The Autism Spectrum Quotient was developed by researcher Simon Baron-Cohen and his team at the Cambridge Autism Research Centre and published in a 2001 study. In the intervening years, clinicians have validated the test through test-retest reliability studies and inter-rater reliability studies.
Throughout the lifespan of this assessment, updates have been made to correct outdated information. For example, in the initial test, a question assumed an Autistic person would score higher on being fascinated by dates, although this is now not considered to be universally true. While some agree that this tool is accurate, some Autistic advocacy groups note that some of the questions rely on outdated assumptions, often based on limited study groups of a certain demographic.
For example, one of the questions states, “When I’m reading a story, I can easily imagine what the characters look like,” which implies that Autistic people lack imagination. This assumption was thought to be the case in older studies. Still, it has since been attributed to affective alexithymia, which not every Autistic person necessarily scores on the test or experiences.
This test has been deemed a reliable preliminary tool for assessing traits within the autism spectrum. Health professionals use it to identify the potential benefit of more detailed assessment, while researchers use it to measure traits across different populations.
Another potential benefit of this test is that it increases autism awareness, allowing more people to recognize autistic traits in themselves and potentially in others. With greater recognition can come better understanding and increased support for the broader community.
The Autism Spectrum Quotient test is made up of 50 statements, for which test-takers may choose one of the following:
The person taking the test may consider “agree” or “disagree” binary choices, as the qualifiers of “slightly” and “definitely” do not affect the scoring. The scoring range for this test is zero to 50, with a score higher than 26 indicating that an individual may have autism, with lower scores indicating that they may not.
Questions address behaviors often associated with autism spectrum conditions, such as having very strong interests, the tendency to notice car number plates and other details, noticing small sounds, and having difficulty understanding people’s intentions. A few sample statements from the test include:
Scoring may be completed automatically on a website at the click of a button, or you can choose to self-score to document the process. However, when taking an online screening, note that the results are not an official diagnosis. Bring your results to a provider, or consider taking the test with a licensed psychologist for diagnosis and support options.
While the Autism Spectrum Quotient has been recognized as an effective and accurate preliminary testing tool, it is not the same as receiving a diagnosis of autism, and not every Autistic person experiences the symptoms on this screening. The AQ is often considered a bridge between self-assessment and medical diagnosis. It may help someone who suspects they may have Autistic traits to identify them early and seek a diagnosis from a medical professional.
Because this test offers a single score, it doesn’t necessarily offer significant insight into Autistic traits; it merely identifies that they are present. Not all adults who confirm through this test or a similar screening tool that they experience these traits may go on to seek a diagnosis. There are benefits to getting a diagnosis, as well as benefits to not getting one. This decision is often personal.
If you choose to get a diagnosis, doing so may be helpful in diagnosing co-occurring conditions. Often, autism is accompanied by one of several other conditions, including anxiety, depression, attention-deficit hyperactivity disorder (ADHD), immune dysfunction, or gastrointestinal disorders. If you experience a combination of these conditions, an autism diagnosis may help your doctor better understand and share useful information about these issues.
Autism diagnosis does not yet utilize any laboratory test. Rather, when you speak to your doctor about suspected traits, they may complete an initial screening that includes observation and questionnaires (more detailed than the AQ) to assess what is present and at what levels of severity they present. Next, your doctor may refer you to a specialist team for further screening and diagnosis.
Being diagnosed with autism as an adult can open doors to joining Autistic programs and services that you may find helpful. Working with these groups might offer an improved understanding of yourself and provide a community with people who face similar challenges and triumphs. You can also learn how the perceptions and language have changed around autism over the years. For example, the term “high-functioning autism” is often considered inaccurate and inappropriate now.
Your doctor can team up with you and other professionals to develop a treatment plan for certain symptoms that can be present with autism and co-occurring disorders such as gastrointestinal issues or ADHD.
Your doctor may also refer you to therapy. Evidence-based therapeutic approaches like cognitive-behavioral therapy have been found to improve symptoms of anxiety and depression, both common conditions found in people with autism. A therapist with experience working with autism may also share tools and coping mechanisms that you may find helpful.
If attending in-person therapy appointments doesn’t work with your inclinations or schedule, online therapy through platforms like BetterHelp may be a more convenient solution. Research has shown that online therapy can be as effective as in-person therapy, and it offers a more flexible schedule while allowing you to meet with your therapist from the comfort of your home.
Online platforms also offer clients the option to utilize resources like support groups, journaling prompts, and worksheets that may be helpful when navigating certain symptoms or accessibility challenges in daily life. Support groups for neurodivergent adults can be a way to meet other people with autism online.
Researchers and clinicians have approved the Autism Spectrum Quotient test as an effective first step in identifying Autistic traits. If you suspect that you may have autism and are interested in learning more, this screening may offer you a starting point. However, the AQ does not diagnose autism. To seek a diagnosis, reach out to a medical or mental health provider online or in your area.
An average score on the Autism Spectrum Quotient (AQ) questionnaire is typically between 16 and 31, indicating few or no autistic traits.
The lowest level of autism traits is often referred to as Level 1, which is sometimes called "high-functioning" autism.
Level 1 autism in a diagnosis might involve difficulty with social interactions and communication, requiring some support, but individuals can generally function independently.
To know your autism level, a comprehensive evaluation by a healthcare professional, including diagnostic assessments and clinical observations, is necessary.
The Autism Spectrum Quotient is a self-administered questionnaire that assesses autistic traits in people ages 16 and older. There are five subscale scores: social skills, attention switching, attention to detail, communication, and imagination. People taking the test choose one response for each item that describes how the statement applies to them, from definitely agree to definitely disagree. Some of the statements are:
The AQ scores obtained from this assessment can provide insight into traits associated with autism and help differentiate between those with and without autism. That said, no single test can give a formal diagnosis.
High-functioning autism is not a recognized diagnostic term or clinical diagnosis in child psychology or in the DSM, but it is sometimes used as an informal way to describe people with autism who do not require a lot of support.
According to the DSM-5, level 2 autism requires substantial support. People with this level of autism may have marked delays in communication and limited ability to or interest in social relationships. While you cannot always tell whether someone has autism based on the person's appearance, people with level 2 autism may engage in behaviors that are obvious to others.
The Autism Spectrum Quotient score associated with autistic traits is 32, but this has been challenged, as some researchers believe there are other optimal cut-off scores. For example, some research found that a cut-off score of 29 is highly sensitive and specific, with only a 1% false positive rate.
Mild autism is not a clinical term. People with mild symptoms may be considered to have level 1 autism. They may have unusual responses or lack interest in social interactions. People with level 1 autism may need to be redirected from their fixed interests, and they may engage in repetitive behaviors that can interfere with their daily routine.
There are other behaviors you may notice in people with autism spectrum disorders as well. Someone with mild autism may have an increased ability to notice patterns, small details, or similar strings of information, but theyhave trouble remembering people's date of birth because they may not see it as an important detail. They may have difficulties understanding television shows, movies, or books because they may not understand a character’s intentions.
A study of autistic adults diagnosed with this disorder looked at personality correlates of the broader autism phenotype. Traits identified by the AQ and a brief Asperger syndrome screening measure found that high scores on both measures were associated with low extraversion, low agreeableness, and high neuroticism. Some people with mild autism may exhibit these traits.
There may be gender differences as well. Autistic females may be able to mask their symptoms more effectively than males, which can make it more difficult to distinguish them from non-autistic adult females.
The biggest predictor of autism may be genetics. Some experts estimate that up to 80% of a child’s risk of developing autism spectrum disorder, though environmental and other factors also contribute.