Autism Spectrum Disorder Symptom Dimensions Questionnaire (ASDQ)

Abstract

The Autism Symptom Dimensions Questionnaire (ASDQ), developed by Frazier et al. (2023), is a 39-item, open-source measure designed to assess core Autism Spectrum Disorder (ASD) symptoms in children and adolescents (aged 2 to 17 years). The instrument was explicitly developed to align with the diagnostic criteria outlined in the DSM-5, thereby addressing known limitations in existing informant-report measures.

Initial psychometric evaluation, based on data collected from parents of children with ASD, confirmed a robust factor structure. The factor analysis identified a general ASD factor and nine specific symptom factors corresponding to the two main DSM-5 domains: social communication/interaction and restricted/repetitive behaviors. The ASDQ demonstrated high reliability (including internal consistency and conditional reliability) and strong validity (convergent, discriminant, and predictive), supporting its use as a reliable and valid dimensional measure of autism symptomatology in research and clinical contexts.

Keywords

Autism Spectrum Disorder (ASD), Autism Symptoms, DSM-5, Children, Adolescents, Informant Report, Social Communication, Restricted and Repetitive Behaviors, Psychometric evaluation, Measurement Invariance.

Authors

Frazier, Thomas W., Dimitropoulos, Anastasia, Abbeduto, Leonard, Armstrong-Brine, Melissa, Kralovic, Shanna, Shih, Andy, Hardan, Antonio Y., Youngstrom, Eric A., Uljarević, Mirko, Quadrant Biosciences -As You Are Team.

[quads id=5]

Purpose

The Autism Symptom Dimensions Questionnaire (ASDQ) was created specifically to enhance the assessment of core autism symptoms in children and adolescents. Its development aimed to rectify the structural and psychometric limitations inherent in older, existing measures of autism symptomatology.

A core objective was the development of an instrument whose factor structure precisely mirrors the two major symptom domains specified by the DSM-5: Social Communication/Interaction and Restricted/Repetitive Behaviors. This dimensional approach allows for a more granular and criteria-aligned assessment, suitable for clinical research and population screening.

Construct

The ASDQ is designed to measure the frequency and severity of dimensional symptoms associated with Autism Spectrum Disorder (ASD). It utilizes a bifactor model to capture both a general underlying ASD severity factor and specific symptom factors, providing a comprehensive profile of a child’s symptomatology.

The 39 items are organized into nine specific factors which cluster under the two overarching DSM-5 domains:

• Social Communication and Interaction: Basic social communication, Affiliation, Perspective taking, and Peer relationships.
• Restricted and Repetitive Behaviors: Repetitive motor behavior, Sensory interests, Insistence on sameness, Sensory sensitivities, and Restricted interests.

Validity

The ASDQ demonstrated robust validity across multiple metrics, supporting its use for measuring autism dimensions.

Convergent and Discriminant Validity: ASDQ total scores showed strong correlations with established measures of autism, specifically the Social Communication Questionnaire (SCQ) and the Strengths and Difficulties Questionnaire total scores, alongside self-reported ASD diagnosis. Moderate correlations (r = 0.39–0.50) were observed with measures of executive functioning, adaptive functioning, and internalizing/externalizing behaviors (from the Strengths and Difficulties Questionnaire), confirming the expected pattern of convergent and discriminant validity.

Predictive Validity: Exploratory analyses indicated that the ASDQ possesses good predictive accuracy when differentiating between clinical (ASD) and non-clinical (neurotypical or other developmental disability) diagnoses. This suggests the tool is effective for identifying at-risk individuals and for use in general population contexts.

Reliability

The scale exhibits high levels of internal consistency and conditional reliability, ensuring consistent measurement of the underlying construct.

Internal Consistency: The overall scale achieved excellent internal consistency ($alpha$ = 0.95). Model reliability ($omega$) was also exceptionally high for the general ASD factor ($omega = 0.97$) and for the specific symptom factors ($omega geq 0.85$). All individual subscale scores met at least the adequate threshold for internal consistency ($alpha geq 0.75$).

Conditional Reliability: Conditional reliability estimates were consistently excellent ($geq 0.90$) for the total ASD scale across a broad range of trait levels, demonstrating that the scale accurately measures individuals with both very low ($theta = -2.1$) and extremely high ($theta = +4.0$) levels of autism symptoms.

