Outcome Measure
Autism Spectrum Quotient
What it measures?
- The AQ aims to assess traits of Autism Spectrum Disorder (ASD) in adults and adolescents with average intelligence (Baron-Cohen et al., 2001). A profile of an individual’s strengths and weaknesses can be identified with the AQ 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 is designed for use in adolescents and adults aged 16 years and older (Baron-Cohen et al., 2001). There are also validated child (aged 4-11 years) and adolescent (aged 12-18) versions of the AQ.
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 and its subscales (English et al., 2020; Baron-Cohen et al., 2001).
- The AQ has been translated into various languages and validated for use in cross-cultural populations, remaining relatively stable and reliable (Ruta et al., 2012; Sonié et al., 2013; Tan & Ashwin, 2023).
- The AQ 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 (English et al., 2020; Zhu et al., 2022).
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. “I find social situations easy.”)
- 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 |
|---|---|
Full-scale (AQ) |
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 |
Communication |
7,17,18,26,27,31,33,35,38,39 |
Imagination |
3,8,14,20,21,24,40,41,42,50 |
Attention Switching |
2,4,10,16,25,32,34,37,43,46 |
Social Skills |
1,11,13,15,22,36,44,45,47,48 |
Attention to Detail |
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 | |
|---|---|---|
| Normal | 0 | |
| Clinically significant | 29 | |
| Autism Spectrum Disorder | >=29 | Provisional Diagnosis |
| Maximum | 50 |
| Description | Score Range | |
|---|---|---|
| Below normative mean | 0 | |
| Normative mean | 2.4 | |
| 1 SD above normative mean | 4.3 | |
| 2 SD above normative mean | 6.2 | |
| Maximum | 10 |
Severity ranges
Normative scores were derived from a sample of randomly selected adults in the United Kingdom (n = 174; 76 males, 98 females; Baron-Cohen et al., 2001). Participants were aged 37 (7.7) years.
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 | 7.2 | Clinical scores were derived from a sample of adults with Asperger syndrome or high-functioning Autism in the United Kingdom (n = 58; 45 males, 13 females; Baron-Cohen et al., 2001). Participants were aged 31.6 (11.8) years. |
| Normative | 2.4 | Normative scores were derived from a sample of randomly selected adults in the United Kingdom (n = 174; 76 males, 98 females; Baron-Cohen et al., 2001). Participants were aged 37 (7.7) years. |
Standard Deviation
| Sample | Mean | Comments |
|---|---|---|
| Clinical | 2 | Clinical scores were derived from a sample of adults with Asperger syndrome or high-functioning Autism in the United Kingdom (n = 58; 45 males, 13 females; Baron-Cohen et al., 2001). Participants were aged 31.6 (11.8) years. |
| Normative | 1.9 | Normative scores were derived from a sample of randomly selected adults in the United Kingdom (n = 174; 76 males, 98 females; Baron-Cohen et al., 2001). Participants were aged 37 (7.7) years. |
Reliability
| Value | Comments |
|---|---|
| 0.97 | Test-retest reliability over a 6- to 12- month period was high in a general Australian population of both normative individuals and individuals with ASD (n = 232; Broadbent et al., 2013). |
| Description | Score Range | |
|---|---|---|
| Below normative mean | 0 | |
| Normative mean | 2.3 | |
| 1 SD above normative mean | 4 | |
| 2 SD above normative mean | 5.7 | |
| Maximum | 10 |
Severity ranges
Normative scores were derived from a sample of randomly selected adults in the United Kingdom (n = 174; 76 males, 98 females; Baron-Cohen et al., 2001). Participants were aged 37 (7.7) years.
