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The 7 questions that might help screen for autism symptoms

This Harvard Autism Research Survey was developed in 2012 by researchers at Harvard University in order to test their theory that the commonly-used long evaluations could be boiled down to just these seven simple questions. 

Below are the questions they proposed using to help more quickly diagnose autism.

1. Comprehension of simple language

How much language do you think the subject understands if you don’t gesture? What about when s/he can’t tell from the situation what is going to happen?

Examples (not part of questionnaire)

  • Can you send her/him into another room to get something like her/his shoes or blanket?
  • What about your purse or a book?
  • Could s/he deliver a simple message?
  • Could s/he follow an instruction with an “if” and a “then”?
  • Does s/he understand if you say “no” without gesturing or raising your voice?
  • How about “yes” or “okay”?
  • How about names of favorite foods or toys or people in your family?
  • Do you think s/he understands 10 words? 50?

Answer according to the most abnormal behavior the subject has ever exhibited.

[   ] in response to a request can usually perform an unexpected action with an unexpected object; or could place an object, other than something to be used by self (such as boots or a toy), in an unexpected location in a different room (“Put the keys on the kitchen table”)
[   ] in response to a request can usually get an object, other than something for self or something highly contextualized, from another room (“Get the keys from the kitchen table”), but usually cannot carry out a new action on this object or put it in a “new” place
[   ] understands many words (more than 50), including “yes” and names of familiar people, toys, or foods, but does not meet criteria for “0” or “1”
[   ] understands fewer than 50 words, but some comprehension of “no” and names of a few favorite objects, foods, or people, or words within familiar routines
[   ] little or no comprehension of words, even in context
[   ] N/A (e.g., deaf)

2. Reciprocal conversation (within subject’s level of language)

Can you have a conversation with the subject? That is, if you say something to her/him, without asking a direct question, what will the subject usually do?


  • Will s/he say something when engaged in conversation?
  • Will s/he ever ask you a question or build on what you have said so that the conversation will continue?
  • Will s/he converse normally on topics that you have introduced?
  • Can s/he also introduce appropriate topics?

Answer according to whether the subject has ever exhibited the described behavior below.

[   ] conversation flows, including both offering information and building on other person’s response in a manner that leads to ongoing dialogue
[   ] occasional reciprocal conversation, but less frequent than normal or limited in flexibility or topics
[   ] little or no reciprocal conversation; others find it difficult to build a conversation even if there is apparent positive or social talk by subject; subject fails to follow anyone else’s conversation topic; may ask or answer questions but not as part of a single interchange
[   ] very little spontaneous speech
[   ] N/A

3. Imaginative play

Does the subject play any pretend games? Does s/he play with toy tea sets or dolls or action figures or cars?


  • Does s/he play with toy tea sets or dolls or action figures or cars?
  • Does s/he drink the tea/push the car/kiss the stuffed animal?
  • Has s/he ever given the doll a drink or the action figure a ride in the car?
  • Has s/he ever used the doll/action figure as the initiator-so that the doll pours and serves the tea or the action figure walks to the car and gets in it?
  • Does s/he ever talk to her/his dolls or animals?
  • Does s/he ever make them talk or make noises?
  • Has s/he ever made up a sort of story or sequence?

Answer according to the most abnormal behavior the subject has exhibited. For subjects aged 10.0 years or older, probe only for the 4.0- to 5.0-year period.

[   ] variety of pretend play, including use of dolls/animals/toys as self-initiating agents
[   ] some pretend play, including actions directed to dolls or cars, etc., but limited in variety or frequency
[   ] occasional, spontaneous pretend actions or highly repetitive pretend play (which may be frequent), or only play that has been taught by others
[   ] no pretend play
[   ] N/A

4. Imaginative play with peers

Does the subject ever play imaginative games with someone else? Do they seem to understand what each other is pretending?


  • Does s/he ever take the lead in the play activity? Or does s/he mostly follow the other person’s ideas?

Answer according to the most abnormal behavior the subject has exhibited. For subjects aged 10.0 or older, probe only for the 4.0- to 5.0-year period.

[   ] imaginative, cooperative play with other children in which the subject both takes the lead and follows another child in spontaneous, pretend activities
[   ] some participation in pretend play with another child, but not truly reciprocal and/or pretending is very limited in variety
[   ] some play with other children, but little or no pretending
[   ] no play with other children or no pretend play even on own
[   ] N/A

5. Direct gaze

Does the subject look you directly in the face when doing things with you or talking with you?


  • Does s/he sometimes watch you walk into the room?
  • Does s/he look back and forth to your face as other children would?
  • What about with others?

Answer according to the most abnormal behavior the subject has exhibited.

[   ] normal reciprocal direct gaze used to communicate across a range of situations and people
[   ] definite direct gaze, but only of brief duration or not consistent during social interactions
[   ] uncertain/occasional direct gaze, or gaze rarely used during social interactions
[   ] unusual or odd use of gaze
[   ] N/A

6. Group play with peers

How does the subject play with others of her/his age when there are more than two together? What is their play like?


  • Is s/he different with children or others outside your immediate family?
  • Does s/he play cooperatively in games that need some participation such as musical games, hide-and-seek, or ball games?
  • Would s/he initiate such games? Or actively seek to join in?
  • Can s/he take different parts in these games (like being chased or doing the chasing, or hiding and looking for the other person)?

Answer according to the most abnormal behavior the subject has exhibited. For subjects 10.0 years or older, probe only for the 4.0- to 5.0-year period.

[   ] actively seeks and plays cooperatively in several different groups (three or more subjects) in a variety of activities or situations
[   ] some cooperative play, but of insufficient initiative, flexibility, frequency, or variety
[   ] enjoys “parallel” active play (such as jumping in turn on a trampoline or falling down with others during Ring A Ring O’Roses), but little or no cooperative play[   ] seeks no play that involves participation in groups of other children, though may chase or play catch
[   ] N/A

7. Age when abnormality first evident

Could you tell what the subject was like about the time of her/his third birthday?


  • What was her/his play like?
  • What toys did s/he play with?
  • Any pretend games?
  • How was her/his talking then?
  • What about looking after herself/himself? Feeding? Toileting? Dressing?
  • What were her/his relationships with other children like?

[   ] development in the first 3 years of life clearly normal in quality and within normal limits for social, adaptational, language, self-help, and motor milestones; no behavioral problems of a type that might indicate developmental delay or deviance
[   ] development possibly within normal limits during first 3 years, but uncertainty because of either the quality of behavior or the level of skills
[   ] development probably abnormal by the age of 3 years, as indicated by developmental delay or deviance, but not of a degree or type that is definitely incompatible with normality
[   ] development definitely abnormal in the first 3 years but quality of behavior/social relationships/communications not unambiguously autistic at that age
[   ] development definitely abnormal in the first 3 years and quality of behavior/social relationships/communications strongly indicative of autism at that age

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