Factor Analysis

The structural evaluation of the ASDQ confirmed its intended dimensional model, comprising both a general factor and specific factors aligned with clinical criteria.

Exploratory Structural Equation Model (ESEM): The optimal model fit was achieved by the a priori hypothesized solution: a general bifactor ESEM solution incorporating nine specific symptom factors. This structure confirmed that the general ASD factor accounted for a substantial 42% of the common variance. A Confirmatory Factor Analysis (CFA) model (model 9b) also demonstrated adequate fit, despite not estimating minor item cross-loadings.

Measurement Invariance: Crucially, the general bifactor CFA model provided evidence of strict measurement invariance across key demographic characteristics, including sex, age, race, and ethnicity. This indicates that the scale measures the same constructs equally across these diverse groups, supporting its generalizability.

Instrument

Test Type: Original Inventory/Questionnaire

Format: The instrument is a 39-item questionnaire administered electronically. All items are rated on a 5-point Likert frequency scale (1, never; 2, rarely; 3, sometimes; 4, often; 5, very often).

Language Available: English

Population Group: Human; Male; Female

Age Group: Childhood (birth-12 yrs); Preschool Age (2-5 yrs); School Age (6-12 yrs); Adolescence (13-17 yrs)

Population Details: Data was collected from parents (primarily biological mothers) of dependent children with Autism Spectrum Disorder (ASD) aged 2 to 17 years in the United States.

Test Methodology: The instrument utilizes Test Validity, Construct Validity, Convergent Validity, Discriminant Validity, Predictive Validity, Test Reliability, Internal Consistency, Factor Analysis, Confirmatory Factor Analysis, Measurement Invariance, and Structural Equation Modeling.

Keywords

Affiliation, Basic Social Communication, Insistence on Sameness, Peer Relationships, Perspective Taking, Repetitive Motor Behavior, Restricted Interests, Sensory Interests, Sensory Sensitivity, Psychometrics, Bifactor Model.

[quads id=5]

Authors

Author ORCID Identifier:

• Frazier, Thomas W.: orcid.org/0000-0002-6951-2667

Affiliation Email addresses:

• Frazier, Thomas W.: John Carroll University Department of Psychology

• Dimitropoulos, Anastasia: Case Western Reserve University Department of Psychological Sciences

• Abbeduto, Leonard: University of California, Davis Department of Psychiatry and Behavioral Sciences and MIND Institute

• Armstrong-Brine, Melissa: MetroHealth Medical Center MetroHealth Autism Assessment Clinic

• Kralovic, Shanna: University Hospitals Case Medical Center Division of Developmental Behavioral Pediatrics and Psychology

• Shih, Andy: Autism Speaks

• Hardan, Antonio Y.: Stanford University Department of Psychiatry and Behavioral Sciences

• Youngstrom, Eric A.: University of North Carolina at Chapel Hill Department of Psychology and Neuroscience

• Uljarević, Mirko: University of Melbourne, Faculty of Medicine, Dentistry, and Health Sciences Melbourne School of Psychological Sciences

• Institutional Author: Quadrant Biosciences -As You Are Team

• Email for Frazier, Thomas W.: [email protected]

Correspondence Address:

• Frazier, Thomas W.: John Carroll University, Department of Psychology, 1 John Carroll Boulevard, University Heights, Ohio, United States, 44118, [email protected]

Permissions & Fee and Test Year

Permissions: May use for Research/Teaching.

Commercial Use: No

Fee: No

Test Year: 2023

Web Site: creativecommons.org/licenses/by/4.0/, osf.io/pyq8r/

References

Frazier, T. W., Dimitropoulos, A., Abbeduto, L., Armstrong‐Brine, M., Kralovic, S., Shih, A., Hardan, A. Y., Youngstrom, E. A., Uljarević, M., & Quadrant Biosciences -As You Are Team. (2023). The Autism Symptom Dimensions Questionnaire: Development and psychometric evaluation of a new, open‐source measure of autism symptomatology. Developmental Medicine & Child Neurology, 65(8), 1081–1092. doi.org/10.1111/dmcn.15497

[quads id=5]

Items of the Autism Symptom Dimensions Questionnaire (ASDQ)

The Autism Symptom Dimensions Questionnaire (ASDQ) is a 39-item measure. All items are rated on a 5-point Likert frequency scale (1, never; 2, rarely; 3, sometimes; 4, often; 5, very often). The specific items are not individually listed in the provided text but are categorized into domains: Social communication and interaction (Basic social communication; Affiliation; Perspective taking; Peer relationships) and Restricted and repetitive behaviors (Repetitive motor behavior; Sensory interests; Insistence on sameness; Sensory sensitivities; Restricted interests). The test items are available, as noted in the “Test Location: 2023-38391-001, Supplemental Material, Pages 3-4.”

