Relationship Survey
Understanding Relationships: Autism Spectrum Disorder Survey
Join us in exploring the connections between Autism Spectrum Disorder (ASD) and romantic and sexual relationship satisfaction. Your insights are invaluable as we aim to gather diverse perspectives and contribute to ongoing research in this field.
- Anonymous responses
- Open to individuals aged 18 and older
- Your participation matters!
You are invited to participate in a survey investigating possible relationships between specific aspects of Autism Spectrum Disorder and satisfaction with romantic and sexual relationships.
This survey will ask about information regarding psychological disorders, romantic relationships, sexual relationships, and demographic information. Questions may be open-ended or multiple choice. This survey may take approximately 10-30 minutes. Responses will remain anonymous, and each survey will be assigned a numerical value to identify the responses. Participation in this survey is voluntary, and subjects may choose to exit the survey at any point. Any identifying information included in open-ended responses will be excluded from the research, so please attempt to avoid including information such as your name, address, identification numbers, email address, etc.
For more information regarding the survey, you may contact [email protected]. Please use “ASD Relationship Survey” in the subject line of the email. Your email inquiry will not be connected to your survey responses.
By continuing with this survey, you consent to participate in this study and have your responses included in the statistical analysis and descriptive answers to be used and shared. Participants must be 18 or older to proceed.
You are invited to participate in a survey investigating possible relationships between specific aspects of Autism Spectrum Disorder and satisfaction with romantic and sexual relationships.
This survey will ask about information regarding psychological disorders, romantic relationships, sexual relationships, and demographic information. Questions may be open-ended or multiple choice. This survey may take approximately 10-30 minutes. Responses will remain anonymous, and each survey will be assigned a numerical value to identify the responses. Participation in this survey is voluntary, and subjects may choose to exit the survey at any point. Any identifying information included in open-ended responses will be excluded from the research, so please attempt to avoid including information such as your name, address, identification numbers, email address, etc.
For more information regarding the survey, you may contact [email protected]. Please use “ASD Relationship Survey” in the subject line of the email. Your email inquiry will not be connected to your survey responses.
By continuing with this survey, you consent to participate in this study and have your responses included in the statistical analysis and descriptive answers to be used and shared. Participants must be 18 or older to proceed.
Select your age.
Under 18
18-24
25-34
35-44
45-54
55-64
65+
Select your assigned sex at birth.
Female
Male
Intersex
Other
Please Specify:
Select your gender identity.
Woman
Man
Nonbinary
Other
Please Specify:
Select your sexual orientation.
Heterosexual ("straight")
Homosexual ("gay" or "lesbian")
Bisexual
Asexual
Other
Please Specify:
Select your romantic relationship status.
*If you are polyamorous, please indicate the status of your primary relationship(s) – you will have the option to add more detail in later questions
Committed (i.e., married, engaged, or in a relationship that is expected to continue for the foreseeable future)
Insecurely Committed (i.e., in a committed relationship that is expected to end in the foreseeable future)
Dating (i.e., not in a relationship but actively seeking a relationship)
Single (i.e., not in a relationship and not seeking one)
Select your educational achievements.
*Please select all options that apply to you
Some high school
High school diploma or GED
Some college
Trade diploma or certification
Associate's Degree
Bachelor's Degree
Master's Degree
PhD
Other
Please Specify:
Select the response that best represents your average finance-related stressors over the past two years.
I struggle greatly with my finances and often find it difficult to afford the essentials (i.e., food, housing, important medications, etc.…)
I struggle somewhat with my finances, and I can only afford the essentials if I buy cheap products (i.e., clearance, on sale, expired, low-quality, etc.…)
I do not struggle to afford essentials, but I often cannot afford reasonable luxuries (i.e., pleasure-oriented products or activities such as going to the movies, purchasing beauty products, etc.…)
I do not struggle to afford essentials and can occasionally afford reasonable luxuries.
I do not struggle to afford essentials and can always afford reasonable luxuries.
I do not struggle to afford essentials and can always afford any luxury I would like (i.e., extravagant luxuries included, such as yachts, private jets, etc.…)
Indicate whether you have any of the following diagnoses.
*If your diagnosis has changed, please select the most recent.
