Appendix

Affection Questionnaires

Adapted from Sofronoff, Lee, Sheffield and Attwood (in press).

Scoring and understanding the affection questionnaires

Important background

The questionnaire was given to 54 children (aged 5–13 years old) with Asperger’s syndrome who participated in a trial of the Affection programme (Andrews, Attwood and Sofronoff, under review). Each of these children completed the questionnaire at the start and at the end of the programme. An average score was calculated each time by adding up all the children’s scores and dividing by the number of children.

The Affection for Others Questionnaire (AOQ)

The AOQ is a 20-item questionnaire that examines giving and receiving verbal and physical affection, and the communication of empathy by the child, to classmates, friends and family members. There are four questions within each subscale, making a total of 20 questions.

There are two parts to each question. The first part asks you about the appropriateness of your child’s affectionate gestures. Scores range from 1, ‘Never appropriate’, through to 7, ‘Always appropriate’. The second part of the question assesses the amount of affection that your child displays, with responses ranging from 1, ‘Not enough’, to 7, ‘Too much’.

To score the AOQ, add up the appropriateness (the first part of the question) and amount (the second part of the question) scores separately to give a Total Appropriateness score and a Total Amount of Affection score.

UNDERSTANDING THE TOTAL APPROPRIATENESS SCORE

In the trial of the Affection programme, the average Total Appropriateness score for a child with Asperger’s syndrome (aged 5–13 years old) was 66 at the start of the programme, and 77 at the end of the programme (Andrews et al., under review). The research trial indicated that most of the children improved in how appropriately they showed affection.

It may be useful for you to compare your child’s Total Appropriateness score with the averages from this research trial, to determine how appropriately he or she demonstrates affection compared to other children with Asperger’s syndrome. Measured before and after the Affection programme, the Total Appropriateness score will be a good indicator of how much improvement your child experiences as a result of the Affection programme.

UNDERSTANDING THE TOTAL AMOUNT OF AFFECTION SCORE

Scores of 59 and below are considered ‘Low affection’, scores between 59 and 100 are considered ‘Adequate affection’, and scores 101 and above are considered ‘High affection’. A desired outcome of the Affection programme is that your child is demonstrating ‘Adequate affection’.

The Affection for You Questionnaire (AYQ)

The AYQ is a 19-item questionnaire that examines giving and receiving verbal and physical affection, and the communication of empathy by the child, to a parent.

Similar to the AOQ, there are two parts to each question. The first part of the question measures the frequency of affection shown to you, on a scale from 1, ‘Never’, to 7, ‘Twice a day or more’. This part of the questionnaire is a qualitative measure and no score is calculated. The second part of the question measures the amount of affection your child shows, Total Affection, on a scale from 1, ‘Not enough’, to 7, ‘Too much’.

To calculate the Total Affection score, add up all of the scores for the second part of each question in the questionnaire.

UNDERSTANDING THE TOTAL AFFECTION SCORE

A score of 57 and below is considered ‘Low affection’, a score between 57 and 95 is denoted as ‘Adequate affection’, and a score of 96 or over is categorized as ‘High affection’. As for the AOQ above, a desired outcome is that the child shows ‘Adequate affection’.

The General Affection Questionnaire (GAQ)

The GAQ is a 12-item questionnaire that examines aspects of affectionate communication such as expressing inadequate or excessive affection, the importance of affection in your child’s daily life, and the degree to which teaching and support regarding affection are required. To complete the questionnaire, assign a rating from 1, ‘Strongly disagree’, to 7, ‘Strongly agree’, to each of 12 statements. These statements variously assess the amount of affection the child shows, the appropriateness of that affection, the impact of the difficulties with affection your child has, and your child’s knowledge of affection.

To score, simply sum all of the 12 items to give a Total Difficulty with Affection score.

UNDERSTANDING THE TOTAL DIFFICULTY WITH AFFECTION SCORE

In the trial of the Affection programme, the average score for the 54 children (aged 5–13 years old) with Asperger’s syndrome was 42 (Andrews et al., under review).

It may be useful to compare your own child’s score to this average. The GAQ was found to be most useful in the initial assessment of children’s affection difficulties, to discover where the child’s difficulties lie.

 

The Affection for Others Questionnaire (AOQ)

The questions below are all to do with the types of affection your child (aged between 5 years and 13 years old) with autism spectrum disorder shows others. This means the affection that he or she shows to people outside of his or her immediate family such as: school teachers, classmates, family friends, shopkeepers and strangers. Please fill this out even if your child has very few difficulties expressing affection for others.

