Outcome Measure
Autism Spectrum Disorder in Adolescents
What it measures?
- The AQ-Adol aims to assess traits of Autism Spectrum Disorder (ASD) in adolescents with average intelligence (Baron-Cohen et al., 2006). A profile of an individual’s strengths and weaknesses can be identified with the AQ-Adol across social skills, attention switching, attention to detail, communication, and imagination. It is useful for the screening of ASD and should be supplemented by clinical interviews to inform diagnosis and treatment. Due to the dimensional nature of ASD, scores should be carefully interpreted in a descriptive manner as a screener rather than a direct diagnostic tool (Ruzich et al., 2015).
Who is it for?
The AQ-Adol is designed for use in adolescents aged 12-15 years (Baron-Cohen et al., 2006).
Instrument Quality
- The AQ is one of the most widely used measures of autistic traits in clinical practice and research (English et al., 2020). Studies have found adequate internal consistency and test-retest reliability of the full-scale AQ-Adol and its subscales (de Vries et al., 2023; Gomez et al., 2019).
- The AQ (and its adult, child, and adolescent versions) has been translated into various languages and validated for use in cross-cultural populations, remaining relatively stable and reliable (Cetinoglu and Aras, 2022).
- The AQ-Adol was developed as a five subscale model which is commonly adopted in practice, however, numerous factor structure studies have disputed the evidence and it remains contentious (de Vries et al., 2023).
Structure
- 50 items - social skills (10), attention switching (10), attention to detail (10), communication (10), imagination (10)
- 2-point Likert scale
- Respondents indicate the extent to which they agree (”Definitely Agree” to “Definitely Disagree”) with statements that reflect autistic-like traits (e.g. “S/he enjoys social chit-chat.”)
- Items 1, 3, 8, 9, 10, 11, 14, 15, 17, 24, 25, 27-32, 34, 36-38, 40, 44, 47-50 are scored as “1” on “Slightly Disagree” and “Definitely Disagree” and “0” on “Slightly Agree” and “Definitely Agree”
- Items 2, 4-7, 9, 12, 13, 16, 18-23, 26, 33, 35, 39, 41-43, 45, 46 are scored as “1” on “Slightly Agree” and “Definitely Agree” and “0” on “Slightly Disagree” and “Definitely Disagree”
Scoring instructions
- Sum all item responses to derive a full-scale score
- Sum the relevant subscale-specific items to derive subscale scores
| Subscale | Item number |
|---|---|
Imagination (AQ-Adolescent) |
3,8,14,20,21,24,40,41,42,50 |
Communication (AQ-Adolescent) |
7,17,18,26,27,31,33,35,38,39 |
Attention Switching (AQ-Adolescent) |
2,4,10,16,25,32,34,37,43,46 |
Social Skills (AQ-Adolescent) |
1,11,13,15,22,36,44,45,47,48 |
Full-scale (AQ-Adolescent) |
1,2,3,4,5,6,7,8,9,10,11,12,13,14,15,16,17,18,19,20,21,22,23,24,25,26,27,28,29,30,31,32,33,34,35,36,37,38,39,40,41,42,43,44,45,46,47,48,49,50 |
Attention to Detail (AQ-Adolescent) |
5,6,9,12,19,23,28,29,30,49 |
Score Interpretation
What higher scores mean?
- Increased level of autistic traits. Greater likelihood of meeting criteria for Autism Spectrum Disorder.
How to assess symptom severity & change?
| Description | Score Range | |
|---|---|---|
| Below normative mean | 0 | |
| Normative mean | 3.2 | |
| 1 SD above normative mean | 5.5 | |
| 2 SD above normative mean | 7.8 | |
| Maximum | 10 |
| Description | Score Range | |
|---|---|---|
| Below normative mean | 0 | |
| Normative mean | 2.7 | |
| 1 SD above normative mean | 4.4 | |
| 2 SD above normative mean | 6.1 | |
| Maximum | 10 |
Severity ranges
Normative scores were derived from a sample of 50 healthy children from the United Kingdom (Baron-Cohen et al., 2006).
Reliable change and clinically significant improvement
Wampold (2001) conducted a meta analysis of psychotherapy outcome studies and noted that the average improvement was reflected in an effect size (ES) of .80. Because a change of 1 SD corresponds to an ES of 1.0, and .80 is considered to be a large ES, Wise (2004) concludes that a change of 1 SD is a defensible indicator of clinically significant change.
