Dear Parent, The following study, conducted by Karen O’Brien under the supervision of Dr Virginia Slaughter, is designed to help us understand how interactions with siblings and parents may influence the social and cognitive development of children with autism spectrum disorders. These children can get a great deal out of their interactions with siblings and clearly enjoy playing with them. This study is intended to lead to participation in a sibling play intervention aimed at increasing the theory of mind, executive function and social understanding in children with autism spectrum disorders. For this first study, all you are asked to do is fill in a survey rating different play behaviours your child with an autism spectrum disorder may engage in alone, with a sibling or with a parent.
The questionnaire should take about 10-15 minutes to complete. Please answer all questions as accurately as possible. Please note your participation in this experiment is completely voluntary, and that if you are uncomfortable at any time, or do not wish to continue, you may withdraw from the study without penalty or question.
This study has been cleared in accordance with the ethical review processes of the University of Queensland and within the guidelines of the National Statement on Ethical Conduct in Human Research. You are, of course, free to discuss your participation with project staff (contactable on: k.obrien@psy.uq.edu.au and vps@psy.uq.edu.au ). If you would like to speak to an officer of the University not involved in the study, you may contact one of the School of Psychology Ethics Review Officers, John McLean and Courtney von Hippel directly on 3365 6394 or by email: john@psy.uq.edu.au for John McLean, or on 3365 7293 or by e-mail: courtney@psy.uq.edu.au for Courtney von Hippel. Alternatively, you may leave a message with Ann Lee (3365 6448, ann@psy.uq.edu.au) for John or Courtney to contact you, or contact the University of Queensland Ethics Officer, Michael Tse, on 3365 3924, e-mail: humanethics@research.uq.edu.au
What is your name? (person answering survey)
Who is completing this survey?
Other (please specify)
Do you currently live with:
Other (please specify)
What gender is your child with ASD?
What age is your child with ASD?
Where was your child with ASD born?
Other (please specify)
What language do you mainly speak at home?
Other (please specify)
What ethnicity do you most identify with?
What is the highest educational attainment of the parents?
Mother
Other (please specify)
What is the highest educational attainment of the parents?
Father
Other (please specify)
Mother
Father
In the following questions please rate from 0 to 5 using the key how often your child with autism engages in each behaviour when playing .
Key: 0=N/A, 1=every play episode, 2=many but not all play episodes, 3=most play episodes, 4=occasionally, 5=never.
Respond when the play partner calls their name
Playing with a younger sibling
 
 
 
 
 
 
0
1
2
3
4
5
Respond when the play partner calls their name
Playing with an older sibling
 
 
 
 
 
 
0
1
2
3
4
5
Respond when the play partner calls their name
Playing with a parent
 
 
 
 
 
 
0
1
2
3
4
5
Use gestures more then speech to communicate desires, wants or interests
Playing on their own
 
 
 
 
 
 
0
1
2
3
4
5
Use gestures more then speech to communicate desires, wants or interests
Playing with a younger sibling
 
 
 
 
 
 
0
1
2
3
4
5
Use gestures more then speech to communicate desires, wants or interests
Playing with an older sibling
 
 
 
 
 
 
0
1
2
3
4
5
Use gestures more then speech to communicate desires, wants or interests
Playing with a parent
 
 
 
 
 
 
0
1
2
3
4
5
Withdraw from the play partner
Playing with a younger sibling
 
 
 
 
 
 
0
1
2
3
4
5
Withdraw from the play partner
Playing with an older sibling
 
 
 
 
 
 
0
1
2
3
4
5
Withdraw from the play partner
Playing with a parent
 
 
 
 
 
 
0
1
2
3
4
5
Smile
Playing on their own
 
 
 
 
 
 
0
1
2
3
4
5
Smile
Playing with a younger sibling
 
 
 
 
 
 
0
1
2
3
4
5
Smile
Playing with an older sibling
 
 
 
 
 
 
0
1
2
3
4
5
Smile
Playing with a parent
 
 
 