There are two components to each question:

1. How appropriately does your child show others that form of affection?

Consider how appropriately your child shows affection to others by rating this on a seven-point scale, from ‘never’ to ‘always’, and writing that number in the box. On the scale, a score of 1 indicates ‘Never appropriate’, 4 indicates ‘Sometimes appropriate’ and 7 indicates ‘Always appropriate’.

a) How appropriate is the amount of affection he or she shows others?

Consider how appropriate you find the amount of affection your child shows to others by giving a rating on the seven-point scale, where 1 indicates ‘Not enough’, 4 indicates ‘About right’ and 7 indicates ‘Too much’.

 

Please see the example below:

1. Is your child able to say ‘hello’ to others in an appropriate manner?

For example, rating this as a ‘1’ means that you consider your child is rarely appropriate when saying ‘hello’ to others because he or she does not do it enough. Alternatively you may rate it as a ‘6’ or ‘7’ if the reason that your child was not able to say ‘hello’ in an appropriate manner was because he or she did it too frequently.

a. What do you think of the amount he/she does this?

For example, rating this as a ‘1’ means your child never says ‘hello’ in an appropriate manner, and may shout it at people or ignore people when a ‘hello’ would be appropriate.

 

There are 20 questions in this section.

The first 8 questions are about your child GIVING affection to others. Examples of ‘others’ are: school teachers, classmates, family friends, shopkeepers, and strangers.

GIVING VERBAL AFFECTION

1. Is your child able to say ‘I love you/I like you’ to others appropriately (e.g. classmates or family friends)?
a. What do you think of the amount he/she does this?
2. Is your child able to say something to others about how important the relationship between them is appropriately?
a. What do you think of the amount he/she does this?
3. Is your child able to compliment others in an appropriate way?
a. What do you think of the amount he/she does this?
4. Is your child able to speak to others in an appropriately friendly manner?
a. What do you think of the amount he/she does this?

GIVING PHYSICAL AFFECTION

5. Is your child able to hug others appropriately?
a. What do you think of the amount he/she does this?
6. Is your child able to hold others’ hands appropriately when he/she needs to (e.g. a school teacher)?
a. What do you think of the amount he/she does this?
7. Is your child able to put his/her arm around the shoulder of others appropriately (e.g. classmates)?
a. What do you think of the amount he/she does this?
8. Is your child able to physically acknowledge others appropriately, by giving them a touch on the arm, pat on the back, or similar?
a. What do you think of the amount he/she does this?

The next 8 questions are about your child accepting and RECEIVING affection from others.

RECEIVING VERBAL AFFECTION

9. Is your child able to respond appropriately to others saying ‘I like you/I love you’ to him/her (e.g. classmates)?
a. What do you think of the amount he/she does this?
10. Is your child able to respond to compliments from others?
a. What do you think of the amount he/she does this?
11. Is your child able to accept thanks or praise from others appropriately?
a. What do you think of the amount he/she does this?
12. Is your child able to speak in an appropriately friendly manner back to others when he/she is included in a conversation?
a. What do you think of the amount he/she does this?

RECEIVING PHYSICAL AFFECTION

13. Is your child able to receive a hug from others appropriately (e.g. classmates or family friends)?
a. What do you think of the amount he/she does this?
14. Is your child able to respond to a kiss from others appropriately (e.g. family friend)?
a. What do you think of the amount he/she does this?
15. Is your child able to react appropriately when others touch him/her (e.g. classmates)?
a. What do you think of the amount he/she does this?
16. Is your child able to react appropriately when others give him/her a pat on the back (e.g. classmates)?
a. What do you think of the amount he/she does this?

The final 4 questions are about your child’s ability to understand and share emotions with others.

COMMUNICATION OF EMPATHY

17. Is your child able to laugh appropriately with others?
a. What do you think of the amount he/she does this?
18. Is your child able to show an appropriate level of interest in the actions and feelings of others?
a. What do you think of the amount he/she does this?
19. Is your child able to be appropriately helpful to others?
a. What do you think of the amount he/she does this?
20. Is your child able to smile at others appropriately?
a. What do you think of the amount he/she does this?

 

The Affection for You Questionnaire (AYQ)

The next questions are all to do with the types of affection your child (aged between 5 years and 13 years old) with autism spectrum disorder shows you. Please fill these questions out even if your child does not have any difficulty expressing affection to you.

