**ADI-R summary**
**INITIAL CONCERNS**
- Parent reports concerns about social interaction and communication difficulties, noted since the child was approximately 18 months old. [Child's age] was not responding to their name, and was not making eye contact.
**DEVELOPMENTAL MILESTONES**
- First words were spoken at 12 months, but language development plateaued around 18 months.
- Toilet training was attempted at age 3, but the child showed no interest and continues to wear nappies.
**LANGUAGE AND COMMUNICATION**
- Comprehension of language is limited; the child struggles to follow multi-step instructions.
- The child uses the parent's hand to point at objects.
- Speech is infrequent, often limited to single words or short phrases. Echolalia is present.
- Non-verbal communication is limited; the child rarely points or makes eye contact.
- Pronunciation is often unclear, with some words being difficult to understand.
- The child does not engage in small talk.
- Reciprocal conversations are rare.
- The child asks socially inappropriate questions, such as asking strangers personal questions.
- The child struggles to understand and express emotions.
**PLAY AND SOCIAL SKILLS**
- The child does not imitate actions or behaviours.
- Play is often solitary and repetitive, with a focus on specific objects.
- The child shows little imagination or creativity.
- The child does not share toys or belongings.
- The child does not attempt to seek enjoyment with others.
- The child does not offer comfort to others.
- The child does not respond appropriately in social situations.
- The child does not engage in social games.
- The child shows little interest in other children.
- The child has no friendships.
**STEREOTYPED BEHAVIOURS AND RESTRICTED INTERESTS**
- The child has a strong interest in trains, often lining them up and spending hours playing with them.
- The child engages in repetitive play behaviour, such as spinning wheels on toy cars.
- The child has sensory sensitivities, particularly to loud noises.
- The child becomes distressed by changes in routine.
- The child is very attached to a specific blanket.
- The child engages in hand-flapping.
**AGGRESSIVE BEHAVIOURS**
- The child has displayed aggressive behaviours towards the parent when frustrated.
**ADDITIONAL INFORMATION**
- The parent reports that the child has difficulty with transitions and becomes easily upset.
**OVERALL INTERPRETATION**
- The interview findings suggest significant difficulties in social interaction and communication, as well as the presence of restricted and repetitive behaviours. These observations are consistent with the diagnostic criteria for Autism Spectrum Disorder, as outlined in the DSM-5. The child exhibits limited reciprocal social interaction, impaired communication skills, and a range of repetitive behaviours and restricted interests. Further assessment is recommended to confirm the diagnosis and develop an appropriate intervention plan.
**ADI-R summary**
**INITIAL CONCERNS**
- [Initial symptoms and concerns reported by parent/caregiver] (Only include if explicitly mentioned in transcript or context, else omit section entirely. Include details such as age of onset, developmental or behavioural concerns that prompted assessment. Write in bullet points.)
**DEVELOPMENTAL MILESTONES**
- [Parent/caregiver report of developmental milestones] (Only include if explicitly mentioned in transcript or context, else omit section entirely. Include fine and gross motor development and any noted regressions. Write in bullet points.)
- [Parent/caregiver report of toilet training] (Only include if explicitly mentioned in transcript or context, else omit section entirely. Include information about day and night continence. Write in bullet points.)
- [Parent/caregiver report of language development] (Only include if explicitly mentioned in transcript or context, else omit section entirely. Include age of first single words and phrases, and any regressions. Write in bullet points.)
**LANGUAGE AND COMMUNICATION**
- [Comprehension of language] (Only include if explicitly mentioned in transcript or context, else omit section entirely. Include parent/caregiver observations and examples, such as ability to follow instructions. Write in bullet points.)
- [Use of others' body to communicate] (Only include if explicitly mentioned in transcript or context, else omit section entirely. Include illustrative examples. Write in bullet points.)
- [Parent/caregiver report of language use] (Only include if explicitly mentioned in transcript or context, else omit section entirely. Include frequency of speech, echolalia, idiosyncratic speech, verbal rituals, and overall quality of language. Write in bullet points.)
- [Parent/caregiver report of non-verbal communication] (Only include if explicitly mentioned in transcript or context, else omit section entirely. Include use of pointing, eye contact, gestures, understanding of gestures, and responsiveness to voice. Write in bullet points.)
- [Parent/caregiver report of articulation and pronunciation] (Only include if explicitly mentioned in transcript or context, else omit section entirely. Include any changes in pitch or tone, clarity of speech, and flow. Write in bullet points.)
- [Parent/caregiver report of small talk and social language skills] (Only include if explicitly mentioned in transcript or context, else omit section entirely. Write in bullet points.)
- [Parent/caregiver report of reciprocal conversations] (Only include if explicitly mentioned in transcript or context, else omit section entirely. Write in bullet points.)