 
 
 
0
1
2
3
4
5
Take turns using toys and equipment
Playing with a younger sibling
 
 
 
 
 
 
0
1
2
3
4
5
Take turns using toys and equipment
Playing with an older sibling
 
 
 
 
 
 
0
1
2
3
4
5
Take turns using toys and equipment
Playing with a parent
 
 
 
 
 
 
0
1
2
3
4
5
Show little response to the play partner’s emotion
Playing with a younger sibling
 
 
 
 
 
 
0
1
2
3
4
5
Show little response to the play partner’s emotion
Playing with an older sibling
 
 
 
 
 
 
0
1
2
3
4
5
Show little response to the play partner’s emotion
Playing with a parent
 
 
 
 
 
 
0
1
2
3
4
5
Give or show objects to the play partner
Playing with a younger sibling
 
 
 
 
 
 
0
1
2
3
4
5
Give or show objects to the play partner
Playing with an older sibling
 
 
 
 
 
 
0
1
2
3
4
5
Give or show objects to the play partner
Playing with a parent
 
 
 
 
 
 
0
1
2
3
4
5
Fight with the play partner
Playing with a younger sibling
 
 
 
 
 
 
0
1
2
3
4
5
Fight with the play partner
Playing with an older sibling
 
 
 
 
 
 
0
1
2
3
4
5
Fight with the play partner
Playing with a parent
 
 
 
 
 
 
0
1
2
3
4
5
Ignore the play partner
Playing with a younger sibling
 
 
 
 
 
 
0
1
2
3
4
5
Ignore the play partner
Playing with an older sibling
 
 
 
 
 
 
0
1
2
3
4
5
Ignore the play partner
Playing with a parent
 
 
 
 
 
 
0
1
2
3
4
5
Resolve conflict with play partner
Playing with a younger sibling
 
 
 
 
 
 
0
1
2
3
4
5
Resolve conflict with play partner
Playing with an older sibling
 
 
 
 
 
 
0
1
2
3
4
5
Resolve conflict with play partner
Playing with a parent
 
 
 
 
 
 
0
1
2
3
4
5
Avoid eye contact with the play partner
Playing with a younger sibling
 
 
 
 
 
 
0
1
2
3
4
5
Avoid eye contact with the play partner
Playing with an older sibling
 
 
 
 
 
 
0
1
2
3
4
5
Avoid eye contact with the play partner
Playing with a parent
 
 
 
 
 
 
0
1
2
3
4
5
Laugh
Playing on their own
 
 
 
 
 
 
0
1
2
3
4
5
Laugh
Playing with a younger sibling
 
 
 
 
 
 
0
1
2
3
4
5
Laugh
Playing with an older sibling
 
 
 
 
 
 
0
1
2
3
4
5
Laugh
Playing with a parent
 
 
 
 
 
 
0
1
2
3
4
5
Imitate an act of the play partner
Playing with a younger sibling
 
 
 
 
 
 
0
1
2
3
4
5
Imitate an act of the play partner
Playing with an older sibling
 
 
 
 
 
 
0
1
2
3
4
5
Imitate an act of the play partner
Playing with a parent
 
 
 
 
 
 
0
1
2
3
4
5
Vocalise without prompting
Playing on their own
 
 
 
 
 
 
0
1
2
3
4
5
Vocalise without prompting
Playing with a younger sibling
 
 
 
 
 
 
0
1
2
3
4
5
Vocalise without prompting
Playing with an older sibling
 
 
 
 
 
 
0
1
2
3
4
5
Vocalise without prompting
Playing with a parent
 
 
 
 
 
 
0
1
2
3
4
5
Decide when the game is over
Playing with a younger sibling
 
 
 
 
 
 
0
1
2
3
4
5
Decide when the game is over
Playing with an older sibling
 
 
 
 
 
 
0
1
2
3
4
5
Decide when the game is over
Playing with a parent
 
 
 
 
 
 
0
1
2
3
4
5
Get annoyed or frustrated
Playing on their own
 
 
 
