Pivotal Skills Selection Box

Communications Learning Play Self Direction of Behavior Sensory Social-Affective Relationships Joint Attention
Comprehension Learning Object Play Self Direction of Behavior Sensory Social Orienting Focus on Faces
Communicative Means Social Play Reaction Taking Turns and Imitation
in Back and Forth Play
Communicative Intent Responsiveness Share Attention: Responds to
Joint Attention Bids of Others
Pragmatic Rules Interactions Share Attention: Initiates
Joint Attention Bids With Others
Shifts Attention from Current
Interest to an Interest of Another


Decodes Language of Others
  • Does not understand the emotions of others
  • Does not understand other’s nonverbal communication
  • Does not respond when others talk to him/her
  • Does not look towards speaker when spoken to
  • Looks at speaker, but does not respond, looking as if he/she does not understand
  • Does not understand other's intentions
  • Cannot decipher words – Does not get the relationship between feelings, observations, actions and objects and the words they refer to
Follows Directions
  • Disregards other's feelings or ideas
  • Looks at the person, but not at any gestures or physical prompts for directions
  • Does not cooperate with others unless coerced
  • Does not understand other’s nonverbal direction
  • Goes off purposefully but does not return to complete directions
Prelinguistic Communication
  • Ignores, avoids or resists people
  • Prefers being alone to being with people
  • Rarely imitates or attempts to act in ways others act
  • Self absorbed
  • Rarely turn takes with others
  • Dominates interactions with others
  • Passive, non-responsive in most interactions
  • Reacts negatively when others attempt to interact with him/her
Gestures/Nonverbal Communication
  • Rarely attempts to communicate in any way
  • Communicates only with movements or non-word sounds
  • Communicates only instrumentally to get needs met
  • Does not respond to communication of others
  • Does not take turns with sounds
  • Does not imitate sounds
  • Does not use gestures
Social Communication
  • Jargons, babbles, or uses words by himself/herself only; not with partners
  • Rarely vocalizes to communicate intentions to others
  • Primarily uses nonverbal communication rather than words to communicate
  • Understands several words but seldom uses them to communicate his/her intentions
  • Understands several words but uses them only in a restricted way
  • Combines words and jargon to communicate
  • Lots of rote or memorized talking
  • Does not use words, or has only a few words
  • Does not combine words into novel phrases
  • Does not combine communicative acts (for example does a word, a gesture and eye contact simultaneously to communicate)
  • Uses both jargon and words to interact with people
  • Expressive vocabulary is rapidly expanding
  • Is starting to put words together to form longer than two-word utterances
  • Seldom stays engaged with partners for more than a few conversational turns
  • Actively attempts to involve others in his/her play, even though his/her language is limited
  • Primarily communicates to get his/her needs met but occasionally for other reasons
  • Is interested in communicating elaborate sequences or observations, but lacks the language to do it
  • Engages in monologues rather than dialogues
  • Insists on his/her own topics
  • Has limited number of topics he/she will engage in conversations about
  • Shifts topics rapidly and haphazardly
  • Initiates with others, but does not respond to others
  • Dominates turns conversational
  • Will only engage in conversation if he/she is directing it
  • Frequently interrupts others
  • Quickly loses interest in conversations with others
  • Partner has to take the lead in the conversation
  • Does not direct requests to a person
  • Just cries when he/she needs help or wants something
  • Partner needs to guess what the child wants
  • Does not point to desired objects
  • Pulls person to or moves person’s hand to desired object
  • Makes pleading sounds, but no words or specific gestures/signs to indicate requests
  • Does not notice other people
  • May look at a person, but does not do or say anything to indicate they notice them
  • Greets people repeatedly or in inappropriate manner
  • Excessively cries or fusses when others arrive and/or depart
Get Someone to Do Something
  • Partner needs to guess what the he/she want him or her to do
  • Does not signal wants, needs or request intentions
Initiates With Others
  • Does not notice others
  • Does not attempt to catch persons eye through movement and sounds
  • Does not come near the other person to get their attention
  • Does not look toward others or attempt to make eye contact to engage the person
  • Responds to others, but does not attempt to initiate
  • Can sustain reciprocal interactions with adults, but usually waits for the adult to decide what to play and to direct the play
  • Does not seek out others or invite others for contact
  • Does not give or show person something to get them to interact
  • Gives too little information in the conversation
  • Gives too much information in the conversation
  • There are definite people he/she will interact with and those he/she will not interact with
  • There are definite situations he/she will interact in and not interact in
  • There are definite times of day he/she will interact and will not interact
  • Goes off in tangents from the conversation
  • Changes topics inappropriately
  • Cannot close the conversation
  • Looks or walk away in mid-conversation
  • Hovers around people who are talking; not able to enter the conversation
  • Does not change talking for the different partners
  • Does not make conversational repairs when unclear to the partner
  • Cannot provide more information, or give more information when partner requests
  • Looks at the other person as if bewildered when they do not do what he/she expected based on what he/she said to them
  • Gets upset at partner when they do not respond as he expects
  • Echoes what other person has said


