Name/Pseudonym:
Please indicate your sex: male female intersexed
Are you gifted? no not sure top ten percent 98th percentile (Mensa level) 99.9th percentile
Are you on the autistic spectrum? no not sure yes - formal diagnosis yes - self diagnosed
If yes, which diagnosis?
Each question should be scored with a number from 0 (does not describe me well) to 4 (describes me very well).
If for some reason this form does not work for you, please copy it into an email (NO ATTACHMENTS PLEASE!) and email it to me at acerridwen@telus.net
What does it mean?
Source: Davis, Mark H, 1980. A multidimensional approach to individual differences in empathy. JSAS Catalog of Selected Documents in Psychology, 10, 85.