2.1.2. Questionnaire and Checklists

We use 11 questionnaires and checklists of which we have consolidated expertise:

(1) The Leiter–R parent social–emotional rating scales [16] provides the parent's perception of the child's cognitive/social functioning and emotion regulation.

(2) The Behavior Rating Inventory of Executive Function Preschool Version (BRIEF-P) [17] offers the possibility of a structured assessment of the executive functioning at preschool age, maximizing the opportunity to detect deficiencies and difficulties and to intervene promptly.

(3) The Behavior Rating Inventory of Executive Function 2, (BRIEF-2) [18] is a set of questionnaires for parents of school-aged children designed to evaluate executive function from multiple perspectives.

(4) The Child Behavior Check List (CBCL) [19] is a parent-report measure designed to record the problem behaviors of boys and girls. Each item describes a specific behavior and the parent is asked to rate its frequency on a three-point Likert scale. The scoring gives a summary profile including a DSM-oriented scale.

(5) The MacArthur Communicative Development Inventory (MCDI) [20] includes word comprehension, word expression, and gestures. Because the children could be older than those in the normative groups, raw data will be used instead of standard scores.

(6) The Questionnaire for Parents or Caregivers (CARS2-QPC) [21] is a parent report measure; the areas covered by the CARS2-QPC include the individual's early development, social, emotional, and communication skills, repetitive behaviors, play and routines, and unusual sensory interests.

(7) The Repetitive Behavior Scale—Revised (RBS-r) [22] is a developed questionnaire that captures the following factors of RRB: ritualistic/sameness behavior, stereotypic behavior, self-injurious behavior, compulsive behavior, and restricted interests.

(8) The Social Communication Questionnaire (SCQ)–Life Time Form (SCQ-LT) [23] is filled out by parents to evaluate children's communication, social, and relational skills. SCQ has established high comparative agreement with the Autism Diagnostic Interview—Revised™. The Lifetime Form focuses on the child's entire developmental history.

(9) The Sensory Profile (SP) [24] evaluates the child's sensory processing patterns in the context of home, school, and community-based activities. Parents indicate their perception of the frequency with which their child exhibits atypical behaviors in response to sensory stimulation. The SP evaluates tactile, visual/auditory, taste/smell, and movement sensitivity, auditory filtering, low energy/weakness, and sensation seeking [25].

(10) The Social Responsiveness Scale (SRS) [26] is a quick scale of evaluation of mutual social behavior, communication, and repetitive and stereotyped behaviors characteristic of autism spectrum disorders in children between four and 18 years of age.

(11) The Parenting Stress Index 4 [27] is focused on the clinical identification of specific problems and strengths in relation to the child, the parent, and the family system.

2.1.3. Meeting with an Expert Psychologist in the Field of the Diagnosis of ASD

During the remote meeting the psychologist explains to the parents how to make some short videos of the child in the home environment.

At the end of the meeting, the psychologist sends to the family a brochure summarizing all the explained procedures to make videos. The PSC phase is distinguished by the age group of the children.

For preschoolers, the psychologist advises a parent to produce 15–20 min of the following five videos:

(a) The child playing with a parent (ADOS-BOSCC inspired setting [28]), 15 min.

A brief child–parent free play interaction aimed at observing the behavioral profile of the child. Parents are asked to place toys on the floor. Parents are instructed to play as usual, without making any additional demands on their child.

(b) The child playing alone (ADOS-2 free play inspired setting [10]), 15 min.

Parents are asked to place toys on the floor and on a small table (or a shelf). The request made to parents is to video record the child while he/she is playing with the toys that he/she spontaneously chooses from those proposed. The goal of this video is to observe the functional and symbolic use of

objects, the sensory characteristics, the presence of restricted and repetitive behaviors, the presence of gergophasia, and the child's ability to vary the play activity.

(c) The child playing with a sibling (if there is one), 15 min.

The (b) and (c) scenarios provide opportunities for the child to show typical social interaction skills and play. The setting is the same as video (b). In this case, the goal of the video is to observe the quality of social interaction with another child (in this case familiar). We are interested in observing social openings, the response to shared attention, the response to names, the child's ability to draw attention, the quality of the social response, and the verbal and non-verbal communication skills.

(d) Family mealtime, 15 min.

The preferred setting for this video is that of breakfast, lunch, snack time, or dinner. The goal of this video is to observe the oral–motor skills and the presence of food selectivity [29]. This type of observation is very important both from the behavioral point of view and for ad hoc suggestions from the speech therapist.

(e) Any behavior that worries parents, 15 min;

The setting of this video is not minimally structured. The goal is to obtain a video recording that describes a specific behavior that has attracted the parents' concern.

The points from (b) to (e) are inspired by Nazneen's work [6,7].

For school-aged children, the videos and their duration are the same, except with regard video (a). For these boys and girls, for video (a), it was decided to record their interaction with a parent in a setting similar to that of LEGO therapy [30]. The parent is asked to build a LEGO set (or other construction, or another game) together with the child. Through this, the therapist can remotely observe the child's social skills, such as turn taking, problem solving, collaboration, and social communication.

For both preschoolers and school-aged children, all videos should have been made on different days in order to have a wider view of the child's behavior.

The five videos and the questionnaires/checklists were sent via internet to the Diagnostic Autism Team at least 1 week before the start of phase B (specialistic assessment).

In the PSC phase, the family can request technical help from the psychologist at any time if doubts or uncertainties arise about how to prepare the videos. Overall, about 3 h were scheduled to complete the PSC phase.