  • Does not actively participate in routine activities (eating, dressing)
  • Does not allow primary caregivers to engage in his/her play
  • Leaves interactions whenever caregivers ask him/her to do something
  • Has difficulty conforming to his/her parents’ expectations and requests
  • Has difficulty playing with other children
  • Cannot make choices
  • Has difficulty with transitions
  • Does not do behaviors on request that are developmentally appropriate
  • Seldom repeats skills that are within his/her developmental level
  • Does not have access to toys or materials he/she enjoys
  • Is often encouraged to produce behaviors that are beyond his/her current developmental level
  • Gives up easily when he/she encounters an obstacle
  • Does not attempt new ways of thinking as demonstrated by giving up old, ineffective behaviors and replacing them with newly learned or discovered behaviors
  • Only does rote or repetitive behaviors; does not joyfully repeat what he/she knows how to
  • Parents talk more about what he/she cannot do rather than what he/she can do
  • Is hesitant or uncertain in most situations
  • Gives up quickly when encountering difficulty or challenge
  • Is dissatisfied with his/her efforts and accomplishments
  • Seldom asks others to notice what he/she is doing or show what he/she has done
Feelings of Control
  • Cannot or has difficulty making decisions
  • Seldom makes choices when offered a choice
  • Usually looks to adults for guidance or direction
  • Hesitant to initiate activities with others
  • Quiet or unoccupied unless someone tells or shows him/her what to do
Logical Thinking
  • Focuses on one part of a item or activity instead of the whole
  • Quickly indicates he/she does not know what to
  • Quickly indication he/she “can’t”
  • Has problems with sequencing
  • The child jumps from one idea to another
  • The child is not able to create new ideas in play or conversations
  • The child is not able to have a logical conversation
  • The child has difficulty making sense of what others say and do
Problem Solving
  • Quickly seeks adult help whenever he/she has difficulty doing something in play
  • Tries to solve problems as they arise, but becomes quickly frustrated when he/she is unable to solve them
  • Avoids engaging in activities that may be difficult or challenging
  • Does not learn from what has not worked
  • Uses things in repetitive manner
  • Does not try new actions in play
  • Does not show curiosity in how things work
  • Does not ask questions to gain information
  • Inflexible – Does not seek out novelty
  • Does not make things up or pretend
  • Does not notice discrepancies or becomes overly upset to discrepencies in familiar activities, items and routines
  • No pretend play
  • Focuses on reality and facts
  • Inflexible thinking
  • Highly restricted in his/her fields of interest


