Category Archives: Asperger’s Tests

Taking the CAM Face-Voice Battery

This week for Take-a-Test Tuesday I took the Cambridge Mindreading Face-Voice Battery (CAM) which is another test of the ability to recognize emotions in others.

The Cambridge Mindreading Face-Voice Battery (CAM)  tests recognition of complex emotional states. It consists of short audio and video clips in which actors convey 1 of 20 different complex emotions through either their voice or their facial expressions.

The theory behind the CAM is that autistic people are able to read basic emotions but have difficulty interpreting complex emotions. Basic emotions are the ones that we learn early in life: happy, sad, angry, surprised. Most people learn these by age 6.

Complex emotions are sometimes described as combinations of basic emotions or as basic emotions plus cultural conditioning. They include mental states like stern, intimate, guarded, admiring, submissive and vibrant. There are hundreds of complex emotions and it takes us years to learn them. Generally, most people can recognize the majority of complex emotions by the time they reach adulthood.

Robert Plutchik's Wheel of Emotions is one of many ways of thinking about the relationships between basic and complex emotions
Robert Plutchik’s Wheel of Emotions is one of many ways of thinking about the relationships between basic and complex emotions

According to the CAM creators, the emotional states presented in the clips are “higher order” emotional concepts:

  • 6 concepts from level 4 (concepts understood by typical 15–16 year olds)
  • 13 concepts from level 5 (understood by typical 17–18 year olds)
  • 1 concept from level 6 (words understood by less than 75% of typical 17–18 year olds)

The purpose of the test is to examine whether autistic people grasp these more complex emotional states. It includes both negative and positive emotions as well as subtle and intense emotional states. Each of the 20 emotions is repeated 5 times.

Taking the Test

The Face-Voice Battery has two parts. Part 1 consists of listening to 50 short clips of actors saying a phrase or sentence. You’re given 4 options for describing the emotional content of the clip. Part 2 consists of watching 50 3-5 second videos of actors silently portraying facial expressions. Again you’re given 4 options that describe the emotional content.

You can take the Cambridge Mindreading (CAM) Face-Voice Battery at aspietests.org. To begin, click on the The Cambridge Mindreading Face-Voice Battery – Part 1 (Voices) link. After entering your age and diagnostic status and accepting the terms, you can proceed to the voice clips. As you take the test, keep in mind that speed counts. In addition to a %-correct score, the test returns an “average time to answer” score. Part 1 took me about 10 minutes to complete.

Once you finish Part 1, click the “back to the homepage” link and then click the Cambridge Mindreading Face-Voice Battery – Part 2 (Faces) link to begin Part 2. Again, speed counts. This part took me about 10 minutes to complete as well.

Scoring the Test

I did well on this test–in fact, I matched the mean score of neurotypical females in the original research study. Here is my score:

You scored 90.0% in 5.7 seconds. Faces: 84.0% (42 correct) Voices: 96.0% (48 correct)

Here are the average scores from the study:

ASD Faces task: 32 correct (64%)
ASD Voice task: 35 correct (70%)
ASD Total: 68 correct (68%)

NT Faces task: 44 correct (88%)
NT Voice task: 43 correct (86%)
NT Total: 86 correct (86%)

I’m not surprised by how well I did on the voices portion of the test. “Voice data” is my primary means of reading social situations. It helped that the informational content of the phrases matched the emotional content of the voices. For example, when I heard “that is horrible” I took into account the information being conveyed by the statement as well as the tone of voice to settle on my choice of “appalled.” This is considered a “strategy” by the test creators, so basically, once again, I’m “cheating.” But it works, so hooray for adaptations.

The video clips were a mixed bag. I think I did better on the ones that had a dissimilar set of possible answers (i.e. appalled, vibrant, blank, or intimate) and the ones that I remembered to glance at the answer choices before the clip played.

As an experiment, for some trials I watched the clip and tried to form an answer before looking at the choices. On one video, I was certain the answer was “sarcastic” but that wasn’t one of the choices; I think the correct answer was “reassured.”

A few other random thoughts:

  • Am I the only one who thought most of the voice clips sounded like they were straight out of Dickens novel?
  • The use of live action videos is more realistic than static photos, but I still didn’t feel like the test results were reflective of my real life ability to read emotions.
  • I liked seeing the contrast in my voice vs. facial expression reading skills.
  • Some of the video clips made me incredibly uncomfortable to the point that I had to glance away.
  • I couldn’t find any data on the “time to answer” scores. From background reading about this type of test, I know that researchers often use the average time to answer as a metric to gauge competency. The assumption is that the longer it takes to answer, the more processing your brain is doing to produce an answer.

The Bottom Line

CAM feels more realistic than Reading the Mind in the Eyes, but it’s still far from an accurate test of the fluid way that emotions present in real life interactions.

Taking the Friendship Questionnaire (FQ)

This week I took the Friendship Questionnaire (sometimes called the Friendship Quotient).

The Friendship Questionnaire (FQ) was developed in 2003 as part of Simon Baron-Cohen’s ongoing quest to prove his “extreme male brain” theory of Asperger’s. Consequently, the FQ measures a very specific model of friendship to prove a point about people on the spectrum.

The developers of the FQ say that an individual will score highly on it if they:

  • enjoy close, empathic supportive friendships
  • like and are interested in people
  • enjoy interaction with others for its own sake
  • find friendships important (Baron-Cohen and Wheelwright, 2003)

The questions are based on assumed gender differences in forming friendships. The FQ developers hypothesized that NT women would score highest, with men scoring slightly lower than NT women, and ASD individuals of both genders scoring significantly lower than NT men.

The average FQ scores from the 2003 study were:

  • NT females: 90.0
  • NT males: 70.3
  • ASD females: 59.8
  • ASD males: 53.2

The fundamental basis for the gender-difference hypothesis seems to be that men and people on the spectrum prefer activity-based friendships. Neurotypical women, on the other hand, are assumed to prefer interaction-based friendships, where the act of connecting is of primary importance.

