TM

Vineland Adaptive Behavior Scales™–Third Edition

Appendixes G–H

Sara S. Sparrow • Domenic V. Cicchetti • Celine A. Saulnier

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 Appendix G: Suggested Interview
Questions and Scoring Criteria for the
Comprehensive Interview Form

Suggested Interview Questions

Table G.1 Suggested Interview Questions for the Comprehensive Interview Form
Domain and subdomain Interview Topic Question
COMMUNICATION DOMAIN
Receptive A: Responding Tell me what [name] does when he/she hears
your voice or sees you nearby.
B: Understanding Words What words does [name] understand?

C: Understanding Nonverbal As you know, we communicate using our bodies in addition to words.
Communication What gestures or facial expressions does [name] respond to?
D: Identifying Things What things does [name] point to or identify in other ways
when asked, like body parts, objects, and things in pictures?
E: Following Basic Instructions What are some examples of [name] following simple
instructions, like ”Sit down” or “Close the door?”
F: Understanding Questions Tell me how [name] responds to “wh” questions,
like “what, where, who, when, and why?”
G: Understanding Sometimes how we say something is just as important
Implied Messages as our actual words. What does [name] understand
about things like tone of voice and sarcasm?
H: Attending to For how long does [name] pay attention to something he/she
Entertaining Material likes, such as a story, TV show, movie, or live performance?
I: Following Complex What are the most complicated kinds of instructions that [name] follows?
Instructions
J: Attending to For how long does [name] pay attention in settings
Informational Material such as school, church, or a meeting?
Expressive A: Beginning Sounds Tell me what types of sounds and gestures [name] is making.
& Gestures
B: Beginning Speech What words is [name] using?

C: Vocabulary What objects and actions does [name] say the

words for, like “dog” or “eat”?
D: Using Gestures What gestures is [name] using?

E: Communicating What information does [name] state about himself/

Names & Age herself, like his/her name and age?
F: Using Simple What are some examples of the sentences that [name] says?
Grammatical Forms
G: Using Intermediate What are some examples of the sentences that [name] says?
Grammatical Forms

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 Domain and subdomain Interview Topic Question
H: Using Pronouns Tell me about how [name] uses pronouns, words like “I” and “me” that
refer to himself/herself, and “you” and “him” that refer to others.
I: Asking Questions What different kinds of questions does [name] ask?

J: Using Complex What are some examples of the sentences that [name] says?
Grammatical Forms
K: Expressing Ideas How does [name] talk about his/her own ideas and experiences?
& Experiences
L: Stating Age, What personal information does [name] state about
Birthday, & Address himself/herself, such as his/her birthday or address?
M: Giving Directions What are the most complicated directions
you’ve heard [name] give to others?
Written A: Identifying Signs & Letters What simple signs or symbols does [name] recognize, like STOP
signs or bathroom door symbols? Also, which alphabet letters?
B: Understanding How Before we learn to read, we have to learn the direction in
Writing Works which our language is written. What does [name] understand
about how language is written and how a book works?
C: Copying What kinds of words and sentences does [name] copy from an example?

D: Beginning Reading What kinds of things does [name] read out loud?

E: Beginning Writing What simple things does [name] write on his/her own, without copying?

F: Working With What does [name] do to find information, like using a

Written Information dictionary or other sources in a library or on the Internet?
G: Personal Writing What are the kinds of things that [name] writes to
others, either by hand or electronically?
H: Reading Level At about what grade level is [name] reading and comprehending?

I: Advanced Writing What kinds of papers does [name] write for school, and
what is the process that he/she uses to write them?
J: Forms & Business Letters Tell me about the types of forms and business letters
that [name] completes or writes on his/her own.
DAILY LIVING SKILLS DOMAIN
Personal A: Beginning to Eat What kinds of food is [name] eating now?
B: Cooperating in [Name] may not be dressing or washing himself/herself yet, but what
Dressing & Washing does he/she do to cooperate when you undress, dress, or wash him/her?
C: Beginning to Drink What is [name] using to drink liquids now?

D: Using Spoon & Fork How well does [name] use a spoon and a fork without spilling?

E: Removing Clothing What kinds of clothing does [name] take off by himself/herself?

F: Toilet Training Tell me where [name] is with toilet training?

G: Cleaning Hands & Face What does [name] do to clean his/her hands and face?

H: Putting on Clothes & Shoes What kinds of clothing is [name] putting on by himself/
herself, and what does he/she need help with?
I: Hygiene Tell me what [name] does to take care of his/her personal
hygiene and to keep from spreading germs.
J: Fastening Fasteners What does [name] do on his/her own with zippers, snaps, and buttons?

K: Bathing What is [name] doing as far as bathing himself/herself?

L: Using the Bathroom What does [name] do as far as using the bathroom away from home?

M: Using Knives When Eating How does [name] use a knife for spreading or cutting food?

N: Eating & Exercise Choices Tell me what [name] knows about healthy eating and exercising.

O: Preparing for Weather What does [name] do as far as choosing clothes

and things if the weather might be bad?
P: Health Care What does [name] do for himself/herself when he/
she gets hurt or has a health problem?
Domestic A: Beginning Home Safety What does [name] understand about things that can burn or cut
someone and what he/she should do to avoid being burned or cut?

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 Domain and subdomain Interview Topic Question
B: Cleaning Up After Self What does [name] do to clean up or pick up after himself/herself?

C: Putting Clothes, etc. Where does [name] put his/her dirty and clean clothes and wet towels?
Where They Belong
D: Food Preparation Basics Tell me what simple or basic things [name] does to prepare food.

E: Advanced Home Safety What safety precautions within the home

environment does [name] follow?
F: Basic Household Chores What kinds of chores does [name] do at home?

G: Cleaning Up After Meals Tell me what [name] does to clean up after meals.

H: More Complex Tell me about how [name] prepares a big meal?

Food Preparation
I: Advanced Household What kinds of chores does [name] do at home?
Chores
Community A: Basic Money Skills What does [name] know about money?
B: Basic Safety Outside Tell me what [name] does to stay safe when he/she is in the
the Home car, crossing streets, and with you in a public place.
C: Telling Time What does [name] know about telling time?

D: Basic Rights & What does [name] understand about people’s rights and responsibilities,
Responsibilities like the right to privacy or the need to follow rules and laws?
E: Calendar Basics What does [name] know about the calendar and dates, such as
naming the days of the week, the current date, and so on?
F: Telephone Use How does [name] use the telephone to make calls?

G: Using Money What does [name] know about the value of coins and bills?

H: Using Technology As you know, our world is full of electronic technology, from
TVs to computers to cell phones. What technology devices
does [name] use, and what does he/she use them for?
I: Eating Out Tell me what [name] does on his/her own when eating out.

J: Advanced Safety Tell me what [name] does to stay safe when he/she
Outside the Home is doing things outside the home, like working with
equipment, having fun, shopping, and so on.
K: Being on Time What does [name] do to be sure he/she gets
up or does something on time?
L: Shopping Skills Tell me what [name] does to be careful and
smart with money when shopping.
M: Achieving Goals Tell me about some goals that [name] has set for
himself/herself and actually achieved.
N: Understanding Rights What does [name] understand about people’s rights, like the right
to complain about a service problem or discontinue a service?
O: Traveling What does [name] do in terms of going places on his/her own?

P: Earning Money Tell me what [name] has done to earn money outside the home.

Q: Managing Money What does [name] do to manage his/her money, like using
a bank account, sticking to a budget, and paying bills?
SOCIALIZATION DOMAIN
Interpersonal A: Beginning Social Behavior What things does [name] do that show you
Relationships that he/she is interested in people?
B: Responding to What kinds of things does [name] do when he/
Familiar People she is around people who he/she knows?
C: Expressing & What kinds of feelings or emotions does [name]
Recognizing Emotions show, and how does he/she show them?
D: Identifying Self & Others Some of the ways we begin to identify ourselves are by recognizing our
image in a mirror or photo and understanding how we’re related to our
family members. What does [name] understand about these things?
E: Imitating Others What kinds of things does [name] do to imitate or
copy what you or someone else is doing?

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 Domain and subdomain Interview Topic Question
F: Interpersonal What does [name] do that shows that he/she understands what
Appropriateness people consider proper, like how close to stand to other people,
how to adjust his/her voice for the situation, and so on?
G: Friendships Tell me about [name]’s friendships.

H: Demonstrating Caring What kinds of things does [name] do to show that he/she
cares about you and others? Tell me about what he/she does
on his/her own, without having to be reminded or told.
I: Conversational Skills Who does [name] have conversations with, and
what are his/her conversations like?
J: Taking Others’ Perspective What are some things that [name] does that show that he/
she is thinking about the other person’s point of view,
like what they think, want, or are interested in?
K: Interpersonal Flexibility How often does [name] do things or talk about things
that others want to, even though he/she doesn’t?
Play and Leisure A: Beginning to Play Tell me how [name] plays, or what he/she did when he/
she was first starting to play as a baby.
B: Playing With Others How does [name] play with other children?

C: Make-Believe What kinds of make-believe activities does [name] play,

or did he/she play when he/she was younger?
D: Sharing When does [name] share toys, books, or
other things with other children?
E: Responding to Social Cues Sometimes a group will let a person know whether he or she is
welcome to join in by saying so, and sometimes by how friendly they
act without saying so directly. What does [name] do when a group lets
him/her know with words that he/she is welcome or not welcome, and
what does he/she do when they let him/her know without words?
F: Following Rules in What does [name] do in terms of taking turns and
Games & Sports following rules in games and sports?
G: Playing Games What kinds of indoor and outdoor games does [name] play?

H: Doing Things With Peers How often does [name] get together with others
his/her age, and what do they do?
I: Planning Activities What does [name] do on his/her own to plan fun activities?

Coping Skills A: Handling Transitions How does [name] usually react to everyday changes like when
you have to leave him/her or when it’s time to change from
doing something he/she is enjoying to doing something else?
B: Beginning What usually happens when [name] gets upset about something?
Emotional Control
C: Good Manners Tell me about some of the ways that [name] acts polite.

D: Asking For & What does [name] usually do in terms of asking for help
Accepting Help when he/she needs it to figure out how to do something
and accepting helpful ideas from others?
E: Adapting Behavior As we get older, we learn to change our behavior to fit the situation,
to the Situation like lowering our voice when others nearby are concentrating. In
what ways does [name] adjust his/her behavior to fit the situation?
F: Respecting Others What are some ways in which [name] is respectful of others, like
apologizing when needed, keeping promises, and so on?
G: Controlling Anger Everyone runs into situations that could make them feel angry or hurt,
like when something doesn’t go their way or someone criticizes them.
How does [name] usually respond to those kinds of situations?
H: Obeying Time Limits If you tell [name] that he/she can only do something for so long or
be away from home for so long, how often does he/she obey?
I: Managing Social Risks What does [name] understand about different ways that
people might try to take advantage of him/her, and what
does he/she do to keep from being taken advantage of?
J: Making Decisions How carefully does [name] think things
through before making decisions?

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 Domain and subdomain Interview Topic Question
MOTOR SKILLS DOMAIN
Gross Motor A: Sitting Tell me what [name] is doing in terms of sitting.
B: Pre-Walking Mobility In what ways does [name] move around on his/her own?

C: Standing Tell me what [name] is doing in terms of standing.

D: Walking Tell me what [name] is doing in terms of walking.

E: Ball Activities What does [name] do with a ball?

F: Climbing What kinds of things does [name] climb on and off of safely?

G: Running Tell me how [name] runs.

H: Using Stairs Tell me how [name] goes up and down stairs.

I: Jumping & Hopping What kinds of things does [name] do in terms of jumping
off the ground with both feet or hopping on one foot?
J: Catching a Ball What size balls does [name] catch, and from how far away?