Does more With Toys Than Just Mouthing or Banging
  • Does not engage in lots of different exploratory play: grasp, roll, squeeze, drop, bang, twirl, shake
  • Does not show interest or shows unusual interest in a variety of sensory experiences, toys, objects, ect.
Plays With a Variety of Objects/Toys Appropriately in Play
  • Does not play alone in ways he/she has seen others play
  • Does not use 3 objects in combination to construct in play (stack three rings on a peg, stack 3 blocks into a tower, string 3 beads, do 3 puzzle pieces)
  • Does not put things in or take things out
  • Does not operate cause and effect toys
  • Engages in repetitive behaviors with toys and objects
Uses Objects Symbolically in Play
  • Does not re-inact behaviors of routines in play (push car, roll ball, sweep)
  • Does not use objects conventionally on self (puts phone to ear, puts on hat)
  • Cannot sustain and/or elaborate on symbolic play he/she has learned
  • Plays literally with objects
  • Does not imagine in play
  • Does not use objects in ways other than their conventional use
  • May imitate play actions but does not yet engage in his.her own spontaneous, creative play
Engages in Spontaneous Activities and Interactions
  • Does not notice others in play
  • Does not allow others in his/her presence
  • Does not respond to or rejects others playful contacts
  • Does not join in others activities in play rather controls the play his/her way
  • Does not play reciprocally
Imitates Others' Actions Spontaneously in Social Situations
  • Does not try to act in ways others do
  • Does not learn by observing others
  • Does not notice when others imitate him/her
  • Does not repeat his/her actions when they are imitated
Imitates Others' Sounds, Facial Expressions, etc. in Social Situations
  • Does not imitate others emotions
  • Does not make environmental sounds with others in play
  • Does not imitate partner's actions in play
Sustained Attention To Activities and Others
  • Does not stay voluntarily in interactions with others
  • Does not engage in sustained back and forth interactions/circles of communication
  • Requires adult direction/prompts to stay engaged
  • Requires physical boundaries to stay with partner in interactions
Accepts Structure
  • Has difficulty controlling his/her impulses
  • Ignores others requests, directions and/or bids to interact
  • Has difficulty following routines and/or schedules
  • Does not learn from consequences
  • Has limited or no sense of his/her boundaries
  • Not able to regulate or moderate his/her behaviors in most situation
Shared Attention With Another Person
  • Does not play reciprocally back and forth with others
  • Does not actively keep others interacting with him/her in play
  • Only briefly stays engaged in social interactions with partner
Accepts Other's Ideas
  • Prefers play routines with partners that are more task oriented than playful and fun
Social Responsiveness to Others
  • Does not initiate with others
  • Does not look with interest at partner or what the partner is doing
  • Does not play in a give and take manner with others
  • Prefers playing alone
Approaches Peers
  • Does not watch peers as they play
  • Does not imitate what peers do in play
  • Does not parallel play
  • Needs adult guidance to be able to interact with peers
  • Clings to or prefers interacting with adults to playing with peers
Plays With People
  • Rarely engages in back and forth play with partner
  • Does not stay engaged in play and other interactive episodes with partner
Takes Turns With Others
  • Does not play in a give and take manner
  • Does not take turns with actions, sounds and/or words
  • Does not wait for partner to take a turn in play
  • Does not stay in an interaction for at least 4 exchanges
  • Does not offer or signal the partner that it is the partner’s turn
  • Needs cues to take turns

Self-Direction of Behavior

Inhibits Irrelevant Response in Interactions
  • Cries or has meltdown with minimal provocation
  • Cries or tantrums frequently and for long periods
  • Cannot control emotions – extreme swings or overreacts
  • Uses inappropriate behaviors to regulate arousal
Demonstrates Goal-Directed Responses
  • Withdraws from challenging situations quickly
  • Cannot follow routines or accept limits
  • Gets “stuck” easily in challenging or changing situations
  • Difficulty with planning and organization
  • Gets stuck on one target, and cannot adapt to another target when appropriate
Demonstrates Goal-Directed Persistence
  • Does not remain with challenging tasks
  • Gives up before trying new ways to do things
  • Asks for “help” before attempting a task
  • Does not respond to requests to do “one more time”
Re-engages in Interaction/Activity After Disruption
  • Does not respond to partner’s attempts to re-engage the child
  • Typically stays upset or dis-regulated for more than 3 minutes
  • Adults cannot read his/her cues or signals as why he/she is dis-regulated
  • Adults cannot find a way to provide assistance to the child to calm him or her
  • Dependent on adults for regulation – Cannot regulate himself/herself
Demonstrates Behavioral Flexibility in Novel Situations
  • Does not anticipate partner’s or other's actions in familiar routines
  • Refuses to enter into or try new and/or challenging situations
  • Exhibits extreme stress in novel situations
  • Exhibits extreme attachment to caregiver
  • Cannot tolerate emotional stress
  • Easily over stimulated
  • Easily frustrated in new situations and activities
  • Problems with transitions from one activity to another
  • Problems with changes in routines
  • Difficulty seeing more than one way to do things
Responds to Feedback Regarding Behavior
  • Does not learn from consequences of his/her actions
  • When given a choice, has difficulty accepting the choice he/she made when it is given to him/her
  • Does not exhibit cause and effect knowledge in play
Frustration Tolerance
  • Impulsive anger
  • Unprovoked aggression
  • Does not express need to others to be calmed or need for a break
  • Extreme reaction to distress and/or excitement
  • If verbal, he/she does not use words to express his/her emotions
  • Has emotional intensity – Experiences all emotions with intensity and has difficulty controlling his/her emotions
Contingency - Responsive to Multiple Cues in the Environment
  • Responds to a restricted number of available cues in the situation/environment
  • Zeros in on a limited or single attribute of an item or task
  • Focuses on irrelevant cues in the environment
  • Cannot sort by more than one attribute
Reinforcement - Responds to Social Reinforcement Inherent in the Situation
  • Shows no reaction to reinforcement, either positive or negative
  • Only responds to tangible reinforcers but not to natural reinforcers
  • Does not react to warm, positive reactions from partner


