Integrated Scale for Diagnosis of Autism Spectrum Disorder (ISD-ASD)

These theoretical-experimental antecedents, this study attempts advance iver research line regarding build an integrated analysis scale that facilitates ASD ́ specific diagnosis, based on disorder criteria, from evolutive-behavioral items and perceptual-cognitive criteria integrated into single diagnostic scale, whose main aims are following: 1) facilitate the statistical probability for ASD specific diagnosis, and 2) specify the empirical probability to ASD ́level according to DSM-5 Intl classification. Integrated Experimental Scale (ISD-ASD) made up of six dimensions which integrate development evolutive, behavior, social and communication abilities with variables regarding psychoneurological perceptual-cognitive information processing: developing, communication, interaction, behavior, attention and cognition. A total of 124 participants of three ASD levels, belonging nine age intervals (y-o) and sex/gender way have been analyzed to experimentally justify the Scale. Results increasingly show the effectiveness of the diagnosis of ASD. Thus, total mean of six dimensions of this study found between 5.777.88 belong to ASD level-1, between 7.889.01 to ASD level-2 level and a score ≥ 9.02 would correspond to ASD level -3.

Although both tests make up the highest levels of accuracy empirically contrasted at present, there are other preliminary and/or complementary tests, which favor diagnostic decisions, in relation to which great efforts of experimental refutation have been carried out. Oosterling et al. (2010) integrates a universal diagnostic study of predictive value to elaborate the modified checklist for autism in young children (MCHAT-R/F), refuted by Robins, Fein and Barton (2001) and Robins et al. (2014). The authors conclude that developmental-based evolutionary deficits explain up to 98% of the diagnostic process in relation to people with specific needs related to evolutionary-intellectual deficits, while it is reduced to 54.3% for the explanatory variance of people diagnosed with ASD and, even, other more recent studies, lower these expectations to 17.8% of the evolutionary symptomatology of development in people with ASD (Carbone et al., 2020). Again, there is a need to investigate other perceptual-cognitive criteria, as specific elements that allow increasing the diagnostic effectiveness of this disorder.
Based on these considerations, there are many scales and tests that try to integrate evolutionary behavioral components with cognitive processing modes and the particularities of emotional reactions before situations that occur, or before the emotional reaction of the other. Highlights include the Diagnostic Screening Tool for Autism in Toddlers and Young Children (STAT) (Stone et al., 2004;Wu & Chiang, 2014;Wu et al., 2019)," which is an interactive tool for the preliminary initial screening of people with high-risk ASD, located, above all, from grade 2 of the DSM-5 classification. The STAT is made up of four social and communication dimensions, in order to analyze the capacity for social reaction to relational situations that must be analyzed by emphasizing the processes learned. Other scales are also recognized, such as the Asperger's Syndrome Diagnostic Scale of Myles et al. (2001), the Questionnaire of Ehlers et al., (1999), the test for the evaluation of Asperger's Syndrome (Scott et al., 2002), the Socio-Communicative Scale of Verification of Skuse et al. (2005), the Social Scale of Communication of Berument et al. (1999), the Interactive Screening Test for Autism in Young Children (RITA-T, 2015) (Choueiri & Wagner, 2015;Robins et al., 2001Robins et al., , 2014Siu et al., 2016), the Behavior Checklist forAges 11/2 to 5 years (CBCL/11/2-5), the Achenbach & Rescorla Caregiver-M Report Form(C-TRF) (2000).
Also, within the scope afore this recent research, we try to respond to the diagnostic evaluation process of adults with ASD, who, for many different reasons, had not been properly diagnosed over time. Thus, Arksey & O'Malley (2005), the National Institute for Health and Care Excellence (2012), Hayes et al., (2018), Penner et al. (2018 and Whitehouse et al. (2018), among others, conduct recent systematic reviews over the evaluation of autism in adults, which focus on the empirical contrast of existing diagnostic instruments.
These theoretical-experimental antecedents, this study attempts advance iver research line regarding build an integrated analysis scale that facilitates ASD´ specific diagnosis, based on disorder criteria, from evolutivebehavioral items and perceptual-cognitive criteria integrated into single diagnostic scale, whose main aims are following: 1) facilitate the statistical probability to ASD´ specific diagnosis, and 2) specify the empirical probability to ASD´ level according to DSM-5 Intl classification.

