A social communications questionnaire is a survey tool that has questions that are specifically formulated to gauge the sample’s ability to perceive, transmit and understand information. Such questionnaires seek to evaluate the level of communication skills and their effect on social functioning. The most common such questionnaire is used in screening for a range of disorders related with autism. Usually, the questionnaire is administered to children aged over 4 years, but whose mental age is rated at 2 years. The questionnaire usually contains closed ended questions that can be answered by parents or caregivers within 10 minutes.

Below is a sample:

Name of the child: _________________ Age_____________

Respondent:  Father_____ Mother________ Other caregiver (specify) _________

(Answer with a simple yes or no answer unless otherwise indicated)

Q1. Is your child able to express him or herself verbally at all? _______

Q2. Does your child have problems in language intonation? _______

Q3. Does your child exhibit any problems in verbal rhythm? _______

Q4. Does your child have problems associating meaning to words and sentences? _______

Q5. Does your child repeat words or phrases said by someone else? _______

Q6. Approximately how long does it take for a child to repeat words said by someone else? (Please specify)____________

Q7. Are you able to attach any meaning to what your autistic child says? _______

Q8. Have you ever had your child’s communications skills evaluated? _______

Q9. Did you follow the specific communication treatments given to the child after evaluation? _______

Q10. Have you noticed any improvement in your child’s communication skills since starting therapy? _______