Sensory Over Responsivity
  • Resists/overreacts/rejects physical contact with others
  • Gets distressed in crowds or when jostled
  • Gets upset by loud sounds
  • Gets upset at sudden/surprising sounds or sights
  • Gets distressed at bright lights
  • Gets distressed to many smells (perfumes, foods)
  • Rejects some food textures
Sensory Under-Responsivity
  • Needs high stimulation to stay focused and alert for learning and interactions
  • Needs physical contact prompts to attend to others
  • Needs constantly changing auditory/visual/tactile/olfactory stimulation to remain alert
  • Seeks out activities that are vigorously stimulating
Sensory Seeking
  • Seeks highly stimulating and/or intense sensory experiences
  • Seeks deep pressure for calming and relaxing
  • Difficulty maintaining his/her own personal space – invades others’ personal space
  • Craves intense tastes in foods
  • Needs things to “fidget” with to be able to attend
  • Gets agitated when there is nothing to do (waiting)
Motor Planning
  • Exhibits lack of speed and accuracy in motor movements
  • Moves another’s hand to do things rather than doing him/herself (pointing to a picture)
  • Frequently trips/falls/runs into objects
  • Difficulty managing age appropriate fasteners (doorknobs, faucets, clothing fasteners)
  • Frequently loses or break things unintentionally
  • Tells others what to do rather than doing him/herself