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 | 6.4 | Clinical scores were derived from a sample of adults with Asperger syndrome or high-functioning Autism in the United Kingdom (n = 58; 45 males, 13 females; Baron-Cohen et al., 2001). Participants were aged 31.6 (11.8) years. |
| Normative | 2.3 | Normative scores were derived from a sample of randomly selected adults in the United Kingdom (n = 174; 76 males, 98 females; Baron-Cohen et al., 2001). Participants were aged 37 (7.7) years. |
Standard Deviation
| Sample | Mean | Comments |
|---|---|---|
| Clinical | 2.1 | Clinical scores were derived from a sample of adults with Asperger syndrome or high-functioning Autism in the United Kingdom (n = 58; 45 males, 13 females; Baron-Cohen et al., 2001). Participants were aged 31.6 (11.8) years. |
| Normative | 1.7 | Normative scores were derived from a sample of randomly selected adults in the United Kingdom (n = 174; 76 males, 98 females; Baron-Cohen et al., 2001). Participants were aged 37 (7.7) years. |
Reliability
| Value | Comments |
|---|---|
| 0.75 | Test-retest reliability over a 6- to 12- month period was high in a general Australian population of both normative individuals and individuals with ASD (n = 232; Broadbent et al., 2013). |
| Description | Score Range | |
|---|---|---|
| Below normative mean | 0 | |
| Normative mean | 3.9 | |
| 1 SD above normative mean | 5.8 | |
| 2 SD above normative mean | 7.7 | |
| Maximum | 10 |
Severity ranges
Normative scores were derived from a sample of randomly selected adults in the United Kingdom (n = 174; 76 males, 98 females; Baron-Cohen et al., 2001). Participants were aged 37 (7.7) years.
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 | 8 | Clinical scores were derived from a sample of adults with Asperger syndrome or high-functioning Autism in the United Kingdom (n = 58; 45 males, 13 females; Baron-Cohen et al., 2001). Participants were aged 31.6 (11.8) years. |
| Normative | 3.9 | Normative scores were derived from a sample of randomly selected adults in the United Kingdom (n = 174; 76 males, 98 females; Baron-Cohen et al., 2001). Participants were aged 37 (7.7) years. |
Standard Deviation
| Sample | Mean | Comments |
|---|---|---|
| Clinical | 1.8 | Clinical scores were derived from a sample of adults with Asperger syndrome or high-functioning Autism in the United Kingdom (n = 58; 45 males, 13 females; Baron-Cohen et al., 2001). Participants were aged 31.6 (11.8) years. |
| Normative | 1.9 | Normative scores were derived from a sample of randomly selected adults in the United Kingdom (n = 174; 76 males, 98 females; Baron-Cohen et al., 2001). Participants were aged 37 (7.7) years. |
Reliability
| Value | Comments |
|---|---|
| 0.96 | Test-retest reliability over a 6- to 12- month period was high in a general Australian population of both normative individuals and individuals with ASD (n = 232; Broadbent et al., 2013). |
| Description | Score Range | |
|---|---|---|
| Below normative mean | 0 | |
| Normative mean | 2.6 | |
| 1 SD above normative mean | 4.9 | |
| 2 SD above normative mean | 7.2 | |
| Maximum | 10 |
Severity ranges
Normative scores were derived from a sample of randomly selected adults in the United Kingdom (n = 174; 76 males, 98 females; Baron-Cohen et al., 2001). Participants were aged 37 (7.7) years.
