City of Coventry Health Centre, 2 Stoney Stanton Road, Coventry, CV1 4FS

024 7526 1333

Out of hours, when it’s less urgent than 999

ASD questionnaire

Autism Spectrum Quotient

A quick referral guide for adults with suspected autism who do not have a learning disability.

Any field marked with * is mandatory

Personal details

Sex*
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Indicate the extent to which you are affected by any of these symptoms

I often notice small sounds when others do not*
I usually concentrate more on the whole picture, rather than the small details*
I find it easy to do more than one thing at once*
If there is an interruption, I can switch back to what I was doing very quickly*
I find it easy to ‘read between the lines' when someone is talking to me*
I know how to tell if someone listening to me is getting bored*
When I’m reading a story I find it difficult to work out the characters’ intentions *
I like to collect information about categories of things (e.g. types of car, types of bird, types of train, types of plants, etc)*
I find it easy to work out what someone is thinking or feeling just by looking at their face*
I find it difficult to work out people’s intention*
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