SEED - Questionaire Packets

Social Responsiveness Scale
Preschool Version for 3-Year-Olds
John N. Constantino, M.D.
Child Name: _________________________
Child’s age: ______________
Child’s gender (circle one):
Male
Female
This form filled out by (circle one):
Mother

Administration date: ________________
Date of Birth: ___/___/_______
Father

Other _____________

Instructions:
For each question, please check the box that best describes your child’s behavior over the last three
months.
SomeAlmost
Not
times Often Always
TRUE TRUE TRUE TRUE

1. Seems much more fidgety in social situations than when alone…………..

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2. Expressions on his/her face don’t match what he/she is saying…………...

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3. Seems self-confident when interacting with others……………………….

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5. Doesn’t recognize when others are trying to take advantage of him/her….

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6. Would rather be alone than with others……………………………………

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7. Is aware of what others are thinking or feeling…………………………....

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8. Behaves in ways which seem strange or bizarre…………………………..

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9. Clings to adults, seems too dependent on them…………………………...

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12. Is able to communicate his or her feelings to others in words or gestures… !

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13. Is slow or awkward in turn-taking interactions with peers ………………..

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14. Is not well coordinated in physical activities………………………………

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4. When under stress, child seems to go on “auto-pilot” (for example,
shows rigid or inflexible patterns of behavior which seem odd)………….

10. Unable to pick up on any of the meaning of conversations of older
children or adults….……………………………………………………….
11. Has good self-confidence………………………………………………….

15. Is able to understand the meaning of other people’s tone of voice and
facial expressions…………………………………………………………... !
16. Avoids eye contact, or has unusual eye contact…………………………… !

Prepublication SRS form copyright © 2006 by Western Psychological Services.
Not to be reprinted in whole or in part – by any medium or for any purpose – without the prior written authorization of
Western Psychological Services, 12031 Wilshire Boulevard, Los Angeles, CA 90025, USA. All rights reserved.
Additonal copies of this form may be purchased from WPS.
Please contact us at 800-648-8857, Fax, 310-478-7838, or www.wpspublish.com.

SomeAlmost
Not
times Often Always
TRUE TRUE TRUE TRUE

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19. Gets frustrated trying to get ideas across in conversations……………….... !

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20. Has strange way of playing with toys..…………………………………….. !

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21. Is able to imitate others’ actions……………………………………………. !

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22. Plays appropriately with children his/her age………………………………. !

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23. Does not join group activities unless told to do so.………………………… !

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24. Has more difficulty than other children with changes in his/her routine…... !

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26. Offers comfort to others when they are sad………………………………… !

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27. Avoids starting social interactions with peers or adults……………………. !

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28. Thinks or talks about the same thing over and over………………………... !

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29. Is regarded by other children as odd or weird……………………………… !

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30. Becomes upset in a situation with lots of things going on…………………. !

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31. Can’t get his/her mind off something once he/she starts thinking about it… !

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32. Wants to be changed when diaper or underwear are soiled or wet…………. !

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33. Is socially awkward…………………………………………………………. !

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34. Avoids people who want to be emotionally close to him/her……………… !

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36. Has difficulty “relating” to adults…………………………………………... !

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37. Has difficulty “relating” to peers…………………………………………… !

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39. Has a restricted (or unusually narrow) range of interests………………….. !

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40. Is imaginative, good at pretending (without losing touch with reality)……. !

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41. Wanders aimlessly from one activity to another…………………………… !

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42. Seems overly sensitive to sounds, textures, or smells……………………… !

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17. Recognizes when something is unfair……………………………………..
18. When on the playground or in a group with other young children, child
does not attempt to interact with the other children……….....……………

25. Doesn’t seem to mind being “out of step” or not on the “same
wavelength” with others……………………………………………………. !

35. Has trouble keeping up with the flow of a normal interaction with
other children………………………………………………….…………… !

38. Responds appropriately to mood changes in others (for example, when a
friend’s or playmate’s mood changes from happy to sad)…………………. !

