Autism

There are persistent deficits in social communication and social interaction across multiple contexts, as manifested by the following: Deficit in Social-emotional reciprocity[comment memo="bad at interacting ( back and forth does not happen fluently) (Struggling to make friends or preferring to be on
their own)"][textarea memo="Additional information" rows="1"], Deficits in nonverbal communicative behaviors used for social interaction[comment memo="abnormal, poor or total lack at eye contact and facial expression"][textarea memo="Additional information" rows="1"], Deficits in developing, maintaining, and understanding relationships[comment memo="making/keeping friends, sharing imaginative play, total lack of interest in peers"][textarea memo="Additional information" rows="1"].

[checkbox name="Stereotyped or repetitive motor movements" memo="Stereotyped or repetitive motor movements" value=""][checkbox name="Insistence on sameness/inflexible adherence to routines" memo="Insistence on sameness/inflexible adherence to routines" value=""][checkbox name="Highly restricted/fixated interests" memo="Highly restricted/fixated interests" value=""][checkbox name="Hyper/hyporeactivity to sensory input" memo="Hyper/hyporeactivity to sensory input" value=""]
[conditional field="Stereotyped or repetitive motor movements" condition="(Stereotyped or repetitive motor movements).is('')"]
Depression is reported to be [select value="stable|unchanged|better|somewhat better|somewhat worse|much worse"]. [select name="variable_10" value="Patient is reporting | There are variability in symptoms such as : | There are decrease in symptoms such as: | There are increase in symptoms such as: |There are no reports of "][checkbox value="no concerning progression of symptoms|lack of motivation|feeling down|little interest or pleasure in doing things|hopelessness|helplessness|feeling tired or having little energy|feelings of inadequacy|irritability|poor concentration|psychomotor retardation|psychomotor agitation|suicidal ideation"]. [textarea memo="Additional information" rows="1"][/conditional]
[conditional field="Insistence on sameness/inflexible adherence to routines" condition="(Insistence on sameness/inflexible adherence to routines).is('')"]
Anxiety is reported to be [select value="stable|unchanged|better|somewhat better|somewhat worse|much worse"]. [select name="variable_11" value="Patient is reporting | There are variability in symptoms such as : | There are decrease in symptoms such as: | There are increase in symptoms such as: |There are no reports of "][checkbox value="no concerning progression of symptoms|fatigue|difficulty concentrating|nervousness|increased heart rate|sense of impending danger/panic|rapid breathing|trembling|experiencing G.I symptoms|irritability|excessive worry|muscle tension|headaches|feeling overwhelmed|irritability|restlessness|loss of appetite"]. [textarea memo="Additional information" rows="1"][/conditional]
[conditional field="Highly restricted/fixated interests" condition="(Highly restricted/fixated interests).is('')"]
Panic symptoms are reported to be [select value="stable|unchanged|better|somewhat better|somewhat worse|much worse"]. [select name="variable_12" value="Patient is reporting | There are variability in symptoms such as : | There are decrease in symptoms such as: | There are increase in symptoms such as: |There are no reports of "][checkbox value="no concerning progression of symptoms|palpitations/racing heart|sweating|shaking|shortness of breath|chest pain/tightness|nausea/stomach cramps|numbness/tingling|fear of losing control|closed in feeling|feeling overwhelmed|heat sensations|chills|trembling/shaking"]. [textarea memo="Additional information" rows="1"][/conditional]
[conditional field="Hyper/hyporeactivity to sensory input" condition="(Hyper/hyporeactivity to sensory input).is('')"]
Cognitive symptoms are reported to be [select value="stable|unchanged|better|somewhat better|somewhat worse|much worse"]. [select name="variable_19" value="Patient is reporting |There are no reports of "][checkbox value="no concerning progression of symptoms|difficulty with complex attention|poor executive functioning|difficulty with short term memory|difficulty with long term memory|motor difficulties|confusion|repetitive behaviors|misplacing objects|difficulty understanding context|difficulty formulating speech|forgetting names/words|loss of interest|confusion|social isolation|loss of motivation|paranoia|visual hallucinations|auditory hallucinations|obsessive behaviors|hoarding behaviors|tremors|night terrors|sleeping during the day|not sleeping at night|agitation|threatening behaviors|inappropriate behaviors"].[textarea memo="Additional information" rows="1"][/conditional]
[conditional field="alcohol" condition="(alcohol).is('')"]
Alcohol use symptoms are reported to be [select value="stable|unchanged|better|somewhat better|somewhat worse|much worse"]. [select name="variable_20" value="Patient is reporting |There are no reports of "] [checkbox value="no concerning progression of alcohol use|daily drinking|drinking more than anticipated|inability to cut down on drinking|cravings to drink|blackouts|hangovers|urges to drink|missing work due to drinking|drinking alone|drinking and driving|drinking to fall asleep|escalating alcohol use|tremors|nausea|vomiting|headaches|sweating|anxiety|racing heart|confusion|visual hallucinations|auditory hallucinations|seizures"].[textarea memo="Additional information" rows="1"][/conditional]
[conditional field="opioid" condition="(opioid).is('')"]
Opioid use symptoms are reported to be [select value="stable|unchanged|better|somewhat better|somewhat worse|much worse"]. [select name="variable_21" value="Patient is reporting |There are no reports of "] [checkbox value="no concerning progression of symptoms of opioid use|cravings|urges to use opioids|continued opioid use|use of fentanyl|recent overdose|drowsiness|dizziness|fainting|fatigue|chest pain|difficulty breathing|missing work|irritability|pinpoint pupils|nausea|vomiting|loss of appetite|constipation|diarrhea|stomach cramping|weight loss|racing heart|sweating|chills|palpitations|tearing eyes|yawning|insomnia|bone pain|goose bumps|tremors|leg swelling|yellowing of eyes|loss of libido|confusion|visual hallucinations|auditory hallucinations"].[textarea memo="Additional information" rows="1"][/conditional]
[conditional field="personality" condition="(personality).is('')"]
Personality symptoms are [select value="stable|unchanged|better|somewhat better|somewhat worse|much worse"]. [select name="variable_22" value="Patient is reporting |There are no reports of "][checkbox value="no concerning progression interpersonal relationships, impulsivity, behavioral regulation, or affect regulation|unstable relationships with others|idealizing and devaluing|identity disturbance|feelings of emptiness|affective lability|excessive anger|aggression|efforts to avoid abandonment|impulsive behaviors|suicidality|self injurious behavior|thrill seeking|paranoia|dissociation|attention seeking"].[textarea memo="Additional information" rows="1"][/conditional]

There are persistent deficits in social communication and social interaction across multiple contexts, as manifested by the following: Deficit in Social-emotional reciprocitybad at interacting ( back and forth does not happen fluently) (Struggling to make friends or preferring to be on
their own)
Additional information, Deficits in nonverbal communicative behaviors used for social interactionabnormal, poor or total lack at eye contact and facial expression
Additional information, Deficits in developing, maintaining, and understanding relationshipsmaking/keeping friends, sharing imaginative play, total lack of interest in peers
Additional information.

Stereotyped or repetitive motor movements Insistence on sameness/inflexible adherence to routines Highly restricted/fixated interests Hyper/hyporeactivity to sensory input








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