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 | 7.5 | Clinical scores were derived from a sample of adults with Asperger syndrome or high-functioning Autism in the United Kingdom (n = 58; 45 males, 13 females; Baron-Cohen et al., 2001). Participants were aged 31.6 (11.8) years. |
| Normative | 2.6 | Normative scores were derived from a sample of randomly selected adults in the United Kingdom (n = 174; 76 males, 98 females; Baron-Cohen et al., 2001). Participants were aged 37 (7.7) years. |
Standard Deviation
| Sample | Mean | Comments |
|---|---|---|
| Clinical | 1.9 | Clinical scores were derived from a sample of adults with Asperger syndrome or high-functioning Autism in the United Kingdom (n = 58; 45 males, 13 females; Baron-Cohen et al., 2001). Participants were aged 31.6 (11.8) years. |
| Normative | 2.3 | Normative scores were derived from a sample of randomly selected adults in the United Kingdom (n = 174; 76 males, 98 females; Baron-Cohen et al., 2001). Participants were aged 37 (7.7) years. |
Reliability
| Value | Comments |
|---|---|
| 0.79 | Test-retest reliability over a 6- to 12- month period was high in a general Australian population of both normative individuals and individuals with ASD (n = 232; Broadbent et al., 2013). |
| Description | Score Range | |
|---|---|---|
| Below normative mean | 0 | |
| Normative mean | 5.3 | |
| 1 SD above normative mean | 7.6 | |
| 2 SD above normative mean | 9.9 | |
| Maximum | 10 |
Severity ranges
Normative scores were derived from a sample of randomly selected adults in the United Kingdom (n = 174; 76 males, 98 females; Baron-Cohen et al., 2001). Participants were aged 37 (7.7) years.
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 | 6.7 | Clinical scores were derived from a sample of adults with Asperger syndrome or high-functioning Autism in the United Kingdom (n = 58; 45 males, 13 females; Baron-Cohen et al., 2001). Participants were aged 31.6 (11.8) years. |
| Normative | 5.3 | Normative scores were derived from a sample of randomly selected adults in the United Kingdom (n = 174; 76 males, 98 females; Baron-Cohen et al., 2001). Participants were aged 37 (7.7) years. |
Standard Deviation
| Sample | Mean | Comments |
|---|---|---|
| Clinical | 2.3 | Clinical scores were derived from a sample of adults with Asperger syndrome or high-functioning Autism in the United Kingdom (n = 58; 45 males, 13 females; Baron-Cohen et al., 2001). Participants were aged 31.6 (11.8) years. |
| Normative | 2.3 | Normative scores were derived from a sample of randomly selected adults in the United Kingdom (n = 174; 76 males, 98 females; Baron-Cohen et al., 2001). Participants were aged 37 (7.7) years. |
Reliability
| Value | Comments |
|---|---|
| 0.79 | Test-retest reliability over a 6- to 12- month period was high in a general Australian population of both normative individuals and individuals with ASD (n = 232; Broadbent et al., 2013). |
Instrument developers
- Baron-Cohen, S., Wheelwright, S., Skinner, R., Martin, J., & Clubley, E. (2001). The autism-spectrum quotient (AQ): Evidence from asperger syndrome/high-functioning autism, males and females, scientists and mathematicians. Journal of autism and developmental disorders, 31, 5-17.
Refrences
* Baron-Cohen, S., Wheelwright, S., Skinner, R., Martin, J., & Clubley, E. (2001). The autism-spectrum quotient (AQ): Evidence from asperger syndrome/high-functioning autism, males and females, scientists and mathematicians. Journal of autism and developmental disorders, 31, 5-17. * 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. * Ruta, L., Mazzone, D., Mazzone, L., Wheelwright, S., & Baron-Cohen, S. (2012). The Autism-Spectrum Quotient—Italian version: A cross-cultural confirmation of the broader autism phenotype. Journal of autism and developmental disorders, 42, 625-633. * 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. * Tan, R., & Ashwin, C. (2023). Validation of the English version of the Autism-Spectrum Quotient in an English-speaking Singaporean sample. Plos one, 18(9), e0291726. * Zhu, Y., Mu, W., Chirica, M. G., & Berenbaum, H. (2022). Testing a theory‐driven factor structure of the autism‐spectrum quotient. Autism Research, 15(9), 1710-1718.
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Severity ranges
Normative scores were derived from a sample of randomly selected adults in the United Kingdom (n = 174; 76 males, 98 females; Baron-Cohen et al., 2001). Participants were aged 37 (7.7) years.
Provisional diagnosis
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
Reliability