Adult (Self-Report) Form Response Sheet

SRS-2
TM

Social Responsiveness Scale, Second Edition

Rated Individual’s Information

Rated individual’s name Assessment ID

Gender Age in years Date of rating

Instructions: For each question, please circle the number that best describes your Almost
Not Sometimes Often Always
behavior over the past 6 months. True True True True

1. I am much more uncomfortable in social situations than when I am by myself. 1 2 3 4

2. My facial expressions send the wrong message to others about how I actually feel. 1 2 3 4

3. I feel self-confident when interacting with others. 1 2 3 4

4. When under stress, I engage in rigid or inflexible patterns of behavior that seem odd 1 2 3 4
to people.

5. I do not recognize when others are trying to take advantage of me. 1 2 3 4

6. I would rather be alone than with others. 1 2 3 4

7. I am usually aware of how others are feeling. 1 2 3 4

8. I behave in ways that seem strange or bizarre to others. 1 2 3 4

9. I am overly dependent on others for help with meeting my everyday needs. 1 2 3 4

10. I take things too literally, and because of that, I misinterpret the intended meaning 1 2 3 4
of parts of a conversation.

11. I have good self-confidence. 1 2 3 4

12. I am able to communicate my feelings to others. 1 2 3 4

13. I am awkward in turn-taking interactions with others (for example, I have a hard time 1 2 3 4
keeping up with the give-and-take of a conversation).

14. I am not well coordinated. 1 2 3 4

15. When people change their tone or facial expression, I usually pick up on that and 1 2 3 4
understand what it means.

16. I avoid eye contact or am told that I have unusual eye contact. 1 2 3 4

17. I recognize when something is unfair. 1 2 3 4

18. I have difficulty making friends, even when trying my best. 1 2 3 4

Continued on next page

Copyright © 2012, 2015 by Western Psychological Services. Permission is granted to qualified individual users of the WPS Online Evaluation
System to reproduce this form for the sole purpose of collecting a client’s SRS-2 responses. No other use—including and not limited to
adaptation and/or translation—may be made without the prior written permission of WPS ([email protected]). All rights reserved.
Instructions: For each question, please circle the number that best describes your Almost
Not Sometimes Often Always
behavior over the past 6 months. True True True True

19. I get frustrated trying to get ideas across in conversations. 1 2 3 4

20. I have sensory interests that others find unusual (for example, smelling or looking at 1 2 3 4
things in a special way).

21. I am able to imitate others’ actions and expressions when it is socially appropriate to 1 2 3 4
do so.

22. I interact appropriately with other adults. 1 2 3 4

23. I do not join group activities or social events unless prompted or strongly urged to 1 2 3 4
do so.

24. I have more difficulty than others with changes in my routine. 1 2 3 4

25. I do not mind being out of step with or “not on the same wavelength” as others. 1 2 3 4

26. I offer comfort to others when they are sad. 1 2 3 4

27. I avoid starting social interactions with other adults. 1 2 3 4

28. I think or talk about the same thing over and over. 1 2 3 4

29. I am regarded by others as odd or weird. 1 2 3 4

30. I become upset in situations with lots of things going on. 1 2 3 4

31. I can’t get my mind off something once I start thinking about it. 1 2 3 4

32. I have good personal hygiene. 1 2 3 4

33. My behavior is socially awkward, even when I am trying to be polite. 1 2 3 4

34. I avoid people who want to be emotionally close to me. 1 2 3 4

35. I have trouble keeping up with the flow of a normal conversation. 1 2 3 4

36. I have difficulty relating to family members. 1 2 3 4

37. I have difficulty relating to adults outside of my family. 1 2 3 4

38. I respond appropriately to mood changes in others (for example, when a friend’s 1 2 3 4
mood changes from happy to sad).

39. People think I am interested in too few topics, or that I get too carried away with 1 2 3 4
those topics.

40. I am imaginative. 1 2 3 4

41. I sometimes seem to wander aimlessly from one activity to another. 1 2 3 4

42. I am overly sensitive to certain sounds, textures, or smells. 1 2 3 4

43. I enjoy small talk (casual conversation with others). 1 2 3 4

44. I have more trouble than most people with understanding chains of causation (in 1 2 3 4
other words, how events are related to one another).

45. When others around me are paying attention to something, I get interested in what 1 2 3 4
they are attending to.

46. Others feel that I have overly serious facial expressions. 1 2 3 4

47. I laugh at inappropriate times. 1 2 3 4

Continued on next page

Copyright © 2012, 2015 by Western Psychological Services. Permission is granted to qualified individual users of the WPS Online Evaluation
System to reproduce this form for the sole purpose of collecting a client’s SRS-2 responses. No other use—including and not limited to
adaptation and/or translation—may be made without the prior written permission of WPS ([email protected]). All rights reserved.
Instructions: For each question, please circle the number that best describes your Almost
Not Sometimes Often Always
behavior over the past 6 months. True True True True

48. I have a good sense of humor and can understand jokes. 1 2 3 4

49. I do extremely well at certain kinds of intellectual tasks, but do not do as well at 1 2 3 4
most other tasks.

50. I have repetitive behaviors that others consider odd. 1 2 3 4

51. I have difficulty answering questions directly and end up talking around the subject. 1 2 3 4

52. I get overly loud without realizing it. 1 2 3 4

53. I tend to talk in a monotone voice (in other words, less inflection of voice than most 1 2 3 4
people demonstrate).

54. I tend to think about people in the same way that I do objects. 1 2 3 4

55. I get too close to others or invade their personal space without realizing it. 1 2 3 4

56. I sometimes make the mistake of walking between two people who are trying to talk 1 2 3 4
to one another

57. I tend to isolate myself. 1 2 3 4

58. I concentrate too much on parts of things rather than seeing the whole picture. 1 2 3 4

59. I am more suspicious than most people. 1 2 3 4

60. Other people think I am emotionally distant and do not show my feelings. 1 2 3 4

61. I tend to be inflexible. 1 2 3 4

62. When I tell someone my reason for doing something, it strikes the person as unusual 1 2 3 4
or illogical.

63. My way of greeting another person is unusual. 1 2 3 4

64. I am much more tense in social settings than when I am by myself. 1 2 3 4

65. I find myself staring or gazing off into space. 1 2 3 4

Copyright © 2012, 2015 by Western Psychological Services. Permission is granted to qualified individual users of the WPS Online Evaluation
System to reproduce this form for the sole purpose of collecting a client’s SRS-2 responses. No other use—including and not limited to
adaptation and/or translation—may be made without the prior written permission of WPS ([email protected]). All rights reserved.