Autism Social Skills Profile - OCALI | Home

1 Autism Social Skills ProfileScott BelliniChild s Name:_____Birthdate: _____ Age: _____ Sex: GFemale GMale Today s Date: _____School: _____ Grade: _____Your Name: _____Relationship to Child: GMother GFather GGuardian GOther _____Street Address: _____City: _____ State: _____ Zip: _____Phone: ( )_____The following phrases describe Skills or behaviors that your child might exhibit dur-ing Social interactions or in Social situations. Please rate HOW OFTEN your childexhibits each skill or behavior independently, without assistance from others( , without reminders, cueing and/or prompting). You should base your judgmenton your child s behavior over the last 3 use the following guidelines to rate your child s behavior:Circle Nif your child neveror almost neverexhibits the skill or Sif your child sometimesor occasionallyexhibits the skill or Oif your child oftenor typicallyexhibits the skill or Vif your child very oftenor alwaysexhibits the skill or do not skip any items.

2 If you are unsure of an item, please provide yourbest estimate. You may use the Brief Description section to provide additional infor-mation on the particular skill or behavior. For instance, if your child will exhibit a par-ticular skill or behavior more frequently when cueing or prompting is provided, orwhen interacting with adults rather than peers, please make note of this in the BriefDescription MIDDLE LASTFIRST MIDDLE LASTMO. DAY YEARMO. DAY YEAR Autism Social Skills ProfileSkill AreaHow OftenBrief DescriptionInvites Peers to Join Him/Her inActivitiesNSOV1234 Joins in Activities With PeersNSOV1234 Takes Turns During Games andActivitiesNSOV1234 Maintains Personal HygieneNSOV1234 Interacts With Peers DuringUnstructured ActivitiesNSOV1234 Interacts With Peers DuringStructured Activities NSOV1234 Asks Questions to RequestInformation About a PersonNSOV1234 Asks Questions to RequestInformation About a Topic NSOV1234 Engages in One-On-One SocialInteractions With PeersNSOV1234 Interacts With Groups of Peers NSOV1234 Maintains the Give-and-Take ofConversationsNSOV1234 Expresses Sympathy for OthersNSOV1234 Talks About or Acknowledges theInterests of OthersNSOV1234

3 NeverSometimesOftenVery oftenNSOVN everSometimesOftenVery oftenNSOVS kill AreaHow OftenBrief DescriptionRecognizes the Facial Expressionsof OthersNSOV1234 Recognizes the Nonverbal Cues,or Body Language of OthersNSOV1234 Requests Assistance From OthersNSOV1234 Understands the Jokes or Humorof OthersNSOV1234 Maintains Eye Contact DuringConversationsNSOV1234 Maintains an AppropriateDistance When Interacting WithPeersNSOV1234 Speaks With an AppropriateVolume in ConversationsNSOV1234 Considers Multiple ViewpointsNSOV1234 Offers Assistance to OthersNSOV1234 Verbally Expresses How He/She IsFeelingNSOV1234 Responds to the Greetings ofOthersNSOV1234 Joins a Conversation With Two orMore People Without InterruptingNSOV1234 Initiates Greetings With OthersNSOV1234 Autism Social Skills ProfileNeverSometimesOftenVery oftenNSOVS kill AreaHow OftenBrief DescriptionProvides Compliments to OthersNSOV1234 Introduces Self to

4 OthersNSOV1234 Politely Asks Others to Move outofHis/Her WayNSOV1234 Acknowledges the ComplimentsDirected at Him/Her by OthersNSOV1234 Allows Peers to Join Him/Her inActivitiesNSOV1234 Responds to the Invitations ofPeers to Join Them in ActivitiesNSOV1234 Allows Others to Assist Him/HerWith TasksNSOV1234 Responds to Questions Directedat Him/Her by OthersNSOV1234 Experiences Positive PeerInteractionsNSOV1234 Compromises DuringDisagreements With OthersNSOV1234 Responds Slowly inConversationsNSOV1234 Changes the Topic ofConversation to Fit Self-InterestsNSOV1234 Misinterprets the Intentions ofOthersNSOV1234 Autism Social Skills ProfileNeverSometimesOftenVery oftenNSOVS kill AreaHow OftenBrief DescriptionMakes Inappropriate CommentsNSOV1234 Engages in Solitary Interests andHobbiesNSOV1234 Ends Conversations AbruptlyNSOV1234 Fails to Read Cues to TerminateConversationsNSOV1234 Exhibits Fear or AnxietyRegarding Social InteractionsNSOV1234 Experiences Negative PeerInteractionsNSOV1234 Engages in Socially InappropriateBehaviorsNSOV1234 Exhibits Poor Timing With His/HerSocial InitiationsNSOV1234Is Manipulated by PeersNSOV1234 Engages in Solitary Activities inthe Presence of PeersNSOV1234 Autism Social Skills ProfileFor more information on how to use this assessment tool in the context of teaching Social Skills , see S.

5 Bellini, BuildingSocial Relationships: A Systematic Approach to Teaching Social Interactin Skills to Children and Adolescents with AutismSpectrum DIsorders and Other Social Difficulties 2006; AAPC Publishing.