The Adolescent Autism Spectrum Quotient (AQ)

Abstract

The Adolescent Autism Spectrum Quotient (AQ) is a psychometric screening instrument developed by Simon Baron-Cohen and colleagues to quantify the severity of Autism Spectrum Disorder (ASD) traits in adolescents. This 50-item self- or proxy-report questionnaire is specifically validated for individuals aged 12 to 15 years, adapting the original adult AQ scale for a younger demographic. The AQ measures five key domains—Social Skills, Attention Switching, Attention to Detail, Communication, and Imagination—providing a total score (0–50) that indicates the extent of autistic characteristics present in the individual. It is widely used in research and clinical settings as a preliminary tool to identify individuals who may require further diagnostic evaluation for ASD.

Keywords

Autism Spectrum Quotient, Adolescent AQ, Autism Spectrum Disorder, Asperger Syndrome, Psychometrics, Screening Tool, Social Skills, Attention Switching, Imagination, Developmental Disorders.

Authors

Simon Baron-Cohen, Rosemary Hoekstra, Rebecca Knickmeyer, Sally Wheelwright, Richard Skinner, Jennifer Martin, Elizabeth Clubley, Bonnie Auyeung, Carrie Allison.

Purpose

The primary purpose of the Adolescent AQ is to provide a standardized, quantifiable measure of autistic traits in adolescents aged 12 to 15. It functions as an efficient screening instrument, allowing for the rapid assessment of behavioral and cognitive styles characteristic of ASD, particularly those associated with high-functioning autism or Asperger Syndrome.

The scale is instrumental in research for identifying individuals with high levels of autistic characteristics within the general population or specific cohorts (e.g., in studies focusing on specific cognitive profiles). Clinically, the total score helps professionals gauge the level of phenotypic expression of autistic features, informing decisions regarding the necessity of a full diagnostic work-up.

Construct

The Adolescent AQ is designed to measure the psychological construct of autistic traits as a continuum, reflecting the dimensional nature of the autism spectrum. It operationalizes the core diagnostic criteria of ASD by assessing difficulties in social interaction and communication, alongside patterns of restricted and repetitive behaviors and interests.

The scale is underpinned by a five-factor model that captures the diverse manifestations of these traits: difficulties with Social Skills and Communication, atypical processing related to Attention to Detail, rigidity and difficulty with Attention Switching, and challenges related to Imagination and pretense.

Validity

The validity of the Adolescent AQ is supported by strong evidence demonstrating its capacity to differentiate between typically developing adolescents and those with a confirmed diagnosis of ASD. Its development ensured fidelity to the original adult AQ, maintaining content validity across the lifespan.

Studies have shown robust criterion validity, where adolescents diagnosed with ASD consistently score significantly higher than control groups. Furthermore, the correlation between the subscales and independent measures of social and behavioral functioning supports the scale’s construct validity, confirming that the AQ-Adolescent measures the intended dimensions of the autistic phenotype.

Reliability

The Adolescent AQ demonstrates high internal consistency (reliability), indicating that its items consistently measure the same underlying trait. The Cronbach’s Alpha coefficients reported in validation studies are exceptionally high, both for the individual subscales and the total score:

• Social Skills: Alpha = 0.93
• Attention to Detail: Alpha = 0.83
• Attention Switching: Alpha = 0.89
• Communication: Alpha = 0.92
• Imagination: Alpha = 0.88
• Total Score: Alpha = 0.97

The outstanding reliability of the total score (Alpha = 0.97) suggests that the instrument is a highly dependable measure for aggregating the overall level of psychometric autistic traits in the target age group.

Factor Analysis

Factor analysis of the Adolescent AQ confirms a stable five-factor model, which mirrors the structure of the original adult AQ. This structure is crucial for providing a comprehensive assessment of the heterogeneous nature of ASD, rather than relying solely on a unitary score. The five domains defined by the factor analysis are:

• Social Skills: Measures difficulties in social reciprocity and interaction.
• Attention Switching: Measures rigidity, resistance to change, and difficulty shifting focus or coping with interruption.
• Attention to Detail: Measures the tendency to focus intensely on small details, systems, or patterns, often at the expense of the “big picture.”
• Communication: Measures pragmatic communication difficulties, such as misinterpreting conversational cues or appearing impolite.
• Imagination: Measures challenges related to creative pretense, perspective-taking, and imagination.

Instrument

Test Type: Self-report or proxy-report psychometric screening tool.

Format: 50 items using a 4-point Likert scale (Definitely agree, slightly agree, slightly disagree, definitely disagree).

Language Available: English (Original). The scale has been translated and validated in numerous languages globally.

Population Group: Adolescents in both clinical and non-clinical settings, specifically those being screened for high levels of autistic traits.

Age Group: 12–15 years.

Population Details: Developed based on populations including individuals with Asperger Syndrome/High-Functioning Autism and typically developing controls.

Test Methodology: Each item is scored dichotomously (0 or 1). For certain items (2, 4, 5, 6, 7, 9, 12, 13, 16, 18, 19, 20, 21, 22, 23, 26, 33, 35, 39, 41, 42, 43, 45, 46), ‘Definitely agree’ or ‘Slightly agree’ scores 1 point. For the remaining items (1, 3, 8, 10, 11, 14, 15, 17, 24, 25, 27, 28, 29, 30, 31, 32, 34, 36, 37, 38, 40, 44, 47, 48, 49, 50), ‘Definitely disagree’ or ‘Slightly disagree’ scores 1 point. The maximum total score is 50.

