The Autism Assessment Report template by s10.ai is expertly crafted for speech pathologists to meticulously document comprehensive evaluations of individuals potentially diagnosed with Autism Spectrum Disorder (ASD). This template encompasses critical areas such as developmental history, social communication variances, and restricted behaviors, while also incorporating sections for family and medical background, educational history, and Autism Quotient scoring. Perfect for clinicians performing in-depth assessments, this template guarantees detailed documentation of observed behaviors and developmental milestones, facilitating the development of personalized intervention strategies. Implement this template to optimize the assessment process and improve communication with families and fellow healthcare professionals.
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Example of completed documentation using this template
AUTISM ASSESSMENT REPORTBACKGROUND INFORMATIONReason for assessment: Developmental differences were initially observed at age 2 when the patient, Alex, exhibited delayed speech and limited social engagement. Current strengths include a strong visual memory and a keen interest in puzzles. Concerns involve difficulties in social environments and repetitive behaviors. The assessment was suggested by Alex's pediatrician and preschool teacher. Family history indicates that Alex's uncle was diagnosed with Autism.Family SituationAlex resides with both parents and a younger sister. The family is supportive, with both parents actively participating in Alex's therapy sessions. There is a family history of Autism on the father's side.Medical BackgroundAlex was born full-term without complications. He has no known allergies and is not on any regular medication. Hearing and vision assessments are normal.Developmental HistoryAlex achieved early developmental milestones such as crawling and walking on time but showed delays in speech and social interaction. Currently, Alex requires support in communication and social skills.Behavioural HistoryAt home, Alex displays repetitive behaviors such as lining up toys and has difficulty with changes in routine. At school, he struggles with group activities and prefers solitary play.Educational HistoryAlex attends a local preschool where his teacher completed the educator questionnaire. He receives funded support for speech therapy and occupational therapy.Previous Assessments and InterventionsAlex has been assessed by a pediatrician and a speech pathologist. He receives NDIS funding for therapy services.SOCIAL COMMUNICATION DIFFERENCESA1: Social Approach and InteractionAlex prefers solitary play and has specific interests in puzzles. He engages minimally in social gatherings and often requires prompts to interact with peers.A2: Nonverbal CommunicationAlex uses limited eye contact and gestures. He often relies on pointing to communicate needs.A3: Play Style and FriendshipsAlex enjoys structured play and has difficulty making and maintaining friendships. He often plays alongside peers rather than with them.RESTRICTED AND REPETITIVE BEHAVIOURSB1: Repetitive BehavioursAlex frequently repeats phrases and engages in repetitive hand movements.B2: Routines and TransitionsAlex has established routines and struggles with transitions, often becoming upset with unexpected changes.B3: Special Interests and CollectionsAlex has a strong interest in collecting toy cars and can spend hours organizing them.B4: Sensory Processing DifferencesAlex shows hypersensitivity to loud noises and prefers quiet environments.AUTISM QUOTIENT SCORINGAlex's Autism Quotient (AQ) score indicates significant challenges in social skills and communication, with a total score of 35, suggesting a high likelihood of Autism based on standard scoring thresholds.
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