 
 
 
0
1
2
3
4
5
Get annoyed or frustrated
Playing with a younger sibling
 
 
 
 
 
 
0
1
2
3
4
5
Get annoyed or frustrated
Playing with an older sibling
 
 
 
 
 
 
0
1
2
3
4
5
Get annoyed or frustrated
Playing with a parent
 
 
 
 
 
 
0
1
2
3
4
5
Approach the play partner with intent to interact
Playing with a younger sibling
 
 
 
 
 
 
0
1
2
3
4
5
Approach the play partner with intent to interact
Playing with an older sibling
 
 
 
 
 
 
0
1
2
3
4
5
Approach the play partner with intent to interact
Playing with a parent
 
 
 
 
 
 
0
1
2
3
4
5
Disengage from the activity
Playing on their own
 
 
 
 
 
 
0
1
2
3
4
5
Disengage from the activity
Playing with a younger sibling
 
 
 
 
 
 
0
1
2
3
4
5
Disengage from the activity
Playing with an older sibling
 
 
 
 
 
 
0
1
2
3
4
5
Disengage from the activity
Playing with a parent
 
 
 
 
 
 
0
1
2
3
4
5
Uses motor stereotyped behaviour (hand flapping, rocking etc)
Playing on their own
 
 
 
 
 
 
0
1
2
3
4
5
Uses motor stereotyped behaviour (hand flapping, rocking etc)
Playing with a younger sibling
 
 
 
 
 
 
0
1
2
3
4
5
Uses motor stereotyped behaviour (hand flapping, rocking etc)
Playing with an older sibling
 
 
 
 
 
 
0
1
2
3
4
5
Uses motor stereotyped behaviour (hand flapping, rocking etc)
Playing with a parent
 
 
 
 
 
 
0
1
2
3
4
5
Engage in pretend play
Playing on their own
 
 
 
 
 
 
0
1
2
3
4
5
Engage in pretend play
Playing with a younger sibling
 
 
 
 
 
 
0
1
2
3
4
5
Engage in pretend play
Playing with an older sibling
 
 
 
 
 
 
0
1
2
3
4
5
Engage in pretend play
Playing with a parent
 
 
 
 
 
 
0
1
2
3
4
5
Tend toward solitary play
Playing with a younger sibling
 
 
 
 
 
 
0
1
2
3
4
5
Tend toward solitary play
Playing with an older sibling
 
 
 
 
 
 
0
1
2
3
4
5
Tend toward solitary play
Playing with a parent
 
 
 
 
 
 
0
1
2
3
4
5
Use objects to represent other things
Playing on their own
 
 
 
 
 
 
0
1
2
3
4
5
Use objects to represent other things
Playing with a younger sibling
 
 
 
 
 
 
0
1
2
3
4
5
Use objects to represent other things
Playing with an older sibling
 
 
 
 
 
 
0
1
2
3
4
5
Use objects to represent other things
Playing with a parent
 
 
 
 
 
 
0
1
2
3
4
5
Share objects with the play partner
Playing with an younger sibling
 
 
 
 
 
 
0
1
2
3
4
5
Share objects with the play partner
Playing with an older sibling
 
 
 
 
 
 
0
1
2
3
4
5
Share objects with the play partner
Playing with a parent
 
 
 
 
 
 
0
1
2
3
4
5
Use various different toys
Playing on their own
 
 
 
 
 
 
0
1
2
3
4
5
Use various different toys
Playing with a younger sibling
 
 
 
 
 
 
0
1
2
3
4
5
Use various different toys
Playing with an older sibling
 
 
 
 
 
 
0
1
2
3
4
5
Use various different toys
Playing with a parent
 
 
 
 
 
 
0
1
2
3
4
5
Take objects from partner without asking
Playing with a younger sibling
 
 
 
 
 
 
0
1
2
3
4
5
Take objects from partner without asking
Playing with an older sibling
 
 
 
 
 