Since every friendship I’ve had as an adult has grown out of a common interest, it’s safe to say I fall into the activity-based preference. Honestly, I have no real idea how friendship works in most cases, so let’s take the test.

Taking the Test

You can take the FQ at the Aspie Tests website. Click the link for the Friendship Quotient and then complete the first three questions (you don’t need to create an account unless you want to) and click the submit button to start the quiz.

There are 34 multiple choice questions.

I found some of these questions hard to answer because there was no “neither” option. For example, on #6 I literally don’t have a wide enough social circle that it requires me to choose between asking someone to meet first or thinking of an activity then choosing a person to do it with. #9: I have no idea. Neither? Why is there no neither option?!

For some questions, I ended up choosing answers based on how I’ve interacted with friends in the past because I couldn’t come up with a current example to base my answer on.

Scoring the Test

After submitting your answers, you’ll get your FQ score. The possible scoring range is 0 to 135. I got 39.

Average scores by gender for the FQ (aspietests.org)
Average scores by gender and neurotype for the FQ (aspietests.org)
FQ score distribution by neurotype
FQ score distribution by neurotype (aspietests.org)

I’m not sure what to make of my 39. I’m not surprised by it. Going down the list of qualities that the FQ tests for:

  • I enjoy close, supportive friendships, but I don’t need more than a couple at a time to feel that I have supportive connections in my life.
  • I don’t really like or have an interest in people as a general rule (sorry, human race).
  • I don’t generally enjoy interaction with others for its own sake, which is different from not enjoying interaction with others at all.
  • I find friendship moderately important, but again I don’t need many friends to feel like I have a satisfactory level of social interaction in my life.

The Bottom Line

The research I read on the FQ doesn’t imply that a low FQ score is “bad”, which is good to see, because I think the FQ is testing for a very specific model of friendship. The research does say that those with low FQ scores tend to have high AQ and low EQ scores.

Two-Factor Imagination Scale (TFIS) Test

This week I took the Two-Factor Imagination Scale (TFIS) test. It was developed to identify the predominant imagination style used by alexithymic and non-alexithymic individuals. I have a couple of questions at the end of this write-up for those who take both TFIS and the Alexithymia Questionnaire.

Imagination–or the alleged lack of imagination in both autistic and alexithymic individuals–seems to be a hot topic around here lately.

Impoverished imagination is often included in the list of traits for alexithymia. Restricted imagination isn’t explicitly included as a diagnostic item for Asperger’s or autism, but it is part of the common ASD stereotype.

People see autistic kids lining up Hot Wheels or sorting Legos by color and assume there isn’t a whole lot going on in the imagination department. As someone who spent a lot of time in organizational-type play as a kid, I can assure you that I had a vivid imagination.

The thing is, it mostly took place inside my head. All that time I spent wandering around aimlessly in the yard or staring off into space? I was often playing with my imaginary friend Will, pretending to be somewhere else entirely. Will and I spent a lot of time on other planets because he was modeled on Will Robinson from “Lost in Space.”

I didn’t need toys to act out my imaginary scenarios. The possibilities that existed in my mind were more interesting than the pretend food my friends wanted to pretend cook or the pretend store they liked pretend shopping at. Sometimes I joined in, but often it just seemed like a less interesting version of real life. I get bored really easily. Picking some berries and pretending to cook and eat them didn’t hold my attention for long.

Spontaneous vs. Controlled Imagination

The Two-Factor Imagination Scale questions are supposed to gauge whether you have a more spontaneous or more controlled imagination process.

  • Spontaneous imagination is defined as effortless, surprising and instantaneous. For example, you’re washing the dishes and suddenly have a great new idea for a drawing. It feels like your idea literally “came out of nowhere.”
  • Controlled imagination is defined as a process that is consciously initiated, guided and terminated. For example, you’re washing the dishes and consciously decide to think about how to resolve a conflict with your roommate. You intentionally stay on task, brainstorming ideas and refining until you have an answer, at which time you stop thinking about it.

That’s not to say that spontaneous imagination is always creative while controlled imagination is always practical. You could suddenly have the perfect solution to your roommate crisis appear out of nowhere. You could also intentionally brainstorm and plan a new drawing.

The theory behind the TFIS is that people with high alexithymic traits are controlled imagination-dominant. The speculation about imagination in autistics is similar–that our imaginations are less flexible or less productive when it comes to generating novel ideas.

While the TFIS isn’t a measure of how imaginative an individual is, it may shed some light on how we use our imaginations. Keep in mind that neither type of imagination is superior–they simply represent different thinking styles.

Taking the Test

You can take the test at Aspie Tests. Once you click the “click here to start” link, you’re taken to a page that asks for age, gender, and diagnostic status. You also have to tick the box agreeing to the terms, but you don’t have to fill in the user name info.

TFIS consists of 22 statements, which you  rate as “more often true” or “less often true”.

I had a lot of trouble choosing an option for many of the statements because I regularly have both controlled and spontaneous imagination experiences. I found myself answering questions in ways that directly contradicted each other, which got frustrating.

Once you’re satisfied with your answers (or can’t stand to look at the questions any longer) click the “Get Results” button to get your score.

Scoring the Test

There are three possible outcomes:

  • equal to or less than 45 = low spontaneous imagination
  • 46 to 59 = proportionate spontaneous/controlled imagination
  • equal to or greater than 60 = high spontaneous imagination

I scored 56.0 (proportionate spontaneous/controlled imagination), which isn’t surprising given how contradictory my answers felt. I think I use both types of imagination in tandem. Spontaneous ideas provide the start of a creative project or enrich the details. Controlled imagination fills in the gaps.

The Aspie Test site provides some interesting data on the scoring page. If you look only at the averages, it looks like people with ASD or suspected ASD have low spontaneous imagination and NTs have proportionate spontaneous/controlled imagination.

Average scores broken down by gender and neurotype
Average scores broken down by gender and neurotype

However, if you look at the graph, the data distribution isn’t “normal” which means the average scores don’t represent the majority of the people in each group. Look at where the yellow line peaks: the largest grouping of NT scores is at 40 (low spontaneous imagination) and the second largest is at 60 (high spontaneous imagination) making the average score of “proportionate” completely meaningless because the majority of NTs scored either low or high, not proportionate.

