Setial Communication Questionnaire (SCA) lifetime BC Answer sheet RS, Anthony Baiey, M.D, Sibel “anak Berument, PrD, ‘ne Lord, PhD, and Andrew Pickles, 2h. Name of usiect{__—_) 0.08 LE imerview Date LB ace: Gender OF OM Name of Respondent: TT petationtosbjecr Directions: Thank you fo taking the time 0 complet this questionnaire. Plaste answer a2ch quertion Dy slecting yes corr A few guesvore atk auovtzevera| rested Types of behavior please selec yet ony of raze sanaviors ware fpresene uring ene saat 3 mantns, enough you may oe uncarta” aueut whether som Denavo“ ware present Shas, inate answer yes or no to every question on te bass of what you tink. rem 4. Insveyhe now able to tikusing shor ohaueso* sentences? ifn, skp to question 8, 2. Can yau haveate ane fo “comarsation” with ne/tim that involve taking torn or bulcing fon what you rave sia? 2. as sre/he ever Use odd ohranesor say the same thing over and aver in almost exactiy the sameway (ether shases thet she/he hears other ecole use or ones tha she/he makes uo? AL Har sna/he aver Use socaly naparoprate questions or taterrons? For examale mar sve/he lay ack perzenal questions or make persona! comments at awkward times? 5. Has sne/re ever ganan his/her pronouns micas up leg, saying you a zhe/he for? as ene se evar su urge enat shane seem to Nave inverted oe ava up at/nimse pvt things in 20, incirac ways; or use metaphorical ways af saying things le saving ar ain forma? 7. Has she/he aver say she same thing over ard overin scaly he sume way or insse at you saythe same ming over snd over agin? 2. as eng so nave tinge shat ane Pa see™e toc in' very parveular way or order or ritualz ‘hat she/he insisted that you go through? 9. famine Wefan xpress'one usualy szemed aperopriate to the particular stustion, as fara youcan aii? 410, Has shee over ures yourhan ke top! or a Fit were pert afi herawn Body ie 2. pointing with your finger or auting your hand on # daoringb 0 Ret yout> open the door? 41, Han ane/ne aver have any interests that preaccupy her/nim and might seem eddto other people jeg, raf lights, arainppes, ar uatabies)? 12. Han sne/he aver seeressta’0¢ more intareted in pats of atoy ar an bese |e-g spinning thewheeis ofacar, ether nan using she anject as it was itenea? 43. Has ane/ne ver have any spec interests that are unusvol in thir intensity but otherwise sporepriate forhis/ner age and peer group (eg, t8ins or dincsaurs)? 14, Hot sv4/he ever seemesito be unutuovy ntavasted inthe sgn esl oun, taste, or smal of sings or atom? 4S, Haz she/he ever have any mannerisms or off ways of moving her/his hands ar Rrgers, suchas ‘apping oF moving ners fingers in fone of nar/ns eyes? 16, Hat sre/he aver rave any complicated mavemants of her/his whole body, suchas spinning or repeatesly Louncing wo and dows? 17, Has she/he ever injurec her/himseif deliberately, such a5 by Bing her/his wm or banging her/nieneae? 18, Hap sra/he aver nave any objects oenartnan a soft ea or confor sankat] that she/he had rocarryaround? 13. Does shenenaveany partcuar frends ora bestfriend? e0ne00eeeeoaese Oooo OOF 0000000000000 000000Forte fallow sehavior, plane foes onthe time period bacw aan the chid's fourth and fifth birthday. You may fing iteasierto remember how things were at that time by focusing on key events, such a8 starting school, moving house Cstmastie, of other spec vents that are particularly memorable for you as fami. f your en'dis nat yet 4 yezrs od, pase consider er 9 his Benavior in the past 12 montns tem 20. Whan shane was-$10 5, eld sne/he eve tak with you ustto be friendly rather shan te pet someting]? 21. When she/ne was 105, did zne/he aver ssoroneously cony you for other peopl) or what you are doing |aven a vacuuming, gardening, or mending ings)? 22. Whanshe/ne was to 5, cd 2ne/he ever sportaneovtly point things aroune!neim jest ‘to show you things (not because she/he warts hem? 23, Wnanshe/ne as-5t0 5, cldsnafhe ever ute gesture, other than peinting ar puling your raed, to lat you kraw what she/he wants? 24. Whenshe/he was 410 5, ld sne/he nod her/his hans to mean yer? 25. When shane wast 5, cid eho shake her/his bead 2 mean 20? 26, Whenshe/ne was 4to 5, 6d she/he usualy look a you Sirectiy in the face when doing things with you orslking with you? 27, Whensnejne was 410 5 ld sra/he sila backit someone smiles ather/Wim? 28, Whanzns/ne wat 4495, eid sne/he ever snow you tinge tat interest nev/nien to angus yoursmenton? 25, Whensne/ne was 419, shale svar ofr ts thare thing ctner tian fo0e ite you? 30, When ane/ne was to 5, gid she/he aver seem 10 want yu tojain in herfhis enjoyment of someting? 31 Whenshe/ne was4to 5, id she/he evar try to comfor you Ifyou are sas orhun? 32. Whenshe/he was 405, wen she/he wants somthing or wantshlg, ic she/he look at you 70 use gestures with sounds or wares to get your attention? 33, Whenshe/ne was 41 5; id she/he show a normal range of fecal exaresions? 34 whan shane was. 105, eid sne/he aver scontaneoutiy pin in ara te copy te actions in social games, su0n 25 The Muloerry Bush af London Bncges Fling Down? 35, When she/ne was 40 5, id ana/he pay any pretend or make-olinvs games? 36, When she/ne wa 40 5, oid she/he saa interested in other children of agpravimataly the same age whom she/ne oi not know? 237. Wnen ane/na was 4105, oid sne/he resgond positively nan ansther cli appreaened her/him? 38. When she/he was 410 §, if you come into 2 room and startaikng to her/him wnout cling per/nis name, a she/he usually look vp and pay attention to you? 239. When she/ne was 4a 5, cid she/he ever play imaginative games wlth another child in sucha vay tat ou ca tel thar eaen end unsertanas wnat te other's pratense? 49, wen mne/ne was 4ta 5 id she/he play copertivaly in games that nae some form of {siting nwt sraus af steer enigren such az hids-snd-seek or ba zamas? eeeaocoooooo0Oo000000 CGC OF ©@0000000000000000000 07