Neurodevelopmental Assessment Social-Communication Questionnaire

This questionnaire is designed to gather information about the social-communication skills and behaviour of children and young people aged 3 to 18 years. Please answer relevant to the individual’s age and learning context.  If you are unsure regarding any items (i.e. you cannot provide a definitive yes/no response), you can note this as  “DK” – don’t know. 

The SCQ is an essential part of the autism assessment.  We understand that young person can present differently across settings.  Your observations are important to us in understanding the young person’s presentation and possible support needs across contexts.  Even if you have few or no concerns, please complete the form stating this (see back page) so as to inform next steps in the assessment.

To save your progress, make sure you are logged in and click 'Save Draft' at the bottom of the page. You can then return when ever you like to complete the form.

Neurodevelopmental Assessment Social-Communication Questionnaire

Child's Details:

Child's Name
Child's Name
Name
Surname

Attendance

Is the child/young person following a reduced or restricted timetable?
If school attendance is irregular, has the Education Welfare Service been informed?

School Supports

What supports, if any, does he/she receive:

Language Skills:

Functional Communication:

tick which applies and describe further where necessary

Social Communication and Interaction

Social Initiation and Responses: tick which applies and describe further where necessary
Conversation: tick which applies and describe further where necessary

Non Verbal Communication tick which applies and describe further where necessary

Eye Contact
Facial Expression
Gesture
Body Language
Tone of Voice
Integration of Verbal and Non-Verbal Communication

Developing and Maintaining Relationships and Sharing in Imaginative Play tick which applies and describe further where necessary

Friendships: tick which applies and describe further where necessary
Interaction Style: tick which applies and describe further where necessary
Understanding of Social Situations / Rules & Boundaries: tick which applies & describe further where necessary

Restricted, Repetitive Patterns of Behavior, Interests or Activities

Stereotyped or Repetitive Speech: tick which applies and describe further where necessary
Stereotyped or Repetitive Motor Movements: tick which applies and describe further where necessary
Stereotyped or Repetitive use of Objects: tick which applies and describe further where necessary
Adherence to Routines, Ritualised Patterns of Behaviour, and Resistance to Change: tick which applies and describe further where necessary
Imagination and Creativity: tick which applies and describe further where necessary

Restricted and or Intense Interests

Preoccupations: tick which applies and describe further where necessary

Sensory Processing: tick which applies and describe further where necessary

Response to Noise: tick which applies and describe further where necessary
Response to Touch: tick which applies and describe further where necessary
Response to Movement: tick which applies and describe further where necessary
Response to Taste/ Smell: tick which applies and describe further where necessary
Response to Visual Stimulation: tick which applies and describe further where necessary

Academic Attainments / Supports

Organisation & Attention/Concentration Skills: tick which applies and describe further where necessary
Homework
Mood / Behavioural and Emotional Wellbeing

Completed By:

Name
Name
Name
Surname