Outcome Measure
Autism Spectrum Disorder in Children
What it measures?
- The AQ-Child aims to assess traits of Autism Spectrum Disorder (ASD) in children with average intelligence (Auyeung et al., 2008). A profile of an individual’s strengths and weaknesses can be identified with the AQ-Chi.d 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-Child is designed for use in children aged 4-11 years (Auyeung et al., 2008).
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-Child and its subscales (Gomez et al., 2019).
- The AQ has been translated into various languages and validated for use in cross-cultural populations, remaining relatively stable and reliable (Sonié et al., 2013; Wakabayashi et al., 2007; Zhang et al., 2016).
- The AQ-Child 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 (Gomez et al., 2019).
Structure
- 50 items - social skills (10), attention switching (10), attention to detail (10), communication (10), imagination (10)
- 4-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 is fascinated by numbers.”)
- Items 1, 3, 8, 10, 11, 14, 15, 17, 24, 25, 27-32, 34, 36-38, 40, 44, 47-50 are scored as 0 on “Slightly Agree” to 3 on “Definitely Disagree”
- Items 2, 4-7, 9, 12, 13, 16, 18-23, 26, 33, 35, 39, 41-43, 45, 46 are scored as 3 on “Slightly Agree” to 0 on “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 |
|---|---|
Attention to Detail (AQ-Child) |
5,6,9,12,19,23,28,29,30,49 |
Attention Switching (AQ-Child) |
2,4,10,16,25,32,34,37,43,46 |
Social Skills (AQ-Child) |
1,11,13,15,22,36,44,45,47,48 |
Imagination (AQ-Child) |
3,8,14,20,21,24,40,41,42,50 |
Communication (AQ-Child) |
7,17,18,26,27,31,33,35,38,39 |
Full-scale (AQ-Child) |
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 |
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 | 8.7 | |
| 1 SD above normative mean | 13.2 | |
| 2 SD above normative mean | 17.7 | |
| Maximum | 30 |
| Description | Score Range | |
|---|---|---|
| Below normative mean | 0 | |
| Normative mean | 10.9 | |
| 1 SD above normative mean | 16 | |
| 2 SD above normative mean | 21.1 | |
| Maximum | 30 |
Severity ranges
* The developers (Auyeung et al, 2008) recommended a cut-off score of 76, demonstrating high sensitivity and specificity. * Given the contentious evidence of cut-off scores and the dimensional nature of ASD, other thresholds may be favoured in different circumstances and considered in the context of the individual (Woodbury-Smith et al., 2005).
Reliable change and clinically significant improvement
Wampold et al (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 | 24.2 | Clinical scores were derived from a sample of 348 children with autism from the United Kingdom (Auyeung et al., 2008). |
| Normative | 10.9 | Normative scores were derived from a sample of 1225 healthy children from the United Kingdom (Auyeung et al., 2008). |
Standard Deviation
| Sample | Mean | Comments |
|---|---|---|
| Clinical | 4.2 | Clinical scores were derived from a sample of 348 children with autism from the United Kingdom (Auyeung et al., 2008). |
| Normative | 5.1 | Normative scores were derived from a sample of 1225 healthy children from the United Kingdom (Auyeung et al., 2008). |
| Description | Score Range | |
|---|---|---|
| Below normative mean | 0 | |
| Normative mean | 7 | |
| 1 SD above normative mean | 12 | |
| 2 SD above normative mean | 17 | |
| Maximum | 30 |
Severity ranges
* The developers (Auyeung et al, 2008) recommended a cut-off score of 76, demonstrating high sensitivity and specificity. * Given the contentious evidence of cut-off scores and the dimensional nature of ASD, other thresholds may be favoured in different circumstances and considered in the context of the individual (Woodbury-Smith et al., 2005).
Reliable change and clinically significant improvement
Wampold et al (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 | 22.1 | Clinical scores were derived from a sample of 348 children with autism from the United Kingdom (Auyeung et al., 2008). |
| Normative | 7 | Normative scores were derived from a sample of 1225 healthy children from the United Kingdom (Auyeung et al., 2008). |
Standard Deviation
| Sample | Mean | Comments |
|---|---|---|
| Clinical | 5.1 | Clinical scores were derived from a sample of 348 children with autism from the United Kingdom (Auyeung et al., 2008). |
| Normative | 5 | Normative scores were derived from a sample of 1225 healthy children from the United Kingdom (Auyeung et al., 2008). |
| Description | Score Range | |
|---|---|---|
| Below normative mean | 0 | |
| Normative mean | 7 | |
| 1 SD above normative mean | 11.6 | |
| 2 SD above normative mean | 16.2 | |
| Maximum | 30 |
Severity ranges
* The developers (Auyeung et al, 2008) recommended a cut-off score of 76, demonstrating high sensitivity and specificity. * Given the contentious evidence of cut-off scores and the dimensional nature of ASD, other thresholds may be favoured in different circumstances and considered in the context of the individual (Woodbury-Smith et al., 2005).