Statistical Justification
These theoretical-experimental antecedents, this study attempts advance iver research line regarding build an integrated analysis scale that facilitates ASD´ specific diagnosis, based on disorder criteria, from evolutivebehavioral items and perceptual-cognitive criteria integrated into single diagnostic scale, whose main aims are following: 1) facilitate the statistical probability for ASD specific diagnosis, and 2) specify the empirical probability to ASD´level according to DSM-5 Intl classification.
Integrated Experimental Scale (ISD-ASD) made up of six dimensions which integrate development evolutive, behavior, social and communication abilities with variables regarding psycho-neurological perceptual-cognitive information processing. Data coding process allows get statistica percentiles to facilitate ASD level diagnosis to 95% confidence index.

Research design
Design is experimental study based on application of ISD-ASD Scale, whose data have been evaluated through SPSS´ statistics, v. 23.

Procedure
The study has been developed from direct observation of children with ASD previous diagnosis along last 5 years, throughout Integrated Experimental Scale (ISD-ASD).

Dimensions and variables of analysis.
ISD-ASD Scale is made up of 27 variables, 24 of which have been grouped into six general dimensions using the statistical calculation of variables. Each dimension is formed by 4 conceptual or developmental variables that make a total of 24 variables each of them has, in turn, 4 values, which facilitate the statistical calculation of probabilities, while three others remain as fixed values.

Integrated Scale for Diagnosis of Autism Spectrum Disorder (ISD-ASD)
International Journal for Innovation Education and Research, Vol.10 No.9 (2022), pg. 207 The calculated dimensions, their labels and meaning are as follows: 1) Developing. This dimension analyzes evolutionary and developmental variables.
2) Communication. Anboosts the ability to communicate verbally and non-verbally, according to social demands.
3) Interaction. Observe the variables related to reciprocal social interaction with peers and adults. 4) Behavior. It analyzes the possible restricted and stereotyped behaviors, issues related to referential interests, and the behavioral reaction to the environment demands. 5) Attention. It encompasses the response to stimuli that require attentional causation and the discrimination of that response according to the understanding over different emotional situations arising from reciprocal social interaction. In this dimension, the capacity of creativity, fiction, and imagination to put oneself in place of a situation that has arisen or before the different interrelated socio-emotional contexts is also analyzed. 6) Cognition. It specifies the type of perceptual-cognitive processing, from the attention span to the stimulus, coding, the establishment of relationships and neural nodes between information and subsequent retrieval.
Each dimension is composed of 4 variables, with the following tags and contents:

Dimension-Developing:
1.1. Motricity: Onset general motility and presence of possible rates for delay and/or regression. 2.4. Signals: Capacity of the action to ask or give something from a distance, making an attribution with meaning of the object, accompanied by the joint directionality of the expressive gaze towards the interlocutor.

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Dimension-Interaction:
3.1. Initiation: Spontaneous ability to initiate a conversation according to the social situation of mutual interaction.
3.2. Contact: Quality of the interaction initiated, samples of related communicative manifestations and emphatic-emotional samples.
3.3. Understanding: Competence to understand the demands and requirements for different situations, especially when they change interlocutors or situations.
3.4. Enjoyment: Observation of the feeling of pleasure for participating in social interaction or, on the contrary, withdraws the gaze, redirects attention and shows signs of restlessness during the relationship.

Dimension-Attention:
5.1. Joint: Ability to redirect attention and gaze towards the manifestations of the interlocutor, with signs of flexibility in the change towards a new objective or goal within the interaction. 5.2. Creativity: Ability to be creative in situations that require a certain level of improvisation and spontaneous initiation, both in relation to one's own and others' situations. Ease or limitations for creativity in different areas: music, art, lyrics, etc.

Fiction:
Competence to suppose a situation that is not real, although it could be, according to the assumptions established during the interaction and respond to said situation in a simulated way, although it could be a real situation, without being one. 5.4. Imagination: Ability to put yourself in a hypothetical situation and perform the required action. Flexibility or limitations to adapt changes to a new hypothetical situation indicated and supervened on the previous action that requires an increase in the level of imagination. Analysis of competences in certain specific areas.

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Dimension-Cognition:
6.1. Perception: Level of analysis of incoming stimuli. Type of analysis, partial, central, global, attribution of meanings and elaboration of relationships to facilitate their understanding. 6.2. Coding: Understanding the stimulus and level of the links or nodes created with the previous related information, in order to give you to pass the new information to the permanent memory.
6.3. Semantics: Level of meaning attributed. It focuses on the details of the stimulus or attributes a global significance, which allows the semantic elaboration of the information.
6.4. Recovery: Quality and quantity to facilitate the memory of encoded information. Use of the links or relationships attributed during the coding process.
Other 3 variables that have not been included in the dimensions are formed into fixed variables afore contrast of the analysis, whose labels are the following: 1. Level: ASD´ levels according to the DSM-5 classification: ASD level-1, of lower type of specific needs in the dimensional areas, ASD level-2, medium level of specific needs and ASD level-3 maximum level of specific needs.
3. Sex: Sex of the participants: Guys and girls.

