Checklist, Interview, and Observation Form for Educational Identification of Autism
Based on the Wisconsin DPI Statewide Criteria
Compiled by Kate McGinnity, Revised 2010
PI 11.35 (2) (i) Autism
1. Autism means a developmental disability significantly affecting a child’s social interaction
and verbal and non verbal communication, generally evident before age 3, that adversely affects
learning and educational performance. Other characteristics often associated with autism are
engagement in repetitive activities and stereotyped movements, resistance to environmental
change or change in daily routines, and unusual responses to sensory experiences. The term does
not apply if a child’s educational performance is adversely affected primarily because the child
has an emotional disturbance, as defined in par. (g).
2. The results of standardized or norm-references instruments used to evaluate and identify a
child under this paragraph may not be reliable or valid. Therefore, alternative means of
evaluation, such as criterion referenced assessments, achievement assessments, observation and
work samples, shall be considered to identify a child under this paragraph. Augmentative
communication strategies, such as facilitated communication, picture boards, or signing shall be
considered when evaluating a child under this paragraph. To identify a child, the criteria
subpars. A and b and one or more criteria under subpars. c through f shall be met.
Use this checklist for parents as well as teachers (indicated by “P” or “T”). Mark “0, 1, or 2”
(0=not at all, 1= sometimes, 2 = frequently) next to each item(s) that describe this individual.
This allows for some comparison between environments.
0 = never
1 = sometimes
2 = frequently
a. SOCIAL PARTICIPATION
The child displays difficulties or differences or both in interacting with people and events. The
child may be unable to establish and maintain reciprocal relationships with people. The child
may seek consistency in environmental events to the point of exhibiting rigidity in routines.
Child Behavior
Great difficulty with initiating and
responding both verbally and non verbally
to bids of others
Great difficulty displaying joint attention
both emotionally and physically. Does not
share accomplishments, interests or
enjoyment of an activity with others
Reciprocal interactions are either not
present or are extremely limited to very
concrete subjects; interactions are used to
get what the child wants (i.e. takes a toy
from a peer, but makes no attempt to
interact with peer after that)
Great difficulty making and maintaining
P
T
Comments
friends
Child Behavior
P
T
Comments
Play tends to be unimaginative, repetitive,
or solitary
Great difficulty in describing friendship in
an age appropriate manner
Great difficulty following the give and take
of conversation
Can be withdrawn or talk to self, or
continue a running commentary or
monologue, does not notice if others are
listening
Is unable to “tune into” the class and the
social environment, easily distracted by
others in classroom (visual or auditory
stimuli)
Great difficulty mixing with or playing
with peers, may interact more readily with
adults
Great difficulty with flexibility within play
themes (i.e. following own set play
sequence without deviating from routine)
Very rule bound, may remind others of
rules; may “police” others’ behavior
Appears to be more interested in objects
than people, completely avoids social
contact with others
Great difficulty responding to consolation
from others
Great difficulty in understanding another’s
perspective
Expects others to know his/her thoughts,
experiences and opinions
Appears to lack intuition, appearing naïve
Lacks an anticipatory response
Demonstrates difficulty learning and using
rules of social interaction. Does not
understand the implications of social
behavior or conventions, or codes of
conduct; may make statements,
demonstrate behavior that is offensive to
others, say things that are socially
inappropriate (i.e. “you’re fat” or “you’re
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really old”)
Child Behavior
P
T
Comments
Lacks empathy (i.e. the intuitive
understanding of another person’s feelings)
Needs excessive reassurance, especially if
things are changed or go wrong
Is indifferent to peer pressure, does not
follow crazes or understand current trendy
language
Does not like to participate in competitive
sports, games or activities
Treats strangers the same as familiar
people (will go with or hug a stranger
without question)
Little or no meaningful eye contact,
appears to stare, blank look
Complete disregard or lack of appreciation
of danger (i.e. running into the street,
climbing up on high cupboards, touching
hot stove etc.)
Additional Comments:
b. COMMUNICATION
The child displays difficulties which extend beyond speech and language to other aspects of
social communication, both receptively and expressively. The child’s verbal language may be
absent or, if present, lacks the usual communicative form which may involve deviance or delay
or both. The child may have a speech or language disorder or both in addition to communication
difficulties associated with autism.
