Autism Assessment

This Autism Assessment Questionnaire is provided as a supplement to the book Autism: From Symptoms to Solutions by James Smith, D.C.
All information is stored in a secure database which you can access at any time to track your child’s progress.
Scoring data may be used for research or other purposes but will never be associated with your child in any recognizable way.
Personal information will not be shared with anyone without specific parental permission.

Steps to completing the questionnaire.

The assessment is designed to guide you through a step by step approach in considering fifteen of the biomedical issues commonly seen in autistic children.
It is a symptoms and history questionnaire, the results of which will give you a “low”, “moderate” or “high” score for the possible presence of biomedical issues with your child. When you have completed the assessment, the scores will be automatically entered into your Autism Scoring Record and Autism Scoring Graph. You can then reference the scores back to your Autism: From Symptoms to Solutions and proceed with your biomedical interventions. The biomedical issues addressed by this questionnaire are:
  • Gluten and casein sensitivity
  • Intestinal yeast overgrowth
  • Food allergy
  • Gastrointestinal disorders; hydrochloric acid, malabsorption, parasites
  • Hypothyroid
  • Methylation and glutathione status
  • Hypoimmunity
  • Allergy
  • Environmental allergy
  • Mitochondrial dysfunction
  • Toxic metals mercury and lead
  • Adrenal insufficiency (ten years and older)
Step 1: Provide the information necessary for your child’s assessment center. Remember your password as you will be returning to the site often.
Step 2: Complete the questionnaire following the instructions provided.
Step 3: This step is done for you. The questionnaire is scored and the results are entered into your Assessment Scoring Record and Assessment Scoring Graph. The scores, record and graph are permanently stored in our secure data base for your future reference.
Step 4: Using the results from your Assessment Scoring Record and Assessment Scoring Graph, implement your intervention protocols as outlined on page 117 of the Autism: From Symptoms to Solutions.