Participants
A total of 124 participants of three ASD levels, belonging nine age intervals (y-o) and sex/gender way have been analyzed, whose synthesis can be seen over Table 3.

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Reliability level
The reliability levels of study variables and dimensions statistically calculated have been found through Cronbach's Alpfa statistic (see Table 1). Likewise, reliability indices to dimensions and related basic statistics are following (see Table 2). Total mean for all dimensions as whole found (αµ: .89).

Factorial Analysis: Principal Components
Sample coherence used in this study for the six operationalized statistically dimensions analysis has been found through the Bartlett test of Factorial Analysis. Indeed, this test facilitates the observation the output of correlation matrix between to all study elements.
Determinant level index can be observed (see Table 4), in which a significantly low score is acquired: Sig: .00, to mean of whole sample µ: .82. Likewise, scoring found along Bartlett sphericity test corroborates the previous data and allows conclude that study sample coherence has a empirical validity significantly high level, whose Chi square (x 2 ): 687.80 and critical level is great significant (sig: .00).

Integrated Scale for Diagnosis of Autism Spectrum Disorder (ISD-ASD)
International Journal for Innovation Education and Research, Vol.10 No.9 (2022), pg. 213 Sig. .00 Sedimentation graph contrasts previous scores and allows observe that just two eigenvalues are significantly higher the others, while third value that´s very around and then graph certain regularity is keep along continuous the scores (see Graph 1).

Graph 1: Sedimentation graph
From data it can be deduced the total explicative variance analysis for six statistically calculated dimensions focuses over first two factors of this analysis, which explain total variance: 84.51% (see Table 5).

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Regression analysis
Predictive analysis for six calculated dimensions has been found through Stepwise Regression Analysis regarding ASD level (DV): (see Table 6).

t-analysis for age
In this study, comparative study t for independent samples is a priority test since their results allows infer the percentiles (p) that will be assumed later for decisions about the probability to ASD diagnosis levels.
Comparative analysis for nine age intervals of participants can be seen in Table 7.

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Comparative analysis to ASD levels.
However, data found regarding ASD levels are significant. As can be seen in Table 8, contrasted comparative study significant differences are found to all study dimensions.

Integrated Scale for Diagnosis of Autism Spectrum Disorder (ISD-ASD)
International Journal for Innovation Education and Research, Vol.10 No.9 (2022), pg. 216 are found in all study dimensions, which indicates there´s data significant discrimination, therefore total dimensional statistical means will allow deducing ASD´ differentiated diagnostic levels.

Comparative analysis to sex.
Comparative t-tests for sex variable indicate non-significant critical levels into six dimensions analyzed (see Table 9).

Personal, Family and School Data
Surname, name of evaluated: Birthdate: Address and contact: Currently studies: Educational supports, if there´s: Adaptations and/or curricular reinforcements, if there´s: Human services of educational supports used: Name of your biological family and/or cohabiting: Brothers and/or sisters:

Integrated Scale for Diagnosis of Autism Spectrum Disorder (ISD-ASD)
International Pregnancy process. Duration.
Birth process. Use of specific measures.
Specific genetic analysis.
Karyotype of relatives in different generations of relatives.

0.2: Acquisition of motor skills (write down the most remarkable aspects):
Motor flexibility Age of the first steps.
Initiation of normal ambulation.
Is there regression in the process of ambulation: age of regression.

0.3: Language acquisition (write down the most remarkable aspects):
Attention of the gaze.
Age of first words.
Age of first sentences.
Is there obvious regression in the language of communication after it has begun.

0.4: Other skills (notated the most remarkable aspects):
Age of acquisition of daytime and nighttime sphincter control (bladder, bowel).

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International Journal for Innovation Education and Research, Vol.10 No.9 (2022), pg. 219 Is there an obvious setback in the acquisitions initiated: age of the setback (if so, indicate in which ones).