Child’s Information

• Child’s Name: [Space for Name]

• Today’s Date: [Space for Date]

Instructions for Completion

Please indicate how frequently the person you are rating engages in each of the following behaviors. Please consider expectations for behavior given the person’s age when responding to each question.

If the question is not applicable to the person you are rating because they are too young, are not verbal, or you feel you do not have enough information to rate the behavior, select the last column (Not Applicable or Not Able to Rate).

Social Interaction and Communication

How often does this person…

1. Start interactions with others without prompting?

2. Prefer to be with family or friends rather than alone?

3. Try to be physically and emotionally-connected to family and friends?

4. Make expected eye contact? (not too brief, too intense, or looking past people)

5. Use gestures to communicate? (ex. wave, point, nod, shake head)

6. Communicate clearly so that other people know how they feel?

7. Offer comfort to others when they are upset or sick?

8. Share enjoyment about interests or activities with other people?

9. Engage in back and forth play with same-age peers? (ex. playing tag or cops-and-robbers by exchanging roles and allowing others to win OR in adolescents/adults playing turn-taking games or activities that require reciprocal give-and-take)

10. Respond appropriately when others approach them? (ex.微笑, nodding, saying something back)

11. Have a back and forth conversation about another person’s interests and activities, not just their own?

12. Read social cues? (ex. facial expressions, gestures, body language)

13. Understand that expected behavior varies by social situation? (ex. being quieter in the library than at a party)

14. Seem to understand what others are thinking or feeling?

15. Show that relationships are important to them?*

16. Seek out playful interactions, playmates, or friendships?

17. Engage with two or more close friends?*

Repetitive Behaviors and Restricted Interests

The following set of questions examines unexpected behaviors. How often does this person…

1. Flap or move their hands in an unusual way? (ex. claps or flaps their hands or flicks their fingers when they are excited)

2. Repetitively jump, rock their body, spin in circles, or do other whole-body motions?

3. Repeat sounds, words, or lines from videos?

4. Repetitively play with objects or repeat actions without a purpose? (ex. lining up toys, spinning wheels, opening and closing doors, turning lights on and off, etc.)

5. Insist on keeping a consistent daily schedule? (ex. gets upset with changes in the routine)

6. Have difficulty transitioning from one activity to another?

7. Want to follow strict rules, rituals, or sequences? (ex. taking the same route to a destination, touching things in a certain sequence, eating foods in a certain order, playing games a certain way, or performing activities until they are “just right”)

8. Have trouble changing their mind and being flexible?

9. Appear overly sensitive to loud noises?

10. Get upset in crowded or busy places?*

11. Dislike certain lights, sounds, textures, foods, or smells?

12. Prefer to engage with specific parts of objects rather than the whole object?* (ex. parts of a toy, small pieces of a game, or parts of electrical equipment)

13. Appear fascinated by sensory experiences? (ex. staring at lights, fans, running water, symmetrical patterns, street signs, falling or dangling objects, textures, smells, etc.)

14. Become preoccupied with visual patterns or sounds?* (ex. fascination with the way something looks or moves, excessive focus on certain sounds or videos)

15. Think or talk about the same topic over and over?

16. Seem overly fixated on one interest or activity?

17. Spend too much time on a game or subject that is not interesting to others?*

18. Seem too focused on an interest that is highly specific or narrow in scope?

19. Prefer to make lists, memorize facts, or learn about technical subjects?

20. Stand too close or show unexpected body language when interacting with others? (ex. a facial expression that doesn’t match what the person is saying or having their body turned away during conversation)

21. Take things too literally? (ex. not understanding when people are sarcastic, joking, or using figures of speech such as “it’s raining cats and dogs” OR “a leopard can’t change his spots”)

22. Speak with an unusual volume, tone, rhythm, or rate of speech?

Notes

• Note: *Indicates items added in Study 2.

• Copyright (C) 2021 Thomas W. Frazier, PhD

• CC BY 4.0 Thomas W. Frazier, PhD