K: Riding a Tricycle or Bicycle Tell me what [name] is doing in terms of riding a tricycle or bicycle.

Fine Motor A: Beginning to What kinds of objects does [name] pick up with his/her hands?
Handle Objects
B: Manipulating Things What kinds of things does [name] move
around by hand when he/she plays?
C: Opening Doors What kinds of doors does [name] open?

D: Beginning Crayon/Pen Use Tell me how [name] is using a crayon, pen, or pencil.

E: Hand Coordination What things does [name] do that require coordinated

hand movements, like unwrapping things, winding
up a toy, or pouring something into a glass?
F: Drawing What does [name] draw without tracing?

G: Coloring Tell me what [name] is doing in terms of coloring.

H: Using Scissors Tell me how [name] uses scissors.

I: Tying How often does [name] tie a knot or a bow without help?

J: Precise Movements Tell me some things that [name] does that require very precise finger
control, like setting a watch or putting together things with small parts.

Scoring Criteria
Communication Domain
Receptive Subdomain
6. An appropriate response is any behavior that shows that the individual understands the meaning of the
gesture. Score 2 if there are at least three basic gestures to which the individual usually responds. Score 1 if
there are at least three basic gestures to which he/she sometimes responds. Score 0 if he/she doesn’t respond to
three basic gestures.
7. Understanding is assumed if the individual responds appropriately to no.
8. An appropriate response is any behavior that shows that the individual understands the meaning of the facial
expression. Score 2 if there are at least three facial expressions to which the individual usually responds. Score
1 if there are at least three facial expressions to which he/she sometimes responds. Score 0 if he/she doesn’t
respond to three facial expressions.
9. Understanding is assumed if the individual responds appropriately to yes.
11. The individual may identify objects in ways other than pointing, for example, by using other gestures or
verbally. Score 2 if there are at least three objects that the individual usually identifies when asked. Score 1 if

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 there are at least three objects that he/she sometimes identifies when asked. Score 0 if he/she doesn’t identify
three objects.
14. The individual may identify body parts in ways other than pointing, for example, identifying his/her nose
by bringing his/her hand to it, or identifying his/her arm by lifting it. Score 2 if there are at least three body
parts that the individual usually identifies on self when asked. Score 1 if there are at least three body parts that
he/she sometimes identifies when asked. Score 0 if he/she doesn’t identify three body parts.
16. Other examples include thumb and index finger apart to show just a little, holding nose to show that stinks,
and shrugging shoulders to mean I don’t know. An appropriate response is any behavior that shows that the
individual understands the meaning of the gesture. Score 2 if there are at least three gestures of this kind to
which the individual usually responds. Score 1 if there are at least three gestures of this kind to which he/she
sometimes responds. Score 0 if he/she doesn’t respond to three gestures of this kind.
17. The individual may identify objects in ways other than pointing, for example, by using other gestures or
verbally. Score 2 if there are at least three objects that the individual usually identifies in pictures when asked.
Score 1 if there are at least three objects that he/she sometimes identifies in pictures when asked. Score 0 if he/
she doesn’t identify three objects in pictures.
18. The individual may identify body parts in ways other than pointing, for example, by using other gestures or
verbally. Score 2 if there are at least three body parts that the individual usually identifies in pictures when
asked. Score 1 if there are at least three body parts that he/she sometimes identifies in pictures when asked.
Score 0 if he/she doesn’t identify three body parts in pictures.
19, 20. Both verbal and nonverbal responses count.
21. The individual may identify actions in ways other than pointing, for example, by using other gestures or
verbally. Score 2 if there are at least three actions that the individual usually identifies in pictures when asked.
Score 1 if there are at least three actions that he/she sometimes identifies in pictures when asked. Score 0 if he/
she doesn’t identify three actions in pictures.
22, 24, 27. Both verbal and nonverbal responses count.
28. Score 2 if the individual usually does this, without reminders. Score 1 if he/she sometimes does this without
reminders, but sometimes fails to perform both requested actions without reminders. Score 0 if he/she never
does this, or never does it without reminders.
29. Both verbal and nonverbal responses count.
30. A “show” includes a TV show, video, live performance, or other entertainment.
31. Score 2 if the individual usually knows left from right on his/her body. Score 1 if he/she sometimes makes
mistakes. Score 0 if he/she does not know left from right on his/her body.
32. Score 2 if the individual usually performs all three actions, without reminders. Score 1 if he/she sometimes does
this without reminders, but sometimes fails to perform all three actions without reminders. Score 0 if he/she
never performs all three actions, or never does so without reminders.
33. A “show” includes a TV show, video, live performance, or other entertainment.
34. Understanding is assumed if the individual responds appropriately to sarcastic statements.
35. Examples of informational presentations are school and community lectures, educational TV shows and
videos, religious sermons, and meetings.
37, 38. Score 2 if the individual usually remembers, without reminders. Score 1 if he/she sometimes remembers
without reminders, but sometimes fails to remember or needs reminders. Score 0 if he/she never remembers,
or never remembers without reminders.
39. Examples of informational presentations are school and community lectures, educational TV shows and
videos, religious sermons, and meetings.

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Expressive Subdomain
4. Score 2 if there are at least three one-syllable speech sounds that the individual commonly makes. Score 1 if
there are at least three one-syllable speech sounds that he/she sometimes makes. Score 0 if he/she does not
make three different speech sounds.
5. Strings do not have to repeat a single consonant–vowel sound to receive credit; for example, “Ba-da-ba-da”
would count.
6. Additional examples include pushing something away, crying in protest, bouncing up and down while
smiling, and clapping. Gestures do not need to be accompanied by speech.
8. Score 2 if there are at least three basic gestures that the individual commonly uses. Score 1 if there are at least
three basic gestures that he/she sometimes uses. Score 0 if he/she doesn’t use three basic gestures.
9. Give credit for word approximations, such as “Ba” for ball or bottle, “Ma” for more, “Oh” for open. Articulation
need not be perfect.
11. Give credit if the individual names the objects when asked or does so spontaneously. Articulation need not be
perfect, but must be understood by people outside the family. Score 2 if there are at least three objects that the
individual regularly names. Score 1 if there are at least three objects that he/she sometimes names. Score 0 if he/
she does not name three objects.
13. Give credit if the individual names the objects when asked or does so spontaneously. Articulation need not be
perfect, but must be understood by people outside the family.
15. Give credit if the individual names the actions when asked or does so spontaneously (for example, “Me play,”
“What are you eating?”). Articulation need not be perfect, but must be understood by people outside the
family. Score 2 if there are at least three actions that the individual regularly names. Score 1 if there are at least
three actions that he/she sometimes names. Score 0 if he/she does not name three actions.
16. Articulation need not be perfect, but must be understood by people outside the family.
17. Articulation need not be perfect.
18, 19. Articulation need not be perfect, but must be understood by people outside the family.
23. Other examples include thumb and index finger apart to show just a little, holding nose to show that stinks,
and shrugging shoulders to mean I don’t know. Score 2 if there are at least three gestures of this kind that the
individual commonly uses. Score 1 if there are at least three gestures of this kind that he/she sometimes uses.
Score 0 if he/she doesn’t use three gestures of this kind.
30. It’s okay if gender is incorrect (for example, using “he” to refer to a female) or grammar is incorrect (for
example, “Her happy,” “Him ball”).
31. Score 2 if the individual uses all three prepositions regularly. Score 1 if he/she uses all three sometimes. Score 0
if he/she never uses one or more of the three.
33. Articulation need not be perfect, but must be understood by people outside the family.
36. Using because as a one-word response doesn’t count.
39. In other words, recounts fairy tale, book, and/or movie plots that most people are familiar with. Neither great
detail nor perfect order is required, but the basic parts of the story must be included without prompting. Score
0 if the individual does not describe details or only lists one or two details (for example, a character’s name).
40. Score 2 if the individual uses all three prepositions regularly. Score 1 if he/she uses all three sometimes. Score 0
if he/she never uses one or more of the three.
41. Examples include “The bathroom’s at the end of the hall”; “Fold this over, then stand it up”; “Look in the little
green box under the bed.” Score 0 for directions that don’t make sense.
43. Additional examples are “Eric doesn’t really like cartoons” and “That movie might be too scary for you.”

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 44. If there is ambiguity, score based on how often the individual provides at least three details: usually, sometimes,
or never. For example, when asked about the school day, says, “We had art this morning. Then I shared my
lunch with Eric, and we played soccer together at recess. Math was boring because I already knew how to do
it.”
45. If there is ambiguity, score based on how often the individual provides at least three details: usually, sometimes,
or never. For example, when asked about a recent vacation, says, “We went to Florida to visit my grandparents.
We went to the beach, and I got to ride on a boat! Amy got bit by something when she was swimming and
wouldn’t go back in the water after that.”
46. Score 2 if the individual usually does this (i.e., says both the month and day of his/her birthday when asked).
Score 1 if he/she sometimes does this. Score 0 if he/she never does this.
47. To receive credit, the individual must express the thought in a different way, rather than simply repeating or
nearly repeating the same words.
49. Examples include “Go to the end of this street, turn right, and go half a block until you see the two-story
white building” and “First cook the noodles, then toss them in a pan with the sauce, and then put the crumbs
on top and bake for 10 minutes.” Score 0 for directions that don’t make sense.

Written Subdomain
1. Score 2 if the individual usually handles a book correctly for reading. Score 1 if he/she sometimes handles a
book correctly for reading. Score 0 if he/she never handles a book, or never handles one correctly for reading.
2. Recognition is inferred from what the individual says or does when seeing these kinds of signs and icons/
symbols.
3. Letters may be uppercase or lowercase. Give credit if the individual identifies the letters when asked or does
so spontaneously. Score 2 if there is at least one letter that he/she regularly identifies. Score 1 if there is at least
one letter that he/she sometimes identifies. Score 0 if he/she does not identify any letters.
5. Letters may be uppercase or lowercase. Give credit if the individual identifies the letters when asked or does
so spontaneously.
6. Understanding is inferred from how the individual reads or points to words in a book.
8, 9. One or more letters may be written with incorrect orientation, as long as the correct letter is copied.
11. Score 2 if the individual usually writes letters correctly. Score 1 if he/she sometimes writes letters correctly, but
sometimes writes them reversed or upside down. Score 0 if he/she does not write alphabet letters.
13. Score 2 if the individual regularly writes both his/her first and last name, without copying and without help.
Score 1 if he/she sometimes writes both names without copying and without help. Score 0 if he/she never writes
both names without copying and without help.
14. Score 2 if the individual regularly reads sentences of three or more words aloud (for example, “See Spot run,”
“Go dog go”). Score 1 if he/she sometimes reads sentences of three or more words aloud. Score 0 if he/she never
reads sentences of three or more words aloud. Printed words may be uppercase and/or lowercase.
15. One or more letters may be written with incorrect orientation, as long as the correct letter is copied. Score 2 if
the individual regularly copies phrases or sentences of four or more words, without mistakes. Score 1 if he/she
sometimes copies phrases or sentences of four or more words, without mistakes. Score 0 if he/she never copies
phrases or sentences of four or more words without mistakes.
17. Score 2 if the individual regularly reads simple stories aloud, getting most words correct. Score 1 if he/she
sometimes does this. Score 0 if he/she never reads simple stories aloud, or never gets most words correct when
doing so. Printed words may be uppercase and/or lowercase.
18. Score 2 if the individual regularly writes sentences of three or more words (for example, “I love you,” “Happy
birthday Mommy,” “I miss you”). Score 1 if he/she sometimes writes sentences of three or more words. Score 0
if he/she never writes sentences of three or more words.

