Adult Autism Spectrum Disorder Diagnostic Assessment

Name

Address

Email Address

Tick box where appropriate Tick box where appropriate Confidentially limitations explained School Reports Professional reports Questionaires returned

1. What do you hope to gain from this assessment? What might it bring about for you? How will you feel is you aren’t given a diagnosis?

2a. What are your current difficulties?

2b. When did you first become aware of having these difficulties?

3. Have you seen any professionals in the past regarding your difficulties?

4. Family Background (Parents, siblings, age occupation, relationships, psychiatric, medical, social)

9. Any unusual speech observed (monotonous, odd tone of voice, too fast, too slow, unusually pedantic or formal, odd words or phrases, idiosyncratic phrases, unusually repetitive)

Do you have any difficulties understanding what is said to you?

Do you have difficulties taking things too literally?

Do you have difficulties not understanding implied meanings?