wanting to fit in I imitate others without realising I suppress my true wishes. I exhibit codependent behaviors (rely on others) I adapt myself in order to avoid ridicule I reject social norms and/or question social norms I often feel extreme isolation Feeling good about myself takes a lot of effort and work. I often switch preferences based on the environment and other people I switch behaviour based on environment and other people Section H: Sense of Self?Strongly disagree1Somewhat disagree2Neither agree nor disagree0Somewhat agree3Strongly agree4I didn't/don't care about hygiene, clothes, and appearance before teenage years and/or before someone else pointed these out to me I can “freak out” but don’t know why until later I have/have been told I have a young sounding voice I have trouble recognising what I look like and/or have occurrences of slight prosopagnosia (difficulty recognising or remembering faces) Sense of Self?score: ______ (max score 56, min score 14)Please use this space to make any notes or questions that this section raises for you:________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________Section I: Confusion? Please indicate on the scale how strongly you feel that the statements apply to you:?Strongly disagree1Somewhat disagree2Neither agree nor disagree0Somewhat agree3Strongly agree4I have/have had a hard time learning others are not always honest My feelings seem confusing, illogical, and unpredictable (self’s and others’) I confuse appointment times, numbers, or dates I expect that by acting a certain way certain results can be achieved, but I realise in dealing with emotions, those results don’t always manifest I speak/spoke frankly and literally (now or in youth) Section I: Confusion?Strongly disagree1Somewhat disagree2Neither agree nor disagree0Somewhat agree3Strongly agree4Jokes go over my head. I feel confused when others ostracise, shun, belittle, trick, and betray I have trouble identifying feelings unless they are extreme. I have trouble with emotions of hate and dislike. I have felt/feel sorry for someone who has persecuted or hurt me I find personal feelings of anger, outrage, deep love, fear, giddiness, and anticipation easier to identify than emotions of joy, satisfaction, calmness, and serenity I sometimes perceive situations and conversations as black or white I sometimes overlook or misunderstand the middle spectrum of outcomes, events, and emotions (all or nothing mentality) A small fight might signal the end of a relationship or collapse of world for me A small compliment might boost me into a state of bliss. Confusion?score: _____?(max score 60, min score 15)?? Please use this space to make any notes or questions that this section raises for you:________________________________________________________________________________________________________________________________________________________________________________________________Section J: Words and Patterns? Please indicate on the scale how strongly you feel that the statements apply to you:?Strongly disagree1Somewhat disagree2Neither agree nor disagree0Somewhat agree3Strongly agree4I like to know word origins I get confused when there is more than one meaning to a word I have great interest in songs and song lyrics I notice patterns frequently I remember things in visual pictures I remember exact details about someone’s life I have a remarkable memory for certain details I write or create to relieve anxiety I have certain “feelings” or emotions towards words Words bring a sense of comfort and peace, akin to a friendship Words and Patterns?Score: _______ (max score 40, min score 10)? Please use this space to make any notes or questions that this section raises for you:________________________________________________________________________________________________________________________________________________________________________________________________Section K: Executive Functioning Please indicate on the scale how strongly you feel that the statements apply to you:?Strongly disagree1Somewhat disagree2Neither agree nor disagree0Somewhat agree3Strongly agree4Simple tasks can cause extreme hardship Learning to drive a car or rounding the corner in a hallway can be troublesome New places offer their own set of challenges Anything that requires a reasonable amount of steps, dexterity, or know-how can rouse a sense of panic The thought of repairing, fixing, or locating something can cause anxiety I avoid mundane tasks Section K: Executive FunctioningStrongly disagree1Somewhat disagree2Neither agree nor disagree0Somewhat agree3Strongly agree4Cleaning may seem insurmountable at times Many questions come to mind when thinking about how to do a task I might leave the house with mismatched socks, shirt buttoned incorrectly, and/or have dyslexia A trip to the grocery store/shops can be overwhelming I have trouble copying dance steps, aerobic moves, or direction in a sports gym class I have a hard time finding certain objects in the house, but remember with exact clarity where other objects are ________________________________________________________________________________________________________________________________________________________________________________________________Use the next page to work out your total score. Working out your score: write your total score for each section below: Deep Thinkers score __________Innocence score __________Escape and Friendship score __________Co-occurring Attributes score __________Social Interaction score __________Finding Refuge when Alone score __________Sensitive score __________Sense of Self score __________Confusion score __________Words and Patterns score __________Executive Functioning? score __________ Overall, your score is:?______________ (max score 664, min score 166)? If you scored above?373* then you may want to discuss the possibility of being Autistic with SYA? and/or student support and/or your GP ?*Based on the idea that you match at least 75% of the questionnaire sections with somewhat agree as a response. ................
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