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 20. To receive credit, the individual must both read and comprehend material at a second-grade level or higher.
He/she may read silently or aloud. Reading ability is more important than interest in reading; do not penalize
the individual who reads only when required to do so.
24, 26. Score 2 if the individual usually does this when needed, without help. Score 1 if he/she sometimes does this
when needed, without help. Score 0 if he/she never does this, or never does it without help.
27. To receive credit, the individual must both read and comprehend material at a fourth-grade level or higher.
He/she may read silently or aloud. Reading ability is more important than interest in reading; do not penalize
the individual who reads only when required to do so.
29. Give credit only for Internet or library use that the individual initiates on his/her own, and does without help.
30. Score 2 if the individual usually does this when needed, without help. Score 1 if he/she sometimes does this
when needed, without help. Score 0 if he/she never does this, or never does it without help.
31. Give credit only for instructions that are accurate.
32. Score 2 if the individual usually does this, without prompting. Score 1 if he/she sometimes does this without
prompting, but sometimes fails to do it or needs prompting. Score 0 if he/she never does this, or never does it
without prompting.
33. Score 2 if the individual usually does this when needed, without help. Score 1 if he/she sometimes does this
when needed, without help. Score 0 if he/she never does this, or never does it without help.
34. To receive credit, the individual must both read and comprehend material at a sixth-grade level or higher. He/
she may read silently or aloud. Reading ability is more important than interest in reading; do not penalize the
individual who reads only when required to do so.
35. Score 2 if the individual usually does this when needed, without help. Score 1 if he/she sometimes does this
when needed, without help. Score 0 if he/she never does this, or never does it without help.
36. To receive credit, the individual must both read and comprehend material at a ninth-grade level or higher.
Reading ability is more important than interest in reading; do not penalize the individual who reads only
when required to do so.
37, 38. Score 2 if the individual usually does this when needed, without help. Score 1 if he/she sometimes does this
when needed, without help. Score 0 if he/she never does this, or never does it without help.

Daily Living Skills Domain

Personal Subdomain
2. Score 2 if the individual regularly does this, without help. Score 1 if he/she sometimes does this, without help.
Score 0 if he/she does not do this, or never does it without help.
5. Score 2 if the individual usually cooperates when being dressed and undressed. Score 1 if he/she sometimes
cooperates when being dressed and undressed. Score 0 if he/she never cooperates with undressing, with
dressing, or with either one.
6. Score 2 if the individual usually cooperates in both washing of hands and washing of face. Score 1 if he/she
sometimes cooperates in both washing of hands and washing of face. Score 0 if he/she never cooperates in
washing of hands, in washing of face, or in either one.
7. Score 2 if the individual usually does this when needed, without help, although he/she may spill. Score 1 if he/
she sometimes does this when needed, without help. Score 0 if he/she never does this, or never does it without
help.
8. Score 2 if the individual usually does this (i.e., takes off both shoes and socks), without help. Score 1 if he/she
sometimes does this, without help. Score 0 if he/she never does this, or never does it without help.
9. Score 2 if the individual usually does this, without help, although he/she may spill. Score 1 if he/she sometimes
does this, without help. Score 0 if he/she never does this, or never does it without help.

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 10. Score 2 if the individual usually does this when needed, without help, although he/she may spill. Score 1 if he/
she sometimes does this when needed, without help. Score 0 if he/she never does this, or never does it without
help.
11, 13, 14. Score 2 if the individual usually does this, without help. Score 1 if he/she sometimes does this, without
help. Score 0 if he/she never does this, or never does it without help.
16. Score 2 if the individual usually does this (i.e., both washes his/her hands and dries them), without help,
although he/she does not need to turn the water on and off or adjust the temperature. Score 1 if he/she
sometimes does this, without help. Score 0 if he/she never does this, or never does it without help.
17. Score 2 if the individual usually does this when needed, without help. Score 1 if he/she sometimes does this
when needed, without help. Score 0 if he/she never does this, or never does it without help.
18. Score 2 if the individual usually does this, without help. Score 1 if he/she sometimes does this, without help.
Score 0 if he/she never does this, or never does it without help.
19. Score 2 if the individual usually puts on his/her shoes, without help, although shoes may be on the wrong feet.
Score 1 if he/she sometimes does this, without help. Score 0 if he/she never does this, or never does it without
help.
20. Score 2 if the individual usually does this, without help, although he/she does not need to zip or button the
clothing. Score 1 if he/she sometimes does this, without help. Score 0 if he/she never does this, or never does it
without help.
22. Score 2 if the individual initiates using the toilet and does not have accidents. Score 1 if he/she initiates using
the toilet but has some accidents. Score 0 if he/she does not initiate using the toilet or has frequent accidents.
23. Score 2 if the individual usually does this, without help. Score 1 if he/she sometimes does this, without help.
Score 0 if he/she never does this, or never does it without help.
24. Score 2 if the individual usually does this, without help or prompting. Score 1 if he/she sometimes does this
without help or prompting, but sometimes fails to do it or needs help or prompting. Score 0 if he/she never
does this, or never does it without help or prompting.
25. Score 2 if the individual usually does this (i.e., both washes his/her face and dries it), without help, although
he/she does not need to turn the water on and off or adjust the temperature. Score 1 if he/she sometimes does
this, without help. Score 0 if he/she never does this, or never does it without help.
26. Score 2 if the individual usually does this (i.e., wipes or cleans both his/her face and his/her hands), without
help or prompting. Score 1 if he/she sometimes does this without help or prompting, but sometimes fails to do
it or needs help or prompting. Score 0 if he/she never does this, or never does it without help or prompting.
27. Score 2 if the individual usually does this, without help or reminders to adjust clothes. Score 1 if he/she
sometimes does this, without help or reminders. Score 0 if he/she never does this, or never does it without help
or reminders.
28. Score 2 if the individual initiates using the toilet and does not have accidents. Score 1 if he/she initiates using
the toilet but has some accidents. Score 0 if he/she does not initiate using the toilet or has frequent accidents.
29. Score 2 if the individual usually does this, without reminders. Score 1 if he/she sometimes does this without
reminders, but sometimes fails to do it or needs reminders. Score 0 if he/she never does this, or never does it
without reminders.
30. Score 2 if the individual initiates using the toilet, does not need help, and does not have accidents. Score 1 if
he/she initiates using the toilet, does not need help, but has some accidents. Score 0 if he/she does not initiate
using the toilet, needs help, or has frequent accidents.
31. Score 2 if the individual usually fastens snaps, without help. Score 1 if he/she sometimes fastens snaps, without
help. Score 0 if he/she never fastens snaps, or never does it without help.
32. Score 2 if the individual usually completes all of these steps, without help or reminders. Score 1 if he/she
sometimes completes all of these steps without help or reminders, but sometimes needs help or reminders for
one or more steps. Score 0 if he/she never completes all of these steps without help, or hasn’t begun brushing.
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 33. Score 2 if the individual usually does this, without help. Score 1 if he/she sometimes does this, without help.
Score 0 if he/she never does this, or never does it without help.
34. Score 2 if the individual usually does this, without help or prompting. Score 1 if he/she sometimes does this
without help or prompting, but sometimes fails to do it or needs help or prompting. Score 0 if he/she never
does this, or never does it without help or prompting.
35. Score 2 if the individual usually does this, without help. Score 1 if he/she sometimes does this, without help.
Score 0 if he/she never does this, or never does it without help.
36. Score 2 if the individual usually does this (i.e., both bathes/showers and dries self), without help, although he/
she does not need to turn the water on and off or adjust the temperature. Score 1 if he/she sometimes does this,
without help. Score 0 if he/she never does this, or never does it without help.
37. Score 2 if the individual usually does this (i.e., puts shoes on the correct feet and securely ties or fastens them),
without help. Score 1 if he/she sometimes does this, without help. Score 0 if he/she never does this, or never
does it without help.
38. Score 2 if the individual usually does this when needed, without help. Score 1 if he/she sometimes does this
when needed, without help. Score 0 if he/she never does this, or never does it without help.
39. Score 2 if the individual usually does this, without help. Score 1 if he/she sometimes does this, without help.
Score 0 if he/she never does this, or never does it without help.
41. Score 2 if the individual usually does this (i.e., both finds and uses an appropriate restroom), without help.
Score 1 if he/she sometimes does this, without help. Score 0 if he/she never does this, or never does it without
help.
42. Includes faucets at the kitchen sink, bathroom sink, bathtub, and shower, as available in the home. Score 2 if
the individual usually does this (i.e., both turns faucets on and adjusts the water temperature), without help.
Score 1 if he/she sometimes does this, without help. Score 0 if he/she never does this, or never does it without
help.
43. Score 2 if the individual usually does this, without help or prompting. Score 1 if he/she sometimes does this
without help or prompting, but sometimes fails to do it or needs help or prompting. Score 0 if he/she never
does this, or never does it without help or prompting.
44. Score 2 if the individual usually does this when needed, without help. Score 1 if he/she sometimes does this
when needed, without help. Score 0 if he/she never does this, or never does it without help.
46. Score 2 if the individual usually does this (i.e., both washes and rinses his/her hair), without help, although he/
she does not need to turn the water on and off or adjust the temperature. Score 1 if he/she sometimes does this,
without help. Score 0 if he/she never does this, or never does it without help.
47. Score 2 if the individual regularly does this, without urging. Score 1 if he/she sometimes does this, without
urging. Score 0 if he/she never does this, or never does it without urging.
48. Score 2 if the individual usually does this, without help or prompting. Score 1 if he/she sometimes does this
without help or prompting, but sometimes fails to do it or needs help or prompting. Score 0 if he/she never
does this, or never does it without help or prompting.
49. Score 2 if the individual usually does this, without urging. Score 1 if he/she sometimes does this without
urging, but sometimes fails to do it or needs urging. Score 0 if he/she never does this, never does it without
urging, or does not make his/her own food choices.
50. Score 2 if the individual usually does this when needed, without help. Score 1 if he/she sometimes does this
when needed, without help. Score 0 if he/she never does this (including if he/she is not allowed to use a sharp
knife), or never does it without help.
51. Score 2 if the individual usually does this, without prompting. Score 1 if he/she sometimes does this without
prompting, but sometimes fails to do it or needs prompting. Score 0 if he/she never does this, or never does it
without prompting.

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 52. Score 2 if the individual usually does this, without help. Score 1 if he/she sometimes does this, without help.
Score 0 if he/she never does this, or never does it without help.
53. Score 2 if the individual usually does this, without help or prompting. Score 1 if he/she sometimes does this
without help or prompting, but sometimes fails to do it or needs help or prompting. Score 0 if he/she never
does this, or never does it without help or prompting.
54. The individual must both recognize the need for professional medical care and decide to seek care without
urging. Score 2 if the individual usually does both on his/her own when needed. Score 1 if he/she sometimes
does both on his/her own when needed, but sometimes fails to recognize the need for care or to seek care.
Score 0 if he/she never does both on his/her own.
55. Score 2 if the individual usually does this, without help or prompting. Score 1 if he/she sometimes does this
without help or prompting, but sometimes fails to do it or needs help or prompting. Score 0 if he/she never
does this, or never does it without help or prompting.

