Child & interview details
Use initials or a case reference — never a full name or exact date of birth.
Report style
Background ADI-R
Family history, milestones, medical history, prior diagnoses, medications, school.
Family HxPregnancy/birthMilestonesMedical HxMedicationsSchool/EHCP
Communication & language ADI-R Domain A
Speech, pointing, gestures, echolalia, pronouns, conversational reciprocity.
Verbal/non-verbalPointingEcholaliaPronounsSocial chatLiteral/pedantic
Reciprocal social interaction ADI-R Domain B
Eye contact, response to name, peer relationships, empathy, imaginative play.
Eye contactResponse to namePeer friendshipsEmpathyPretend play
Restricted, repetitive behaviours ADI-R Domain C
Preoccupations, rigidity, mannerisms, sensory differences, food selectivity.
Intense interestsRoutinesMotor mannerismsSensoryFood
General behaviour ADI-R Domain D
Self-injury, aggression, anxiety, sleep, eating, other concerns.
Inattention Young DIVA-5 Part 1
Which of the 9 DSM-5 inattention criteria are present? Note current and childhood counts.
A1 errorsA2 sustainingA3 not listeningA4 follow-throughA5 organisationA6 avoids effortA7 loses thingsA8 distractedA9 forgetful
Hyperactivity & impulsivity Young DIVA-5 Part 2
Which of the 9 DSM-5 H/I criteria are present? Note current and childhood counts.
H1 fidgetsH2 leaves seatH3 runsH4 noisyH5 on-the-goH6 talks excessivelyI7 blurtsI8 waits turnI9 interrupts
Onset, chronicity & impairment Young DIVA-5 Parts 3-4
Age of onset, settings affected, evidence of impairment across home, school, peers, leisure.
Differential diagnosis & comorbidity
Anxiety, mood, ODD/conduct, DCD, language and learning difficulties, sleep.
Strengths & parent priorities
Child's strengths, family priorities, resources and concerns.
Clinician formulation & impressions
Working diagnosis, algorithm scores, differential considerations, next steps.
Generated report
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