File 2259405 SMART Observation Checklist 20200507 175926
File 2259405 SMART Observation Checklist 20200507 175926
File 2259405 SMART Observation Checklist 20200507 175926
Delay in, or total lack of, the development of spoken language Comments
□ Delay in speaking first words
□ Delay in combining words
□ Delay in current language ability (quantity or quality)
Difficulty holding conversation Comments
□ Does not make small talk (just to be friendly)
□ Rarely/never initiates conversation
□ Difficulty sustaining conversation
□ Difficulty discussing topics chosen by another person
□ Says inappropriate things
□ Doesn't understand sarcasm/humor
Unusual or repetitive language Comments
□ Repeats what others say often (e.g., movies, people, etc.)
□ Uses incorrect pronouns (e.g., she instead of I)
□ Speaks in an overly formal way
□ Unusual volume, rate, or pitch
Play that is not developmentally appropriate Comments
□ Doesn't imitate (e.g., vacuuming, phone, etc.)
□ No/limited pretend play (e.g., doll, action figure, etc.)
□ No imaginary play (e.g., pretending an object is another, etc.)
Restricted, Repetitive, Stereotyped Behaviors/Movements
Interests that are narrow in focus, intense, or unusual Comments
□ Nonfunctional play with toys (e.g., lining up toys)
□ Repeatedly watching individual scenes in movies
□ So focused on one thing to the exclusion of others
Unreasonable insistence on sameness/routines Comments
□ Rituals/routines that need to be done in a particular way/order
□ Difficulty with minor change in routine
□ Upset if objects are rearranged □
□ Difficulty with transitions
Repetitive motor mannerisms Comments
□ Hand flapping or wringing
□ Toe walking
□ Head banging
Preoccupation with parts of objects Comments
□ Playing with parts of toys (e.g., doors, wheels, strings)
Adapted 8/17/15 from Autism Communication Tool created by Maureen Turner, Psy.D.
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Social Skills
Lack of social or emotional reciprocity Comments
□ Doesn't respond to his/her name
□ Doesn't enjoy/seek out social games (e.g., peek-a-boo)
□ Limited empathy towards others’ feelings
Difficulty using nonverbal behaviors to regulate social interaction Comments
□ Inconsistent eye contact (unusual quality or coordination)
□ Doesn't nod for yes or shake head for no
□ Doesn't direct facial expressions towards others
□ Doesn't read others’ facial expressions (e.g., feelings)
□ Doesn't go to others to be comforted when hurt
□ Doesn't recognize personal space
Little sharing of pleasure, achievements, or interests with others Comments
□ Doesn't point to indicate wants (e.g., bottle, toys, etc.)
□ Doesn't point to indicate interests (e.g., plane, dog, etc.)
□ Doesn't share things with others
□ Isn't interested in praise or compliments
Failure to develop age-appropriate peer relationships Comments
□ Limited/unusual response to peer initiation
□ Limited/unusual initiation of interactions with peers
□ Prefers to be alone
□ Gets along only with much older/younger children
Associated Concerns
Unusual sensory interests Comments
□ Strong sensory preferences (e.g., food textures)
□ Sensory seeking behavior (e.g., excessive smelling or touching)
□ Sensory interests rather than toys/games direct activities
Unusual responses to sensory input Comments
□ Indifference to pain, heat, or cold
□ Sensitivity to lights or sounds
□ Irritated by clothing or tactile input
Delayed motor skills Comments
□ Delayed gross motor (e.g., odd gait, poor balance, etc.)
□ Delayed fine motor (e.g., handwriting, buttoning clothes, etc.)
Other Comments
Adapted 8/17/15 from Autism Communication Tool created by Maureen Turner, Psy.D.
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