Domestic Subdomain
1. Score 2 if the individual is usually careful, without reminders. Score 1 if he/she is sometimes careful without
reminders, but sometimes fails to be careful or needs reminders. Score 0 if he/she is not aware of the danger of
hot objects, or is never careful around them without reminders.
2. Score 2 if the individual is usually careful, without reminders. Score 1 if he/she is sometimes careful without
reminders, but sometimes fails to be careful or needs reminders. Score 0 if he/she never uses sharp objects, or
never uses them carefully without reminders.
3. Score 2 if the individual usually does this, without help or prompting. Score 1 if he/she sometimes does this
without help or prompting, but sometimes fails to do it or needs help or prompting. Score 0 if he/she never
does this, or never does it without help or prompting.
4. Score 2 if the individual usually does this, without prompting. Score 1 if he/she sometimes does this without
prompting, but sometimes fails to do it or needs prompting. Score 0 if he/she never does this, or never does it
without prompting.
5, 6. Score 2 if the individual usually does this, without help or prompting. Score 1 if he/she sometimes does this
without help or prompting, but sometimes fails to do it or needs help or prompting. Score 0 if he/she never
does this, or never does it without help or prompting.
7. Score 2 if the individual usually does this, without prompting. Score 1 if he/she sometimes does this without
prompting, but sometimes fails to do it or needs prompting. Score 0 if he/she never does this, or never does it
without prompting.
8. Score 2 if the individual usually clears all of his/her own dishes etc., without help or prompting. Score 1 if he/
she sometimes clears all of his/her own dishes etc. without help or prompting, but sometimes fails to do this
fully or needs help or prompting. Score 0 if he/she never clears all of his/her own dishes etc., or never does so
without help or prompting.
9. Score 2 if there are at least two household chores that the individual regularly does, without help or prompting.
Score 1 if there are at least two chores that he/she sometimes does, without help or prompting. Score 0 if he/she
does not do two chores without help or prompting.
10. Score 2 if the individual usually does this when required, without help. Score 1 if he/she sometimes does this
when required, without help. Score 0 if he/she never does this, or never does it without help. It’s okay if he/she
is only allowed to prepare food when an adult is present.
11. Understanding can be shown by either saying what to do or by having responded appropriately in actual
dangerous situations.
12. Score 2 if the individual usually does this, without prompting. Score 1 if he/she sometimes does this without
prompting, but sometimes fails to do it or needs prompting. Score 0 if he/she never does this, or never does it
without prompting.

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 13. Score 2 if the individual usually does this, without help or prompting. Score 1 if he/she sometimes does this
without help or prompting, but sometimes fails to do it or needs help or prompting. Score 0 if he/she never
does this, or never does it without help or prompting.
14. Score 2 if there are at least two simple kitchen appliances that the individual usually uses when needed,
without help. Score 1 if there are at least two appliances that he/she sometimes uses when needed, without help.
Score 0 if he/she does not use two appliances without help. It’s okay if he/she is only allowed to use kitchen
appliances when an adult is present.
15. Score 2 if the individual usually does this, without prompting. Score 1 if he/she sometimes does this without
prompting, but sometimes fails to do it or needs prompting. Score 0 if he/she never does this, or never does it
without prompting.
16. Score 2 if the individual usually does this on his/her own, without prompting. Score 1 if he/she sometimes does
this on his/her own without prompting, but sometimes fails to do it or needs prompting. Score 0 if he/she is
not expected to do this on his/her own, or never does it without prompting.
17. Score 2 if there are at least three kitchen utensils that the individual usually uses when needed. Score 1 if there
are at least three utensils that he/she sometimes uses when needed. Score 0 if he/she does not use three utensils.
18. Score 2 if the individual is usually careful, without reminders. Score 1 if he/she is sometimes careful without
reminders, but sometimes fails to be careful or needs reminders. Score 0 if he/she never operates household
appliances or equipment, or never operates them carefully without reminders.
19. Score 2 if the individual usually does this when required, without help. Score 1 if he/she sometimes does this
when required, without help. Score 0 if he/she never does this, or never does it without help. It’s okay if he/she
is only allowed to prepare food when an adult is present.
20. Score 2 if the individual usually does this, without help or reminders. Score 1 if he/she sometimes does this
without help or reminders, but sometimes fails to do it or needs help or reminders. Score 0 if he/she never uses
household products, or never uses them correctly without help or reminders.
21. Score 2 if the individual usually does this when required, without help or prompting. Score 1 if he/she
sometimes does this when required without help or prompting, but sometimes fails to do it or needs help or
prompting. Score 0 if he/she never does this, or never does it without help or prompting.
22. Score 2 if the individual usually does this on his/her own, without prompting. Score 1 if he/she sometimes does
this on his/her own without prompting, but sometimes fails to do it or needs prompting. Score 0 if he/she is
not expected to do this on his/her own, or never does it without prompting.
23, 24, 25. Score 2 if the individual usually does this when required, without help or prompting. Score 1 if he/she
sometimes does this when required without help or prompting, but sometimes fails to do it or needs help or
prompting. Score 0 if he/she never does this, or never does it without help or prompting.
26. Score 2 if the individual usually does this when needed, without help. Score 1 if he/she sometimes does this
when needed, without help. Score 0 if he/she never does this, or never does it without help. It’s okay if he/she
is only allowed to use the stove or oven when an adult is present.
27. Score 2 if the individual usually does this (i.e., both recognizes when a task needs to be done and does it
without help). Score 1 if he/she sometimes does this. Score 0 if he/she never does this.
28. Score 2 if the individual usually does this when required, without help or prompting. Score 1 if he/she
sometimes does this when required without help or prompting, but sometimes fails to do it or needs help or
prompting. Score 0 if he/she never does this, or never does it without help or prompting.
29. Score 2 if the individual usually does laundry when required, without help or prompting. Score 1 if he/she
sometimes does laundry when required without help or prompting, but sometimes fails to do it or needs help or
prompting. Score 0 if he/she never does laundry, or never does it without help or prompting.
30. Score 2 if the individual usually does this when required, without help. Score 1 if he/she sometimes does this
when required, without help. Score 0 if he/she never does this, or never does it without help. It’s okay if he/she
is only allowed to prepare food when an adult is present.

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Community Subdomain
2. The individual does not need to actually use money himself/herself.
4. Score 2 if the individual usually does this, without prompting. Score 1 if he/she sometimes does this without
prompting, but sometimes fails to do it or needs prompting. Score 0 if he/she is not able to leave the caregiver
on his/her own, or never remains within safe distance without prompting.
5. Score 2 if the individual both understands passenger safety precautions and usually follows them without
reminders. Score 1 if he/she both understands passenger safety precautions and sometimes follows them
without reminders. Score 0 if he/she does not understand passenger safety precautions, or never follows them
without reminders.
6. The individual does not need to actually tell time himself/herself.
7. Score 2 if there are at least two technology devices that the individual regularly operates without help for
entertainment. Score 1 if there are at least two devices that he/she sometimes operates without help. Score 0 if
he/she doesn’t operate two devices without help.
8. Score 2 if the individual usually does this, without prompting. Score 1 if he/she sometimes does this without
prompting, but sometimes fails to do it or needs prompting. Score 0 if he/she never does this, or never does it
without prompting.
9. Score 2 if the individual usually says all seven days of the week in order (starting with any day) when asked.
Score 1 if he/she sometimes says all seven days in order, but sometimes makes mistakes. Score 0 if he/she never
says all seven days in order.
10. Neighborhood streets count. Score 2 if the individual usually does this, without prompting. Score 1 if he/she
sometimes does this without prompting, but sometimes fails to do it or needs prompting. Score 0 if he/she does
not cross streets or roads on his/her own, or never looks both ways without prompting.
11. Understanding is inferred from what the individual has done and/or what he/she says in regard to this.
12. Score 2 if the individual usually names all four coins when asked. Score 1 if he/she sometimes names all four
coins, but sometimes makes mistakes. Score 0 if he/she never names all four coins.
15. Score 2 if the individual usually both says the correct number to call and knows how to make the call. Score 1
if he/she sometimes both says the correct number to call and knows how to make the call, but sometimes makes
mistakes with either or both. Score 0 if he/she does not know the correct number to call or how to make the
call.
16. Score 2 if the individual usually does this on his/her own (i.e., without being told what to do or simply
following someone else). Score 1 if he/she sometimes does this on his/her own, but sometimes fails to do it or
has to be told. Score 0 if he/she does not cross streets or roads on his/her own, or never obeys lights and signs
without being told.
18. Score 2 if the individual both understands community rules and laws and usually follows them without
prompting. Score 1 if he/she both understands community rules and laws and sometimes follows them without
prompting. Score 0 if he/she does not understand community rules and laws, or never follows them without
prompting.
19. Score 2 if the individual regularly does this, without help. Score 1 if he/she sometimes does this, without help.
Score 0 if he/she never does this, or never does it without help.
21. Understanding is inferred from what the individual says about these kinds of signs and symbols and from how
he/she has acted in response to them.
23. Score 2 if the individual usually correctly states the value of all four coins when asked. Score 1 if he/she
sometimes correctly states the value of all four coins, but sometimes makes mistakes. Score 0 if he/she never
correctly states the value of all four coins.
24. Score 2 if the individual usually does this on his/her own, without prompting. Score 1 if he/she sometimes does
this on his/her own without prompting, but sometimes fails to do it or needs prompting. Score 0 if he/she
never does this on his/her own, or never does it without prompting.
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 25. Score 2 if the individual usually does this on his/her own when needed or asked to. Score 1 if he/she sometimes
does this on his/her own when needed or asked to. Score 0 if he/she never does this on his/her own.
26. Score 2 if the individual usually does this correctly when needed, without help. Score 1 if he/she sometimes
does this correctly when needed, without help. Score 0 if he/she never does this, or never does it correctly
without help.
27. Score 2 if the individual usually does this on his/her own, without prompting. Score 1 if he/she sometimes does
this on his/her own without prompting, but sometimes fails to do it or needs prompting. Score 0 if he/she
never does this on his/her own, or never does it without prompting.
31. Score 2 if the individual usually does this, without help. Score 1 if he/she sometimes does this, without help.
Score 0 if he/she never does this, or never does it without help.
32. Score 2 if the individual usually does this on his/her own, without prompting. Score 1 if he/she sometimes does
this on his/her own without prompting, but sometimes fails to do it or needs prompting. Score 0 if he/she
never does this, or never does it on his/her own without prompting.
33. It’s okay if someone wakes the individual up as long as the individual has arranged to be awakened.
34. Score 2 if the individual usually does this, without prompting. Score 1 if he/she sometimes does this without
prompting, but sometimes fails to do it or needs prompting. Score 0 if he/she never does this, or never does it
without prompting.
35. Score 2 if there are at least two kinds of tasks that the individual regularly performs using technology without
help. Score 1 if there are at least two kinds of tasks that he/she sometimes performs using technology without
help. Score 0 if he/she doesn’t perform two kinds of tasks using technology without help.
37. Score 2 if there are at least two social interaction technologies that the individual regularly uses without help.
Score 1 if there are at least two social interaction technologies that he/she sometimes uses without help. Score 0
if he/she doesn’t use two social interaction technologies without help.
38. Score 2 if the individual usually checks his/her change (without necessarily counting it to the penny), without
help or prompting. Score 1 if he/she sometimes does this, without help or prompting, but sometimes fails to do
it or needs help or prompting. Score 0 if he/she never does this, or never does it without help or prompting.
39. Score 2 if the individual usually does this (i.e., evaluates both quality and price), without prompting. Score
1 if he/she sometimes does this without prompting, but sometimes fails to do it or needs prompting. Score
0 if he/she never makes buying decisions on his/her own, or never evaluates both quality and price without
prompting.
40. Understanding is inferred if the individual has actually begun or discontinued services, or if he/she says things
that show that he/she recognizes this right.
41. Understanding is inferred if the individual has actually reported legitimate problems (for example, returned a
defective product, reported a utility service outage, reported a disruptive neighbor), or if
he/she says things that show that he/she recognizes this right (for example, “You should call and complain
about that”).
42. Score 2 if the individual usually does this, without prompting. Score 1 if he/she sometimes does this without
prompting, but sometimes fails to do it or needs prompting. Score 0 if he/she never does this, or never does it
without prompting.
44. Score 0 if the individual never needs to travel at least a mile to a familiar destination on his/her own.
46. Score 2 if the individual usually does this, without help. Score 1 if he/she sometimes does this, without help.
Score 0 if he/she never does this, or never does it without help.
47. Understanding is inferred if the individual has actually accessed records and information, or if he/she says
things that show that he/she recognizes this right.
48. Score 0 if the individual never needs to travel at least a mile to an unfamiliar destination on his/her own.