I) Task For Receiving the Student to The Game Room
Goal: To adapt the student to the contextual situation, creating a natural and relaxed environment.
Materials: A wooden puzzle arranged on the table and a global visual sheet of the image. A piece of cloth and a glass or bowl without water Activity 1.1: ¡Hello! ¿What is your name? "Look, this picture shows the image of an elephant. The elephant is in a field eating tree branches. On this wooden board, we can place the pieces that form the elephant in the image. I will place the first piece, ¿See?" The pieces must be out of reach for the child, the child can take them or ask for them to complete the puzzle. In the case the child does not know how to continue by himself, help for the student must be provided by collaborating as much as necessary, interacting verbally and gesturally.

Observations 1.1 (write down the aspects that respond to the following questions):
Level of interaction of the student during the activity. Does the student seek approval for the activity performed or is he/she afraid of failure by withdrawing his/her head slightly?
Activity 1.2: The evaluator removes three pieces of the puzzle and leaves it incomplete, one of the pieces intentionally falls to the ground near the student, the other two pieces are left out of the student's sight, while the evaluator makes comments that he/she also wants to play. After a short time, the evaluator places the pieces on the board and asks for the one on the floor.

Observations 1.2 (write down the aspects that respond to the following questions):
Student's reaction to the evaluator's attitude. Make verbal comments or gestures.
Is the student surprised by the action of the evaluator? Does the student look at his/her mother/father or companion?
Does the student ask about missing pieces or redirect attention to other tasks and places in the room?
Does the student pick up the piece that fell to the ground or does he/she remain oblivious to the situation? Activity 1.3: The evaluator takes a piece of the puzzle formed and uses it as if it were the complete elephant: "Look, now this piece is the elephant, he is thirsty and I take him to drink water" (takes the elephant to the bowl or glass without water and makes it drink water), Can you do the same with another piece of the puzzle?
Finally, return the puzzle piece to its place and ask the student to do the same; meanwhile, the evaluator asks the student to cover the elephant with the piece of cloth because he is going to sleep.

Integrated Scale for Diagnosis of Autism Spectrum Disorder (ISD-ASD)
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II) Interactive Game
Goal: To analyze the capacity for socio-communicative interaction through complementary cooperative pro-

cedures.
Materials: A large white cardboard, two markers, one black and one red. Green, red and yellow stickers.
Vignettes/pictures: House, sun, rain. The motor stroke is secure and corresponds to the intended objective.
Activity 2.3: The evaluator says that the house is in the countryside and surrounded by flowers. Then takes a red color sticker and a yellow color sticker and stick them close to the house,"okay, now you can do the same and draw lots of flowers surrounding the house".

Observations 2.3 (write down the aspects that respond to the following questions):
Response to new demand.
Verbalizations and/or gestures during execution (note the type of responses).
Did involvement in the activity increase from the beginning?
Does he/she cooperate and is interested?
Does it increase the elements significantly or just use a sticker or two?
Does it stick the red and yellow stickers alone or also stick the green one?
Visomotor coordination to pick up and paste the stickers.
Activity 2.4: The evaluator says that the day is getting darker and believes it will rain, then with blue color paint in the fingers makes a vertical mark representing rain, then says: "Do as I, draw the rain with a finger dipped in blue paint swiping over the sky, the house and the field, everything gets wet, even the dog, the child and the rest of the family".

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Observations 2.4 (write down the aspects that respond to the following questions):
Capacity to adapt to the immediate change.
Does it cooperate or refuse the action of swiping the finger over previously made drawings?
Realization of strokes corresponding to the objective of the drawing.
Does it smile during the execution or feel upset?
Improvise or increase while drawing with the fingers?

Globalización Del Significado De La Actividad:
The evaluator will request the child to resume all what occurred during this task: "There is a house, a family lives in it, it was a sunny day, then all of the sudden everything turn darker and started to rain strongly, everything got cover by the rain and everyone got wet" (if the child is non verbal, it will be asked to use the following pictogram or vignette in the right order: house, sun, rain).

III) Anticipation to the Task
Goal: To analyze the capacity to anticipate an action.

Materials:
The cardboard with the drawing of the previous activity. Images of a house of a dimension that allows to paste inside the images of: puppy, child, father and mother. A doll representative of a boy or girl.
Bubble making device and liquid to make bubbles.
Activity 3.1: On the table is arranged the cardboard with the previous drawing and in a corner of the table is located a doll. In relation to the cardboard, the evaluator says: "The dog, the child and the parents got wet because they were outside the house, as it wasn't supposed to rain that much, "but now that we know it is raining hard, tell me, What will you do for them to not get wet? (I will place the dog inside the house, then, the evaluator will take the image of the dog and place it inside the house) What will you do?"