Autism Spectrum Disorder (ASD) – Diagnosed by practitioner
Autism Spectrum Disorder (ASD) – Self-diagnosed
Autistic Disorder – Diagnosed by practitioner
Autistic Disorder – Self-diagnosed
Asperger’s Disorder – Diagnosed by practitioner
Asperger’s Disorder – Self-diagnosed
Pervasive Developmental Disorder (PDD) – Diagnosed by practitioner
Pervasive Developmental Disorder (PDD) – Self-diagnosed
I do not have any of the diagnoses listed
Indicate whether you have any other mental health, neurological, or physical disorders/diseases. Please specify whether each item has been practitioner-diagnosed or self-diagnosed, and any observations or opinions regarding your experience with the disorder/diagnosis.
*If you do not have or suspect another diagnosis, please type "N/A"
You are about to fill out a series of statements related to personality and lifestyle.
For each question, select the answer that best describes how often that statement applies to you.
Many of these questions ask about your interactions with other people. Please think about the way you are with most people, rather than special relationships you may have with spouses or significant others, children,
siblings, and parents.
Everyone changes over time, which can make it hard to fill out questions about personality. Think about the way you have been the majority of your adult life, rather than the way you were as a teenager, or times you may have felt different than normal.
You must answer each question. If you are confused, please give it your best guess.
You may refer back to this page if needed.
You are about to fill out a series of statements related to personality and lifestyle.
For each question, select the answer that best describes how often that statement applies to you.
Many of these questions ask about your interactions with other people. Please think about the way you are with most people, rather than special relationships you may have with spouses or significant others, children,
siblings, and parents.
Everyone changes over time, which can make it hard to fill out questions about personality. Think about the way you have been the majority of your adult life, rather than the way you were as a teenager, or times you may have felt different than normal.
You must answer each question. If you are confused, please give it your best guess.
You may refer back to this page if needed.
1 -- Very Rarely
2 -- Rarely
3 -- Occasionally
4 -- Somewhat Often
5 -- Often
6 -- Very Often
1 -- Very Rarely
2 -- Rarely
3 -- Occasionally
4 -- Somewhat Often
5 -- Often
6 -- Very Often
I like being around people.
1
2
3
4
5
6
Very RarelyVery Often
I find it hard to get my words out smoothly.
1
2
3
4
5
6
Very RarelyVery Often
I am comfortable with unexpected changes in plans.
1
2
3
4
5
6
Very RarelyVery Often
It's hard for me to avoid getting sidetracked in conversation.
1
2
3
4
5
6
Very RarelyVery Often
I would rather talk to people to get information than to socialize.
1
2
3
4
5
6
Very RarelyVery Often
People have to talk me into trying something new.
1
2
3
4
5
6
Very RarelyVery Often
I am ‘‘in-tune’’ with the other person during conversation.
* Consider casual interaction with acquaintances, rather than special relationships, such as with close friends and family members.
1
2
3
4
5
6
Very RarelyVery Often
I have to warm myself up to the idea of visiting an unfamiliar place.
1
2
3
4
5
6
Very RarelyVery Often
I enjoy being in social situations.
1
2
3
4
5
6
Very RarelyVery Often
I feel disconnected or ‘‘out of sync’’ in conversations with others.
* Consider casual interaction with acquaintances, rather than special relationships, such as with close friends and family members.
1
2
3
4
5
6
Very RarelyVery Often
People find it easy to approach me.
* Consider casual interaction with acquaintances, rather than special relationships, such as with close friends and family members.
1
2
3
4
5
6
Very RarelyVery Often
I feel a strong need for sameness from day to day.
1
2
3
4
5
6
Very RarelyVery Often
People ask me to repeat things I’ve said because they don’t understand.
1
2
3
4
5
6
Very RarelyVery Often
I am flexible about how things should be done.
1
2
3
4
5
6
Very RarelyVery Often
I look forward to situations where I can meet new people.
1
2
3
4
5
6
Very RarelyVery Often
I have been told that I talk too much about certain topics.
1
2
3
4
5
6
Very RarelyVery Often
When I make conversation it is just to be polite.
* Consider casual interaction with acquaintances, rather than special relationships, such as with close friends and family members.