Distribution of scores by neurotype
Distribution of scores by neurotype

The same holds for the ASD scores. There’s a peak at 45 (proportionate) and a larger peak at 25 (low). The suspected ASD scores are literally all over the map, with no clear peak.

The Bottom Line

I’m struggling to draw any conclusions from this test, so I have questions for those who took it and would like to share:

  • How hard was it to choose answers that felt accurate?
  • Was your score surprising or what you expected?
  • Did you TFIS score “agree” with your alexithymia quiz score? (high alexithymic = low spontaneous imagination)

Taking the Alexithymia Questionnaire

This week for Take-a-Test Tuesday we’re taking the online alexithymia questionnaire.

Alexithymia refers to people who have difficulty identifying and describing emotions as well as differentiating between physical and emotional sensations. It’s not a formal diagnosis, but a way of describing a common set of experiences related to emotional dysfunction.

Some descriptions of alexithymia also include impoverished imagination and a tendency toward externally oriented (concrete) thinking. I found it interesting that both studies I cite below omitted these last two characteristics. Many of you who commented on the emotional dysfunction post last week questioned the inclusion of impoverished imagination, saying that you personally felt the opposite was true. I have to agree with this. My imagination is, if anything, overactive. Perhaps there is an autistic subtype of alexithymia?

Alexithymia is extremely common in autistic individuals. About 50% of people diagnosed with ASD have severe alexithymia, however nearly all people on the spectrum experience it to some degree. Among the general population, about 10% fit the alexithymia profile and parents of autistic children are more likely to be alexithymic than parents of nonautistic children.

When it comes to social communication, the line between autistic traits and alexithymic traits is blurry. Two recent studies (Bird et al, 2010 and Silani et al, 2008) suggest that alexithymia, not ASD, is responsible for impaired affective empathy.

The 2008 study looked at brain activity in autistic and nonautistic people with and without alexithymia. It found a correlation between a person’s level of alexithymia, brain activity in one of the regions believed to be responsible for identifying one’s own emotions, and scores on an empathy questionnaire. This was true of both the autistic and nonautistic participants, suggesting that impaired processing of emotion, not autism, is the source of impaired affective empathy.

The brain uses the same neural pathways for perceiving and interpreting our own  emotions as well as the emotions of others, so it makes sense that if we cannot process our emotions easily, we’ll also struggle to process emotions demonstrated by others..

One question that remains unanswered is why autism and alexithymia occur together so frequently.

Many commenters on last week’s post recognized themselves in my description of my own emotional dysfunction, so I thought it would be interesting to take the Online Alexithymia Questionnaire. While not a clinically recognized measure of alexithymia, it is based on commonly used clinical screening questionnaires.

Pros and Cons of the Online Alexithymia Questionnaire

Pros

  • Self-scoring
  • Provides subscale scores with cutoffs
  • Overall score is presented on a simple visual “severity” scale
  • Includes questions phrased as self-observation (I feel . . .) and other observation (People tell me . . .)

Cons

  • Not clinically tested or validated
  • Unclear how cutoffs were derived
  • Includes questions on topics that are not a part of generally accepted alexithymia definition

Taking the Test

The alexithymia questionnaires used in clinical research (TAS-20, BVAQ) aren’t available online, so I took the Online Alexithymia Questionnaire (OAQ-G2).

Take the test here. There are 37 questions. You have to answer at least 20 to get a result, meaning you can skip any you find overly invasive. The answers for each question become “grayed out” once you make a selection but you can go back and change your answer if you want to.

Scoring the Test

When you’re satisfied with your answers, click the “Evaluate Test” button and you’ll be given an overall score as well as 7 subscale scores. Here are mine:

Test Results: 141 Points.
Alexithymia: You show high alexithymic traits.

The yellow area indicates "some alexithymic traits" and the orange area indicates "high alexithymic traits"
The yellow area indicates “some alexithymic traits” and the orange area indicates “high alexithymic traits”

Difficulty Identifying Feelings: 23 Points <15 – 18> high alexithymic traits

Difficulty Describing Feelings: 17 Points <10 – 12> high alexithymic traits

Vicarious Interpretation of Feelings: 13 Points <8 – 9> high alexithymic traits

Externally-Oriented Thinking: 29 Points <18 – 21> high alexithymic traits

Restricted Imaginative Processes: 19 Points <18 – 21> some alexithymic traits

Problematic Interpersonal Relationships: 29 Points <15 – 18> high alexithymic traits

Sexual Difficulties and Disinterest: 11 Points <10 – 12> some alexithymic traits

The subscale scores in parentheses appear to be equivalent to the yellow area on the slider bar, meaning “some alexithymic traits.” A score below the range in parentheses indicates the absence of alexithymic traits (green area) and a score above indicates high alexithymic traits (orange area).

Keep in mind that the last two subscales, problematic interpersonal relationships and sexual difficulties/disinterest, aren’t specifically part of the formal definition of alexithymia. It’s possible that the sexual difficulties subscale could be impacted by whether a person is in a long-term relationship and feels comfortable with their partner.  Also, externally-oriented thinking and restricted imaginative processes are not always included in clinical definitions of alexithymia. The first three subscales are the best gauge of the core deficits of alexithymia.

I was surprised by my score on externally oriented thinking. This item refers to a tendency to think in concrete, nonintrospective terms. I don’t view concrete and nonintrospective as synonymous, but that could be my autistic brain.

I think in concrete terms, but I also spend a lot of time examining my thoughts and feelings. I might spend more time on the latter because I have to consciously “check-in” with my feelings to identify them. However, neurotypical people may be spending more time considering their feelings as part of decision making or social interaction. My introspection usually tends toward “what the heck is going on?”

The Bottom Line

The Online Alexithymia Questionnaire is the only freely available alexithymia  test. Although not scientifically validated, it appears to be a reasonable “amatuer” measure of alexithymic traits and a useful starting point for better understanding how you process emotions.