Mean
| Sample | Mean | Comments |
|---|---|---|
| Clinical | 8 | Clinical scores were derived from a sample of 79 adolescents with autism from the United Kingdom (Baron-Cohen et al., 2006). |
| Normative | 2.7 | Normative scores were derived from a sample of 50 healthy children from the United Kingdom (Baron-Cohen et al., 2006). |
Standard Deviation
| Sample | Mean | Comments |
|---|---|---|
| Clinical | 1.5 | Clinical scores were derived from a sample of 79 adolescents with autism from the United Kingdom (Baron-Cohen et al., 2006). |
| Normative | 1.7 | Normative scores were derived from a sample of 50 healthy children from the United Kingdom (Baron-Cohen et al., 2006). |
| Description | Score Range | |
|---|---|---|
| Below normative mean | 0 | |
| Normative mean | 4.5 | |
| 1 SD above normative mean | 6.5 | |
| 2 SD above normative mean | 8.5 | |
| Maximum | 10 |
Severity ranges
Normative scores were derived from a sample of 50 healthy children from the United Kingdom (Baron-Cohen et al., 2006).
Reliable change and clinically significant improvement
Wampold (2001) conducted a meta analysis of psychotherapy outcome studies and noted that the average improvement was reflected in an effect size (ES) of .80. Because a change of 1 SD corresponds to an ES of 1.0, and .80 is considered to be a large ES, Wise (2004) concludes that a change of 1 SD is a defensible indicator of clinically significant change.
Mean
| Sample | Mean | Comments |
|---|---|---|
| Clinical | 8.3 | Clinical scores were derived from a sample of 79 adolescents with autism from the United Kingdom (Baron-Cohen et al., 2006). |
| Normative | 4.5 | Normative scores were derived from a sample of 50 healthy children from the United Kingdom (Baron-Cohen et al., 2006). |
Standard Deviation
| Sample | Mean | Comments |
|---|---|---|
| Clinical | 1.6 | Clinical scores were derived from a sample of 79 adolescents with autism from the United Kingdom (Baron-Cohen et al., 2006). |
| Normative | 2 | Normative scores were derived from a sample of 50 healthy children from the United Kingdom (Baron-Cohen et al., 2006). |
| Description | Score Range | |
|---|---|---|
| Below normative mean | 0 | |
| Normative mean | 2 | |
| 1 SD above normative mean | 3.9 | |
| 2 SD above normative mean | 5.8 | |
| Maximum | 10 |
Severity ranges
Normative scores were derived from a sample of 50 healthy children from the United Kingdom (Baron-Cohen et al., 2006).
Reliable change and clinically significant improvement
Wampold (2001) conducted a meta analysis of psychotherapy outcome studies and noted that the average improvement was reflected in an effect size (ES) of .80. Because a change of 1 SD corresponds to an ES of 1.0, and .80 is considered to be a large ES, Wise (2004) concludes that a change of 1 SD is a defensible indicator of clinically significant change.
Mean
| Sample | Mean | Comments |
|---|---|---|
| Clinical | 8 | Clinical scores were derived from a sample of 79 adolescents with autism from the United Kingdom (Baron-Cohen et al., 2006). |
| Normative | 2 | Normative scores were derived from a sample of 50 healthy children from the United Kingdom (Baron-Cohen et al., 2006). |
Standard Deviation
| Sample | Mean | Comments |
|---|---|---|
| Clinical | 1.9 | Clinical scores were derived from a sample of 79 adolescents with autism from the United Kingdom (Baron-Cohen et al., 2006). |
| Normative | 1.9 | Normative scores were derived from a sample of 50 healthy children from the United Kingdom (Baron-Cohen et al., 2006). |
| Description | Score Range | |
|---|---|---|
| Normal | 0 | |
| Clinically significant | 30 | |
| Autism Spectrum Disorder | >=30 | Provisional Diagnosis |
| Maximum | 50 |
Severity ranges
Normative scores were derived from a sample of 50 healthy children from the United Kingdom (Baron-Cohen et al., 2006).
Provisional diagnosis
Reliable change and clinically significant improvement
Wampold (2001) conducted a meta analysis of psychotherapy outcome studies and noted that the average improvement was reflected in an effect size (ES) of .80. Because a change of 1 SD corresponds to an ES of 1.0, and .80 is considered to be a large ES, Wise (2004) concludes that a change of 1 SD is a defensible indicator of clinically significant change.