There are two components to each question:

1. How often does your child show you that form of affection?

Consider how often your child shows affection to you by rating this on a seven-point scale, from ‘never’ to ‘twice a day or more’, and writing that number in the box. On the scale, a score of 1 = Never, 2 = Yearly, 3 = Monthly, 4 = Twice a week, 5 = Once a week, 6 = Once a day, 7 = Twice a day or more.

a) How appropriate is the amount of affection he or she shows you?

Consider the amount of affection your child shows you by giving a rating on the seven-point scale, where 1 indicates ‘Not enough’, 4 indicates ‘About right’ and 7 indicates ‘Too much’.

 

Please see the example below:

1. How often does he/she say ‘hello’ to you?

For example, rating this as a ‘6’ indicates that your child says ‘hello’ to you once a day on average.

a. What do you think of the amount he/she does this?

For example, rating this as a ‘4’ means that you consider your child saying ‘hello’ to you once a day to be about the ‘right’ amount.

 

There are 19 questions in this section.

The first 9 questions are about your child GIVING affection to you. Please consider how often he/she does this as well as how satisfied you are with this amount.

GIVING VERBAL AFFECTION

1. How often does he/she say ‘I love you’ to you?
a. What do you think of the amount he/she does this?
2. How often does he/she say something to you about how important your relationship is to him/her?
a. What do you think of the amount he/she does this?
3. How often does he/she thank you?
a. What do you think of the amount he/she does this?
4. How often does he/she speak to you in a friendly manner?
a. What do you think of the amount he/she does this?

GIVING PHYSICAL AFFECTION

5. How often does he/she come up and hug you?
a. What do you think of the amount he/she does this?
6. How often does he/she want to hold your hand?
a. What do you think of the amount he/she does this?
7. How often does he/she want to sit close to you?
a. What do you think of the amount he/she does this?
8. How often does he/she put his/her arm around your shoulder, around your waist, or around your legs?
a. What do you think of the amount he/she does this?
9. How often does he/she acknowledge your presence by touching you in some way, e.g. a pat on the back or arm, a touch on the hand, or similar?
a. What do you think of the amount he/she does this?

The next 6 questions are about your child accepting and RECEIVING affection from you.

RECEIVING VERBAL AFFECTION

10. How often does he/she say ‘I love you’ back to you?
a. What do you think of the amount he/she does this?
11. How often does he/she respond with pleasure to you using a pet name or term of endearment to refer to him/her?
a. What do you think of the amount he/she does this?
12. How often does he/she speak in a friendly manner back to you?
a. What do you think of the amount she/she does this?

RECEIVING PHYSICAL AFFECTION

13. How often does he/she enjoy it when you hug him/ her?
a. What do you think of the amount he/she does this?
14. How often does he/she enjoy it when you kiss him/ her?
a. What do you think of the amount he/she does this?
15. How often does he/she hold hands with you when you ask him/her to?
a. What do you think of the amount he/she does this?

The final 4 questions are about your child’s ability to understand and share emotions with you.

COMMUNICATION OF EMPATHY

16. How often does he/she laugh with you?
a. What do you think of the amount he/she does this?
17. How often does he/she show an interest in what you are doing or feeling?
a. What do you think of the amount he/she does this?
18. How often is he/she helpful when you need it?
a. What do you think of the amount he/she does this?
19. How often does he/she smile at you with happiness?
a. What do you think of the amount he/she does this?

 

The General Affection Questionnaire (GAQ)

Please answer the following questions about your child by writing a number in the box, which shows your level of agreement with the 12 statements. On the scale, a score of 1 indicates ‘Strongly disagree’ and 7 indicates ‘Strongly agree’.

1. He/she has only a limited number of ways of expressing affection.
2. He/she shows a lack of affection.
3. He/she has difficulties initiating affection.
4. He/she finds it difficult receiving affection from others.
5. He/she uses inappropriate expressions of affection.
6. I have had to spend time teaching him/her about affection.
7. There seems to be a difference between his/her physical need for touch and his/her desire to express affection.
8. He/she has difficulties with affection and these interfere with school.
9. He/she has difficulties with affection that cause problems with his/her siblings.
10. He/she has difficulties displaying affection to those outside of our immediate family.
11. He/she has quirky or unusual ways of giving or wanting to receive affection.
12. He/she has difficulties understanding that certain types and levels of affection are not appropriate to show to everyone (e.g. does not discriminate well between those who it is appropriate to hug/kiss/touch).