UCC-CL

UNDERLYING CHARACTERISTICS CHECKLIST-CLASSIC

Ruth Aspy, Ph.D., and Barry G. Grossman, Ph.D.
NAME: _MARLENA____________ DATE: ___________ COMPLETED BY: ____________
FOLLOW-UP DATE: __________ COMPLETED BY: -___________

INSTRUCTIONS FOR COMPLETING INITIAL ASSESSMENT:
The UCC may be completed by an individual; however, the perspective of others who know and/or work with the person of
focus is beneficial. Working as a team is optimal. Additionally, the team may include the individual who is the focus of the
UCC as developmentally appropriate.

Each item describes behaviors or characteristics that may be exhibited by individuals with autism spectrum disorders. Please
place a check beside ALL items that currently apply to the individual. Use the Notes column to describe the behavior and
characteristics in more detail, provide specific examples, or indicate frequency, settings, etc.

Projected Follow-up date: _______________
Area Item Notes: Follow-up:
1. Has difficulty recognizing the
feelings and thoughts of others
(mindblindness)


Often does not appear to recognize or
respond when others cry
Other times, responses are inappropriate
laughs when others cry



2. Uses poor eye-contact or fails
to orient to others


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L

3. Shows little interest in or
response to praise


Acts like he does not hear you
Does not do the activity more after being
praised


INSTRUCTIONS FOR FOLLOW-UP ASSESSMENT:
Review checked and unchecked items. Use the Notes column to add further descriptors or to indicate changes. If an item no
longer applies, strike through the check and explain changes in the Follow-up column.

Area Item Notes: Follow-up:
1. Has difficulty recognizing the
feelings and thoughts of others
(mindblindness)


Often does not appear to recognize or
respond when others cry
Other times, responses are inappropriate
laughs when others cry
Able to identify the feelings
demonstrated in video scenarios and
written stories

2. Uses poor eye-contact or fails
to orient to others


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L

3. Shows little interest in or
response to praise


Acts like he does not hear you
Does not do the activity more after being
praised
Says, Thank you and smiles
(sometimes with prompting)








2007 AAPC All rights reserved, including translation. No part of this form may be photocopied or otherwise reproduced.
Area Item

Notes: Follow-up:
1. Has difficulty recognizing
the feelings and thoughts
of others (mindblindness)







2. Uses poor eye-contact or
fails to orient to others


Does not consistently orient
towards the speaker

3. Shows little interest in or
response to praise


4. Does not seek others
attention in order to share
an experience (e.g., bring
an object to show, or
point out an item or
person)


Poor joint attention skills
5. Interacts with others as if
they were objects (e.g.,
cause and effect)


6. Has difficulty maintaining
personal space, physically
intrudes on others


7. Has difficulty taking turns
in social interactions or
activities


8. Has difficulty imitating
the actions or words of
others


9. Fails to respond to the eye
gaze or pointing of others
- does not orient to the
object or person


10. Has difficulty making or
keeping friends


In her own world
11. Has difficulty joining an
activity



12. Is nave, easily taken
advantage of, or bullied


Wanders without awareness of
proximity of caretaker

13. Has difficulty waiting


S
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14. Chooses or prefers
solitary activities


In her own world
2007 AAPC All rights reserved, including translation. No part of this form may be photocopied or otherwise reproduced.
Area Item

Notes: Follow-up:
15. Has difficulty
understanding nonverbal
communication (e.g., tone
of voice, facial
expressions, body
language)


16. Appears to be
unresponsive to others
(e.g., unaware of presence
of others; ignores
greetings, questions, and
requests)


Appeared unresponsive to
questions

17. Shows little curiosity or
interest in others or the
immediate environment -
appears to be in own
world


Tends to be in own world.
Majority of focus appears to
be on objects rather than
people.

