SRS-2 AutoScore Form
School Aged
Please select the answer that best describes your child's behavior over the last 6 months.
Personal Information
Child's name
*
Gender
*
Male
Female
Rater's name
*
Child's age
*
Years
Child's age
*
Months
Assessment Version
*
Please Select
School Aged
Date of rating
*
/
Month
/
Day
Year
Date
Relationship to rated individual
*
Mother
Father
Other custodial adult
Other custodial adult
Teacher
Other specialist
School or clinic
Supervisor / Administrator
*
i.e who assigned the assessment
Who assigned the assessment?
Please Select
Jennifer Tennyson
Krista Shotwell
Lisa Gravatt
Jenna Hall
Cassie Oliver
Katie Camp
Elyse Scafidi
Kamryn Ring
Casey Kerig
Brandi Webb
Carole Petner
Clare Prouty-Due
ADOS Evaluation
Unknown
Other
1. Seems much more fidgety in social situations than when alone.
Not true
Sometimes true
Often true
Almost always true
2. Expressions on his or her face don't match what he or she is saying.
*
Not true
Sometimes true
Often true
Almost always true
3. Seems self-confident when interacting with others.
*
Not true
Sometimes true
Often true
Almost always true
4. When under stress, child seems to go on "autopilot" (for example, shows rigid or inflexible patterns of beahvior that seem odd)
*
Not true
Sometimes true
Often true
Almost always true
5. Doesn't recognize when others are trying to take advantage of him or her.
*
Not true
Sometimes true
Often true
Almost always true
6.Would rather be alone than with others.
*
Not true
Sometimes true
Often true
Almost always true
7. Is aware of what others are thinking or feeling.
*
Not true
Sometimes true
Often true
Almost always true
8. Behaves in ways that seem strange or bizarre.
*
Not true
Sometimes true
Often true
Almost always true
9. Clings to adults, seems too dependent on them.
*
Not true
Sometimes true
Often true
Almost always true
10. Takes things too literally and doesn't get the real meaning of a conversation.
*
Not true
Sometimes true
Often true
Almost always true
11. Has good self-confidence.
*
Not true
Sometimes true
Often true
Almost always true
12. Is able to communicate his/her feelings to others in words or gestures.
*
Not true
Sometimes true
Often true
Almost always true
13. Is awkward in turn-taking interactions with peers (for example, doesn't seem to understand the give-and-take of conversations.
*
Not true
Sometimes true
Often true
Almost always true
14. Is not well coordinated.
*
Not true
Sometimes true
Often true
Almost always true
15. Is able to understand the meaning of other people's tone of voice and facial expressions.
*
Not true
Sometimes true
Often true
Almost always true
16. Avoids eye contact or has unusual eye contact.
*
Not true
Sometimes true
Often true
Almost always true
17. Recognizes when something is unfair.
*
Not true
Sometimes true
Often true
Almost always true
18. Has difficulty making friends, even when trying his or her best.
*
Not true
Sometimes true
Often true
Almost always true
19. Gets frustrated trying to get ideas across in conversations.
*
Not true
Sometimes true
Often true
Almost always true
20. Shows unusual sensory interests (for example, Mouthing objects or sinning objects,) or strange ways of playing with toys.