Thinking on your Feet: A Trio of Cognitive Tests

Thinking on Your Feet is a new test at Test My Brain. I was planning to do the creepy Face in the Branches test today but it’s no longer available. Instead I took Thinking on Your Feet, which isn’t an Asperger’s test but does test some of the cognitive areas that can be impacted by ASD.

Thinking on your Feet consists of three short tests:

  1. Find the flickering dot: You’re shown a set of blue and yellow dots that flash intermittently and you have to find the dot that’s changing color. There are sixteen sets of dots.
  2. Visual working memory: You’re briefly shown a set of four shapes arrayed around a plus (+) sign. The set disappears and one shape reappears. You press “s” if the shape is the same as the one you saw in that position in the set and “d” if it is different. There are 42 sets of shapes.
  3. Visual reasoning: You’re shown a matrix of shapes and have to identify the “missing piece” from 5 possible choices. There are 35 matrices and they become increasingly difficult.
Example of a nonverbal reasoning matrix
Example of a nonverbal reasoning matrix

As I was taking the tests, they reminded me of some of the cognitive tests I took during my Asperger’s evaluation.

The first and third tests measure components of executive function: attention and working memory. Executive function is way of describing our brain’s command and control center. It encompasses things like planning, problem solving, and verbal reasoning as well as starting, stopping, switching and monitoring tasks. Many aspies, including me, have impaired executive function.

The second test–visual reasoning–relies on nonverbal reasoning. Many aspies excel at tasks requiring nonverbal reasoning, either because they think visually or are skilled at pattern recognition.

Working with those general assumptions, individuals on the spectrum are probably more likely to score above average on the second test and average or below average on the other two.

Taking the Test

First a warning: One section of this test has a set of colored dots that flash at a steady rate. The flashing isn’t rapid, but the dots are quite bright and you have to study them as they flash to find one that is different. Is this sounds like it may be uncomfortable or triggering for you, don’t take this test.

The test guidelines say it takes about 30 minutes to complete. I finished in a little over 20. The first and third tests go pretty quickly, but you may want to spend more time on the visual reasoning section, depending on how quickly you can solve the harder puzzles and how much you care about your score.

When you’re ready to give it a try, go to the Test My Brain site and click the Go! button next to the Thinking on Your Feet test. You’ll be asked to agree to the consent form and provide some demographic information (age, handedness, primary language, etc.) to help the researchers analyze the data they’re collecting via these tests. It’s all anonymous and you won’t be asked for any personally identifying data.

Before each section of the test, you’ll be given written directions as well as two practice trials to be sure you understand what to do. After the three tests are complete, you’ll be asked for your SAT scores. If you don’t remember them or never took the SAT you can skip this section. It has no impact on the results you receive.

Scoring the Test

You’ll get three separate scores. Here are mine:

Find the Flickering Dot:  I got 14.63, which is a measure of the average number of screen flashes it took me to find the dot. The average score on this test is 20.53.

My scores on the Find the Flickering Dot test
I scored better than 30% of other test takers

Visual Reasoning Test: I got 31 out of 35 correct. The average score is 25.76

My visual reasoning score is in the 90th percentile group
My visual reasoning score is in the 90th percentile group

Visual Working Memory: I got 37 out of 42 correct. The average score is 33.91.

My visual working memory score is better than 60% of the other test takers
My visual working memory score is better than 60% of the other test takers

If we assume that the scores are normally distributed, then scores that fall between the 25th and 75th percentile are in the average range of ability. Or to put it another way, if your blue guy is standing somewhere in the middle of the pack, your scores are average. If he’s standing in the first two or last positions, you’re above or below average.

For the flickering dot and visual working memory scores, my blue guy is standing in the middle six, which means I have average scores . On the visual reasoning test, my blue guy is in the second to last position, meaning I have an above average score.

I went back and looked at my ASD evaluation report to compare the results of the comparable cognitive tests with these and they’re quite similar. My scores were above average for perceptual reasoning and average for attention. I didn’t take a visual working memory test so I don’t have a direct comparison there. I did take two verbal working memory tests and my results were “impaired” on both, meaning my little blue guy was standing in the first position in line.

It’s no surprise to me that I scored better on visual working memory than verbal. My verbal cognitive test scores are poor across the board and I’m much more comfortable working from printed or visual material than from oral directions.

The Bottom Line

This set of tests is an interesting look at some of the cognitive elements that are thought to be ASD strengths and weaknesses.

Taking the Empathy Quotient Test

This week I took the Empathy Quotient (EQ) test. I know many of you have been waiting for this one. Next week we’ll do something less technical and more fun, but this week, I’m gonna hit you with a lot of background info. The EQ and the 2004 study that it was originally used in created a firestorm of controversy that never really died down.

The Empathy Quotient (EQ) test is intended to be a measure of your ability to understand how people feel and to respond appropriately. The questions on the EQ are based on the following definition of empathy:

“Empathy is the drive or ability to attribute mental states to another person/animal, and entails an appropriate affective response in the observer to the other person’s mental state.” (Baron-Cohen and Wheelwright, 2004)

This definition encompasses both cognitive empathy (perspective taking/attribution) and affective empathy (emotional response to another’s emotional state). Although many autistic people have described distinct variations in their perceived levels of cognitive and empathic empathy, Baron-Cohen and Wheelwright state that cognitive and affective empathy are too difficult to untangle and therefore must be looked at as a whole.