Keywords

Psychological assessment, Autism Spectrum Quotient, ASD screening, Social interaction, Restricted interests, Repetitive behaviors, Likert scale, Baron-Cohen, Developmental screening.

Authors

Author ORCID Identifier: Information not provided in source material.

Affiliation Email addresses: [email protected] & [email protected]

Correspondence Address: Research associated with the Autism Research Centre (ARC), University of Cambridge, UK.

Permissions & Fee and Test Year

The Autism Spectrum Quotient scales, including the adolescent version, are generally available for non-commercial research use through the Autism Research Centre (ARC). The original adult AQ was published in 2001, and the specific validation and publication of the Adolescent AQ occurred in 2006.

The original PDF for the Adolescent AQ (2006 validation) can be downloaded here: http://docs.autismresearchcentre.com/papers/2006_BC_Hoekstra_etal_AQ-adol.pdf. A related instrument, the Child AQ (2008), is available here: http://docs.autismresearchcentre.com/papers/2008_Auyeung_etal_ChildAQ.pdf.

Reference’s

The following references document the development, validation, and application of the Autism Spectrum Quotient, including the adolescent version:

• 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(1); 5-17.
• Baron-Cohen S, Hoekstra RA, Knickmeyer R, Wheelwright S (2006). “The Autism-Spectrum Quotient (AQ)—adolescent version”. Journal of Autism and Developmental Disorders, 36 (3): 343–50.
• Woodbury-Smith MR, Robinson J, Wheelwright S, Baron-Cohen S (2005). Screening Adults for Asperger Syndrome using the AQ: a Preliminary Study of its Diagnostic Validity in Clinical Practice. Journal of Autism and Developmental Disorders, 35(3), 331-335.
• Auyeung. Bonnie, Baron-Cohen. Simon, Wheelwright. Sally, Allison. Carrie. (2008). The Autism Spectrum Quotient: Children’s Version (AQ-Child). Journal of Autism and Developmental Disorders, 38(7); 1230-1240.

Items of the The Adolescent Autism Spectrum Quotient (AQ)

1. S/he prefers to do things with others rather than on her/his own.

2. S/he prefers to do things the same way over and over again.

3. If s/he tries to imagine something, s/he finds it very easy to cr‎eate a picture in her/his mind.

4. S/he frequently gets so strongly absorbed in one thing that s/he loses sight of other things.

5. S/he often notices small sounds when others do not.

6. S/he usually notices car number plates or similar strings of information.

7. Other people frequently tell her/him that what s/he has said is impolite, even though s/he thinks it is polite.

8. When s/he is reading a story, s/he can easily imagine what the ch‎aracters might look like.

9. S/he is fascinated by dates.

10. In a social group, s/he can easily keep track of several different people’s conversations.

11. S/he finds social situations easy.

12. S/he tends to notice details that others do not.

13. S/he would rather go to a library than a party.

14. S/he finds making up stories easy.

15. S/he finds her/himself drawn more strongly to people than to things.

16. S/he tends to have very strong interests, which s/he gets upset about if s/he can’t pursue.

17. S/he enjoys social chit-chat.

18. When s/he talks, it isn’t always easy for others to get a word in edgeways.

19. S/he is fascinated by numbers.

20. When s/he is reading a story, s/he finds it difficult to work out the ch‎aracters’ intentions.

21. S/he doesn’t particularly enjoy reading fiction.

22. S/he finds it hard to make new friends.

23. S/he notices patterns in things all the time.

24. S/he would rather go to the theatre than a museum.

25. It does not upset him/her if his/her daily routine is disturbed.

26. S/he frequently finds that s/he doesn’t know how to keep a conversation going.

27. S/he finds it easy to ‘‘read between the lines’’ when someone is talking to her/him.

28. S/he usually concentrates more on the whole picture, rather than the small details.

29. S/he is not very good at remembering phone numbers.

30. S/he doesn’t usually notice small changes in a situation, or a person’s appearance.

31. S/he knows how to tell if someone listening to him/her is getting bored.

32. S/he finds it easy to do more than one thing at once.

33. When s/he talks on the phone, s/he is not sure when it’s her/his turn to speak.

34. S/he enjoys doing things spontaneously.

35. S/he is often the last to understand the point of a joke.

36. S/he finds it easy to work out what someone is thinking or feeling just by looking at their face.

37. If there is an interruption, s/he can switch back to what s/he was doing very quickly.

38. S/he is good at social chit-chat.

39. People often tell her/him that s/he keeps going on and on about the same thing.

40. When s/he was younger, s/he used to enjoy playing games involving pretending with other children.

41. S/he likes to collect information about categories of things (e.g. types of car, types of bird, types of train, types of plant, etc.).

42. S/he finds it difficult to imagine what it would be like to be someone else.

43. S/he likes to plan any activities s/he participates in carefully.

44. S/he enjoys social occasions.

45. S/he finds it difficult to work out people’s intentions.

46. New situations make him/her anxious.

47. S/he enjoys meeting new people.

48. S/he is a good diplomat.

49. S/he is not very good at remembering people’s date of birth.

50. S/he finds it very to easy to play games with children that involve pretending.