- [Parent/caregiver report of socially inappropriate questions or statements] (Only include if explicitly mentioned in transcript or context, else omit section entirely. Write in bullet points.)
- [Parent/caregiver report of pronominal reversal] (Only include if explicitly mentioned in transcript or context, else omit section entirely. Write in bullet points.)
- [Observed understanding and expression of emotions] (Only include if explicitly mentioned in transcript or context, else omit section entirely. Include ability to recognise, express, or respond to emotional cues. Write in bullet points.)
**PLAY AND SOCIAL SKILLS**
- [Parent/caregiver report of imitation skills] (Only include if explicitly mentioned in transcript or context, else omit section entirely. Write in bullet points.)
- [Parent/caregiver report of play behaviour] (Only include if explicitly mentioned in transcript or context, else omit section entirely. Include pretend play, imaginative play, and group play. Write in bullet points.)
- [Observed imagination and creativity] (Only include if explicitly mentioned in transcript or context, else omit section entirely. Include examples from play or storytelling. Write in bullet points.)
- [Parent/caregiver report of sharing behaviours] (Only include if explicitly mentioned in transcript or context, else omit section entirely. Write in bullet points.)
- [Parent/caregiver report of client’s attempts to seek enjoyment with others] (Only include if explicitly mentioned in transcript or context, else omit section entirely. Note whether interests are shared with others. Write in bullet points.)
- [Parent/caregiver report of attempts to offer comfort] (Only include if explicitly mentioned in transcript or context, else omit section entirely. Write in bullet points.)
- [Parent/caregiver report of appropriateness of social responses] (Only include if explicitly mentioned in transcript or context, else omit section entirely. Write in bullet points.)
- [Parent/caregiver report of engagement in social games] (Only include if explicitly mentioned in transcript or context, else omit section entirely. Write in bullet points.)
- [Parent/caregiver report of interest in other children] (Only include if explicitly mentioned in transcript or context, else omit section entirely. Include responses to peer interaction. Write in bullet points.)
- [Parent/caregiver report of friendships] (Only include if explicitly mentioned in transcript or context, else omit section entirely. Write in bullet points.)
**STEREOTYPED BEHAVIOURS AND RESTRICTED INTERESTS**
- [Parent/caregiver report of preoccupations and restricted interests] (Only include if explicitly mentioned in transcript or context, else omit section entirely. Include specific examples and degree of intensity. Write in bullet points.)
- [Parent/caregiver report of repetitive play behaviour] (Only include if explicitly mentioned in transcript or context, else omit section entirely. Write in bullet points.)
- [Parent/caregiver report of compulsive or ritualistic behaviours] (Only include if explicitly mentioned in transcript or context, else omit section entirely. Write in bullet points.)
- [Parent/caregiver report of sensory behaviours] (Only include if explicitly mentioned in transcript or context, else omit section entirely. Include responses to noise, taste, texture, hearing, smell, and other sensory stimuli. Write in bullet points.)
- [Parent/caregiver report of response to changes in environment or routine] (Only include if explicitly mentioned in transcript or context, else omit section entirely. Write in bullet points.)
- [Parent/caregiver report of attachment to objects] (Only include if explicitly mentioned in transcript or context, else omit section entirely. Write in bullet points.)
- [Parent/caregiver report of unusual motor mannerisms] (Only include if explicitly mentioned in transcript or context, else omit section entirely. Include hand/finger mannerisms, gait, and other body movements. Write in bullet points.)
**AGGRESSIVE BEHAVIOURS**
- [Parent/caregiver report of aggressive behaviours] (Only include if explicitly mentioned in transcript or context, else omit section entirely. Include aggression toward caregivers, others, or self. Write in bullet points.)
**ADDITIONAL INFORMATION**
- [Any other relevant parent/caregiver comments] (Only include if explicitly mentioned in transcript or context, else omit section entirely. Write in bullet points.)
**OVERALL INTERPRETATION**
- [Summary of interview findings and interpretation] (Only include if explicitly mentioned in transcript or context, else omit section entirely. Summarise reported symptoms relevant to DSM-5 criteria for Autism Spectrum Disorder. Write in paragraph format.)
(Never come up with your own patient details, assessment, plan, interventions, evaluation, or next steps—use only the transcript, contextual notes, or clinical note as reference for all information. If any information related to a placeholder has not been explicitly mentioned, do not state that in the output; simply leave the relevant placeholder or section out entirely. If described behaviours or examples fit into multiple criteria, only include in the most relevant/salient criteria. Do not list the same example in multiple places. Provide direct quotes where salient information is provided. Use as many lines, paragraphs, or bullet points as needed to capture all relevant information from the transcript.)