The POSI was created as one part of a comprehensive screening instrument designed for pediatric primary care. It is a brief questionnaire that screens for autism traits. Items for the POSI were selected by a team of experts who reviewed existing assessment instruments and relevant research literature. The POSI is a parent reported paper questionnaire that takes less than 5 minutes to complete. Questions were modeled after the M-CHAT with two additions. There are five response options for each question that vary based on the specific question, and the responses represent the severity of the behavior.

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