ASD Parent Interview

ASD DSM-5 Parent Interview: Pre-School

Instructions to the interviewer:

For each DSM 5 criterion, we have provided a number of questions to guide you in gathering information from parents or
other caregivers to help determine if a child does or does not meet that criterion. Some numbered questions include
follow-up questions in ( ). You do not need to ask each question. You may omit questions that are not relevant due to
age, developmental level or cultural or religious factors. You may stop asking questions once you are clear about the
child’s skill set for that criterion. You also may need to ask follow up questions that are not listed here to clarify
information from parents. Boxes have been added below to assist with the ease of scoring. R = rarely, S = sometimes
and O = often. The shading indicates a behavior that is compatible with an ASD.

Begin the interview by saying, “Now I’m going to ask you some questions about how your child communicates, how s/he
relates to other members of the family and other children, and how s/he plays with toys.” Then ask “First, I’d like to
know how many words, signs &/or gestures your child uses?” As appropriate, ask “does s/he say 2-3 words together or
use sentences with 4 or more words?” Pause and then ask, “How does s/he usually let you know what s/he wants? Does
s/he use words or vocalizations, gestures such as pointing, does s/he hand you the object or just look at the object s/he
wants?” Then ask, “Can you understand what your child is trying to communicate? Can other people understand what
your child is trying to communicate?”

A. Deficits in use or understanding of social communication and social interaction in multiple

 Yes
contexts, not accounted for by general developmental delays, and manifested by all 3 of
 No
the following:

1. Deficits in nonverbal communicative behaviors used for social interaction including:

 Yes
abnormalities in eye contact and body-language, lack of facial expression or gestures,
 No
deficits in understanding and use of nonverbal communication, poorly integrated verbal
and nonverbal communication.
Next say, “Now I’d like to know more about how s/he uses eye contact, signs and gestures to
communicate with you?” Pay particular attention to the questions in this section for children
who are non-verbal. Make sure to ask parents to describe any concerns and make sure to
ask about past behavior.
R S O
1. Does s/he look at you or others in the eye when s/he wants something or when s/he
is talking to you?
2. Does your child turn and look when you walk up and start talking to him/her, or
when you call his or her name?
3. Does your child ever use your hand like a tool, grab it and place it on what s/he
wants? Did s/he do so in the past?
4. Does s/he use simple gestures to direct your attention or to request something; e.g.,
pointing at a toy or picture in a book, reaching up to be picked up, waving bye-bye to
let you know s/he wants to go? (Clarify whether the child spontaneously initiated
the gesture or is imitating the parent.)

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R S O
5. Does your child use words and gestures together, for example, pointing to an object
and saying “look Mommy,” waving bye-bye and saying “bye-bye,” nodding his/her
head and saying “Yes” or shaking his/her head and saying “no?” (Does the child also
use eye contact?)
6. Does s/he show a range of facial expressions, for example, does s/he smile, frown,
pout, or raise his or her eyebrows in surprise? (Does s/he direct his or her facial
expressions to others; for example, does s/he look at you and smile? Do his/her
facial expressions always match the situation?)
7. Does s/he understand the expressions of other people’s faces; for example, when
you frown or have an angry face, does s/he stop and pay attention? Will s/he smile
back if you smile?
8. How does your child respond when you use a gesture? For example, if you point to a
picture in a book, will s/he look or point at it? Will s/he look where you point when
you want to show him/her something interesting across the room?

2. Deficits in social-emotional reciprocity including: lack of initiation of social contact,

 Yes
reduced sharing of interests, emotions and affect, abnormal social approach, failure of
 No
normal back and forth conversation.
First ask a few general questions, “How much of the time does s/he play alone versus
playing with a family member? Who does s/he like to play with in the family? What types of
activities or games do you (they) do together?” Then start with the questions below.
R S O
1. How does s/he let you know s/he wants you to pay attention to him/her or play with
him/her; for example, does s/he bring a toy or book to you? (Clarify whether s/he
brings a book or toy to engage parents in play and not just to get help).
2. If you say “I’m going to get you” or cover your eyes for peek-a-boo, does your child
get excited because s/he knows what’s going to happen next? (Does s/he request
you do it again, for example, by getting excited, grabbing your hand or saying
“more”)?
3. Will s/he play imitative games such as pat-a-cake or peek-a-boo? (Will s/he cover his
or her eyes to play peek-a-boo with you? Does s/he request you do it again?)
4. Will s/he copy or imitate what you do; for example, when you make funny sounds or
make funny faces, or when you wave bye-bye, clap your hands or shake your head
“no”?
5. If you sit down next to him or her and imitate what s/he is doing, will s/he watch
you, repeat what you are doing? (For clarification ask, “How does s/he usually react
when you sit down next to him/her to play? Does s/he only want you to watch?
Does s/he move away when you sit next to him or her?)

