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Instructions: Please complete the questionnaire together with your spouse and return to us on or before (Date) through email or fax. All the information provided will be kept confidential and might be used for the programme or acticity planning. We might invite you for aninterview before the commencement of the group meeting if necessary.

1. Basic information

1.1 Please list the family member(s) who have Autism Spectrum Disorders or other Special Educational Needs (Giftedness, ADHD, Specific Learning Difficulties in reading

and writing, Twice-Exceptionality, etc.)

Relationship with the child

Diagnosis

Parents

Siblings

Other Relatives

1.2 Diagnosis related to the child 1.2.1 Age of diagnosis

1.2.2 Please describe how the family members respond to the Autism Spectrum Disorders diagnosis.

Parents

Siblings

1.2.3 Medication (whether before it is recommended that the child should take any medication and whether medication is now being taken by the child)

Drug Name

Dosage

Diagnosis (ADHD/Depression/OCD

//

Taken within 6 months?

Ritalin

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GiftednessASD

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Father Mother Medication taken?

Medication taken?

Please specify:

Please specify:

1.3 Medication (whether it has been recommended to have any medication before and whether medication has been taken by the parents)

1.4 Training/intervention ASD/Giftedness children have received or are receiving

/

Autism Spectrum Disorders

Types/focus of training/

Organisation

Duration

Giftedness

Types/focus of training/

Organisation

Duration

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1.5 The community resources that you have located for you and your child

For you as parents

For your child

1.6 The online resources that you have located for you and your child

For you as parents

For your child

2. Problem behaviour/concerns at home and at school

/

2.1 Sensory integration

2.1.1 How do your childs sensory needs affect him/her?

/

At home setting At school setting

2.1.2 How do you cope with it? What strategies have you tried?

At home setting At school setting

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2.2 Organisation skills

2.2.1 How do your childs organisation skills affect him/her?

At home setting At school setting

2.2.2 How do you cope with it? What strategies have you tried?

At home setting At school setting

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2.3 Social and communication skills

2.3.1 How do your childs social and communication skills affect his/her life?

At home setting At school setting

2.3.2 How do you cope with it? What strategies have you tried?

At home setting At school setting

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2.4 Transition or changes

2.4.1 Please describe the problems encountered by your children when they face changes.

At home setting At school setting

2.4.2 How do you cope with it? What strategies have you tried?

At home setting At school setting

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2.5 Emotional breakdown

2.5.1 Please describe any emotional breakdown or behaviour faced by your children.

At home setting At school setting

2.5.2 How do you cope with it? What strategies have you tried?

At home setting At school setting

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2.6 Other issues of concern

2.6.1 Please describe if your child has any issue of concern that has not been covered above.

2.1 2.5

At home setting At school setting

2.6.2 How do you cope with it? What strategies have you tried?

At home setting At school setting

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2.7 Specific obsessive interests or passions of the child

/

2.7.1 Please describe if your child has any specific interests that he is preoccupied with:

/

2.7.2 How does this interest affect:

a) adjustment at school ? ?

b) family life? ?

2.7.3 How do you cope with it/What strategies have you tried?

a) at home

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b) at school

2.7.4 How do you nurture this interest?

THANK YOU!

END OF THE QUESTIONNAIRE

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1. Smart but scatteredDawson & Guare, 2009 Executive skills questionnaires for parentsP. 50

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2. Executive skills questionnaires for childrenP. 34 43)

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1. Temple Grandin 28 32

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Temple Grandin http://www.ted.com/talks/lang/eng/temple_grandin_the_world_needs_all_kinds_of_minds.html

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2.6.1 Understanding myself as Asperger Larson, Elaine Marie. (2006). I am utterly unique: Celebrating the strengths of children with Asperger syndrome and high-functioning autism. Kan: Autism Asperger Publishing Company. Wine, A. (2005). What it is to be me! An Asperger kid book. Fairdale Publishing Welton, J. (2004). Can I tell you about Asperger syndrome? New York : Jessica Kingsley Publishers. Elder, J. (2005). Different like me: My book of autism heroes. New York : Jessica Kingsley Publishers.Self-help BooksFor Kids Huebner, D. (2008). What to do when bad habits take hold: A kids guide to overcoming nail biting and more. US: Magination Press. Huebner, D. (2008). What to do when you worry too much: A kids guide to overcoming anxiety. Magination Press. Ledgin, N. (2002). Aspergers and self esteem: Insight and hope through famous role models. US: Future Horizons Inc. Verdick, E. (2003). How to take the grrrr out of anger. Minneapolis : Free Spirit Pub. Madrigal, S. & Winner, M.G. (2009). New! Superflex takes on glassman and the team of unthinkables! US: Think Social Publishing Inc. Winner, M. G. (2008). You are a social detective. US: Think social Publishing Inc.For Teens Newsport, J. (2001). Your life is not a label. US: Future Horizons. James, I. (2006). Aspergers syndrome and high achievement: Some very remarkable people. London: Jessica Kingsley Publishers. Winner, M. G. & Crooke, P. (2009). Socially curious and curiously social: A social thinking guidebook for teens & young adults with Aspergers, ADD, PDD-NOS, NVLD or other murky undiagnosed social learning issues. US: Think Social Publishing Inc. Asperger writes about Asperger Newport, J. & Newport, M. (2007). Mozart and the whale - an aspergers love story. US: Touchstone. Grandin, T. (2006). Thinking in Pictures. New York: Vintage Book.

http://www.aspergerssyndrome.org/

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2012

: www.hkage.org.hk: (852) 3940 0101 : (852) 3940 0201 : academy@hkage.org.hk

Guidebook cover ASD outp2e resource pack ASDGuidebook backcover ASD out