Child Behavior
P
T
Comments
Demonstrates a delay in the pragmatics of
language
Demonstrates a delay in the use non verbal
language, clumsy body language, limited
or inappropriate facial expression, peculiar
or stiff gaze.
Great difficulty reading non verbal
message in communication partner
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Child Behavior
P
T
Comments
If using verbal language, great difficulty
using speech to communicate wants and
needs and other functions
Echolalia, repetition of words or phrases
(i.e. may repeat exactly what has been said
to him/her)
Speech is overly formal, precise or
pedantic (scholarly in a dull or narrow
way)
Uses speech in a repetitive manner,
perseverates on a favorite topic, describes
technical things in great detail, uses
technical jargon
Great difficulty using spontaneous
language
Uses scripted language (i.e. may repeat
commercials, items from a book, song
lyrics, or lines from movies over and over
or at inappropriate times; May say the
same thing in the same or similar context)
Uses a loud unmodulated voice, odd
prosody or peculiar vocal quality;
immature inflection and pitch (very singsong, monotone, robotic, high pitched or
other obvious deviation)
Non logical use of pronouns, pronoun
reversals, or no use of pronouns (Sally
says, “Sally wants cookie” instead of “I
want cookie)
Is hyper verbal
Expresses emotions in a unconventional
manner
Great difficulty taking turns in
conversation, topic maintenance or use of
referents
Interprets what is said literally
Does not respond to or interprets social
gestures / information
Mute or little or non language; Relies on
gestures, signs, or pointing; may tantrum to
get things or do things; may grab people
and pull to what is wanted.
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Child Behavior
P
T
Comments
Does not initiate conversation, fails to use
greetings, does not ask questions
Use of picture communication, signs, or
with facilitation demonstrates a higher
level of understanding or communication
other than verbal language
Failure or great difficulty with abstract
concepts or reasoning, very rote or literal,
may make topically related response that is
not accurate to actual conversation (i.e.
Teacher: “We must learn to wait in line at
McDonald’s” Child: “Chicken
McNuggets are good!”)
May be able to engage in conversation with
adults, but is unable to with peers, can be
bossy or critical of others without regard to
social implications
Difficulty disengaging thoughts from
language, says exactly what is on his or her
mind (“you’re fat” or “you’re really old”)
Appears disinterested in the other person’s
side of the conversation
Failure to repair the conversation or seek
clarification
Has been previously labeled as deaf
Describe his/her auditory processing time:
Additional Comments:
c. DEVELOPMENTAL RATES AND SEQUENCES
The child exhibits delays, arrests or regressions in motor, sensory, social or learning skills. The
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child may exhibit precocious or advanced skill development, while other skills may develop at
normal or extremely depressed rates. The child may not follow normal developmental patterns
in the acquisition of skills.
Child Behavior
P
T
Comments
Developmental facts that do not seem to
“fit” together, some type of discontinuity in
development (e.g. may have progressed
fairly appropriately until about age two or
three, then regression began)
Demonstrates skills of high proficiency
offset by challenges that don’t seem to ‘fit’
developmental profile (e.g. may be adept at
calculus yet not be able to remain
continent)
Uneven profile of skills - social, motor,
sensory and or learning are unevenly
developed (i.e. very good math skills, very
poor reading skills, good ability to read and
no comprehension skills, math skills above
grade level while creative writing skills are
several years delayed)
Hyperlexia (defined as a precocious ability
to read words far above what is expected at
that age, or an intense fascination with
letters or numbers)
Exhibits precocious or advanced skill
development in some areas, while other
skills develop at a normal or extremely
depressed rate
Does not follow a predictable, “normal”
pattern of development, there are delays,
arrest or regressions in motor, sensory
social or learning skills
Additional Comments:
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d. COGNITION
The child exhibits abnormalities in the thinking process and in generalizing. The child exhibits
strengths in concrete thinking while difficulties are demonstrated in abstract thinking, awareness
and judgment. Perseverant thinking and impaired ability to process symbolic information may
be present.

What are the student’s learning strengths? (look at visual special information, concrete
rules and information, motor memory, rote memory?)