Social-Affective Relationships

Turns to Physically Interact with Caregiver
  • Does not look toward people when they are near
  • Does not look to what partner is doing
  • Does not react when partner speaks to him/her
  • Does not attend to peers engaged in play
Attends to People
  • Does not attend to people
  • Is not motivated to attend or interact with people
  • Does not spontaneously, actively alert when people approach or near him/her
  • Needs partner to alert or organize the situation for him or her in most situations
Attempts to Locate Sounds Made by Humans
  • Does not share emotional states with others
  • Does not exhibit feelings through his/her eyes, facial expressions or body movements
  • Does not share emotions of those around him/her
  • Does not orient to sounds made by people
Reacts to the Emotions of Other (Empathy)
  • Does not respond to emotions of others
  • Displays unusual emotional reactions
  • Has flat affect
  • Appears depressed or withdrawn
Social Referencing
  • Does not imitate facial expressions
  • Does not look to you for information on how to emotionally react in a situation
  • Does not use your emotions to influence his/her reactions in a situation
  • Does not consistently orient to name
Face Processing
  • Does not visually orient to people
  • Does not mirror facial expressions of others
  • Does not react to facial expressions of others
Responds Appropriately to Soothing and Cuddling
  • Does not respond within 30 seconds when partner offers comfort (except in extreme distress)
  • Does not respond or gets more upset to partner’s attempts to move him/her away from distressing situation, or redirect him/her to another situation
  • Does not respond or gets more upset to behavioral strategies of the partner (rubbing, soothing talking)
Attachment to Caregivers
  • Does not exhibit attachment behaviors to caregivers
  • Does not seek out familiar caregivers for comfort over non familiar people
  • Does not accept and/or offer warm interactions to caregivers
  • Does not notice when separated from caregiver
  • Does not look to caregiver for behavior cues and reassurance
  • Does not respond within 5 seconds to partner’s bid to interact
  • Does not engage in reciprocal interactions for at least two exchanges (One exchange is on act from the child and one act from the partner. At least one of the child’s acts must by initiated by the child)
Social Smiling
  • Does not smile or laugh while looking at the partner
  • Does not smile in response to partner’s smile
  • Shows preference for other objects or pictures of objects to humans or pictures of humans
Warm, Joyful Expressions
  • Does not joyfully share enjoyment with the partner
  • Does not imitate joyful reactions of partner
  • Does not share positive emotions with partner (squeal, move to, touch partner, reach to be picked up)
Displays Affection to Others
  • Does not spontaneously touch caregiver in ways that express affection (touch, pat, stroke)
  • Does not spontaneously seek out close contact with caregiver (sit in lap, lay head on)
  • Does not spontaneously kiss or hug caregiver
Shared Affect
  • Does not respond when you change your emotions
  • Does not mirror emotional tone of partner
  • Prefers non-human sounds to human sounds
  • Does not orient to human voice
Interacts Frequently With Others
  • Difficulty adjusting to new people
  • Does not demonstrate interest in people (looking at them, visually tracking them, reaching for them)
  • Does not spontaneously stay with others in play
  • Does not signal desire to continue a game or routine
Values Social Experiences with Others
  • Only communicates to get his/her needs met
  • Does not respond to social bids of others
  • Does not initiate social bids to others
  • Prefers to play by self or with objects than to play/interact with people
Prefers Being With People to Being Alone
  • Purposefully moves away from others to play
  • Does not watch others play
  • Seeks out places to play that are away from others
  • Does not react when others attempt to play with him/her
Prefers People Play to Object Play
  • Does not engage in people games
  • Passive or reacts negatively when physically prompted by partner to play
  • Looks exclusively at toy or object but not partner in play
  • Does not do play acts on partner (feed with spoon, put blanket on)
Social Reciprocity
  • Does not respond back with action with the expectation of a response from the partner
  • Does not realize his/her nonverbal or verbal behaviors have an effect on others
  • Does not make choices offered in social situations
Plays Active Rather Than Passive Role in Interactions With Others
  • Does not signal for play or action to continue
  • Does not give or show object to partner
  • Does not initiate routine play with partner
  • Watches but does not join in people play

Joint Attention

Focus on Faces
  • Exhibits little or no interest in faces of others
  • Focuses attention on faces of others for less than one minute
  • Requires much animation or dramatics from other person to get his/her attention
  • Caregiver has found very few or no ways to alert the child to attend to them
  • Difficult or not possible to get the child’s attention to you by approaching and/or talking to him/her
  • Does not attune to the emotions of others expressed in facial expressions or voice
  • Attends more to things than people
Taking Turns and Imitation in Back and Forth Play
  • Does not exchange looks with others
  • Does not exchange noises, mouth or facial movements with others
  • Does not smile back when smiled at
  • Only plays in a simple give and take game with familiar person for less than one minute
  • Does not initiate play with familiar person
  • Does not imitate sounds (example, animals, vehicles, etc.) in play with others
  • Engages in purposeful back and forth exchanges only one or two times
Share Attention: Responds to Joint Attention Bids of Others
  • Does not look at interesting sites (example, people’s faces, toys, etc.) spontaneously
  • Does not make a choice when presented with choices of preferred items or activities
  • Only uses others to get his/her needs met
  • Gives attention to another’s interest for less than 30 seconds
  • Does not follow other's gestures or directions to share their interest
Share Attention: Initiates Joint Attention Bids With Others
  • Only seeks out other’s attention to get wants and needs met
  • Only takes another person to or points to indicate his/her wants, not to share his/her interests
  • Does not make requests or ask for things
  • Can follow another person’s gesture, point or words to look at something but does not then check back with the person after looking at the object, event or person
  • Does not show, reach, point, vocalize or verbalize to share interest with others (not just to make requests)
Understands Another's Needs and Interests in the Interaction
  • Does not respond when attention is directed to something else when he/she involved in his/her interest
  • Gets upset or frustrated when his/her attention is directed away from his/her interest
  • Does not watch others in play or other activities
  • Does not incorporate additional items, actions or people into his/her interest when suggested


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