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 50. Score 2 if the individual usually does this when needed, without help. Score 1 if he/she sometimes does this
when needed, without help. Score 0 if he/she never does this, or never does it without help.
51. Score 2 if the individual usually does this when required, without help. Score 1 if he/she sometimes does this
when required, without help. Score 0 if he/she never does this, or never does it without help.
52. Score 2 if the individual both plans realistically for expenses and sticks to the plan, so that he/she usually has
the money needed for daily expenses. Score 1 if he/she sometimes does this successfully, but sometimes doesn’t.
Score 0 if he/she is not responsible for his/her daily expenses.
53. Score 2 if the individual usually does this, without help. Score 1 if he/she sometimes does this, without help.
Score 0 if he/she does not have a bank account, or never uses it responsibly without help.
56. Score 2 if the individual both plans realistically for expenses and sticks to the plan, so that he/she usually has
the money needed for monthly expenses. Score 1 if he/she sometimes does this successfully, but sometimes
doesn’t. Score 0 if he/she is not responsible for his/her monthly expenses.
57. Score 2 if the individual usually does this, without prompting. Score 1 if he/she sometimes does this without
prompting, but sometimes fails to do it or needs prompting. Score 0 if he/she does not pay bills, or never pays
them on time without prompting.

Socialization Domain
Interpersonal Relationships Subdomain
1. Give credit if the individual looks only briefly.
2. Do not give credit for smiling if physical touch is involved.
3. Recognition is assumed if the individual smiles, vocalizes, or gestures.
5. Score 2 if there are three or more emotions that the individual regularly displays. Score 1 if there are three
or more emotions that the individual sometimes displays. Score 0 if the individual does not display three
emotions.
6. Smiling or making noises in a solitary or nonsocial manner does not count.
7. The individual may reach while lying, sitting, or standing, and may use one or both hands.
8. Give credit for initiating affection or responding appropriately to affection from others.
10. For example, when the parent or caregiver moves out of sight, the individual looks or moves around to find
him/her.
11. In order to receive credit, the individual must clearly show understanding of his/her own image, for example,
by smiling at self, pointing to self, saying “that’s me,” etc.
14. Recognition is inferred from what the individual says or does in response to others’ emotions.
15. Efforts to imitate are more important than skill, and any object required to do the actual task (for example, a
razor) need not be present.
16. Score 2 if the individual usually does this when appropriate, without prompting. Score 1 if he/she sometimes
does this when appropriate without prompting, but sometimes fails to do it or needs prompting. Score 0 if he/
she never does this, or never does it without prompting.
17. Examples include asking for a play date or to go somewhere with another child.
21. The individual’s response must be appropriate in order to count. Score 2 if the individual usually does this,
without prompting. Score 1 if he/she sometimes does this without prompting, but sometimes fails to do it or
needs prompting. Score 0 if he/she never does this, or never does it without prompting.
22. The individual may imitate a familiar person or a person from a movie or show, but it must be several hours
after observation to receive credit. Efforts to imitate are more important than skill, and any object required to
do the actual task (for example, a razor) need not be present.

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 24. Score 2 if the individual regularly does this, without prompting. Score 1 if he/she sometimes does this, without
prompting. Score 0 if he/she never does this, or never does it without prompting.
25. Score according to the individual’s current situation. Friendships must be reciprocal to count.
27. Score 0 if he/she has not had any friends for the past year.
29. Friendships must be reciprocal to count. Score 0 if he/she has not had any friends for the past year.
30. Recognition is assumed if the individual talks about instances where someone else’s likes and dislikes differ
from his/her own.
31. The individual’s small talk must be appropriate in order to count.
32. Score 0 if he/she has not had any friends for the past year.
33. To receive credit, the individual must show flexibility in shifting topics. “Conversation” is defined as a back-
and-forth exchange lasting at least 2 to 3 minutes. Score 0 if the individual does not have “conversations” by
this definition.
35. For example, says “That hurt my feelings” or “This is really important to me.”
36. “Conversation” is defined as a back-and-forth exchange lasting at least 2 to 3 minutes. Score 0 if the
individual does not have “conversations” by this definition.
37. Score 2 if the individual usually does this when appropriate, without prompting. Score 1 if he/she sometimes
does this when appropriate without prompting, but sometimes fails to do it or needs prompting. Score 0 if he/
she never does this, or never does it without prompting.
38. The individual may make or buy cards and/or gifts. Examples of “special days” are birthdays, Mother’s Day,
Father’s Day, Valentine’s Day, and religious holidays. Score 2 if the individual usually does this, without
prompting. Score 1 if he/she sometimes does this without prompting, but sometimes fails to do it or needs
prompting. Score 0 if he/she never does this, or never does it without prompting.
39. The focus is on the individual’s flexibility in engaging in nonpreferred activities. Score 0 if he/she only
engages in activities that he/she prefers, even if they are suggested by others.
40. The individual’s initiating questions or remarks must be appropriate in order to count. “Conversation” is
defined as a back-and-forth exchange lasting at least 2 to 3 minutes. Score 0 if the individual does not have
“conversations” by this definition.
41. The individual’s ability to sustain the interaction is more important than his/her pleasure in the interaction.
“Conversation” is defined as a back-and-forth exchange lasting at least 2 to 3 minutes. Score 0 if the
individual does not have “conversations” by this definition.
42. To receive credit, the individual must modify his/her behavior in a way that shows sensitivity to the needs
and wishes expressed through indirect cues in conversation. “Conversation” is defined as a back-and-forth
exchange lasting at least 2 to 3 minutes. Score 0 if the individual does not have “conversations” by this
definition.
43. To receive credit, the individual must take the other’s point of view to recognize when he/she needs
background information or clarification.

Play and Leisure Subdomain

3. Motor ability is not important.
4. The individual need not interact with the other child, but must show awareness of his/her presence by looking
toward him/her from time to time.
5. For example, the individual observes another child stacking blocks and then begins to stack blocks.
6. Someone older may prompt or facilitate the interaction, but the individual must participate in it. Score 2 if the
individual regularly does this for at least 5 minutes. Score 1 if he/she sometimes does this for at least 5 minutes.
Score 0 if he/she never does this for at least 5 minutes.

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 7. Score 2 if the individual usually joins in play, without prompting from someone older. Score 1 if he/she
sometimes joins in play without prompting from someone older, but sometimes fails to join or needs prompting
from someone older. Score 0 if he/she never joins in play, or never does it without prompting from someone
older.
8. To receive credit, the individual must use the objects to represent something else.
9. It’s okay if the individual does not share a specific toy or possession to which he/she is strongly attached.
10. Examples of welcoming verbal cues are “We have room” and “Come hang out with us.” Score 2 if the
individual usually joins the group, without prompting from someone older. Score 1 if he/she sometimes joins the
group without prompting from someone older, but sometimes fails to join or needs prompting from someone
older. Score 0 if he/she never joins the group, or never does it without prompting from someone older.
11. Someone older may prompt or facilitate the interaction, but the individual must participate in it. Score 2 if
the individual regularly does this for at least 30 minutes. Score 1 if he/she sometimes does this for at least 30
minutes. Score 0 if he/she never does this for at least 30 minutes.
12. Score 2 if the individual usually does this, without prompting. Score 1 if he/she sometimes does this without
prompting, but sometimes fails to do it or needs prompting. Score 0 if he/she never does this, or never does it
without prompting.
14. The individual may play with children and/or adults.
15. Score 2 if the individual regularly does this, without prompting from someone older. Score 1 if he/she
sometimes does this without prompting from someone older, but sometimes fails to do it or needs prompting
from someone older. Score 0 if he/she never does this, or never does it without prompting from someone older.
16. To receive credit, the individual must interact with the other child or children rather than simply playing
nearby without conflict. Do not count play that requires someone older facilitating or prompting.
19. Give credit if the individual shares when asked by another child or on his/her own initiative, as long as he/she
was not told to share by someone older.
20. Examples of welcoming nonverbal cues are a welcoming smile, a “come here” gesture, and a “sit here” tap on
an available seat. Score 2 if the individual usually joins the group, without prompting from someone older.
Score 1 if he/she sometimes joins the group without prompting from someone older, but sometimes fails to
join or needs prompting from someone older. Score 0 if he/she never joins the group, or never does it without
prompting from someone older.
22. The individual may play with children and/or adults. The game need not involve physical activity; count any
game in which points are accumulated. Score 2 if the individual regularly plays these kinds of games, without
help. Score 1 if he/she sometimes plays these kinds of games, without help. Score 0 if he/she never plays these
kinds of games, or never plays them without help.
23. For example, the individual does not peek during “Hide and Seek,” does not look at other people’s cards in a
card game, does not skip ahead in a board game.
24. The individual may play with children and/or adults. Score 2 if he/she regularly plays these kinds of games,
without help. Score 1 if he/she sometimes plays these kinds of games, without help. Score 0 if he/she never
plays these kinds of games, or never does so without help.
25. Examples of non-welcoming verbal cues are “We’re almost done” and “Big kids only.” Score based on the
individual’s recognition of and response to verbal cues, not his/her interest in group activities.
26. The individual must ask permission and wait for a response before attempting to use the object. Asking at
the same time as grabbing for the object doesn’t count. Score 2 if the individual usually does this, without
prompting. Score 1 if he/she sometimes does this without prompting, but sometimes fails to do it or needs
prompting. Score 0 if he/she never does this, or never does it without prompting.
27. Score 2 if the individual usually does this, without prompting. Score 1 if he/she sometimes does this without
prompting, but sometimes fails to do it or needs prompting. Score 0 if he/she never does this, or never does it
without prompting.

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 28. To receive credit, the individual must interact with others, not just spend time with them.
29. Examples of non-welcoming nonverbal cues are lack of eye contact, not being spoken to, and frowns. Score
based on the individual’s recognition of and response to nonverbal cues, not his/her interest in group activities.
30. Score 2 if the individual regularly does this, without prompting. Score 1 if he/she sometimes does this, without
prompting. Score 0 if he/she never does this, or never does it without prompting.
31. The individual may play with children and/or adults. Score 2 if there are two or more games of this kind that
he/she regularly plays with others, without help. Score 1 if there are two or more games of this kind that he/
she sometimes plays with others, without help. Score 0 if he/she does not play two games of this kind, or never
does so without help.
32. For example, the individual arranges to go to dinner with a friend the following night, or to the movies with a
group of friends during the upcoming weekend. He/she can either initiate the activity or accept an invitation.
34, 36. Someone else may provide transportation, but may not remain with the individual after arrival for the
behavior to count. Score 2 if the individual regularly does this, without prompting. Score 1 if he/she sometimes
does this, without prompting. Score 0 if he/she never does this, or never does it without prompting.