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R S O
6. Does your child give a hug or pretend to feed or take care of a doll or stuffed
animal? (For somewhat older children; will s/he imitate you when you are doing
housework such as dusting, sweeping or cooking? Does your child make hand
gestures or movements to familiar songs such as “itsy-bitsy-spider” or “wheels on
the bus”? Will s/he sing along and fill in a word in a familiar song?)
7. Will s/he take turns when playing with you? When you do something will s/he do
the same thing; if you do it again, does s/he do it again? For example, will s/he play
ball by rolling, kicking or throwing it back and forth? (How difficult is it to engage
your child when you or a sibling initiate the play?)
8. In a new or disturbing situation, does your child look to you for comfort?
9. How does s/he share his or her interests or accomplishments with you? For
example, will s/he bring a picture to show you, or make sure you come to see
something s/he has drawn or built? (Then does s/he get excited when you praise
him or her, for example, when you clap or if you say “nice job” or “big boy”?)
10. Does s/he recognize how you are feeling? For example, when upset, sad or ill, will
s/he try to comfort you or do something you like? (Also ask about siblings.)
11. If you make a comment to him or her but don’t ask a question, will s/he say
something in response? (Will s/he take turns vocalizing or communicating?)

 Yes 3. Deficits in developing and maintaining relationships appropriate to developmental level

 No (beyond those with caregivers) including: apparent absence of interest in people,
difficulties adjusting behavior to suit different social contexts, difficulties in sharing
imaginative play and in making friends.
Start this section by saying, “Now I would like to find out more about his/her relationships
with other children.”
R S O
1. Is s/he interested in other children? (If no, ask if there are other people s/he is
interested in).
2. Does s/he watch other children while they are playing at the park, school or
daycare? (Will s/he go over and play close to other children? Does s/he imitate what
they are doing?)
3. Does s/he talk to or try to join other children in their play? (How does s/he join
another child or group, e.g., go up and ask to play, start doing what the other
children are doing?)
4. How does s/he respond if other children talk to or try to play with him/her?
5. Is your child interested in making friends? For example, does s/he play regularly with
the same child or children at school or in the neighborhood? (What do they do when
they play together, for example, chase, cars & trucks, dolls, pretend kitchen?)
6. Does s/he talk about other children, ask about inviting children over to play or going
to play with another child? Is s/he invited to play at other children’s houses? (Clarify
whether the child or parent initiates.)

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R S O
7. Does s/he pretend a toy is something different, for example, a block or banana is a
phone? (Will s/he then hand it to you or a playmate to pretend to talk?)
8. Does s/he pretend toy figurines are talking to each other, offer you a pretend bite or
pretend to have a tea party and serve pretend food? Does s/he “make-believe” s/he
is someone or something else, or play other imaginative games? (Make sure to ask
how the child involves the parent or other children in his or her pretend or make-
believe play.)

 Yes B. Restricted, repetitive patterns of behavior, interests, or activities as manifested by 2 of

 No the following:

