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Adolescent Autism Spectrum Quotient (AQ10) - Parent/Guardian
Assessment 1 of 13
Form Instructions & Things to Know
How to fill this form:
Read each question carefully before selecting an answer.
Select the most accurate option based on your observations.
Do not skip questions; every response helps in the assessment.
Things to know:
10-15 Mins
Estimated completion time.
Secure
Your data is fully encrypted.
Note:
This is a screening and assessment tool, not clinical (medical).
First, please provide your contact information.
Your Full Name
Email Address
Phone Number
Information about the individual being assessed.
Who are you filing for?
Choose relationship...
Self
Child
Partner
Family Member
Friend
Caretaker
Guardian
Teacher/Tutor
Name of Individual Being Assessed
Date of Birth
Age
Gender
*
Select Gender
Male
Female
School Grade (Optional)
Assessment Reasons / Reason for Assessment
1. She or he notices patterns in things all the time
Definitely Agree
Slightly Agree
Slightly Disagree
Definitely Disagree
2. She or he usually concentrates more on the whole picture, rather than the small details
Definitely Agree
Slightly Agree
Slightly Disagree
Definitely Disagree
3. In a social group, she or he can easily keep track of several different people’s conversations
Definitely Agree
Slightly Agree
Slightly Disagree
Definitely Disagree
4. If there is an interruption, she or he can switch back to what she or he was doing very quickly
Definitely Agree
Slightly Agree
Slightly Disagree
Definitely Disagree
5. She or he frequently finds that s/he doesn’t know how to keep a conversation going
Definitely Agree
Slightly Agree
Slightly Disagree
Definitely Disagree
6. She or he is good at social chit-chat
Definitely Agree
Slightly Agree
Slightly Disagree
Definitely Disagree
7. When she or he was younger, she or he used to enjoy playing games involving pretending with other children
Definitely Agree
Slightly Agree
Slightly Disagree
Definitely Disagree
8. She or he finds it difficult to imagine what it would be like to be someone else
Definitely Agree
Slightly Agree
Slightly Disagree
Definitely Disagree
9. She or he finds social situations easy
Definitely Agree
Slightly Agree
Slightly Disagree
Definitely Disagree
10. She or he finds it hard to make new friends
Definitely Agree
Slightly Agree
Slightly Disagree
Definitely Disagree
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