Coping Skills Subdomain

1. For example, if the individual falls or bumps his/her head, he/she seeks out a parent for comfort.
4. In other words, the individual does not resist change (for example, does not have a tantrum or refuse to stop
an activity when it’s time to have dinner or take a bath).
5, 6. Score 2 if the individual usually does this, without prompting. Score 1 if he/she sometimes does this without
prompting, but sometimes fails to do it or needs prompting. Score 0 if he/she never does this, or never does it
without prompting.
7. The individual may express some disappointment or minor annoyance, but does not complain excessively or
act out by shouting, swearing, becoming aggressive, etc.
8. The individual may express disappointment, but does not become overly upset or angry.
9. Examples include saying “Stop!”; saying “Ouch, that hurts!”; expressing distress through facial expressions or
nonaggressive motor behaviors such as hopping on one foot after stubbing toe.
10, 11, 12. Score 2 if the individual usually does this, without prompting. Score 1 if he/she sometimes does this
without prompting, but sometimes fails to do it or needs prompting. Score 0 if he/she never does this, or never
does it without prompting.
15. To receive credit, the individual must both recognize that he/she has hurt someone’s feelings and apologize
with sincerity. Score 2 if the individual usually does this, without prompting. Score 1 if he/she sometimes does
this without prompting, but sometimes fails to do it or needs prompting. Score 0 if he/she never does this, or
never does it without prompting.
18. In other words, the individual does not respond by pouting, becoming overly upset, or becoming verbally or
physically aggressive.
19. Score 2 if the individual usually does this, without reminders. Score 1 if he/she sometimes does this without
reminders, but sometimes fails to do it or needs reminders. Score 0 if he/she never does this, or never does it
without reminders.
20. Understanding is inferred if the individual refrains from blaming people when they hurt him/her
unintentionally.
21. Score 2 if the individual usually does this, without having to be asked or told. Score 1 if he/she sometimes does
this without having to be asked or told, but sometimes fails to do it or has to be asked or told. Score 0 if he/she
never does this, or never does it without having to be asked or told.
22. In other words, the individual does not respond by pouting, becoming overly upset, or becoming verbally or
physically aggressive.

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 23. Score 2 if the individual usually keeps his/her promises, without reminders. Score 1 if he/she sometimes keeps
promises without reminders, but sometimes fails to do it or needs reminders. Score 0 if he/she never keeps
promises, or never does it without reminders.
24. In other words, the individual does not respond by pouting, becoming overly upset, or becoming verbally or
physically aggressive.
25. Scoring should reflect both what the individual says about the possibility of being duped by a friendly
appearing person and whether he/she allows himself/herself to be duped. Score 2 if the individual rarely or
never displays gullibility regarding the intentions of a friendly appearing person. Score 1 if he/she sometimes
displays gullibility. Score 0 if he/she often displays gullibility.
29. The individual’s decisions need not be those that others consider correct, as long as he/she appears to have
considered different options and their consequences.
31. Scoring should reflect both what the individual says about these kinds of situations (for example, “I’ve never
met this person, so I don’t trust him”) and how he/she chooses to act when encountering them (for example,
“Some people will probably be using heavy drugs, so I’m not going”). Score 2 if the individual usually displays
awareness of risk and acts with caution. Score 1 if he/she sometimes displays awareness of risk and acts with
caution, but sometimes fails to do so. Score 0 if he/she is too young or naïve to recognize the risk, or often
fails to use caution despite recognizing the risk.
32. Score 2 if the individual usually does this, without prompting. Score 1 if he/she sometimes does this without
prompting, but sometimes fails to do it or needs prompting. Score 0 if he/she never does this, never does it
without prompting, or does not make plans independently.
33. Score 2 if the individual rarely or never displays gullibility regarding advertising. Score 1 if he/she sometimes
displays gullibility. Score 0 if he/she often displays gullibility (including taking advertising messages literally).

Motor Skills Domain

Gross Motor Subdomain
1. Score 2 if the individual regularly sits for at least 1 minute with support. Score 1 if he/she sometimes sits for at
least 1 minute with support. Score 0 if he/she never sits for at least 1 minute, even with support.
3. Score 2 if the individual regularly sits for at least 1 minute without needing support. Score 1 if he/she sometimes
sits for at least 1 minute without needing support. Score 0 if he/she never sits for at least 1 minute without
support.
5. Score 2 if the individual regularly sits for at least 10 minutes without needing support. Score 1 if he/she
sometimes sits for at least 10 minutes without needing support. Score 0 if he/she never sits for at least 10
minutes without support.
6. Being held up by a person doesn’t count. Score 2 if the individual regularly stands for at least 5 seconds while
holding on to a stable object. Score 1 if he/she sometimes stands for at least 5 seconds while holding on to a
stable object. Score 0 if he/she never stands for at least 5 seconds while holding on to a stable object.
7. Being pulled up by a person doesn’t count.
10. Score based on how the individual goes up stairs when they are available.
11. Score 2 if the individual regularly stands for at least 1 minute without needing support. Score 1 if he/she
sometimes stands for at least 1 minute without needing support. Score 0 if he/she never stands for at least 1
minute without support.
12. Score 2 if the individual regularly takes at least two steps without needing support. Score 1 if he/she sometimes
takes at least two steps without needing support. Score 0 if he/she never takes at least two steps without
support.
16. Score based on how the individual goes down stairs when they are available.
21. Putting hands on the steps while going up doesn’t count as walking. Score based on how the individual goes
up stairs when they are available.
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 22. To count, the individual must kick the ball without losing his/her balance and falling.
23. The individual may walk with others, but must walk without needing support. Score 2 if he/she usually walks
at least two blocks when needed. Score 1 if he/she sometimes walks at least two blocks when needed, but
sometimes fails to do so. Score 0 if he/she never walks at least two blocks.
24. Score based on how the individual goes down stairs when they are available.
31. The individual may catch the ball with two hands or one. Score 2 if he/she usually catches a ball of this size
when thrown from 2 or 3 feet away. Score 1 if he/she sometimes catches a ball of this size when thrown from
2 or 3 feet away, but sometimes fails to do so. Score 0 if he/she never catches a ball of this size when thrown
from 2 or 3 feet away.
35. Score 2 if the individual regularly pedals a tricycle or other three-wheeled vehicle for at least 6 feet. Score 1 if
he/she sometimes pedals a vehicle of this kind for at least 6 feet. Score 0 if he/she never pedals a vehicle of this
kind for at least 6 feet.
38. The individual may catch the ball with two hands or one. Score 2 if he/she usually catches a ball of this size
when thrown from at least 6 feet away. Score 1 if he/she sometimes catches a ball of this size when thrown
from at least 6 feet away, but sometimes fails to do so. Score 0 if he/she never catches a ball of this size when
thrown from at least 6 feet away.
40. Trapping the ball against the body doesn’t count. Score 2 if the individual usually catches a ball of this size
when thrown from 2 or 3 feet away. Score 1 if he/she sometimes catches a ball of this size when thrown from
2 or 3 feet away, but sometimes fails to do so. Score 0 if he/she never catches a ball of this size when thrown
from 2 or 3 feet away.
41. Score 2 if the individual regularly rides a balance bike or a bicycle with training wheels for at least 10 feet.
Score 1 if he/she sometimes rides for at least 10 feet. Score 0 if he/she never rides for at least 10 feet.
42. The individual may catch the ball with two hands or one. Score 2 if the individual usually catches a ball of
this size when thrown from at least 10 feet away. Score 1 if he/she sometimes catches a ball of this size when
thrown from at least 10 feet away, but sometimes fails to do so. Score 0 if he/she never catches a ball of this
size when thrown from at least 10 feet away.
43. The individual must mount the bicycle and start pedaling without help.

Fine Motor Subdomain

9. Score 2 if the individual regularly does this, without help. Score 1 if he/she sometimes does this, without help.
Score 0 if he/she never does this, or never does it without help.
10. Score 2 if the individual regularly stacks at least four small objects. Score 1 if he/she sometimes stacks at least
four small objects. Score 0 if he/she never stacks at least four small objects.
12, 13. Score 2 if the individual regularly does this, without help. Score 1 if he/she sometimes does this, without
help. Score 0 if he/she never does this, or never does it without help.
14. Instances in which the individual drops the object don’t count.
16. Buttons may be actual or on a touchscreen.
18. The drawing need not be perfect, but must be recognizable as a circle.
20. Tracing doesn’t count.
22. The drawing need not be perfect, but must be recognizable as a square.
24. The drawing need not be perfect, but must be recognizable as a triangle.
30, 32. Score 2 if the individual usually does this when needed, without help. Score 1 if he/she sometimes does this
when needed, without help. Score 0 if he/she never does this, or never does it without help.
34. For purposes of this item, “complex” means consisting of many parts, use of various kinds of parts, and a
complex assembly or creation process.

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Maladaptive Behavior Domain
Internalizing Section
2. If the only problem is that he/she will not eat a few specific foods such as spinach or broccoli, score 0.
4. Examples include saying he/she is afraid to go to school or work, or saying he/she can’t go because no one
likes him/her. If he/she does not attend school or have a job, score 0.
9. To count, the individual must actively avoid the object or situation, or become extremely distressed upon
exposure to the object or situation.

Externalizing Section
10. If he/she does not go to school or work, score 0.

Critical Items Section

2. Childhood imaginary friends don’t count.
9. Score based on the persistence of the behavior (for example, the individual must wash hands 20 times a day)
and the level of distress if the individual is prevented from engaging in the behavior.
10. If he/she has brought a weapon to school or work, score 2.
12. This item is targeting delusional beliefs, not mere misconceptions about facts.

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 Appendix H: Suggested Interview
Questions and Scoring Criteria for the
Domain-Level Interview Form

Suggested Interview Questions

Table H.1 Suggested Interview Questions for the Domain-Level Interview Form
Interview Topic Question
COMMUNICATION DOMAIN
A: Vocabulary What objects and actions does [name] say the words for, like “dog” or “eat”?
B: Understanding Questions Tell me how [name] responds to “wh” questions, like “what, where, and who?”
C: Use of Grammar What are some examples of the sentences that [name] says?
D: Following Instructions What are the most complicated kinds of instructions that [name] follows?
E: Stating Personal Information What information does [name] state about himself/herself, like his/her name, address, and birthday?
F: Attending to Entertaining For how long does [name] pay attention to something he/she likes,
Material such as a story, TV show, movie, or live performance?
G: Attending to Informational For how long does [name] pay attention in settings such as school, church, or a meeting?
Material
H: Expressing Ideas & Experiences How does [name] talk about his/her own ideas and experiences?
I: Left & Right What kind of instructions involving left and right does [name] follow?
J: Beginning Writing What kinds of things does [name] write on his/her own, without help?
K: Working With Written What does [name] do to find information, like using a dictionary
Information or other sources in a library or on the Internet?
L: Reading Level At about what grade level is [name] reading and comprehending?
M: Advanced Writing What kinds of papers does [name] write for school, and what
is the process that he/she uses to write them?
DAILY LIVING SKILLS DOMAIN
A: Eating & Drinking Tell me how [name] feeds himself/herself at the table, and how he/she drinks liquids?
B: Toilet Training Tell me how [name] uses the toilet?
C: Washing & Bathing What is [name] doing in terms of washing and bathing?
D: Putting on Clothes & Shoes What kinds of clothing does [name] put on by himself/herself,
and how often does he/she do it correctly?
E: Home Safety What safety precautions within the home environment does [name] follow?
F: Cleaning Up After Self What does [name] do to clean up after himself/herself, like with spills and dirty clothes?
G: Safety Outside the Home Tell me what [name] does to stay safe outside the home.
H: Phone & Technology Use How does [name] use a phone and other technology like a computer to communicate with people?
I: Health & Hygiene Tell me what [name] does to stay healthy, including caring for his/her teeth.
J: Using Money Tell me what [name] knows about money, and how he/she uses money?
K: Rights & Responsibilities What does [name] understand about people’s rights and responsibilities,
like the right to vote or the need to follow rules and laws?
L: Food Preparation Tell me what things [name] does to prepare food.