 
0
1
2
3
4
5
Take objects from partner without asking
Playing with a parent
 
 
 
 
 
 
0
1
2
3
4
5
Verbally express a desire, want or interest
Playing on their own
 
 
 
 
 
 
0
1
2
3
4
5
Verbally express a desire, want or interest
Playing with a younger sibling
 
 
 
 
 
 
0
1
2
3
4
5
Verbally express a desire, want or interest
Playing with an older sibling
 
 
 
 
 
 
0
1
2
3
4
5
Verbally express a desire, want or interest
Playing with a parent
 
 
 
 
 
 
0
1
2
3
4
5
Play for a longer period of time
Playing on their own
 
 
 
 
 
 
0
1
2
3
4
5
Play for a longer period of time
Playing with a younger sibling
 
 
 
 
 
 
0
1
2
3
4
5
Play for a longer period of time
Playing with an older sibling
 
 
 
 
 
 
0
1
2
3
4
5
Play for a longer period of time
Playing with a parent
 
 
 
 
 
 
0
1
2
3
4
5
Follow the gaze or pointing of play partner
Playing with a younger sibling
 
 
 
 
 
 
0
1
2
3
4
5
Follow the gaze or pointing of play partner
Playing with an older sibling
 
 
 
 
 
 
0
1
2
3
4
5
Follow the gaze or pointing of play partner
Playing with a parent
 
 
 
 
 
 
0
1
2
3
4
5
Use toys appropriately
Playing on their own
 
 
 
 
 
 
0
1
2
3
4
5
Use toys appropriately
Playing with a younger sibling
 
 
 
 
 
 
0
1
2
3
4
5
Use toys appropriately
Playing with an older sibling
 
 
 
 
 
 
0
1
2
3
4
5
Use toys appropriately
Playing with a parent
 
 
 
 
 
 
0
1
2
3
4
5
Initiate the game to be played
Playing with a younger sibling
 
 
 
 
 
 
0
1
2
3
4
5
Initiate the game to be played
Playing with an older sibling
 
 
 
 
 
 
0
1
2
3
4
5
Initiate the game to be played
Playing with parent
 
 
 
 
 
 
0
1
2
3
4
5
Make jokes when playing
Playing on their own
 
 
 
 
 
 
0
1
2
3
4
5
Make jokes when playing
Playing with a younger sibling
 
 
 
 
 
 
0
1
2
3
4
5
Make jokes when playing
Playing with an older sibling
 
 
 
 
 
 
0
1
2
3
4
5
Make jokes when playing
Playing with a parent
 
 
 
 
 
 
0
1
2
3
4
5
Use inappropriate speech for the context
Playing on their own
 
 
 
 
 
 
0
1
2
3
4
5
Use inappropriate speech for the context
Playing with a younger sibling
 
 
 
 
 
 
0
1
2
3
4
5
Use inappropriate speech for the context
Playing with an older sibling
 
 
 
 
 
 
0
1
2
3
4
5
Use inappropriate speech for the context
Playing with a parent
 
 
 
 
 
 
0
1
2
3
4
5
Seem uninterested in the play activity
Playing on their own
 
 
 
 
 
 
0
1
2
3
4
5
Seem uninterested in the play activity
Playing with a younger sibling
 
 
 
 
 
 
0
1
2
3
4
5
Seem uninterested in the play activity
Playing with an older sibling
 
 
 
 
 
 
0
1
2
3
4
5
Seem uninterested in the play activity
Playing with a parent
 
 
 
 
 
 
0
1
2
3
4
5
Willingly shares toys
Playing with a younger sibling
 
 
 
 
 
 
0
1
2
3
4
5
Willingly shares toys
Playing with an older sibling
 
 
 
 
 
 
0
1
2
3
4
5
Willingly shares toys
Playing with a parent
 
 
 
 
 
 
0
1
2
3
4
5
Use physical aggression towards the play partner
Playing with a younger sibling
 
 
 
 
 
