Autism Survey
This survey is for purposes of determining characteristics standard to autism, and should be completed by people on the autistic spectrum only, whether diagnosed or not. Neurotypical parents and professionals, do not take this survey. Click here for the neurotypical perspective survey. The purpose of this particular survey is not to find out your perceptions of your autistic child/patient's condition, but to determine how autism is seen through the eyes of the autistic.
The following questions are a general survey of traits that are commonly considered to be indicative of autism. Please answer these questions as briefly as possible. However, keeping in mind that pat answers are often not entirely applicable, text input has been provided to allow for explanation of the answer if you feel there is a need for it.
All radio () button choices are required. Just give the closest answer you can or "No" if you really just don't know. All other required fields are marked as such.
A Note to Curmudgeons: If you have the need to make a snide, cynical or sarcastic remark, feel free, but please identify it as such. :-) |
Classification (for statistical purposes only) |
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There is some debate on whether Asperger's is autism or a derivitive thereof, and also whether LFA or HFA are even valid diagnoses. Therefore, for purposes of general classification, please state your "degree" of autism. |
Low-Functioning Autistic (LFA)
High-Functioning Autistic (HFA)
Asperger's Syndrome (AS)
Autistic Spectrum Disorder (ASD)
Pervasive Developmental Disorder-Not Otherwise Specified (PDD-NOS)
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If LFA or HFA, please explain this conclusion briefly: |
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Have you been diagnosed by a professional? |
Yes
No
If no, explain: |
Please state the year of your birth (required): |
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Please state your gender: |
Female
Male
Other (AIS or Hermaphroditic) |
Co-morbid Conditions |
Learning Disability: |
Yes
No
Explain: |
| Attention Deficit Disorder (ADD): |
Yes
No |
| Obsessive Compulsive Disorder (OCD): |
Yes
No |
| Central Auditory Processing Disorder (CAPD): |
Yes
No |
| Hyperlexia: |
Yes
No |
| Depression (clinical): |
Yes
No |
| Anxiety: |
Yes
No |
| Non-verbal Learning Disorder (NVLD): |
Yes
No |
| Hypertension: |
Yes
No |
| Semantic Pragmatic Language Disorder: |
Yes
No |
| Tourette's Syndrome: |
Yes
No |
| Dysthymia: |
Yes
No |
| Other (please specify): |
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Additional Autistic Features |
If you feel there are other aspects that are applicable to autism, please give a brief synopsis here. |
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| Are you a "savant"? |
Yes
No |
Questionnaire: |
What, in your opinion, is the cause of autism? |
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Do you believe autism can be cured? |
Yes
No |
If a cure were found, would you want it, and why (or why not)? |
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Are you currently employed? |
Yes
No |
If not, are you seeking employment? |
Yes
No |
If you are seeking employment, what are some things you feel are causing difficulty in obtaining it? |
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Do you feel it is possible for NTs (neurotypicals, "normal people") to better understand us (autistics) given the opportunity? |
Yes
No
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