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Table H.1 Suggested Interview Questions for the Domain-Level Interview Form
Interview Topic Question
M: Achieving Goals Tell me about some goals that [name] has set for himself/herself and actually achieved.
SOCIALIZATION DOMAIN
A: Playing With Others How does [name] play or socialize with others?
B: Expressing & Recognizing How do you know what feelings or emotions [name] is having, and
Emotions whether he/she knows what emotions others are having?
C: Friendships Tell me about [name]’s friendships.
D: Following Social Rules When playing with others, what does [name] do in terms of
sharing things, taking turns, and following rules?
E: Asking For & Accepting Help What does [name] usually do in terms of asking for help when he/she needs it to
figure out how to do something and accepting helpful ideas from others?
F: Emotional Control What kinds of things cause [name] to get upset, and how does he/she usually respond?
G: Interpersonal Appropriateness What does [name] do that shows that he/she understands what people consider proper, like
how close to stand to other people, how to adjust his/her voice for the situation, and so on?
H: Adapting Behavior to the As we get older, we learn to change our behavior to fit the situation, like lowering our voice when
Situation others nearby are concentrating. In what ways does [name] adjust his/her behavior to fit the situation?
I: Conversational Skills Who does [name] have conversations with, and what are his/her conversations like?
J: Taking Others’ Perspective What are some things that [name] does that show that he/she is thinking about the
other person’s point of view, like what they think, want, or are interested in?
K: Obeying Time Limits How is [name] about following time limits you give him/her and letting
you know about his/her plans when he/she goes out?
L: Gullibility What does [name] understand about different ways that people might try to take advantage
of him/her, and what does he/she do to keep from being taken advantage of?
M: Doing Things With Peers How often does [name] get together with others his/her age, what do they do, and who plans it?
MOTOR SKILLS DOMAIN
A: Running & Walking Tell me how [name] runs, and how far he/she walks by himself/herself.
B: Using Stairs Tell me how [name] goes up and down stairs.
C: Gripping & Twisting Opening a door with a doorknob or unscrewing a jar lid require us to grip and turn our
wrist. What kinds of things does [name] do that require gripping and twisting?
D: Drawing & Coloring Tell me the kinds of things that [name] draws or colors.
E: Riding a Tricycle or Bicycle Tell me what [name] is doing in terms of riding a tricycle or bicycle.
F: Catching a Ball What size balls does [name] catch, and from how far away?
G: Using Scissors Tell me how [name] uses scissors.
H: Tying How often does [name] tie a knot or a bow without help?

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Scoring Criteria
Communication Domain
1. Give credit if the individual names the actions when asked or does so spontaneously (for example, “Me
play,” “What are you eating?”). Articulation need not be perfect, but must be understood by people outside
the family. Score 2 if there are at least three actions that the individual regularly names. Score 1 if there
are at least three actions that he/she sometimes names. Score 0 if he/she does not name three actions.
2. Articulation need not be perfect.
3, 4, 5. Both verbal and nonverbal responses count.
6. Articulation need not be perfect, but must be understood by people outside the family.
10. Score 2 if the individual uses all three prepositions regularly. Score 1 if he/she uses all three sometimes.
Score 0 if he/she never uses one or more of the three.
11, 12. Score 2 if the individual usually does this, without reminders. Score 1 if he/she sometimes does this
without reminders, but sometimes fails to perform both requested actions without reminders. Score 0 if
he/she never does this, or never does it without reminders.
13. Score 2 if the individual usually performs all three actions, without reminders. Score 1 if he/she sometimes
does this without reminders, but sometimes fails to perform all three actions without reminders. Score 0 if
he/she never performs all three actions, or never does so without reminders.
15. Score 2 if the individual usually remembers, without reminders. Score 1 if he/she sometimes remembers
without reminders, but sometimes fails to remember or needs reminders. Score 0 if he/she never
remembers, or never remembers without reminders.
16, 17. Articulation need not be perfect, but must be understood by people outside the family.
19. Score 2 if the individual usually does this (i.e., says both the month and day of his/her birthday when
asked). Score 1 if he/she sometimes does this. Score 0 if he/she never does this.
21, 22. A “show” includes a TV show, video, live performance, or other entertainment.
23, 24. Examples of informational presentations are school and community lectures, educational TV shows
and videos, religious sermons, and meetings.
25. In other words, recounts fairy tale, book, and/or movie plots that most people are familiar with. Neither
great detail nor perfect order is required, but the basic parts of the story must be included without
prompting. Score 0 if the individual does not describe details or only lists one or two details (for example,
a character’s name).
26. Additional examples are “Eric doesn’t really like cartoons” and “That movie might be too scary for you.”
27. If there is ambiguity, score based on how often the individual provides at least three details: usually,
sometimes, or never. For example, when asked about the school day, says, “We had art this morning. Then
I shared my lunch with Eric, and we played soccer together at recess. Math was boring because I already
knew how to do it.”
28. To receive credit, the individual must express the thought in a different way, rather than simply repeating
or nearly repeating the same words.
29. Score 2 if the individual usually knows left from right on his/her body. Score 1 if he/she sometimes makes
mistakes. Score 0 if he/she does not know left from right on his/her body.
31. One or more letters may be written with incorrect orientation, as long as the correct letter is copied.
33. Score 2 if the individual regularly writes sentences of three or more words (for example, “I love you,”
“Happy birthday Mommy,” “I miss you”). Score 1 if he/she sometimes writes sentences of three or more
words. Score 0 if he/she never writes sentences of three or more words.
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 37. Score 2 if the individual usually does this when needed, without help. Score 1 if he/she sometimes does this
when needed, without help. Score 0 if he/she never does this, or never does it without help.
38. Give credit only for Internet or library use that the individual initiates on his/her own, and does without
help.
39. To receive credit, the individual must both read and comprehend material at a second-grade level or
higher. He/she may read silently or aloud. Reading ability is more important than interest in reading; do
not penalize the individual who reads only when required to do so.
40. To receive credit, the individual must both read and comprehend material at a fourth-grade level or
higher. He/she may read silently or aloud. Reading ability is more important than interest in reading; do
not penalize the individual who reads only when required to do so.
41. To receive credit, the individual must both read and comprehend material at a sixth-grade level or higher.
He/she may read silently or aloud. Reading ability is more important than interest in reading; do not
penalize the individual who reads only when required to do so.
42. To receive credit, the individual must both read and comprehend material at a ninth-grade level or higher.
Reading ability is more important than interest in reading; do not penalize the individual who reads only
when required to do so.
43, 44. Score 2 if the individual usually does this when needed, without help. Score 1 if he/she sometimes does
this when needed, without help. Score 0 if he/she never does this, or never does it without help.
45. Score 2 if the individual usually does this, without prompting. Score 1 if he/she sometimes does this
without prompting, but sometimes fails to do it or needs prompting. Score 0 if he/she never does this, or
never does it without prompting.

Daily Living Skills Domain

1. Score 2 if the individual usually does this, without help. Score 1 if he/she sometimes does this, without
help. Score 0 if he/she never does this, or never does it without help.
2, 3. Score 2 if the individual usually does this when needed, without help. Score 1 if he/she sometimes does this
when needed, without help. Score 0 if he/she never does this, or never does it without help.
6. Score 2 if the individual initiates using the toilet, does not need help, and does not have accidents. Score
1 if he/she initiates using the toilet, does not need help, but has some accidents. Score 0 if he/she does not
initiate using the toilet, needs help, or has frequent accidents.
7. Score 2 if the individual usually does this (i.e., both washes his/her hands and dries them), without help,
although he/she does not need to turn the water on and off or adjust the temperature. Score 1 if he/she
sometimes does this, without help. Score 0 if he/she never does this, or never does it without help.
8. Score 2 if the individual usually does this (i.e., both bathes/showers and dries self), without help, although
he/she does not need to turn the water on and off or adjust the temperature. Score 1 if he/she sometimes
does this, without help. Score 0 if he/she never does this, or never does it without help.
9. Score 2 if the individual usually does this, without help or reminders to adjust clothes. Score 1 if he/she
sometimes does this, without help or reminders. Score 0 if he/she never does this, or never does it without
help or reminders.
10. Score 2 if the individual usually does this (i.e., puts shoes on the correct feet and securely ties or fastens
them), without help. Score 1 if he/she sometimes does this, without help. Score 0 if he/she never does this,
or never does it without help.
11. Score 2 if the individual is usually careful, without reminders. Score 1 if he/she is sometimes careful
without reminders, but sometimes fails to be careful or needs reminders. Score 0 if he/she is not aware of
the danger of hot objects, or is never careful around them without reminders.

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 12. Score 2 if the individual is usually careful, without reminders. Score 1 if he/she is sometimes careful
without reminders, but sometimes fails to be careful or needs reminders. Score 0 if he/she never uses sharp
objects, or never uses them carefully without reminders.
13. Understanding can be shown by either saying what to do or by having responded appropriately in actual
dangerous situations.
14. Score 2 if the individual is usually careful, without reminders. Score 1 if he/she is sometimes careful
without reminders, but sometimes fails to be careful or needs reminders. Score 0 if he/she never operates
household appliances or equipment, or never operates them carefully without reminders.
15. Score 2 if the individual usually does this on his/her own, without prompting. Score 1 if he/she sometimes
does this on his/her own without prompting, but sometimes fails to do it or needs prompting. Score 0 if
he/she is not expected to do this on his/her own, or never does it without prompting.
16, 17, 18, 19. Score 2 if the individual usually does this, without help or prompting. Score 1 if he/she
sometimes does this without help or prompting, but sometimes fails to do it or needs help or prompting.
Score 0 if he/she never does this, or never does it without help or prompting.
20. Score 2 if the individual usually does this, without help or reminders. Score 1 if he/she sometimes does this
without help or reminders, but sometimes fails to do it or needs help or reminders. Score 0 if he/she never
uses household products, or never uses them correctly without help or reminders.
21. Score 2 if the individual usually does this, without prompting. Score 1 if he/she sometimes does this
without prompting, but sometimes fails to do it or needs prompting. Score 0 if he/she is not able to leave
the caregiver on his/her own, or never remains within safe distance without prompting.
22. Understanding is inferred from what the individual says about these kinds of signs and symbols and from
how he/she has acted in response to them.
23. Score 2 if the individual usually does this on his/her own, without prompting. Score 1 if he/she sometimes
does this on his/her own without prompting, but sometimes fails to do it or needs prompting. Score 0 if
he/she never does this on his/her own, or never does it without prompting.
25. Score 2 if the individual usually both says the correct number to call and knows how to make the call.
Score 1 if he/she sometimes both says the correct number to call and knows how to make the call, but
sometimes makes mistakes with either or both. Score 0 if he/she does not know the correct number to call
or how to make the call.
26. Score 2 if there are at least two social interaction technologies that the individual regularly uses without
help. Score 1 if there are at least two social interaction technologies that he/she sometimes uses without
help. Score 0 if he/she doesn’t use two social interaction technologies without help.
27. Score 2 if the individual usually completes all of these steps, without help or reminders. Score 1 if
he/she sometimes completes all of these steps without help or reminders, but sometimes needs help or
reminders for one or more steps. Score 0 if he/she never completes all of these steps without help, or
hasn’t begun brushing.
28. Score 2 if the individual usually does this, without urging. Score 1 if he/she sometimes does this without
urging, but sometimes fails to do it or needs urging. Score 0 if he/she never does this, never does it
without urging, or does not make his/her own food choices.
30. Score 2 if the individual usually does this, without reminders. Score 1 if he/she sometimes does this without
reminders, but sometimes fails to do it or needs reminders. Score 0 if he/she never does this, or never does
it without reminders.
31. Score 2 if the individual usually does this, without help. Score 1 if he/she sometimes does this, without
help. Score 0 if he/she never does this, or never does it without help.
32. The individual does not need to actually use money himself/herself.