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Observation 3.1 (write down the aspects that respond to the following questions):
Level of understanding of the action that is presented as anticipation.
Capacity to place itself in the anticipated situation.
Does  , now that we know, what could we do to avoid it?" (after a short time, the evaluator picks up the doll and places it back to the same place as before on the table), ``What will you do to avoid this situation from repeating?" Observation 3.2 (write down the aspects that respond to the following questions): Does the student attempt to pick the doll from the floor promptly?
The student left the doll on the floor.
The student feels bewildered by the situation, verbalizes it or presents representative gestures of bewilderment.
When the evaluator places the doll in the same place again, the student does not do, or say anything.
The student changes the doll placed by the evaluator in the same place to a more central and safe place on the table.

Integrated Scale for Diagnosis of Autism Spectrum Disorder (ISD-ASD)
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Integrated Scale for Diagnosis of Autism Spectrum Disorder (ISD-ASD)
International Journal for Innovation Education and Research, Vol.10 No.9 (2022), pg. 227 General Observations:

IV) Coping With the Unforeseen
Goal: To analyze the coping capacity over unforeseen situations and over situations that turn impossible.
Materials: Four cubes of Kohs, plate/sheet with the first figure of the Kohs cubes. A car with remote control.
Activity 4.1: With the first sheet of the Kohs cubes, the evaluator forms the figure with the four cubes, "now, you can do it" (the student can repeat the actions several times), once it is used to carry out the action, the evaluator removes one of the cubes and tell the student: "Can you repeat the puzzle one more time?"

Observations 4.1 (write down the aspects that respond to the following questions):
Attention span to the performance of the exercise by the evaluator.
Observation of the plate/sheet.

Execution of the requested action.
Reaction of the student when he/she notices there is a missing cube to complete the puzzle.
Verbalize or gesticulate the unforeseen action?
Ask or search for the cube that is missing?
Request help from the evaluator?
Manipulate the cubes searching for a solution?
Abandons the game and redirects his attention to a different place in the room?
Activity 4.2: The evaluator puts into operation a car with a remote control. Then the evaluator explains to the student how the car is functioning, extracting the batteries from the remote control that facilitates the car movement, "now, can you put the batteries in the remote control for the car to work". After sometime the evaluator removes the batteries from the car and says "Can you keep playing by yourself with the car?"

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Observations 4.2. (write down the aspects that respond to the following questions):
Understanding of the game.
Observation capacity over the evaluator. then leaves the remote control on the floor but takes the car and stores it. Finally, the evaluator abandons the game room leaving the child alone for a few minutes.

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Observations 4.3 (write down the aspects that respond to the following questions):
Verbalization or gesticulation upon the new situation. The task from Kohs cubes is retrieved and the student is asked to indicate what was the reason why the puzzle could not be done.
Then, the car task is retrieved and the student is asked to indicate the reason why the car did not work.

General Observations: V) Response to the Reinforcement Hierarchy
Goal: To analyze the discrimination capacity upon the different degrees of contingent reinforcement.

Materials:
A doll, a soap, a towel, a comb, dolls clothing.
Activity 5.1: The evaluator place on the table a doll and a piece of soap, immediately simulates the action of washing the doll with the soap, "now you can do it" (invite the student to play at washing the doll). Upon the response of the student, the evaluator expressively and firmly "well done, you have done very well" (with a higher tone and a very expressive social smile).

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Observations 5.1 (write down the aspects that respond to the following questions):
Verbalization or related gesticulation (write down every type).
Does it perform the simulated action of washing the doll with the soap?
Improvisation over the game further of the action requested.
Student reaction over the high positive reinforcement of the evaluator.
Signs of social smile over the expressive approval from the evaluator.
Directionality of the gaze towards the evaluator.
Activity 5.2: At this moment, the evaluator incorporates the towel to the game and begins to dry the doll, "now, you can do it". Upon the performance of the activity by the student, the evaluator approves of the action, but with less emphasis: "Okay, is fine" (with a lower tone).

Observations 5.2 (write down the aspects that respond to the following questions):
Verbalization or gesticulation (which ones). Verbalization or gesticulation of insecurity (which ones).

Activity 5.3:
The evaluator introduces to the activity the doll's clothing and starts to get the doll dressed, "now, you can continue" (upon the performance of the activity the evaluator simply nods approval with the head, without saying a word).