What are the student’s learning weaknesses? (look at understanding symbols,
understanding means to end and cause and effect, time based information, abstract
concepts and information, imitation, ability, generalization)
Child Behavior
P
T
Comments
Has a gestalt processing style
Has a difficult time identifying relevant
cues
Verbal IQ is equal to or exceeds
performance IQ
Has a particular talent in art, music, or
mathematics
Perseveration (to be stuck thinking about or
doing one thing over and over) on topics
using very concrete facts, but at the same
time having an inability to generalize or
think abstractly about topics, fascinated
with a particular topic or avidly collects
information or statistics of interest (i.e.
walking encyclopedia)
Has long term memory for events or facts
(or, even, photographic in memory)
Inability to comprehend abstract ideas or
commands
Narrow range of interests, inability to play
creatively; Or, may appear to play
creatively but the script never changes &
little or no imagination is apparent in play
schemes
Difficulty or inability to process symbolic
information (e.g.does not seem to have an
internal sense of time)
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Has a difficult time demonstrating
flexibility in rule structure
Additional Comments.
SENSORY PROCESSING
The child exhibits unusual, inconsistent, repetitive or unconventional responses to sounds, sights,
smell, tastes, touch or movement. The child may have a visual or hearing impairment or both in
addition to processing difficulties associated with autism.
Child Behavior
P
T
Comments
Has unusual sleep patterns (i.e. difficulty
falling asleep, waking frequently at night
etc.)
Experiences sensory input differently
(more or less sensitive than typical peers)
Extremely passive or hyper
Has extreme changes in arousal level
Handles objects in an unusual way
Demonstrates self stimulatory behaviors –
stereotyped movements: rocking, spinning,
darting, lunging, hand-flapping, pacing
Auditory: attention to a self induced
sound, non response or over-reaction to
noises of varying levels
Visual: close scrutiny of visual details,
non-use of eye contact, staring, prolonged
regarding of object, attention to
illumination (lights), use of peripheral
vision, etc.
Olfactory or gustatory: repetitive sniffing
of objects, specific food preferences or
aversions, gagging on certain foods,
difficulty swallowing not associated with a
physical problem, pica - eating inedible
objects
Tactile: over / under responsive to pain,
touch, or temperature, prolonged rubbing
of surfaces, refuses to keep shoes on,
avoids walking on grass with bare feet
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Child Behavior
P
T
Comments
Vestibular: over / under responsive to
gravity, whirling, spinning, bumping into
things, need to lift or push heavy objects
Need for: tight hugs, soft touch, deep
pressure (sometimes manifested in physical
aggression or pushing or pulling on others)
ear mufflers, sun glasses
Combinations of sensory input overstimulates: unable to look at while
listening to someone, cannot sing at the
same time others are singing, unable to
follow directions while watching
something
Additional Comments:
f. CHALLENGING BEHAVIOR
The child displays marked distress over changes, insistence on following routines, and a
persistent preoccupation with or attachment to objects. The child’s capacity to use objects in an
age appropriate or functional manner may be absent, arrested, or delayed. The child may have
difficulty displaying a range of interests or imaginative activities or both. The child may exhibit
stereotyped body movements.
Child Behavior
P
T
Comments
Is dependent on routine, perseverates on
the sameness of the environment (i.e. must
have same activity at the same time each
day, or particularly aware of the sequence
of events, expecting them to happen that
way each time, may panic or tantrum if
they do not)
Becomes distressed with changes in
routines – gets stuck in behavior, may
refuse to do anything until routine is
followed, obsessive / compulsive behavior
Focuses on specific objects or people,
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seemingly passionate or even obsessive
(i.e. spinning wheels on a car, lining up
toys, moving them back and forth, etc.)
Has a limited range of interest
Child Behavior
P
T
Comments
Is aggressive or self abusive rising out of
challenges in understanding the
environment or world (i.e. head banging,
picking at skin, hitting self, biting hand
etc.)
May appear inflexible to neurotypical
people
Mood swings, tantrums for no apparent
reason, crying, giggling, laughing without
apparent reason, inappropriate fears
Has difficulty with transitions between
materials, people, environment or activities
Additional Comments:
Updated by Kate McGinnity (2010)
(Adapted from Kate McGinnity and Tiffany Yocum, 2004)
Sources:
1. WI DPI State Autism Criteria
2. Graczyk, McGinnity, Negri & Shoultz (1995) "Characteristics of and Support Strategies for
Individuals with Autism" (A handout)
3. Tanguay, P. & Lourde, C. (2002) "Affective Reciprocity & ASD" (Conference notes)
4. Milwuakee Public Schools’ Autism Spectrum Checklist, 2004
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