A subsequent 2005 study by Muncer and Ling challenged this belief by sorting 23 of the 40 EQ questions into three domains: cognitive, emotional reactivity, and social skills. To give you an idea of what types of skills fall into each domain, here are the top 5 most relevant questions for each:

Cognitive

  1. I can tune into how someone else feels rapidly and intuitively
  2. I am good at predicting how someone will feel
  3. I am quick to spot when someone in a group is feeling awkward or uncomfortable
  4. I can easily work out what another person might want to talk about
  5. I can sense if I am intruding, even if the other person does not tell me

Social skills

  1. I do not tend to find social situations confusing
  2. I find it hard to know what to do in a social situation
  3. I often find it difficult to judge if something is rude or polite
  4. I find it difficult to explain to others things that I understand easily, when they do not understand it first time
  5. Friendships and relationships are just too difficult, so I tend not to bother with them

Emotional reactivity

  1. I tend to get emotionally involved with a friend’s problems
  2. Seeing people cry does not really upset me
  3. I really enjoy caring for other people
  4. I usually stay emotionally detached when watching a film
  5. If I say something that someone else is offended by, I think that is their problem, not mine

The 2005 study tested the 23 domain-specific EQ questions for gender differences. The emotional reactivity domain had the greatest gender differences, the cognitive domain had fewer differences and the social skills domain showed no differences in scores along gender lines. The authors theorized that emotional reactivity may be strongly rooted in the “willingness of an individual to express emotion” (drive) rather than the ability to understand another person’s emotional state.

This raises the question of how alexithymia (emotional dysfunction), which affects many people on the spectrum, might impact EQ scores. Many people on the spectrum experience alexithymia, making them less willing or able to express emotion due to challenges in regulating and processing feelings. Perhaps it isn’t that autistic people can’t understand the emotions of others, but that the cost of responding appropriately is too high.

Gender Bias Revisited

If you’ve been following Take-a-Test Tuesday closely, you’ve seen the discussion of gender bias in other screening instrument studies. The EQ study was heavily weighted toward males, with 65 males and 25 females in each group. That’s more than twice as many males as females in a study of a trait that is known to have gender differences in scoring.

Traditionally males score significantly lower than females on self-reported measures of empathy. On top of that, the EQ study had significantly more control group women than men with above average scores (>54) and 14% of control group males in the EQ study scored in the AS/HFA range.

Now consider that this study was used to test:

  • whether adults with high-functioning autism (HFA) or Asperger’s Syndrome (AS) have lower EQ scores
  • whether the EQ is inversely correlated with the AQ (i.e. the “more autistic” you are, the “less empathetic” you are)
  • whether the EQ inversely correlates with the Friendship Questionnaire (i.e. the “more autistic” you are, the less reciprocity and intimacy you’ll report having in relationships)
  • for sex differences in empathy

Baron-Cohen used the low EQ scores of the HFA/AS group as support for his theory that HFA/AS is an “empathy disorder.” The researchers subsequently conducted interviews with many of the HFA/AS study participants and reported that while they had difficulty knowing that their actions hurt another person, they did feel bad about it when such instances were pointed out to them, and therefore “are not like unfeeling psychopaths.”  (As I write this, I’m envisioning the tops of my autistic readers’ heads flying off. Repeatedly. Sorry.)

This study is also used as evidence to uphold another of Baron-Cohen’s theories (extreme male brain theory), further calling the motivation of the study design into question.

So, now that we’ve gotten ourselves all worked up about the questionable science underlying the EQ, let’s actually take the darn thing.

Pros and Cons of the EQ

Pros

  • Self-scoring
  • Scoring of slightly/definitely choices is weighted
  • Filler questions attempt to reduce repetitiveness
  • Clinically tested in both ASD and non-ASD populations

Cons

  • Measures cognitive empathy, emotional reactivity and social skills but doesn’t provide subscale scores
  • May be gender biased
  • May exhibit bias toward developer’s theory of autism
  • Probably longer than it needs to be (a 15-item version has shown similar outcomes)
  • Self-reported measures of empathy often have poor correlation with tests of empathic accuracy (i.e. we tend to think we’re either more or less empathetic than we are)

Taking the Test

When you take the EQ, you may question the relevance of some of the items. That’s because 40 are related to empathy and 20 are filler questions meant to be a distraction from the repetitive nature of the empathy questions. Only the 40 empathy-related questions count in the scoring; the 20 filler questions score a zero no matter how you answer them.

You can take the test here. There are 60 questions. Unlike some of the other tests we’ve taken, this test gives 2 points for a “definitely” answer and 1 point for a “slightly” answer so degree matters.

Scoring the Test

Possible scores range from 0 to 80. The average NT scores from two different studies were 47 and 50 for women and 41 and 42 for men. The average aspie score is 20.

A general scoring guideline:

  • 0-32 = below average
  • 33-52 = average
  • 53-63 = above average
  • 64-80 = significantly above average

I got a 12. The Scientist got a 48. I’ve taken the EQ twice in the past, and got an 8 and a 10. I jokingly told The Scientist this past week that I’m now 50% more empathetic.

If you get a ridiculously low score on this test, keep in mind that it’s measuring a few different things and conflating them into one “empathy” score, which isn’t very accurate. After reading the Muncer study, I wish the test returned subscale scores for cognitive, emotional reactivity and social skills. I’d like to know which of the areas I actually scored some points in.

The Bottom Line

The evidence for the EQ as a unidimensional measure of empathy is weak. Aspies tend to score low on the EQ, but what that means is unclear.

The Broad Autism Phenotype Questionnaire

This week for Take-a-Test Tuesday, I took the Broad Autism Phenotype Questionnaire.The only online version I was able to locate is seriously flawed so I’m going to recommend against taking it. However, I’ve been looking for an excuse to talk about the Broad Autism Phenotype and here it is! If you’re the parent of an autistic child, I have a question for you about the BAP at the end.

The Broad Autism Phenotype (BAP) is a fancy way of saying that nonautistic relatives of autistic individuals often have subclinical autistic traits themselves. As far back as Leo Kanner’s original study on autism, researchers have been observing a tendency for parents of autistic children to exhibit traits that are milder but qualitatively similar to the defining characteristics of autism, especially in the area of social communication.

Consequently, the Broad Autism Phenotype Questionnaire (BAPQ) focuses primarily on social communication, rigid personality traits and pragmatic language deficits, which are thought to be the most common characteristics of BAP. It is designed to be taken by nonautistic individuals, specifically parents of autistic children.