1
2
3
4
5
6
Very RarelyVery Often
I look forward to trying new things.
1
2
3
4
5
6
Very RarelyVery Often
I speak too loudly or softly.
1
2
3
4
5
6
Very RarelyVery Often
I can tell when someone is not interested in what I am saying.
* Consider casual interaction with acquaintances, rather than special relationships, such as with close friends and family members.
1
2
3
4
5
6
Very RarelyVery Often
I have a hard time dealing with changes in my routine.
1
2
3
4
5
6
Very RarelyVery Often
I am good at making small talk.
* Consider casual interaction with acquaintances, rather than special relationships, such as with close friends and family members.
1
2
3
4
5
6
Very RarelyVery Often
I act very set in my ways.
1
2
3
4
5
6
Very RarelyVery Often
I feel like I am really connecting with other people.
1
2
3
4
5
6
Very RarelyVery Often
People get frustrated by my unwillingness to bend.
1
2
3
4
5
6
Very RarelyVery Often
Conversation bores me.
* Consider casual interaction with acquaintances, rather than special relationships, such as with close friends and family members.
1
2
3
4
5
6
Very RarelyVery Often
I am warm and friendly in my interactions with
others.
others.
* Consider casual interaction with acquaintances, rather than special relationships, such as with close friends and family members.
1
2
3
4
5
6
Very RarelyVery Often
I leave long pauses in conversation.
1
2
3
4
5
6
Very RarelyVery Often
I alter my daily routine by trying something different.
1
2
3
4
5
6
Very RarelyVery Often
I prefer to be alone rather than with others.
1
2
3
4
5
6
Very RarelyVery Often
I lose track of my original point when talking to people.
1
2
3
4
5
6
Very RarelyVery Often
I like to closely follow a routine while working.
1
2
3
4
5
6
Very RarelyVery Often
I can tell when it is time to change topics in
conversation.
conversation.
* Consider casual interaction with acquaintances, rather than special relationships, such as with close friends and family members.
1
2
3
4
5
6
Very RarelyVery Often
I keep doing things the way I know, even if another way might be better.
1
2
3
4
5
6
Very RarelyVery Often
I enjoy chatting with people.
* Consider casual interaction with acquaintances, rather than special relationships, such as with close friends and family members.
1
2
3
4
5
6
Very RarelyVery Often
Select the length of your relationship.
Less than 1 year.
More than 1 year and less than 3 years.
More than 3 years and less than 5 years.
More than 5 years and less than 10 years.
10 years or longer.
Indicate whether your relationship is monogamous or polyamorous. Describe any details regarding your relationship dynamic and boundaries in as much detail as possible.
To the best of your knowledge, has your partner been diagnosed or self-diagnosed with Autism Spectrum Disorder (ASD), Autistic Disorder, Asperger's Disorder, or Pervasive Developmental Disorder (PDD)?
*Please be sure to specify whether they were diagnosed by a practitioner or self-diagnosed.
To the best of your knowledge, has your partner been diagnosed or self-diagnosed with any other mental health, neurological, or physical disorders/diseases? Please specify whether each item has been practitioner-diagnosed or self-diagnosed, and any observations or opinions regarding your experience with the disorder/diagnosis.
*Please be sure to specify whether they were diagnosed by a practitioner or self-diagnosed.
*If you do not know of or suspect another diagnosis, please type "N/A"
For the following questions, please answer based on how you normally feel about the romantic and emotional aspects of your current relationship.
For the following questions, please answer based on how you normally feel about the romantic and emotional aspects of your current relationship.
I am respectful of my partner's boundaries.
1
2
3
4
5
Strongly DisagreeStrongly Agree
I am unresponsive to my partner's needs.
1
2
3
4
5
Strongly DisagreeStrongly Agree
My partner does not trust me.
1
2
3
4
5
Strongly DisagreeStrongly Agree
My partner does not respect my boundaries.
1
2
3
4
5
Strongly DisagreeStrongly Agree
I am comfortable being honest with my partner.
1
2
3
4
5
Strongly DisagreeStrongly Agree
My partner is responsive to my needs.
1
2
3
4
5
Strongly DisagreeStrongly Agree
My partner does not communicate their needs clearly.