*
Not true
Sometimes true
Often true
Almost always true
21. Is able to imitate others' actions.
*
Not true
Sometimes true
Often true
Almost always true
22. Plays appropriately with children his or her age.
*
Not true
Sometimes true
Often true
Almost always true
23. Does not join group activities unless told to do so.
*
Not true
Sometimes true
Often true
Almost always true
24. Has more difficulty than other children with changes in his or her routine.
*
Not true
Sometimes true
Often true
Almost always true
25. Doesn't seem to mind being out of step with or "not on the same wavelength" as others.
*
Not true
Sometimes true
Often true
Almost always true
26. Offers comfort to others when they are sad.
*
Not true
Sometimes true
Often true
Almost always true
27. Avoids starting social interactions with peers or adults.
*
Not true
Sometimes true
Often true
Almost always true
28. Thinks or talks about the same thing over and over.
*
Not true
Sometimes true
Often true
Almost always true
29. Is regarded by other children as odd or weird.
*
Not true
Sometimes true
Often true
Almost always true
30. Becomes upset in a situation with lots of things going on.
*
Not true
Sometimes true
Often true
Almost always true
31. Can't get his or ger mind off something once he or she starts thinking about it.
*
Not true
Sometimes true
Often true
Almost always true
32. Has good personal hygiene.
*
Not true
Sometimes true
Often true
Almost always true
33. Is socially awkward, even when he or she is trying to be polite.
*
Not true
Sometimes true
Often true
Almost always true
34. Avoids people who want to be emotionally close to him or her.
*
Not true
Sometimes true
Often true
Almost always true
35. Has trouble keeping up with the flow of conversation.
*
Not true
Sometimes true
Often true
Almost always true
36. Has difficulty relating to adults.
*
Not true
Sometimes true
Often true
Almost always true
37. Has difficulty relating to peers.
*
Not true
Sometimes true
Often true
Almost always true
38. Responds appropriately to mood changes in others (for example: when a friend's or playmate's mood changes from happy to sad).
*
Not true
Sometimes true
Often true
Almost always true
39. Has an unusually narrow range of interests.
*
Not true
Sometimes true
Often true
Almost always true
40. Is imaginative, good at pretending (without losing touch with reality).
*
Not true
Sometimes true
Often true
Almost always true
41. Wanders aimlessly from one activity to another.
*
Not true
Sometimes true
Often true
Almost always true
42. Seems overly sensitive to sounds, textures, or smells.
*
Not true
Sometimes true
Often true
Almost always true
43. Separates easily from caregivers.
*
Not true
Sometimes true
Often true
Almost always true
44. Doesn't understand how events relate to one another (cause and effect) the way other children his or her age do.
*
Not true
Sometimes true
Often true
Almost always true
45. Focuses his or her attention to where others are looking or listening.
*
Not true
Sometimes true
Often true
Almost always true
46. Has overly serious facial expressions.
*
Not true
Sometimes true
Often true
Almost always true
47. Is too silly or laughs inappropriately.
*
Not true
Sometimes true
Often true
Almost always true
48. Has a sense of humor, understands jokes.
*
Not true
Sometimes true
Often true
Almost always true
49. Does extremely well at a few tasks, but does not do as well at most other tasks.
*
Not true
Sometimes true
Often true
Almost always true
50. Has repetitive, odd behaviors such as hand flapping or rocking.
*
Not true
Sometimes true
Often true
Almost always true
51. Has difficulty answering questions directly and ends up talking around the subject.
*
Not true
Sometimes true
Often true
Almost always true
52. Knows when he or she is talking too loud or making too much noise.
*
Not true
Sometimes true
Often true
Almost always true
53. Talks to people with an unusual tone of voice (for example, talks like robot or like he or she is giving a lecture).
*
Not true
Sometimes true
Often true
Almost always true
54. Seems to react to people as if they are objects.
*
Not true
Sometimes true
Often true
Almost always true
55. Knows when he or she is too close to someone or is invading someone's space.
*
Not true
Sometimes true
Often true
Almost always true
56. Walks in between two people who are talking.
*
Not true
Sometimes true
Often true
Almost always true
57. Get's teased a lot.
*
Not true
Sometimes true
Often true
Almost always true
58. Concentrates too much on parts of things rather than seeing the whole pictures. For example, if asked to describe what happened in a story, he or she may talk only about the kid of clothes the characters are wearing.
*
Not true
Sometimes true
Often true
Almost always true
59. Is overly suspicious.
*
Not true
Sometimes true
Often true
Almost always true
60. Is emotionally distant, doesn't show his or her feelings.
*
Not true
Sometimes true
Often true
Almost always true
61. Is inflexible, has a hard time changing his or her mind.
*
Not true
Sometimes true
Often true
Almost always true
62. Gives unusual or illogical reasons for doing things.
*
Not true
Sometimes true
Often true
Almost always true
63. Touches others in an unusual way (for example, he or she may touch someone just to make contact then walk away without saying anything).
*
Not true
Sometimes true
Often true
Almost always true
64. Is too tense in social settings.
*
Not true
Sometimes true
Often true
Almost always true
65. Stares or gazes off into space.
*
Not true
Sometimes true
Often true
Almost always true
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