The BAPQ has questions in three areas:

  • social communication deficits (aloof personality subscale)
  • stereotyped-repetitive behaviors (rigid personality subscale)
  • social language deficits (pragmatic language subscale)

Each of these areas corresponds to one of the core domains of autism (though that will change with the DSM-V): social, stereotyped-repetitive, and communication deficits. The researchers who developed the BAPQ defined the three subscales that the test measures as follows:

Aloof personality: a lack of interest in or enjoyment of social interaction
Rigid personality: little interest in change or difficulty adjusting to change
Pragmatic language problems: deficits in the social aspects of language, resulting in
difficulties communicating effectively or in holding a fluid, reciprocal conversation

In developing the BAPQ, traits like anxious/worrying,hypersensitive to criticism, and untactful (which can all be autistic traits) were omitted because the researchers believed they were observed less frequently as part of the BAP. An individual is considered to “have” BAP if they exceed the threshold score on two of the three subscales.

It’s interesting to note that parents, grandparents, aunts and uncles of autistic children also have higher than average rates of major depression and social phobia. A number of studies (like this one) have indicated no direct relationship between BAP and major depression or social phobia in autism families. There have also been a number of studies that have refuted the notion that raising an autistic child is the cause of these elevated rates (take a look at the discussion section of the linked to study if you’re curious about how they reached this conclusion and what other factors might be at work).

Taking the Test

The only place I could find to take this online is at OKCupid. The test is riddled with grammatical errors and the result summaries are downright insulting. The scoring also appears flawed, so unless you have literally nothing better to do, I don’t recommend taking it. Seriously, go see what’s new on Tumblr or something.

My primary purpose in analyzing the online test is to point out how flawed it is and how it doesn’t align with the intended scoring method of the original BAPQ. You might want to go through the test to see what questions are included but you can also find the questions on page 10-11 of this PDF.

Scoring the Test

It’s unclear how the online test is scored. The original BAPQ has 6 answer choices, scored on a scale  from 1-6, but the online test collapses the first and last two choices. The BAPQ cutoff scores are averages (2.75 – 3.5), which were developed as part of a study using the 1 to 6 scale. The OK Cupid test appears to be using a summed score rather than an averaged score to determine a cutoff, so maybe the person who posted this decided to make up their own cutoff?

Like I said, you’d be better off wasting fifteen minutes on Tumblr.

At any rate, it provides four scores: diagnosis (overall score), aloof (aloof personality traits), rigid (rigid personality traits) and pragmatic (pragmatic language problems). The fact that the scores are presented as percentages (in excess of 100, no less!) makes no sense. Even worse is the little “diagnostic” description provided.

Mine says: “You scored 123 aloof, 117 rigid and 100 pragmatic. You scored above the cutoff on all three scales. Clearly, you are either autistic or on the broader autistic phenotype. You probably are not very social, and when you do interact with others, you come off as strange or rude without meaning to. You probably also like things to be familiar and predictable and don’t like changes, especially unexpected ones.”

Yep, that's me, 123% aloof and 117% rigid.
Yep, that’s me, 123% aloof and 117% rigid.

I looked at all of the possible outcome descriptions (you can force the test to reveal them at the end even if they don’t pertain to your score) and they’re all just as meaningless. Some are downright wrong. Many of them state that you’re on the BAP if you are over the cutoff on one subscale but not the other two, which is incorrect.

Basically, the “results” of the online test are useless.

If you’re interested in taking the BAP and getting a valid score, you can look at the appendix of the original research paper which has the full set of questions with a scoring key.

The Bottom Line

The online version of the test is too flawed to provide meaningful results. The BAPQ as administered in a clinical setting is used to screen for BAP in parents of autistic children, but the goal of screening is unclear.

My question for any parents of autistic children who might want to answer: do you see aspects of yourself in the BAP questions? Do you think the BAP has any significance for you personally?

Taking the AQ-10

A few weeks ago I took the Autism Spectrum Quotient (AQ) test. In the comments on that post, Nat who you can find on Twitter at @quarridors, mentioned that there is shorter version–the AQ-10. This week for Take-a-Test Tuesday, I took the AQ-10. If you’ve taken both the AQ and the AQ-10, check out my note at the bottom of this post.

The AQ-10 is a condensed (10 question) version of the AQ test. It’s relatively new, and was developed based on a 2011 study involving 1000 people with ASD and 3000 neurotypical controls.

Though the AQ-10 is much shorter than the AQ, according to the 2011 study, it has a similar predictive power. There are some concerns about the AQ-10 study–like the original AQ study, it consisted almost entirely of adults with Asperger’s Syndrome, making it hard to generalize the usefulness of the AQ or AQ-10 for autistic adults who aren’t aspies. There is also a gender disparity in the groups, with about 60% of the control group members being female and about 54% of the ASD group members being male.

The AQ-10 is used as a screening tool for adults in the UK, to identify people who may benefit from receiving a comprehensive autism assessment. The developers of the AQ-10 have emphasized the greater practicality of a 10-question screening test, which can easily be completed as part of typically brief primary care doctor visits.

Like the AQ, the questions on the AQ-10 are drawn equally (2 questions each) from five domains:

  • attention to detail
  • attention switching
  • communication
  • imagination
  • social

It’s interesting to note that the 10 questions with the best predictive value on the short versions of the AQ for adults, adolescents and children were all the same except for one. The developers of the test point to this as evidence that autistic traits are relatively stable across a person’s lifespan. Think about that for a moment.

Pros and Cons of the AQ-10

Pros:

  • Very brief (10 questions)
  • Clinically tested
  • Has similar predictive properties as the 50-item AQ
  • Adult and child versions are available

Cons:

  • Requires manual scoring
  • Limited number and type of questions
  • Lack of subscale scores

Taking the Test

You have to take this one the old-fashioned way, with a pencil and paper. You can find the test in PDF format here but for ease of use (and because there is no automated scoring version available online), I’m going to include the 10 questions in this post as well.