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Observations 5.3 (write down the aspects that respond to the following questions):
Verbalization or gesticulation (write down all of them).
Does it perform the simulated action of dressing the doll?
Improvisation over the game further of the action requested.
Emotional reaction over the changing evaluator attitude.
The student continues the action of dressing the doll?
Redirects the gaze towards the evaluator?
Searches for the gaze of the companion?
Abandon the game and search for other activities in the room?
Activity 5.4: Lastly, the evaluator includes the comb in the game, combs the doll's hair and says "If you wish, you can continue" (the evaluator gets up and leaves the game place, ignoring the task the student is performing).

Observations 5.4 (write down the aspects that respond to the following questions):
Verbalization or gesticulation (which ones).
Does it perform the action of combing the doll's hair?
Improvisation over the game further of the action requested.
Emotional reaction over the evaluator's new attitude.
The student continues to perform the action of combing the doll 's hair?
Searches with the eyes for the evaluator?
Refugees on the companion?
Abandon the game? Shows insecurity, confusion or perplexity ob¡ver the change of attitude of the evaluator?

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Global Meaning of The Activity:
The evaluator requests the child to perform a successive sequence of actions already performed in the prior task. "Wash the doll with soap, dry the doll with the towel, dress the doll and comb the doll's hair" (if the child does not possess the capacity to verbalize, there will be representative visual elements on the table, with the aim that the child will placed them in the correct sequence order).
General Observations:

VI) Sensitivity and Restrictive Behaviors
Goal: To analyze the presence of sensoriality and/or sensitivity, as well as possible restrictive behaviors.
Materials: Elements with different textures: sponge, plasticine, a piece of iron, wool, glass with water. There will also be different levels of sound to be used: Ambulance, car's horn and the sound of a door closing.
Activity 6.1: During this session, the student must manipulate the different textures with the hand and say what material is made of and associate it with an image. The evaluator takes the wool and says "this is a piece of wool; now, you do the same with the elements I give you: Sponge, plasticine, iron piece, etc" (During the intervals of the process, the evaluator ask to the family member for possible negative or allergic reactions to certain objects. During the conversation food allergies/reactions are included).

Observación 6.1 (write down the aspects that respond to the following questions):
Understanding of the activity.
Intensity of the hand manipulation.
Prior knowledge over the materials.
States the name of the material.
Refuse to perform some type of manipulation.
Rejectment gesture to a certain material.
Shows negative reactions to a certain type of food?
Are the negative reactions related to the texture, color or other characteristics??

Integrated Scale for Diagnosis of Autism Spectrum Disorder (ISD-ASD)
International Indicates another type of sensitive reaction? (Indicate which ones).

Global Meaning of The Activity:
The evaluator asks the child to categorize the treated elements during this task, forming categories: 1) Recognizable elements to the tact, 2) Sound elements. In case of limited oral language expressions, perform the same activity using pictograms or representative images.

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VII) Emotions
Goal: To analyze the capacity to emulate cognitively human emotions.
Materials: Images or pictograms of emotions related to actions that can cause joy, sadness, fear and surprise.
Activity 7.1: The evaluator will place itself on the opposite corner of the room and facing the student will show a image or action (it could also play a video) that produce joy, then the evaluator will exaggerate a happiness/joy expression and will say to the student: "now, you come over here and say or do something that makes you feel joy (in the case of limited verbal skills, select an image that produces joy)" Subsequently, expresses the emotion of joy, which the evaluator observes from the other corner of the room.

Observation 7.1 (write down the aspects that respond to the following questions):
Understanding over the demand of the activity.
Verbalization or gestures requesting help.
Observation over the evaluators gestures.
Motor movement when the student walks from one corner to the other in the room. (oscillations, movement, coordination, flexibility, rigidity).
Verbalization over an action that produces joy.
Doubts over the selection of the action.

Requires help?
Emotional Joy express, quality of the imitation.
Improvisation over the activity, including non solicited elements.
Movement coordination during the execution of the activity.

Integrated Scale for Diagnosis of Autism Spectrum Disorder (ISD-ASD)
International Journal for Innovation Education and Research, Vol.10 No.9 (2022), pg. 235 Activity 7.2: Once more, exchange places in the room and repeat the action in relation to the rest of the emotions: sadness, fear and surprise.

Observations 7.2 (write down the aspects that respond to the following questions):
Motor movements during the exchange of placement in the room.
Coordination movements during the emotional expression.
Quality of the improvised representation of the emotional situation.
Verbalization and/or gesticulation during the process.
Search for support and help to execute the task.
Improvisation of elements outside the ones required for the activity.
Presence of hand flapping, fingers, oscillations and/or arm movements.
Presence of eye tics.
Other remarkable behaviors (indicate which ones).

