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]