Prepublication SRS form copyright © 2006 by Western Psychological Services.
Not to be reprinted in whole or in part – by any medium or for any purpose – without the prior written authorization of
Western Psychological Services, 12031 Wilshire Boulevard, Los Angeles, CA 90025, USA. All rights reserved.
Additonal copies of this form may be purchased from WPS.
Please contact us at 800-648-8857, Fax, 310-478-7838, or www.wpspublish.com.

SomeAlmost
Not
times Often Always
TRUE TRUE TRUE TRUE

43. Separates easily from caregivers…………………………………………… !

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45. Focuses his/her attention to where others are looking or listening…………. !

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46. Has overly serious facial expressions………………………………………. !

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47. Is too silly or laughs inappropriately……………………………………….. !

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48. Has a sense of humor, understands jokes…………………………………… !

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56. Walks in between two people who are talking……………………………... !

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57. Other children do not like to play with him/her…………………………….. !

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59. Is overly suspicious…………………………………………………………. !

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60. Is emotionally distant, doesn’t show his/her emotions……………………... !

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61. Is inflexible, has a hard time changing his/her mind……………………….. !

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62. Gives unusual or illogical reasons for doing things………………………… !

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64. Is too tense in social settings……………………………………………….. !

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65. Stares or gazes off into space………………………………………………. !

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44. Doesn’t understand how events are related to one another the way other
children his/her age do …………………………………………………….. !

49. Does extremely well at a few tasks, but does not do as well at most other
tasks………………………………………………………………………… !
50. Has repetitive, odd behaviors such as hand flapping or rocking…………… !
51. Responds to clear, direct questions in ways that don’t seem to make any
sense……………………………………………………………………….

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52. Knows when he/she is talking too loud or making too much noise………... !
53. Talks to people with an unusual tone of voice (for example, talks like a
robot or like he/she is giving a lecture)…………………………………….. !
54. Seems to react to people as if they are objects……………………………... !
55. Knows when he/she is too close to someone or is invading someone’s
space………………………………………………………………………… !

58. Concentrates too much on parts of things rather than “seeing the whole
picture” (for example, spins the wheels of a toy car but doesn’t play with
it as if it is a car, or plays with doll’s hair but not with the whole doll)…...

63. Touches others in an unusual way (for example, child may touch someone
just to make contact and then walk away without saying anything)……….. !

Prepublication SRS form copyright © 2006 by Western Psychological Services.
Not to be reprinted in whole or in part – by any medium or for any purpose – without the prior written authorization of
Western Psychological Services, 12031 Wilshire Boulevard, Los Angeles, CA 90025, USA. All rights reserved.
Additonal copies of this form may be purchased from WPS.
Please contact us at 800-648-8857, Fax, 310-478-7838, or www.wpspublish.com.

Scoring Key
Positive coded items (Not True = 0, Sometimes True = 1, Often True = 2, Almost Always True = 3)
# 1, 2, 4, 5, 6, 8, 9, 10, 13, 14, 16, 18, 19, 20, 23, 24, 25, 27, 28, 29, 30, 31, 33, 34, 35, 36, 37, 39, 41,
42, 44, 46, 47, 49, 50, 51, 53, 54, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65

Reverse-scored items (Not True = 3, Sometimes True = 2, Often True = 1, Almost Always True = 0)
# 3, 7, 11, 12, 15, 17, 21, 22, 26, 32, 38, 40, 43, 45, 48, 52, 55

Prepublication SRS form copyright © 2006 by Western Psychological Services.
Not to be reprinted in whole or in part – by any medium or for any purpose – without the prior written authorization of
Western Psychological Services, 12031 Wilshire Boulevard, Los Angeles, CA 90025, USA. All rights reserved.
Additonal copies of this form may be purchased from WPS.
Please contact us at 800-648-8857, Fax, 310-478-7838, or www.wpspublish.com.