Semantic Integration:
Creation of a coherent narrative about the successive steps taken during the four parts of this activity, based on the actions indicated by the student: actions that produce joy, sadness, fear and surprise, in the order that took place during the task. If there are verbal skills limitations, the sequence order can be expressed using representative images of the performed actions.
General Observations:

VIII) Cognición Y Elaboración Semántica.
Goal: To analyze the ability to perform a synthetic demonstration about an event.
Materials: a Cell Phone. Bag of fries/ chips, gummy bears and two bananas.
Activity 8.1: The evaluator takes the cell phone and says: "I want to send a message via WhatsApp, but I don't know how. Can you help me? What are the steps I must follow to send the message?" (cell phone remains in

Integrated Scale for Diagnosis of Autism Spectrum Disorder (ISD-ASD)
International Journal for Innovation Education and Research, Vol.10 No.9 (2022), pg. 236 the hand of the evaluator).

Observations 8.1 (write down the aspects that respond to the following questions):
Understanding of the activity.
Take the phone or ask for it?
Open the WhatsApp application and gaze at the evaluator?
Continues to attempt to explain the steps to send the message?
How many steps does it takes, Verbalize the actions?
Smile at the evaluator and enjoy the interaction?
Activity 8.2: "Very well! (Says the evaluator), now I know how to send a message to my friend, thank you".
The evaluator places various foods on the table: chips, gummy bears (depending on the student's age) and says "you can take what you want".

Observations 8.2 (write down the aspects that respond to the following questions):
Smiles at the evaluator.

Take the desired bag and open it?
Ask for the desired bag?

Ask if he/she can open it?
Is he/she capable of opening it by himself?
Request assistance to open the bag?
Eats in an autonomic manner?
Activity 8.3: The evaluator introduces the banana to the task to share with the student and says: "look, I have two bananas, but I do not remember how to peel them, don't remember very well if I need a knife or I can do it with my hands. Can you help me? One banana is for you and the other one is for me".

Observations 8.3 (write down the aspects that respond to the following questions):
Social smile of the student.
Does it leave the bag on the table and take the banana from the evaluator's hand?

Integrated Scale for Diagnosis of Autism Spectrum Disorder (ISD-ASD)
International Motor level while eating the banana.

Semantic Integration:
Inside every sequence of actions the student shall organize each of the steps taken during the development of the prior activities in relation to: 1) A WhatsApp, 2) Bag of Chips, 3) Bananas. During the development, indicates the necessary steps for each task either verbally or repeating the prior actions following the time sequence with images.
General Observations:

IX) Friendships
Goal: To analyze the concept of friendship inside the social relations environment.
Materials: Plasticine of various colors and small thin sticks.
Activity 9.1: The evaluator picks a piece of plasticine and shapes it as a body, then shapes a head, arms and legs, then with a small thin stick (or smaller pieces of plasticine of a different color) shapes the eyes, nose and mouth and saya: "this is a child, is my friend, if you want you can help me make more friends with plasticine as I did".

Observation 9.1 (write down the aspects that respond to the following questions):
Understanding of the activity.
Observation of the evaluator.
Imitation of the evaluator action.
Does it takes the steps following the evaluator's sequence: body, head, arms, legs (eyes, nose & mouth within stick or different color plasticine)

Integrated Scale for Diagnosis of Autism Spectrum Disorder (ISD-ASD)
International Journal for Innovation Education and Research, Vol.10 No.9 (2022), pg. 238 Does it complete the steps in his own order that might differ from the order of the evaluator?
Motor coordination during the execution of the task.
Verbalize or gesticulate during the execution of the activity?
Includes non requested elements in the action: hands, fingers or toes?
Activity 9.2: The evaluator says: "these are my two best friends, they hug (place the plasticine figures in hugging action) because they love each other very much and ask the student: What does it mean for you to have friends?"

Observation 9.2 (write down the aspects that respond to the following questions):
Observation of the evaluator.