For each of the questions below, choose one of these answers: definitely agree, slightly agree, slightly disagree, definitely disagree:

1. I often notice small sounds when others do not.

2. I usually concentrate more on the whole picture, rather than the small details.

3. I find it easy to do more than one thing at once.

4. If there is an interruption, I can switch back to what I was doing very quickly.

5. I find it easy to ‘read between the lines’ when someone is talking to me.

6. I know how to tell if someone listening to me is getting bored.

7. When I’m reading a story I find it difficult to work out the characters’ intentions.

8. I like to collect information about categories of things (e.g. types of car, types of bird, types of train, types of plant, etc).

9. I find it easy to work out what someone is thinking or feeling just by looking at their face.

10. I find it difficult to work out people’s intentions.

Don’t worry too much about the definitely or slightly designations. Scoring is based on whether you agree or disagree, not on how strongly you feel.

Scoring the Test

Use the following to score your answers (“definitely” or “slightly” get the same score so just focus on whether you agreed or disagreed for scoring purposes):

Question 1: agree=1 point, disagree=0 points
Question 2: agree=0 points, disagree=1 point
Question 3: agree=0, disagree=1
Question 4: agree=0, disagree=1
Question 5:agree=0, disagree=1
Question 6: agree=0, disagree=1
Question 7: agree=1, disagree=0
Question 8: agree=1, disagree=0
Question 9: agree=0, disagree=1
Question 10: agree=1, disagree=0

Phew! Okay, now you should have a number between 0 and 10. The cutoff score is 6. If you score 6 or higher, the doctor in the UK who administered this would then consider recommending you for a full autism evaluation.

One of the things I see over and over in the literature about the AQ is that patients should be referred for an evaluation if they score above the cutoff and are suffering some distress. So if you score above the cutoff and are not distressed by your symptoms, I guess you can go on your merry way.

I scored an 8 (which is very much in line with my 41/50 on the AQ).

The Bottom Line

This is a relatively new, self-report screening instrument.

If you took both the AQ and AQ-10 did you find that your scores were similar?* Did you score significantly higher (or lower) on one than the other? Did anyone score above the cutoff of 6 on the AQ-10 but below the cutoff of 32 on the AQ?

*A quick way to compare your scores is to convert them to a percentage. For example, I got 41/50 on the AQ, which is 82% (41 divided by 50 = .82). I got 8/10 on the AQ-10, which is 80%.

Taking the Reading the Mind in the Eyes test

The “Reading the Mind in the Eyes” is meant to test Theory of Mind (ToM) or the ability to recognize and understand another person’s mental state. It’s supposed to be a more advanced test than “Fear, Anger, Joy“, which tests simple emotion recognition.

The original 1997 version of Reading the Mind in the Eyes consisted of a set of 25 photos showing the area around the eyes and a choice of two possible mental states for each photo.

However, the limited number of items on the test combined with the choice of only two responses resulted in a test that wasn’t very reliable. Parents of autistic children were scoring as far below the controls as the AS/HFA group was. Additionally, the original version of the test included some expressions for basic emotions (happiness, sadness) which were considered too easily recognizable and not a true test of ToM.

The revised version of Reading the Mind in the Eyes contains 36 items with 4 answer choices for each item, increasing the possible range of scores along with the difficulty level. It also contains a balance of male and female photos, a choice between more closely related mental states (i.e. not a choice between opposites like sympathetic/unsympathetic), and is composed entirely of photos representing complex mental states.

In the original study to validate the test, the AS/HFA group scored a mean of 21.9 while the control had a mean of 26.2. However, the AS/HFA group had only 15 participants versus 239 controls. A sample size of 15 is small, especially for study in which participants only have to complete two questionnaires (the AQ and Reading the Mind the Mind in the Eyes. I’m curious why the researchers didn’t make an effort to obtain a larger AS/HFA sample when they had the resources to administer the test to so many controls.

Pros and Cons of the Reading the Mind in the Eyes test

Pros:

  • Tests recognition of complex mental states
  • Balanced presentation of male and female expressions
  • Offers subtly similar answer options to increase difficulty level
  • Self-scoring
  • Provides a list of items that were answered incorrectly (with the correct answers)

Cons:

  • Validation study relied on a small sample size
  • Sets up artificial constraints not present in real life (limited choice of options, time to study “frozen” expressions)
  • Allows for unlimited time to answer each item

Taking the Test

You can take the test here. It’s all on one page. Just look at each set of eyes and then choose which of the four options best describes the state of mind that the pair of eyes conveys. Ideally, you should make your choice as quickly as possible.

It took me a little over 5 minutes to complete the test. I feel like I spent too much time on a few of the photos. For an idea of how unintuitive my process is when I take this kind of test, at one point I found myself unable to decide if a particular expression was content or defiant. These are very different mental states, but I ended up guessing (correctly!) because I couldn’t conclusively pick one over the other.

Once you’ve selected an answer for all 36 items, click the “get score” button and your score will be displayed at the top of the page.

Scoring the Test

Your score is a measure of how many out of the 36 items you answer correctly. You’ll also get a list of which answers you missed and a short summary of where your score fits in the distribution (below average, average or above average).

Here is my scoring information:

Your score: 31

A typical score is in the range 22-30. If you scored over 30, you are very accurate at decoding a person’s facial expressions around their eyes. A score under 22 indicates you find this quite difficult.

The correct answers for the ones you missed are: [I added in my answers in brackets so you can laugh at how wildly off some of them are]

    • 17: doubtful [I chose affectionate – this could be a serious gaffe in a social situation!]
    • 18: decisive [I chose bored]
    • 19: tentative [I chose grateful]
    • 28: interested [I chose affectionate – not that far off]
    • 35: nervous [I chose contemplative]

Like the “Fear, Anger, Joy” test, I scored slightly above average. I’m starting to question how much these tests say about a person’s ability to read facial expressions in “live” social contexts.

When I’m taking a test like this, there are two artificial constraints:

  1.  I’m forcing myself to intensely focus on and study each facial expression.
  2.  I’m given limited options to choose from.

Based on the availability of 4 choices, random guessing alone would result in, on average, 13 correct answers. If you look at the options for each expression, at least one and often two are obviously incorrect (to me, and that may just be me). One of my primary test taking strategies is process of elimination and my approach to this test was no different. If I can eliminate one or two options, my odds of guessing correctly go up significantly.