Mean
| Sample | Mean | Comments |
|---|---|---|
| Clinical | 38.3 | Clinical scores were derived from a sample of 79 adolescents with autism from the United Kingdom (Baron-Cohen et al., 2006). |
| Normative | 17.7 | Normative scores were derived from a sample of 50 healthy children from the United Kingdom (Baron-Cohen et al., 2006). |
Standard Deviation
| Sample | Mean | Comments |
|---|---|---|
| Clinical | 6 | Clinical scores were derived from a sample of 79 adolescents with autism from the United Kingdom (Baron-Cohen et al., 2006). |
| Normative | 5.7 | Normative scores were derived from a sample of 50 healthy children from the United Kingdom (Baron-Cohen et al., 2006). |
Reliability
| Value | Comments |
|---|---|
| 0.92 | Test-retest reliability was high in a sample of 15 adolescents (Baron-Cohen et al., 2006). |
| Description | Score Range | |
|---|---|---|
| Below normative mean | 0 | |
| Normative mean | 5.3 | |
| 1 SD above normative mean | 7.7 | |
| 1.5 SD above clinical mean | 8.9 | |
| Maximum | 10 |
Severity ranges
Normative scores were derived from a sample of 50 healthy children from the United Kingdom (Baron-Cohen et al., 2006).
Reliable change and clinically significant improvement
Wampold (2001) conducted a meta analysis of psychotherapy outcome studies and noted that the average improvement was reflected in an effect size (ES) of .80. Because a change of 1 SD corresponds to an ES of 1.0, and .80 is considered to be a large ES, Wise (2004) concludes that a change of 1 SD is a defensible indicator of clinically significant change.
Mean
| Sample | Mean | Comments |
|---|---|---|
| Clinical | 6.5 | Clinical scores were derived from a sample of 79 adolescents with autism from the United Kingdom (Baron-Cohen et al., 2006). |
| Normative | 5.3 | Normative scores were derived from a sample of 50 healthy children from the United Kingdom (Baron-Cohen et al., 2006). |
Standard Deviation
| Sample | Mean | Comments |
|---|---|---|
| Clinical | 2.1 | Clinical scores were derived from a sample of 79 adolescents with autism from the United Kingdom (Baron-Cohen et al., 2006). |
| Normative | 2.4 | Normative scores were derived from a sample of 50 healthy children from the United Kingdom (Baron-Cohen et al., 2006). |
Instrument developers
- Baron-Cohen, S., Hoekstra, R. A., Knickmeyer, R., & Wheelwright, S. (2006). The autism-spectrum quotient (AQ)—adolescent version. Journal of autism and developmental disorders, 36, 343-350.
Refrences
* Baron-Cohen, S., Hoekstra, R. A., Knickmeyer, R., & Wheelwright, S. (2006). The autism-spectrum quotient (AQ)—adolescent version. Journal of autism and developmental disorders, 36, 343-350. * Cetinoglu, E., & Aras, S. (2022). The Autism-Spectrum Quotient (AQ) adolescent’s version in turkey: Factor structure, reliability and validity. Journal of Autism and Developmental Disorders, 52(7), 3260-3270. * de Vries, M., Begeer, S., & Geurts, H. M. (2023). Psychometric characteristics of the AQ-Adolescent in autistic and non-autistic adolescents. Research in Autism Spectrum Disorders, 106, 102201. * English, M. C., Gignac, G. E., Visser, T. A., Whitehouse, A. J., & Maybery, M. T. (2020). A comprehensive psychometric analysis of autism‐spectrum quotient factor models using two large samples: Model recommendations and the influence of divergent traits on total‐scale scores. Autism Research, 13(1), 45-60. * Gomez, R., Stavropoulos, V., & Vance, A. (2019). Psychometric properties of the autism spectrum quotient: Children’s version (AQ-Child). Journal of Autism and Developmental Disorders, 49, 468-480. * Ruzich, E., Allison, C., Smith, P., Watson, P., Auyeung, B., Ring, H., & Baron-Cohen, S. (2015). Measuring autistic traits in the general population: a systematic review of the Autism-Spectrum Quotient (AQ) in a nonclinical population sample of 6,900 typical adult males and females. Molecular autism, 6, 1-12.
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Severity ranges
Normative scores were derived from a sample of 50 healthy children from the United Kingdom (Baron-Cohen et al., 2006).
Reliable change and clinically significant improvement
Wampold (2001) conducted a meta analysis of psychotherapy outcome studies and noted that the average improvement was reflected in an effect size (ES) of .80. Because a change of 1 SD corresponds to an ES of 1.0, and .80 is considered to be a large ES, Wise (2004) concludes that a change of 1 SD is a defensible indicator of clinically significant change.
Mean
Standard Deviation