Integrated Scale for Diagnosis of Autism Spectrum Disorder (ISD-ASD)
International Journal for Innovation Education and Research, Vol.10 No.9 (2022), pg. 239

Observations 9.3 (write down the aspects that respond to the following questions):
Verbalization or gesticulation of the student over the action (which ones).
Imitation of the activity.
Improvisation of the action, ¿Flattens other parts of the object or refuses to do so?
Expresses his feelings during the decision taken?
Response coherently and understand the meaning of friendship.
¿Increases or improvises more actions to the tasks which have not been requested?
Activity 9.4: The evaluator says: "My friend insulted me on one occasion and I felt really bad because of it.
Have you experienced something similar? Will you play with me? (The evaluator directs himself to the plasticine object that represents that friend, and shows an angry gesture).

Observation 9.4 (write down the aspects that respond to the following questions):
Verbalization over the action.
Head nodding or denial.
Imitation of interlocutor action.

Shows anger gestures?
Verbalize the action while performing it?
Understanding of the objective concept of the task.

Semantic Integration:
The student elaborates a diagram with positive and negative treats that might exist in the concept of friendship: Positive: -companionship, -collaboration, -help, -respect.

Integrated Scale for Diagnosis of Autism Spectrum Disorder (ISD-ASD)
International Journal for Innovation Education and Research, Vol.10 No.9 (2022), pg. 240

X) Daily Life Abilities
Goal: To verify the understanding over daily life abilities in accordance with the age and competences of the student.
Materials: Coins (pennies, cents), used books and toys. The plasticine figurines made in the prior task.
Activity 10.1: The evaluator places himself behind a table where books are displayed for sale along with used toys, each item has been assigned a price. The student has to simulate the purchase of the desired products considering the prices and the amount of coins he has been given/assigned.

Observation 10.1 (write down the aspects that respond to the following questions):
Understanding of the activity.
Understanding of money as an exchange instrument.
Completing the purchase action.
Verbalization or gesticulation during the process (which ones).
Adjustment to the budget allocated to purchase.
Understanding quantity as a mathematical concept.
Activity 10.2: Subsequently, the papers are exchanged, now the student is the one who sells, while the evaluator is the one who buys, according to the prices stipulated above.

Observations 10.2 write down the aspects that respond to the following questions):
Verbalization of the action.
Understanding of the exchange of functions.
Coherent participation in the activity.
Level of adjustment to the demand request.
Exchange of products according to prices.
Improvisation during the activity.
Increased stimuli to enrich the task spontaneously.
Activity 10.3: The evaluator takes up the plasticine figurines made previously and says "today we are going to

Integrated Scale for Diagnosis of Autism Spectrum Disorder (ISD-ASD)
International Journal for Innovation Education and Research, Vol.10 No.9 (2022), pg. 241 the cinema, we must take out the tickets, each of them costs, 10 cents of euro, so we have to distribute the money for each of our friends: Will you help me?"

Observations 10.3 (write down the aspects that respond to the following questions):
Verbalization of the action.
Ability to understand the new task presented.
Count of the money to allocate to each figurine.
Verbalization about the type of film they are supposed to watch.
Gesticulation in relation to the type of film.
Understanding collaboration and shared tasks among friends.
Improvisation during the task that enriches it.
Activity 10.4: The evaluator says that money is acquired with personal work, which facilitates the independence of people in the social sphere and asks: "What would you need to live alone and, if you lived alone, what would you do?
Observations 10.4 (write down the aspects that respond to the following questions): Understanding of the activity. General Observations:

Codification
(Surround the numbering that corresponds to the item indicated) (Table 10).

Conclusions
Combining the evolutive variables and objective variables-criteria of DSM-5 currently classification with basic of psycho-cognitive human processing hypothesis, it´s possible increase the ASD diagnostic processes effectiveness, and specify it according to ASD level.
As observed in section 7 of this experimental study, mean scores found allow operationally define the ASD´ levels with a confidence border about .95.
For this reason, it´s possible calculate equivalence of the direct scores means to evaluate the contrasted probability index regarding ASD´ level (see Table 25).

Integrated Scale for Diagnosis of Autism Spectrum Disorder (ISD-ASD)
International Journal for Innovation Education and Research, Vol.10 No.9 (2022), pg. 243  However, as diagnostic instrument, the same other existing instruments, it´s always advisable use it complementary way, as specific corroboration element through ldiagnosis longitudinal process, especially if there´re initial doubts about specific diagnostic process.

TOTAL DIRECT SCORES MEANS BY
It´s also necessary consider the high frequency of comorbidity associations related ASD, owing, always recommending use specific test related each particular evaluation situation.

Integrated Scale for Diagnosis of Autism Spectrum Disorder (ISD-ASD)
International Journal for Innovation Education and Research, Vol.10 No.9 (2022), pg. 274 ANNEX 5