The artificial nature of the test seems to reduce its value in identifying problems with ToM. When I’m interacting with another person, I’m usually too preoccupied with trying to follow the conversation to spend much time “studying” the other person’s constantly changing expressions.

Often when I’m concentrating on a conversation, I’ll look away from the other person’s face because I find it easier to process information that way. You can’t gather a lot of facial expression data when you’re staring out the window. And, most importantly, there are no prompts. The other person’s expression could be saying literally anything and I have no helpful cue words to narrow that down for me.

Can you guess what these pair of eyes are saying without any cue words to help you? Give it a shot in the comments if you like.
Can you guess what this pair of eyes is saying without any cue words to help you? Give it a shot in the comments if you like.

Then there is the fact that recognizing an expression is one thing; attributing causation is another thing entirely. Facial expressions are supposed to provide the clues that allow us to understand what another person is experiencing (the content of their mental state). Recognizing an expression of anticipation is the first step; deducing what the other person is anticipating should logically follow. Together these make up the concept of Theory of Mind.

To say that the Reading the Mind in the Eyes test is a measure of Theory of Mind is only partially true, especially for those of us on the spectrum. The second step of the process–understanding the content of the other person’s mental state–is where I often go wrong.

The Bottom Line

This is an interesting test of static facial expression reading. It’s value as a test of Theory of Mind is less certain.

Taking the RAADS-R Test

It’s Take-a-Test Tuesday and this week I’m taking The Ritvo Autism Asperger Diagnostic Scale-Revised (RAADS-R).

The Ritvo Autism Asperger Diagnostic Scale-Revised (RAADS-R) is a diagnostic instrument that is intended to be administered by a professional in a clinical setting. It was primarily designed to identify adults who often “escape diagnosis” due to a “subclinical” level or presentation of ASD.

The 80 questions on the RAADS-R cover four symptom categories:

  • language (7 questions)
  • social relatedness (39 questions)
  • sensory-motor (20 questions)
  • circumscribed interests (14 questions)

Its validity as a diagnostic instrument was assessed in a 2010 study in which the RAADS-R was administered to 779 people at 9 different clinics in the US, UK and Australia. This is an impressive undertaking; the variety of testing sites suggests that results of the study are highly generalizable (that they can be extended to the general population). However, like all of the other instrument validation studies I’ve seen, this one also has an imbalance in male-female ASD participants, with a greater proportion of males in the ASD groups.

Pros and Cons of the RAADS-R

Pros:

  • Self-scoring
  • Validated in a clinical setting by a multisite study with a large sample size
  • Provides overall and subscale scores
  • Includes questions to assess sensory-motor skills
  • Takes autistic childhood traits into account, even if they are no longer present

Cons:

  • Many questions phrased as always/only/never
  • Complex answer choices may be confusing for some
  • Questions skewed toward social relatedness
  • Longer than most other tests

Taking the Test

There are a few places you can take the test online:

  • I took it at aspietests.org because I like the way they present the scores at the end. However, you’ll need to create an account to take the test there. (I did so about 2 weeks ago and they haven’t spammed me at all, which is nice.)
  • If you’d rather not create an account, you can find a no-personal-information-required version at Aspergian Women United.
  • There is also a paper based version of the test available but it doesn’t include a scoring key.

Wherever you decide to take the test, the format is the same. It took me about 20 minutes, but I spent a lot of time thinking about some of the questions so you may finish more quickly. You’ll be presented with 80 questions and for each you have to select one of the following:

  • True now and when I was young
  • True only now
  • True only when I was younger than 16
  • Never true

This answer format, which is unique to the RAADS-R, allows for the fact that some adults on the spectrum had symptoms as children that they no longer experience or vice versa. Having to think about these options can make the test challenging to complete, but do your best to select the most applicable option. Each of the four options has a different score value so accuracy counts on this one.

I often found that none of the four choices was exactly right because the questions tend to be phrased in an “always/never/only” format when what I really needed was a “sometimes” or “most of the time” phrasing. I also found it hard to answer some of the vaguer questions when it came to my childhood because my memories weren’t specific enough or I wasn’t a very self-aware child (which is a clue in itself, I suppose).

Scoring the Test

Each question is scored on a 4 point scale:

  • 3 if the symptom is always present (or never present for “normative” questions)
  • 2 if the symptom is only present now
  • 1 if the symptom was only present in childhood
  • 0 if the symptom was never present (or always present for “normative” questions)

If you take the test at the Aspie Tests site, you’ll receive an overall score plus 4 subscale scores. If you take it at the Aspergian Women United site, you’ll get only an overall score.

In the 2010 study, the scores for those previously diagnosed with ASD range from 44 to 227. The scores for control group members ranged from 0 to 65. The researchers set a threshold of 65, meaning that a score of 65 or greater “is consistent with a clinical diagnosis of ASD.”

It’s interesting to note that only 3% of the people with ASD had a score below 65 and 0% of the control group participants had a score of 65 or higher. There is very little overlap between the two groups, unlike the AQ study results.

In addition to an overall score, the RAADS-R provides 4 subscale scores. The creators of the test emphasize that the overall score is more accurate than any of the subscale scores alone, but the subscales are still informative if you’re curious about where your stronger/weaker areas are. The researchers also state that the RAADS-R is not intended to be administered outside of a clinical setting (such as online or by mail, both of which are valid AQ administration methods).

Here are my scores:

Overall and subscale scores from aspietests.org
Overall and subscale scores from aspietests.org (click to see a larger version)

Total score: 175

Subscales:

  • Language: 6
  • Social relatedness: 97
  • Sensory/motor: 36
  • Circumscribed interests: 36

Any of the scores that are highlighted in yellow are above the clinically identified threshold values for ASD.

The averages given in the chart above are for people who took the test at the aspietest site. They tell you how you compared against other people who identify with the same neurotype as you, but little else.

The Bottom Line

The RAADS-R uses a slightly different approach than other autism screening instruments, making its use more appropriate in a clinical setting. However, it still provides an interesting snapshot of autistic traits for those who take it informally.