Reliable change and clinically significant improvement
Wampold et al (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 | 19.2 | Clinical scores were derived from a sample of 348 children with autism from the United Kingdom (Auyeung et al., 2008). |
| Normative | 7 | Normative scores were derived from a sample of 1225 healthy children from the United Kingdom (Auyeung et al., 2008). |
Standard Deviation
| Sample | Mean | Comments |
|---|---|---|
| Clinical | 5.4 | Clinical scores were derived from a sample of 348 children with autism from the United Kingdom (Auyeung et al., 2008). |
| Normative | 4.6 | Normative scores were derived from a sample of 1225 healthy children from the United Kingdom (Auyeung et al., 2008). |
| Description | Score Range | |
|---|---|---|
| Below normative mean | 0 | |
| Normative mean | 8.2 | |
| 1 SD above normative mean | 13.2 | |
| 2 SD above normative mean | 18.2 | |
| Maximum | 30 |
Severity ranges
* The developers (Auyeung et al, 2008) recommended a cut-off score of 76, demonstrating high sensitivity and specificity. * Given the contentious evidence of cut-off scores and the dimensional nature of ASD, other thresholds may be favoured in different circumstances and considered in the context of the individual (Woodbury-Smith et al., 2005).
Reliable change and clinically significant improvement
Wampold et al (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 | 24.4 | Clinical scores were derived from a sample of 348 children with autism from the United Kingdom (Auyeung et al., 2008). |
| Normative | 8.2 | Normative scores were derived from a sample of 1225 healthy children from the United Kingdom (Auyeung et al., 2008). |
Standard Deviation
| Sample | Mean | Comments |
|---|---|---|
| Clinical | 4 | Clinical scores were derived from a sample of 348 children with autism from the United Kingdom (Auyeung et al., 2008). |
| Normative | 5 | Normative scores were derived from a sample of 1225 healthy children from the United Kingdom (Auyeung et al., 2008). |
| Description | Score Range | |
|---|---|---|
| Normal | 0 | |
| Clinically significant | 76 | |
| Autism Spectrum Disorder | >=76 | Provisional Diagnosis |
| Maximum | 150 |
Severity ranges
* The developers (Auyeung et al, 2008) recommended a cut-off score of 76, demonstrating high sensitivity and specificity. * Given the contentious evidence of cut-off scores and the dimensional nature of ASD, other thresholds may be favoured in different circumstances and considered in the context of the individual (Woodbury-Smith et al., 2005).
Provisional diagnosis
* The developers (Auyeung et al, 2008) recommended a cut-off score of 76, demonstrating high sensitivity and specificity. * Given the contentious evidence of cut-off scores and the dimensional nature of ASD, other thresholds may be favoured in different circumstances and considered in the context of the individual (Woodbury-Smith et al., 2005).
Reliable change and clinically significant improvement
Wampold et al (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 | 104.8 | Clinical scores were derived from a sample of 348 children with autism from the United Kingdom (Auyeung et al., 2008). |
| Normative | 41.7 | Normative scores were derived from a sample of 1225 healthy children from the United Kingdom (Auyeung et al., 2008). |
Standard Deviation
| Sample | Mean | Comments |
|---|---|---|
| Clinical | 15.6 | Clinical scores were derived from a sample of 348 children with autism from the United Kingdom (Auyeung et al., 2008). |
| Normative | 18.6 | Normative scores were derived from a sample of 1225 healthy children from the United Kingdom (Auyeung et al., 2008). |
Reliability
| Value | Comments |
|---|---|
| 0.85 | Test-retest reliability over a 12.3 (2.01) week period was high in a sample of 272 children (Auyeung et al., 2008). |
Instrument developers
- Auyeung, B., Baron-Cohen, S., Wheelwright, S., & Allison, C. (2008). The autism spectrum quotient: Children’s version (AQ-Child). Journal of autism and developmental disorders, 38, 1230-1240.
Refrences
* Auyeung, B., Baron-Cohen, S., Wheelwright, S., & Allison, C. (2008). The autism spectrum quotient: Children’s version (AQ-Child). Journal of autism and developmental disorders, 38, 1230-1240. * 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. * Sonié, S., Kassai, B., Pirat, E., Bain, P., Robinson, J., Gomot, M., ... & Manificat, S. (2013). The French version of the autism-spectrum quotient in adolescents: a cross-cultural validation study. Journal of Autism and Developmental Disorders, 43, 1178-1183. * Wakabayashi, A., Baron-Cohen, S., Uchiyama, T., Yoshida, Y., Tojo, Y., Kuroda, M., & Wheelwright, S. (2007). The autism-spectrum quotient (AQ) children’s version in Japan: a cross-cultural comparison. Journal of Autism and Developmental Disorders, 37, 491-500. * Zhang, L., Sun, Y., Chen, F., Wu, D., Tang, J., Han, X., ... & Wang, K. (2016). Psychometric properties of the Autism-Spectrum Quotient in both clinical and non-clinical samples: Chinese version for mainland China. BMC psychiatry, 16, 1-10.
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Severity ranges
* The developers (Auyeung et al, 2008) recommended a cut-off score of 76, demonstrating high sensitivity and specificity. * Given the contentious evidence of cut-off scores and the dimensional nature of ASD, other thresholds may be favoured in different circumstances and considered in the context of the individual (Woodbury-Smith et al., 2005).
Reliable change and clinically significant improvement
Wampold et al (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