 
0
1
2
3
4
5
Use physical aggression towards the play partner
Playing with a older sibling
 
 
 
 
 
 
0
1
2
3
4
5
Use physical aggression towards the play partner
Playing with a parent
 
 
 
 
 
 
0
1
2
3
4
5
Make suggestions about games or toys
Playing with a younger sibling
 
 
 
 
 
 
0
1
2
3
4
5
Make suggestions about games or toys
Playing with an older sibling
 
 
 
 
 
 
0
1
2
3
4
5
Make suggestions about games or toys
Playing with a parent
 
 
 
 
 
 
0
1
2
3
4
5
Play with toys in a more mature way
Playing on their own
 
 
 
 
 
 
0
1
2
3
4
5
Play with toys in a more mature way
Playing with a younger sibling
 
 
 
 
 
 
0
1
2
3
4
5
Play with toys in a more mature way
Playing with an older sibling
 
 
 
 
 
 
0
1
2
3
4
5
Play with toys in a more mature way
Playing with a parent
 
 
 
 
 
 
0
1
2
3
4
5
Use play or toys to make them feel happier
Playing on their own
 
 
 
 
 
 
0
1
2
3
4
5
Use play or toys to make them feel happier
Playing with a younger sibling
 
 
 
 
 
 
0
1
2
3
4
5
Use play or toys to make them feel happier
Playing with an older sibling
 
 
 
 
 
 
0
1
2
3
4
5
Use play or toys to make them feel happier
Playing with a parent
 
 
 
 
 
 
0
1
2
3
4
5
Have a tantrum when they do not get their way
Playing with a younger sibling
 
 
 
 
 
 
0
1
2
3
4
5
Have a tantrum when they do not get their way
Playing with an older sibling
 
 
 
 
 
 
0
1
2
3
4
5
Have a tantrum when they do not get their way
Playing with a parent
 
 
 
 
 
 
0
1
2
3
4
5
Show affection towards the play partner
Playing with a younger sibling
 
 
 
 
 
 
0
1
2
3
4
5
Show affection towards the play partner
Playing with an older sibling
 
 
 
 
 
 
0
1
2
3
4
5
Show affection towards the play partner
Playing with a parent
 
 
 
 
 
 
0
1
2
3
4
5
Imitate the speech of the play partner
Playing with a younger sibling
 
 
 
 
 
 
0
1
2
3
4
5
Imitate the speech of the play partner
Playing with an older sibling
 
 
 
 
 
 
0
1
2
3
4
5
Imitate the speech of the play partner
Playing with a parent
 
 
 
 
 
 
0
1
2
3
4
5
Watch the play partner when they play with a toy
Playing with a younger sibling
 
 
 
 
 
 
0
1
2
3
4
5
Watch the play partner when they play with a toy
Playing with an older sibling
 
 
 
 
 
 
0
1
2
3
4
5
Watch the play partner when they play with a toy
Playing with a parent
 
 
 
 
 
 
0
1
2
3
4
5
Play with toys in a more varied way
Playing on their own
 
 
 
 
 
 
0
1
2
3
4
5
Play with toys in a more varied way
Playing with a younger sibling
 
 
 
 
 
 
0
1
2
3
4
5
Play with toys in a more varied way
Playing with an older sibling
 
 
 
 
 
 
0
1
2
3
4
5
Play with toys in a more varied way
Playing with a parent
 
 
 
 
 
 
0
1
2
3
4
5
Use toys in pretend actions with the play partner
Playing with a younger sibling
 
 
 
 
 
 
0
1
2
3
4
5
Use toys in pretend actions with the play partner
Playing with an older sibling
 
 
 
 
 
 
0
1
2
3
4
5
Use toys in pretend actions with the play partner
Playing with a parent
 
 
 
 
 
 
0
1
2
3
4
5
What types of games (if any) does your child with ASD normally play with their younger siblings? (Put a tick next to all that apply)
Other (please specify)
Are you interested in participating the the next stage of the research? (This will involve your child being tested on some activities)

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