1. Stereotyped or repetitive speech, motor movements, or use of objects including: echolalia

 Yes
or idiosyncratic phrases, repetitive use of objects, simple motor stereotypes.
 No
Introduce this section by saying, “Now I would like to talk more about his/her use of speech
and language.” Then ask, “Is there anything unusual about his/her use of speech?” If the
child is non-verbal, ask “Is there anything unusual about his/her use of sounds?” and pay
particular attention to the following questions on the use of nonsense words and gibberish,
tone of voice, and rote repetition of musical notes from songs.
R S O
1. Does your child use his/her name instead of I; for example, “Melissa wants” instead
of “I want,” or does s/he mix up the pronouns s/he should use to refer to
her/himself, does s/he say “you want” when s/he means “I want?”
2. Does s/he often say what you said right afterward (immediate echolalia)?
3. Does s/he say the same word, sound or phrase over and over, or use scripted
language; for example, things you may have said or that s/he heard someone else
say, phrases from TV, a video or movie, songs from videos? (Does s/he repeat the
musical notes from songs in just the right order even though s/he doesn’t know the
words?)
4. Does s/he make nonsense noises or say nonsense words to himself/herself during
play; for example, humming, gibberish, words that s/he has made up?
5. Does s/he use the same tone of voice each time (for example, monotone or
scripted), have an odd intonation or have a sing-song pattern to his/her voice, or is
speech overly formal, like a teacher lecturing?
6. Next ask what are her/his favorite toys and activities. Then ask, does s/he play with
toys as you would expect; for example, driving toy cars around, or building
something with blocks or Legos?
7. Does s/he play with toys by doing the same thing over and over; for example, rolling
or dropping objects over and over? Does s/he always play with toys in the same way
(for example, lining up toy cars or sorting toys by color or size)? (Are there any other
times when s/he does the same thing over and over?)

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R S O
8. Does s/he have any physical mannerisms or odd way of moving his hands or his body
that look the same each time, e.g., flapping hands when excited, walking on his toes,
flicking his fingers, spinning or rocking his body?

 Yes 2. Excessive adherence to routines, ritualized patterns of verbal or nonverbal behavior, or

 No excessive resistance to change including: insistence on same route or food, motoric
rituals, repetitive questioning, extreme distress at small changes.
Introduce this discussion by stating “Many young children like things to happen in a certain
way or in a certain sequence.” Then proceed with question 1.
R S O
1. Does your child have routines that s/he set up? For example, are there things s/he
has to do in a particular way or sequence every time at bedtime, in the bathroom,
when dressing or when greeting others?
2. Does s/he have a markedly selective diet, eat the same few foods over and over and
resist new foods? Do foods need to be presented a certain way; for example, food
not touching on the plate or sandwich cut diagonally not straight across, food needs
to come from a certain package?
3. Does s/he have a marked insistence on adherence to the rules, show extreme
distress if rules are broken or incorrect information given, or insist on correcting
others?
4. Does your child get stuck asking the same question over and over, for example,
about an object, a situation, or a person? (Does s/he get stuck repeating the same
play routine over and over, resist any change to his or her routine if others join in?)
5. Does s/he have motor rituals, need to repeat an activity a certain number of times,
walk or pace in a certain pattern, or walk only along the outside of a sidewalk or the
perimeter of a room or park?
6. Does s/he become very upset (show extreme distress or irritability) if his or her
routine is interrupted or s/he can’t complete it; a block or toy car is moved out of
place, a special food is gone, s/he needs to stop an activity before s/he is finished or
when s/he needs to transition to another activity?
7. Does s/he become very upset with changes in a usual activity (for example, being
picked up by Mom instead of riding the bus home, an unexpected errand, a
substitute teacher or new child in the class), or changes in his/her environment, (for
example, how the furniture is arranged at home or classroom, where s/he sits at the
dinner table), or if you drive a different way to school or the store?
8. Does your child need to make sure everything is in its place (toys, clothes, towels in
the bathroom), make sure doors are closed or electrical appliances are off? Does
s/he repetitively count things (toys, money, steps) or repetitively name numbers and
letters?

3. Highly restricted, fixated interests that are abnormal in intensity or focus including: strong
 Yes
attachment to or preoccupation with unusual objects, excessively circumscribed or
 No
perseverative interests.
Introduce this section by saying, “Now I’d like to talk more about the toys s/he plays with.”

