Autism Social Skills Profile

7/27/2019 Autism Social Skills Profile

1/5

Autism Social Skills Profile

Scott Bellini

Childs Name:______________________________________________________________________

Birthdate: ____________ Age: _____ Sex: GFemale GMale Todays Date: ____________

School: _______________________________________________________________ Grade: ______

Your Name: ______________________________________________________________________

Relationship to Child: GMother GFather GGuardian GOther ______________________

Street Address: ____________________________________________________________________

City: ________________________________________ State: ________ Zip: ________________

Phone: ( ) ________________________________________________________________

The following phrases describe skills or behaviors that your child might exhibit dur-

ing social interactions or in social situations. Please rate HOW OFTEN your child

exhibits each skill or behavior independently, without assistance from others

(i.e., without reminders, cueing and/or prompting). You should base your judgment

on your childs behavior over the last 3 months.

Please use the following guidelines to rate your childs behavior:

Circle N if your child never or almost never exhibits the skill or behavior.

Circle S if your child sometimes or occasionally exhibits the skill or behavior.

Circle O if your child often or typically exhibits the skill or behavior.

Circle V if your child very often or always exhibits the skill or behavior.

Please do not skip any items. If you are unsure of an item, please provide your

best estimate. You may use the Brief Description section to provide additional infor-mation on the particular skill or behavior. For instance, if your child will exhibit a par-

ticular skill or behavior more frequently when cueing or prompting is provided, or

when interacting with adults rather than peers, please make note of this in the Brief

Description section.

FIRST MIDDLE LAST

FIRST MIDDLE LAST

MO. DAY YEAR MO. DAY YEAR


2/5


Skill Area How Often Brief Description

Invites Peers to Join Him/Her inActivities

N S O V1 2 3 4

Joins in Activities With PeersN S O V1 2 3 4

Takes Turns During Games andActivities

N S O V1 2 3 4

Maintains Personal HygieneN S O V1 2 3 4

Interacts With Peers DuringUnstructured Activities

N S O V1 2 3 4

Interacts With Peers DuringStructured Activities

N S O V1 2 3 4

Asks Questions to RequestInformation About a Person

N S O V1 2 3 4

Asks Questions to RequestInformation About a Topic

N S O V1 2 3 4

Engages in One-On-One SocialInteractions With Peers

N S O V1 2 3 4

Interacts With Groups of PeersN S O V1 2 3 4

Maintains the Give-and-Take of

ConversationsN S O V1 2 3 4

Expresses Sympathy for OthersN S O V1 2 3 4

Talks About or Acknowledges theInterests of Others

N S O V1 2 3 4

Never Sometimes Often Very often

N S O V


3/5


N S O V


Recognizes the Facial Expressionsof Others

N S O V1 2 3 4

Recognizes the Nonverbal Cues,or Body Language of Others

N S O V1 2 3 4

Requests Assistance From OthersN S O V1 2 3 4

Understands the Jokes or Humor

of Others

N S O V1 2 3 4

Maintains Eye Contact DuringConversations

N S O V1 2 3 4

Maintains an AppropriateDistance When Interacting WithPeers

N S O V1 2 3 4

Speaks With an AppropriateVolume in Conversations

N S O V1 2 3 4

Considers Multiple ViewpointsN S O V1 2 3 4

Offers Assistance to OthersN S O V1 2 3 4

Verbally Expresses How He/She IsFeeling

N S O V1 2 3 4

Responds to the Greetings of

OthersN S O V1 2 3 4

Joins a Conversation With Two orMore People Without Interrupting

N S O V1 2 3 4

Initiates Greetings With OthersN S O V1 2 3 4



4/5


N S O V


Provides Compliments to OthersN S O V1 2 3 4

Introduces Self to OthersN S O V1 2 3 4

Politely Asks Others to Move outof His/Her Way

N S O V1 2 3 4

Acknowledges the Compliments

Directed at Him/Her by Others

N S O V1 2 3 4

Allows Peers to Join Him/Her inActivities

N S O V1 2 3 4

Responds to the Invitations ofPeers to Join Them in Activities

N S O V1 2 3 4

Allows Others to Assist Him/HerWith Tasks

N S O V1 2 3 4

Responds to Questions Directedat Him/Her by Others

N S O V1 2 3 4

Experiences Positive PeerInteractions

N S O V1 2 3 4

Compromises DuringDisagreements With Others

N S O V1 2 3 4

Responds Slowly in

ConversationsN S O V1 2 3 4

Changes the Topic ofConversation to Fit Self-Interests

N S O V1 2 3 4

Misinterprets the Intentions ofOthers

N S O V1 2 3 4



5/5


N S O V


Makes Inappropriate CommentsN S O V1 2 3 4

Engages in Solitary Interests andHobbies

N S O V1 2 3 4

Ends Conversations AbruptlyN S O V1 2 3 4

Fails to Read Cues to Terminate

Conversations

N S O V1 2 3 4

Exhibits Fear or AnxietyRegarding Social Interactions

N S O V1 2 3 4

Experiences Negative PeerInteractions

N S O V1 2 3 4

Engages in Socially InappropriateBehaviors

N S O V1 2 3 4

Exhibits Poor Timing With His/HerSocial Initiations

N S O V1 2 3 4

Is Manipulated by PeersN S O V1 2 3 4

Engages in Solitary Activities inthe Presence of Peers

N S O V1 2 3 4


For more information on how to use this assessment tool in the context of teaching social skills, see S. Bellini, BuildingSocial Relationships: A Systematic Approach to Teaching Social Interactin Skills to Children and Adolescents with AutismSpectrum DIsorders and Other Social Difficulties2006; AAPC Publishing; www.asperger.net

Documents

Autism Social Skills Profile