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 33. Score 2 if the individual usually does this correctly when needed, without help. Score 1 if he/she sometimes
does this correctly when needed, without help. Score 0 if he/she never does this, or never does it correctly
without help.
34. Score 2 if the individual usually does this on his/her own when needed or asked to. Score 1 if he/she
sometimes does this on his/her own when needed or asked to. Score 0 if he/she never does this on
his/her own.
35. Score 2 if the individual usually checks his/her change (without necessarily counting it to the penny),
without help or prompting. Score 1 if he/she sometimes does this, without help or prompting, but
sometimes fails to do it or needs help or prompting. Score 0 if he/she never does this, or never does it
without help or prompting.
36. Score 2 if the individual usually does this, without prompting. Score 1 if he/she sometimes does this
without prompting, but sometimes fails to do it or needs prompting. Score 0 if he/she never does this, or
never does it without prompting.
37. Score 2 if the individual both understands community rules and laws and usually follows them without
prompting. Score 1 if he/she both understands community rules and laws and sometimes follows them
without prompting. Score 0 if he/she does not understand community rules and laws, or never follows
them without prompting.
39. Score 2 if the individual usually does this when required, without help. Score 1 if he/she sometimes does
this when required, without help. Score 0 if he/she never does this, or never does it without help. It’s okay
if he/she is only allowed to prepare food when an adult is present.
40. Score 2 if the individual usually does this, without prompting. Score 1 if he/she sometimes does this
without prompting, but sometimes fails to do it or needs prompting. Score 0 if he/she never does this, or
never does it without prompting.
41. Score 2 if the individual usually does this when required, without help or prompting. Score 1 if he/she
sometimes does this when required without help or prompting, but sometimes fails to do it or needs help or
prompting. Score 0 if he/she never does this, or never does it without help or prompting.
42. Score 2 if there are at least two simple kitchen appliances that the individual usually uses when needed,
without help. Score 1 if there are at least two appliances that he/she sometimes uses when needed, without
help. Score 0 if he/she does not use two appliances without help. It’s okay if he/she is only allowed to use
kitchen appliances when an adult is present.
43. Score 2 if the individual usually does this when needed, without help. Score 1 if he/she sometimes does this
when needed, without help. Score 0 if he/she never does this, or never does it without help. It’s okay if he/
she is only allowed to use the stove or oven when an adult is present.

Socialization Domain
1. Someone older may prompt or facilitate the interaction, but the individual must participate in it. Score 2
if the individual regularly does this for at least 5 minutes. Score 1 if he/she sometimes does this for at least 5
minutes. Score 0 if he/she never does this for at least 5 minutes.
2. Someone older may prompt or facilitate the interaction, but the individual must participate in it. Score 2
if the individual regularly does this for at least 30 minutes. Score 1 if he/she sometimes does this for at least
30 minutes. Score 0 if he/she never does this for at least 30 minutes.
3. Score 2 if the individual usually does this, without prompting. Score 1 if he/she sometimes does this
without prompting, but sometimes fails to do it or needs prompting. Score 0 if he/she never does this, or
never does it without prompting.

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 4. Score 2 if the individual regularly does this, without prompting from someone older. Score 1 if he/
she sometimes does this without prompting from someone older, but sometimes fails to do it or needs
prompting from someone older. Score 0 if he/she never does this, or never does it without prompting from
someone older.
5. Examples of welcoming nonverbal cues are a welcoming smile, a “come here” gesture, and a “sit here” tap
on an available seat. Score 2 if the individual usually joins the group, without prompting from someone
older. Score 1 if he/she sometimes joins the group without prompting from someone older, but sometimes
fails to join or needs prompting from someone older. Score 0 if he/she never joins the group, or never does
it without prompting from someone older.
6. Examples of non-welcoming verbal cues are “We’re almost done” and “Big kids only.” Score based on the
individual’s recognition of and response to verbal cues, not his/her interest in group activities.
8. Recognition is inferred from what the individual says or does in response to others’ emotions.
9. Examples include asking for a play date or to go somewhere with another child.
10. Friendships must be reciprocal to count. Score 0 if he/she has not had any friends for the past year.
11. It’s okay if the individual does not share a specific toy or possession to which he/she is strongly attached.
12. The individual must ask permission and wait for a response before attempting to use the object. Asking at
the same time as grabbing for the object doesn’t count. Score 2 if the individual usually does this, without
prompting. Score 1 if he/she sometimes does this without prompting, but sometimes fails to do it or needs
prompting. Score 0 if he/she never does this, or never does it without prompting.
14. For example, the individual does not peek during “Hide and Seek,” does not look at other people’s cards in
a card game, does not skip ahead in a board game.
15. Score 2 if the individual usually does this, without prompting. Score 1 if he/she sometimes does this
without prompting, but sometimes fails to do it or needs prompting. Score 0 if he/she never does this, or
never does it without prompting.
17. In other words, the individual does not resist change (for example, does not have a tantrum or refuse to
stop an activity when it’s time to have dinner or take a bath).
18. Examples include saying “Stop!”; saying “Ouch, that hurts!”; expressing distress through facial expressions
or nonaggressive motor behaviors such as hopping on one foot after stubbing toe.
19. In other words, the individual does not respond by pouting, becoming overly upset, or becoming verbally
or physically aggressive.
26. Score 2 if the individual usually does this, without having to be asked or told. Score 1 if he/she sometimes
does this without having to be asked or told, but sometimes fails to do it or has to be asked or told. Score
0 if he/she never does this, or never does it without having to be asked or told.
27. To receive credit, the individual must show flexibility in shifting topics. “Conversation” is defined
as a back-and-forth exchange lasting at least 2 to 3 minutes. Score 0 if the individual does not have
“conversations” by this definition.
28. “Conversation” is defined as a back-and-forth exchange lasting at least 2 to 3 minutes. Score 0 if the
individual does not have “conversations” by this definition.
29. To receive credit, the individual must take the other’s point of view to recognize when he/she needs
background information or clarification.
30. Recognition is assumed if the individual talks about instances where someone else’s likes and dislikes
differ from his/her own.

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 31. The individual’s initiating questions or remarks must be appropriate in order to count. “Conversation” is
defined as a back-and-forth exchange lasting at least 2 to 3 minutes. Score 0 if the individual does not
have “conversations” by this definition.
32. The individual’s ability to sustain the interaction is more important than his/her pleasure in the
interaction. “Conversation” is defined as a back-and-forth exchange lasting at least 2 to 3 minutes. Score 0
if the individual does not have “conversations” by this definition.
33. The focus is on the individual’s flexibility in engaging in nonpreferred activities. Score 0 if he/she only
engages in activities that he/she prefers, even if they are suggested by others.
34. Score 2 if the individual usually does this, without reminders. Score 1 if he/she sometimes does this without
reminders, but sometimes fails to do it or needs reminders. Score 0 if he/she never does this, or never does
it without reminders.
35. Score 2 if the individual usually does this, without prompting. Score 1 if he/she sometimes does this
without prompting, but sometimes fails to do it or needs prompting. Score 0 if he/she never does this,
never does it without prompting, or does not make plans independently.
36. Scoring should reflect both what the individual says about the possibility of being duped by a friendly
appearing person and whether he/she allows himself/herself to be duped. Score 2 if the individual rarely
or never displays gullibility regarding the intentions of a friendly appearing person. Score 1 if he/she
sometimes displays gullibility. Score 0 if he/she often displays gullibility.
37. Scoring should reflect both what the individual says about these kinds of situations (for example, “I’ve
never met this person, so I don’t trust him”) and how he/she chooses to act when encountering them (for
example, “Some people will probably be using heavy drugs, so I’m not going”). Score 2 if the individual
usually displays awareness of risk and acts with caution. Score 1 if he/she sometimes displays awareness
of risk and acts with caution, but sometimes fails to do so. Score 0 if he/she is too young or naïve to
recognize the risk, or often fails to use caution despite recognizing the risk.
38. Score 2 if the individual rarely or never displays gullibility regarding advertising. Score 1 if he/she
sometimes displays gullibility. Score 0 if he/she often displays gullibility (including taking advertising
messages literally).
39. The individual’s decisions need not be those that others consider correct, as long as he/she appears to have
considered different options and their consequences.
41. Score 2 if the individual regularly does this, without prompting. Score 1 if he/she sometimes does this,
without prompting. Score 0 if he/she never does this, or never does it without prompting.
42. Someone else may provide transportation, but may not remain with the individual after arrival for
the behavior to count. Score 2 if the individual regularly does this, without prompting. Score 1 if he/
she sometimes does this, without prompting. Score 0 if he/she never does this, or never does it without
prompting.
43. For example, the individual arranges to go to dinner with a friend the following night, or to the movies
with a group of friends during the upcoming weekend. He/she can either initiate the activity or accept an
invitation.

Motor Skills Domain

3. The individual may walk with others, but must walk without needing support. Score 2 if he/she usually
walks at least two blocks when needed. Score 1 if he/she sometimes walks at least two blocks when needed,
but sometimes fails to do so. Score 0 if he/she never walks at least two blocks.
7, 8. Score 2 if the individual regularly does this, without help. Score 1 if he/she sometimes does this, without
help. Score 0 if he/she never does this, or never does it without help.

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 9. Instances in which the individual drops the object don’t count.
11. The drawing need not be perfect, but must be recognizable as a circle.
14. Score 2 if the individual regularly pedals a tricycle or other three-wheeled vehicle for at least 6 feet. Score
1 if he/she sometimes pedals a vehicle of this kind for at least 6 feet. Score 0 if he/she never pedals a vehicle
of this kind for at least 6 feet.
16. Score 2 if the individual regularly rides a balance bike or a bicycle with training wheels for at least 10 feet.
Score 1 if he/she sometimes rides for at least 10 feet. Score 0 if he/she never rides for at least 10 feet.
17. The individual must mount the bicycle and start pedaling without help.
18. The individual may catch the ball with two hands or one. Score 2 if he/she usually catches a ball of this
size when thrown from at least 6 feet away. Score 1 if he/she sometimes catches a ball of this size when
thrown from at least 6 feet away, but sometimes fails to do so. Score 0 if he/she never catches a ball of this
size when thrown from at least 6 feet away.
19. Trapping the ball against the body doesn’t count. Score 2 if the individual usually catches a ball of this size
when thrown from 2 or 3 feet away. Score 1 if he/she sometimes catches a ball of this size when thrown
from 2 or 3 feet away, but sometimes fails to do so. Score 0 if he/she never catches a ball of this size when
thrown from 2 or 3 feet away.
20. The individual may catch the ball with two hands or one. Score 2 if the individual usually catches a ball
of this size when thrown from at least 10 feet away. Score 1 if he/she sometimes catches a ball of this size
when thrown from at least 10 feet away, but sometimes fails to do so. Score 0 if he/she never catches a ball
of this size when thrown from at least 10 feet away.
24, 25. Score 2 if the individual usually does this when needed, without help. Score 1 if he/she sometimes does
this when needed, without help. Score 0 if he/she never does this, or never does it without help.

Internalizing Section
2. If the only problem is that he/she will not eat a few specific foods such as spinach or broccoli, score 0.
4. Examples include saying he/she is afraid to go to school or work, or saying he/she can’t go because no one
likes him/her. If he/she does not attend school or have a job, score 0.
9. To count, the individual must actively avoid the object or situation, or become extremely distressed upon
exposure to the object or situation.

Externalizing Section
10. If he/she does not go to school or work, score 0.

Critical Items Section

2. Childhood imaginary friends don’t count.

Vineland–3 Manual ■ Appendix H: Suggested Interview Questions and Scoring Criteria for the Domain-Level Interview Form ■ Scoring Criteria 347

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