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R S O
1. Does s/he spend most of the time playing with just one or two toys or in one or two
activities? (Make sure to ask parents to describe the toy and activity. These special
interests may change over time).
2. Does s/he have any special interests that are unusual in intensity; for example, toys
or topics s/he always plays with or always talks about such as trains, letters and
numbers, or dinosaurs?
3. Is your child fixated by toys or objects that are shiny or that light up or spin (also see
B 4.1)? For example, does s/he repeatedly activate toys that are shiny or light up,
persist in staring at objects that spin such as a fan?
4. Is s/he preoccupied with only part of a toy; for example, spinning the wheels of a toy
car or opening and closing the car’s doors over and over? (Does s/he play with non-
functional parts of toys or objects, for example, the label on a blanket?)
5. Does your child play with objects that are not usually toys? For example, does s/he
carry around DVD cases, straws or strings? Does s/he always carry something around
in his or her hands? Is s/he preoccupied with certain activities (e.g., the vacuum,
water play, or flushing the toilet)?
6. Does s/he have any special interests in toys, activities or topics that seem unusual,
odd or advanced for his or her age; for example, astronomy, flags of the world,
sprinkler systems?

 Yes 4. Hyper- or hypo-reactivity to sensory input or unusual interest in sensory aspects of

 No environment including: apparent indifference to pain/heat/cold, adverse response to
specific sounds or textures, excessive smelling or touching of objects, fascination with
lights or spinning objects.
Introduce this section by saying, “Now I have some questions about how s/he responds to
different sensations such as touch and sound.”
R S O
1. Is your child fixated by toys or objects that are shiny or that light up or spin? Is s/he
overly interested in light reflecting from mirrors or other objects? (From B.3.3)
2. Is he/she fearful of some loud sounds; for example, noises of household appliances
such as the vacuum or babies crying? (How does s/he show s/he’s afraid?)
3. Does s/he like very tight hugs or forcefully press his or her face, head or body against
people or furniture?
4. Does s/he play with toys by touching them to his/her lips, smelling, sniffing or licking
them? Is your child fixated on chewing on non-food items?
5. Is your child overly interested in the way things feel? Does s/he enjoy touching or
rubbing certain surfaces, rubbing or twirling your hair or his/her hair?
6. Does s/he dislike wearing certain clothes, for example, won’t wear tight clothes,
won’t wear long sleeves or short sleeves, resists tags in clothes or seams in socks?
7. Does s/he only eat certain types of foods, for example, does s/he refuse to eat
certain textures, or only eat foods that are a specific temperature or color?
8. Do his or her hands need to be cleaned right away if sticky or dirty, or shirt changed
right away if wet or dirty? (Does s/he avoid messy materials such as paints or glue?)

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 R S O
9. Does s/he bring toys very close to his/her face, look out of the side of his/her eyes or
lay his/her head on the floor and look from the side at toys such as the wheels
turning on a toy car?
10. Does s/he have a high pain tolerance? How can you tell when s/he is having pain?

Supplemental Questions:
1. Has your child lost any skills once s/he has developed them? (A typical autistic regression involves
language and behavior and generally occurs between 14 and 24 months of age. For example, a child is
regularly using 4 or more words after 12 months of age and then stops using them, stops pointing or
use of other gestures and loses interest in engaging parents or playing social games such as pat-a-
cake.)
2. Does s/he put non-edible items in his mouth (pica)? Do you worry about him/her swallowing non-food
items?
3. Is your child clumsy? Does s/he fall a lot, have an odd-looking walk or run?
4. Do you have any other behavioral concerns?
a. Is s/he overly active, have difficulty sitting still?
b. Is s/he frequently irritable, have intense, angry outbursts?
c. Does your child say “No” or refuse to comply when asked to do something?
d. Does your child have many fears? Do you think your child worries more than other children?
e. Does s/he hurt him/herself deliberately, for example, banging his/her head, hitting his/her head
with hands or scratching face?
f. Is s/he aggressive with you, siblings, other children or adults; for example, hitting or pushing?
(Is it related to being told “No” or a limit being set, a toy the child wants or does it happen for
no apparent reason?)

*Interview questions are adapted from a number of sources including the ADI-R (Lord et.al., 1994), the Parent Interview
for Autism – Clinical Version (Stone et.al., 2002), the First Year Inventory (Reznick et.al., 2007), the Communication and
Symbolic Behavior Scales Developmental Profile Caregiver Questionnaire (Wetherby & Prizant, 2002), the CARS-2
Questionnaire for Parents or Caregivers (Schopler et.al., 2010), and the CDRC Autism Interview (unpublished).

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State Implementation Grant for Children with ASD and other Developmental
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