1
2
3
4
5
Strongly DisagreeStrongly Agree
I do not feel that my partner is honest with me.
1
2
3
4
5
Strongly DisagreeStrongly Agree
I am comfortable communicating my needs to my partner.
1
2
3
4
5
Strongly DisagreeStrongly Agree
I trust my partner.
1
2
3
4
5
Strongly DisagreeStrongly Agree
My partner seems to be happy in our relationship.
1
2
3
4
5
Strongly DisagreeStrongly Agree
My partner is often unwilling to compromise.
1
2
3
4
5
Strongly DisagreeStrongly Agree
I am unhappy with my relationship.
1
2
3
4
5
Strongly DisagreeStrongly Agree
I try to compromise when my partner and I disagree.
1
2
3
4
5
Strongly DisagreeStrongly Agree
For the following questions, please answer based on how you normally feel about the sexual and physical intimacy aspects of your current relationship.
For the following questions, please answer based on how you normally feel about the sexual and physical intimacy aspects of your current relationship.
My partner does not communicate their needs clearly.
1
2
3
4
5
Strongly DisagreeStrongly Agree
My partner is responsive to my needs.
1
2
3
4
5
Strongly DisagreeStrongly Agree
I am unresponsive to my partner's needs.
1
2
3
4
5
Strongly DisagreeStrongly Agree
I am comfortable being honest with my partner.
1
2
3
4
5
Strongly DisagreeStrongly Agree
I am respectful of my partner's boundaries.
1
2
3
4
5
Strongly DisagreeStrongly Agree
I trust my partner.
1
2
3
4
5
Strongly DisagreeStrongly Agree
My partner does not respect my boundaries.
1
2
3
4
5
Strongly DisagreeStrongly Agree
My partner does not trust me.
1
2
3
4
5
Strongly DisagreeStrongly Agree
I do not feel that my partner is honest with me.
1
2
3
4
5
Strongly DisagreeStrongly Agree
I am comfortable communicating my needs to my partner.
1
2
3
4
5
Strongly DisagreeStrongly Agree
My partner is often unwilling to compromise.
1
2
3
4
5
Strongly DisagreeStrongly Agree
I try to compromise when my partner and I disagree.
1
2
3
4
5
Strongly DisagreeStrongly Agree
My partner seems to be happy in our relationship.
1
2
3
4
5
Strongly DisagreeStrongly Agree
I am unhappy with my relationship.
1
2
3
4
5
Strongly DisagreeStrongly Agree
Use this space to describe any thoughts about your relationship in terms of barriers or the quality of the relationship.
For the following questions, please answer based on how you normally feel regarding close personal relationships.
For the following questions, please answer based on how you normally feel regarding close personal relationships.
I struggle to trust people.
1
2
3
4
5
Strongly DisagreeStrongly Agree
I try to be honest with the people I care about.
1
2
3
4
5
Strongly DisagreeStrongly Agree
Communication is important in my relationships.
1
2
3
4
5
Strongly DisagreeStrongly Agree
I do not care about others' needs.
1
2
3
4
5
Strongly DisagreeStrongly Agree
I don't like to compromise.
1
2
3
4
5
Strongly DisagreeStrongly Agree
I am happy with my relationship status.
1
2
3
4
5
Meaningful communication is important in relationships.
1
2
3
4
5
I struggle to respect others' boundaries.
1
2
3
4
5
Strongly DisagreeStrongly Agree
For the following questions, please answer based on how you normally feel regarding close personal relationships.
For the following questions, please answer based on how you normally feel regarding close personal relationships.
My relationships are usually stress free.
1
2
3
4
5
Strongly DisagreeStrongly Agree
I have no control over what happens in my relationships.
1
2
3
4
5
Strongly DisagreeStrongly Agree
I am more confident dating online.
1
2
3
4
5
Strongly DisagreeStrongly Agree
I am not experienced in relationships.
1
2
3
4
5
Strongly DisagreeStrongly Agree
My relationships never end well.
1
2
3
4
5
Strongly DisagreeStrongly Agree
Online dating is easier for me.
1
2
3
4
5
Strongly DisagreeStrongly Agree
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