1
.
Do you like to arrange items in rows or patterns?
Never or rarely
One or more times daily (mild or occasional)
15 or more times daily (marked or notable)
30 or more times daily (serious or severe)
2
.
Do you repetitively fiddle with items? (e.g. spin, twiddle, bang, tap, twist, or flick anything repeatedly?)
Never or rarely
One or more times daily (mild or occasional)
15 or more times daily (marked or notable)
30 or more times daily (serious or severe)
3
.
Do you like to spin yourself around and around?
Never or rarely
One or more times daily (mild or occasional)
15 or more times daily (marked or notable)
30 or more times daily (serious or severe)
4
.
Do you rock backwards and forwards, or side to side, either when sitting or when standing?
Never or rarely
One or more times daily (mild or occasional)
15 or more times daily (marked or notable)
30 or more times daily (serious or severe)
5
.
Do you pace or move around repetitively (e.g. walk to and fro across a room, or around the same path in the garden?)
Never or rarely
One or more times daily (mild or occasional)
15 or more times daily (marked or notable)
30 or more times daily (serious or severe)
6
.
Do you make repetitive hand and/or finger movements? (e.g. flap, wave, or flick your hands or fingers repetitively?)
Never or rarely
One or more times daily (mild or occasional)
15 or more times daily (marked or notable)
30 or more times daily (serious or severe)
7
.
Do you have a fascination with specific objects (e.g. trains, road signs, or other things?)
Never or rarely
Mild or occassional
Marked or notable
8
.
Do you like to look at objects from particular or unusual angles?
Never or rarely
Mild or occassional
Marked or notable
9
.
Do you have a special interest in the smell of people or objects?
Never or rarely
Mild or occassional
Marked or notable
10
.
Do you have a special interest in the feel of different surfaces?
Never or rarely
Mild or occassional
Marked or notable
11
.
Do you have any special objects you like to carry around?
Never or rarely
Mild or occassional
Marked or notable
12
.
Do you collect or hoard items of any sort?
Never or rarely
Mild or occassional
Marked or notable
13
.
Do you insist on things at home remaining the same? (e.g. furniture staying in the same place, things being kept in certain places, or arranged in certain ways?)
Never or rarely
Mild or occasional (does not affect others)
Marked or notable (occasionally affects others)
Serious or severe (affects others on a regular basis)
14
.
Do you get upset about minor changes to objects (e.g. flecks of dirt on your clothes, minor scratches on objects?)
Never or rarely
Mild or occasional (does not affect others)
Marked or notable (occasionally affects others)
Serious or severe (affects others on a regular basis)
15
.
Do you insist that aspects of daily routine must remain the same?
Never or rarely
Mild or occasional (does not affect others)
Marked or notable (occasionally affects others)
Serious or severe (affects others on a regular basis)
16
.
Do you insist on doing things in a certain way or re-doing things until they are 'just right'?
Never or rarely
Mild or occasional (does not affect others)
Marked or notable (occasionally affects others)
Serious or severe (affects others on a regular basis)
17
.
Do you play the same music, game or video, or read the same book repeatedly?
Never or rarely
Mild or occasional (not entirely resistant to change or new things)
Marked or notable (will tolerate changes when necessary)
Serious or severe (will not tolerate any changes)
18
.
Do you insist on wearing the same clothes or refuse to wear new clothes?
Never or rarely
Mild or occasional (not entirely resistant to change or new things)
Marked or notable (will tolerate changes when necessary)
Serious or severe (will not tolerate any changes)
19
.
Do you insist on eating the same foods, or a very small range of foods, at every meal?
Never or rarely
Mild or occasional (not entirely resistant to change or new things)
Marked or notable (will tolerate changes when necessary)
Serious or severe (will not tolerate any changes)
20
.
If you are left to occupy yourself, will you choose from a restricted range of repetitive activities?
A range of different and flexible self-chosen activities
Some varied and flexible interests but commonly choose the same activities
Almost always choose from a restricted range of repetitive activities
Score