18. Other































2007 AAPC All rights reserved, including translation. No part of this form may be photocopied or otherwise reproduced.
Area Item

Notes: Follow-up:
19. Expresses strong need for
routine or sameness -
has difficulty with change


20. Displays rituals/non-
functional routines (e.g.,
must perform activities in
an unusual and specific
way)


21. Uses objects in repetitive,
atypical manner (e.g.,
meticulously lines up
objects, purposefully
drops objects to see them
fall)


22. Seeks repetition of
specific sounds, words,
phrases, or music


Repeats sounds and
words/phrases

23. Has distinct preference
for objects that move


24. Has eccentric or intense
preoccupations
absorbed in own unique
interests


25. Attached to unusual
objects


26. Seems to be unmotivated
by customary rewards
(e.g., stickers, social
praise)


27. Displays repetitive motor
movements (e.g., flaps
hands, paces, rocks)


Flaps hands; dance-like
movement; unusual mouth
movements

28. Has difficulty
transitioning from a
preferred activity


R
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P
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O
F

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A
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,

I
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,

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29. Has strong need for
closure or difficulty
stopping a task before it is
completed





2007 AAPC All rights reserved, including translation. No part of this form may be photocopied or otherwise reproduced.
Area Item

Notes: Follow-up:
30. Displays difficulty
engaging in activities
other than intense special
interests


31. Other



32. Has little or no speech


Has some words but does not
appear to use them functionally


33. Has difficulty expressing
wants and needs



34. Makes frequent mistakes
using pronouns (e.g.,
reverses he and she)

Not applicable at this time
because she does not have
adequate speech

35. Makes sounds or states
words or phrases
repeatedly


Babbles and squeals and repeats
words and phrases

36. Does not respond or
shows delayed response
when name is called


Delayed and inconsistent
response does not orient to
speaker

37. Makes up new words or
creates alternate meanings
for words or phrases


38. Displays immediate or
delayed echolalia (e.g.,
recites lines from movies,
repeats another persons
questions or statements,
repeats sounds)


Immediate echolalia
39. Asks repetitive questions

Not applicable does not have
the language skills at this time


40. Talks to self excessively


While playing, eating, etc.
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41. Interprets words or
conversations literally
has difficulty
understanding figurative
language

Does not appear to have the
language skills at this time

2007 AAPC All rights reserved, including translation. No part of this form may be photocopied or otherwise reproduced.
Area Item

Notes: Follow-up:
42. Has difficulty with rules
of conversation (e.g.,
interrupts others, asks
inappropriate questions,
makes poor eye-contact,
has difficulty maintaining
conversation, staying on
topic)



Does not appear to have the
language skills at this time

43. Fails to initiate or respond
to greetings


44. Communicates needs
through behaviors such as
crying, aggression, or
destruction of property


45. Has difficulty using
gestures and facial
expressions or makes
unusual facial expressions



46. Has difficulty starting,
joining, and/or ending a
conversation


Marlena does not appear to
communicate verbally or
nonverbally

47. Has difficulty asking for
help



Does not indicate need for
assistance

48. Does not respond to
commentsmay speak
only when asked a direct
question

Does not appear to have the
language skills at this time

49. Has difficulty expressing
thoughts and feelings



50. Displays absence of smile
or vacant smile



No social smile
51. Has unusual voice or
speech qualities (e.g.,
babbles, hums, grunts;
uses sing song or
mechanical speech)


Babbles, squeals
52. Has difficulty following
instructions






2007 AAPC All rights reserved, including translation. No part of this form may be photocopied or otherwise reproduced.
Area Item

Notes: Follow-up:
53. Has difficulty
understanding language
with multiple meanings,
humor, sarcasm, or
synonyms

Does not appear to have the
language skills at this time

54. Displays little pretend or
imaginative play or
thought





No apparent pretend or
imaginative play. Play seems
more cause and effect.

55. Other



56. Responds in an unusual
manner to sounds (e.g.,
ignores sounds or
overreacts to sudden,
unexpected noises, high-
pitched continuous
sounds, or
complex/multiple noises)


57. Responds in an unusual
manner to pain (e.g.,
overreacts or seems
unaware of an illness or
injury)


58. Responds in an unusual
manner to taste (e.g.,
resists certain textures,
flavors)


59. Responds in an unusual
manner to light or color
(e.g., focuses on shiny
items, shadows,
reflections, shows
preference or strong
dislike for certain colors)


60. Responds in an unusual
manner to temperature


S
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D
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61. Responds in an unusual
manner to smells (e.g.,
may comment on smells
that others do not detect)





2007 AAPC All rights reserved, including translation. No part of this form may be photocopied or otherwise reproduced.
Area Item

Notes: Follow-up:
62. Seeks activities that
provide touch or pressure
(e.g., touching others,
hugging, feeling surfaces,
lifting heavy objects)


