Assessment of social-emotional and behavioral development in children

Chief Complaint

Assessment of social-emotional and behavioral development in children

Template

### A1. Social-emotional reciprocity [Indicate if there is a problem in any of these areas. Depending on the item, it may be the presence or absence/reduction that is concerning.] - **Show/Give**: Observe if the child brings a toy over to you or the caregivers to show or give it to them. Note if the child orients the item to be more easily seen by someone else, ideally combined with eye contact. - **Initiate joint attention**: Does the child point to something and look between what is being pointed to and the other person? Or do they just point without looking at another person? - **Respond to joint attention**: Try to get the child’s attention to a poster or a toy while saying “Oh, look, there’s a (tiger)!” Does the child’s gaze follow your point? - **Respond to name**: Call the child’s name in a friendly manner when they are not directly interacting with you. Observe if they turn in your direction. - **Comforting/sharing emotions**: How does the child respond to playfulness or a smile? Do they smile back? How do they react to scenarios like a toy doll getting "hurt"? - **Initiation of play/interaction**: With toys available, does the child try to include others in their play? For example, will they hand you a ball to throw? - **Conversation**: In toddlers, look for simple back-and-forth vocalizing/talking in response to comments. Observe the quality of conversation between the child and others. ### A2. Nonverbal communication [Indicate if there is a problem in any of these areas.] - **Eye contact**: Observe the quality of the child’s eye contact with caregivers or family members. Note if it is prolonged, unusual, or difficult to elicit. - **Gestures/Pointing**: Look for gestures such as shaking the head "no," waving goodbye, or pointing with the index finger. - **Facial expression**: Notice whether the child has flat affect or unusual expressions that do not match the context. - **Integration of nonverbal strategies into communication**: Observe the child’s use and understanding of nonverbal strategies in their communication, such as combining eye contact with vocalizations or gestures. ### A3. Relationships [Indicate if there is a problem in any of these areas.] - **Interaction with caregivers**: Observe the level of interest in interacting with caregivers or other children. - **Adjusting behavior for the situation**: Notice the child’s behavior in different settings, such as the waiting room and office. - **Preferred playmates**: Note if the child mentions a best or favorite friend. - **Interactive pretend play**: Set up an imaginative scenario with toys and invite the child to play. Observe their participation and creativity. ### B: Restricted, Repetitive Behavior [Need at least two criteria (B1, B2, B3, or B4), currently or by history.] #### B1. Stereotyped/repetitive motor movements, use of objects, speech - **Flapping, Toe walking, Tensing**: Look for evidence of these behaviors, particularly when the child is excited. - **Rocking**: Observe for back-and-forth body rocking. - **Hand mannerisms**: Look for unusual hand movements, such as flapping or contorting fingers. - **Spinning self/items**: Observe if the child spins toys or themselves. - **Lining up toys**: Note if the child lines up toys and their reaction to disruptions. - **Echolalia**: Observe if the child repeats phrases or questions verbatim. - **Scripted/repetitive speech**: Look for repeated use of lines from media or repetitive phrases. - **Idiosyncratic/made-up words**: Note any made-up words or unusual associations. #### B2. Insistence on sameness/routines/rituals - **Distress with small changes**: Observe the child’s reaction to changes in the environment. - **Transitions**: Note the child’s response to transitions between activities or rooms. - **Rigid thinking**: Observe reactions to changes in play routines or unexpected actions. - **Rituals**: Look for evidence of specific routines or rituals. #### B3. Restricted, fixated interests - **Attachment to unusual objects**: Note if the child brings a special item and their level of attachment to it. - **Intense interest**: Observe if the child has a particular intense interest. #### B4. Sensory differences - **Sensory responses**: Present items with different textures and observe reactions. Note any unusual sensory behaviors, such as visual inspection, mouthing, or aversions to noise.