63. Seeks activities that
provide movement (e.g.,
swinging, rocking,
spinning, pacing)


64. Avoids activities that
provide touch or pressure
(e.g., resists wearing
certain types of clothing,
strongly dislikes being
dirty, resists hugs)


65. Avoids activities that
provide movement (e.g.,
running, sports)


66. Preoccupied with sensory
exploration of objects
(e.g., mouths, licks,
chews, sniffs, holds close
to eyes, rubs, squeezes, or
uses object to make
sounds)


67. Makes noises such as
humming or singing
frequently


68. Other
















2007 AAPC All rights reserved, including translation. No part of this form may be photocopied or otherwise reproduced.
Area Item

Notes: Follow-up:
69. Has below average or
severely delayed
intellectual abilities


Communication skills are
significantly delayed and impact
measurement of intellectual
functioning

70. Has excellent memory for
details (e.g., facts, stories,
movies, songs)


71. Demonstrates learned
skills
erratically/inconsistently
(i.e., may not
demonstrate skill upon
request)


72. Displays weakness in
reading comprehension
but has strong word
recognition


73. Has difficulty applying
learned skills in new
settings


74. Demonstrates academic
skills deficits



75. Has attention problems



Distracted by own interests (e.g.,
sensory exploration, babbling,
games and apparent need for
movement)


76. Has difficulty organizing
self in order to initiate or
complete an activity



Requires frequent prompting to
complete tasks

77. Displays very literal
understanding of
concepts

Does not appear to have the
language skills at this time

78. Recalls information
inconsistently (i.e.,
seems to forget
previously learned
information)


C
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D
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79. Has difficulty
understanding the
connection between
behavior and resulting
consequences



2007 AAPC All rights reserved, including translation. No part of this form may be photocopied or otherwise reproduced.
Area Item

Notes: Follow-up:
80. Other



81. Has difficulty with
handwriting




82. Has atypical or weak
grasp




83. Has poor motor
coordination or is
accident prone


84. Has difficulty using
hands for fine-motor
tasks (e.g., fastening,
buttoning, zipping, tying
shoes, using eating
utensils)



Often eats with fingers/hands.
Needs prompting to use
utensils. Puts food on spoon
with fingers; inconsistent
grasp

85. Displays atypical activity
level (e.g., over-active/
hyperactive, under-
active/hypoactive)


86. Has difficulty moving
through environment
(e.g., in and out of
buildings, using stairs,
walking on uneven
surfaces)


87. Has athletic skills
deficits




88. Displays an awkward
gait


Awkward gait while running
89. Displays unusual body
postures and movements
or facial expressions
(e.g., odd postures,
stiffness, freezing,
facial grimacing)


Odd facial expressions; hand
flapping

M
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90. Has difficulty starting or
completing actions (e.g.,
may rely on physical or
verbal prompting by
others)



2007 AAPC All rights reserved, including translation. No part of this form may be photocopied or otherwise reproduced.
Area Item

Notes: Follow-up:
91. Other




92. Is anxious or easily
stressed


93. Appears to be depressed
or sad

94. Becomes stressed when
presented with new task
or novel situation (e.g.,
does not initially attempt
new things)

95. Has unusual fear
responselacks
appropriate fears or is
overly fearful


96. Exhibits rage reactions or
meltdowns in response
to apparently minor
events


97. Injures self (e.g., bangs
head, picks skin, bites
nails until they bleed,
bites self)


98. Displays inconsistent
behaviors


99. Has difficulty tolerating
mistakes own and
others

100. Has low frustration
tolerance

101. Has difficulty
identifying, quantifying,
expressing, and/or
controlling emotions
(e.g., can only recognize
and express emotions in
extremes or fails to
express emotions-
emotionally flat)
Does not appear to have the
language skills at this time

102. Has a limited
understanding of own
and others emotional
responses





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103. Other

2007 AAPC All rights reserved, including translation. No part of this form may be photocopied or otherwise reproduced.

DIRECTIONS: Summarize medical/biological factors (e.g., seizures, sleep disturbance, fatigue, allergies).

Description Notes: Follow-up:
K
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B
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2007 AAPC All rights reserved, including translation. No part of this form may be photocopied or otherwise reproduced.