Tag Archives: asperger’s tests

Asperger's Tests

Taking the Aspie Quiz (Version 3)

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The Aspie Quiz was recently updated to Final Version 3, which is a major update, so I thought it would be a good idea to retake it. Much of what’s changed is behind the scenes refinement of the test items and won’t be evident to the average test taker. If you’re new to the Aspie Quiz, you might want to read my original write up for more background. This post will focus primarily on what’s new.

If you’ve taken the Aspie Quiz before, you’ll likely notice that there are some new questions and that the wording of the test result has changed. Previously, test takers received Neurotypical and Aspie scores; currently the scores are presented as Neurotypical and Neurodiverse, with an outcome of “likely neurotypical”, “likely neurodiverse” or a mix of the two.

In the context of the test, the term neurodiverse includes autism, ADHD, dyslexia, dyscalculia, and dyspraxia (and perhaps OCD and Tourettes). However, the test still appears to be primarily a test for autistic traits. This is reflected in the statement that:

The goal of this test is to check for neurodiverse / neurotypical traits in adults. The neurodiversity classification can be used to give a reliable indication of autism spectrum traits prior to eventual diagnosis.

If you want to read more in detail about the development of the Aspie Quiz and what has changed over time, Leif Ekblad has published a paper detailing his research and a detailed history of the quiz. Of particular interest is the comparison of the AQ and Aspie Quiz scores, particularly for women. As many of us who’ve taken both have noticed, the AQ has a strong gender bias and the Aspie Quiz is more gender neutral. Anecdotally, the Aspie Quiz has always appeared to be a better predictor of whether someone is on the spectrum and that is addressed in the paper as well.

There are some aspects of the paper that I found problematic, but I’ll leave that to others to critique and focus here on the test itself. Before I do that, however, there is one sentence in the paper that jumped out at me that I want to share:

The idea that neurodiversity/autistic traits lie on the extreme end of a normal distribution is not supported by Aspie Quiz, rather the neurodiversity traits seem to have its own normal distribution overlapping the normal distribution of typical traits.

For those who have wondered why they receive two scores on this test, I think the above quote sums it up nicely. It’s also a good response to the oft-repeated fallacy that “everyone is on the spectrum” or “everyone is a little autistic.”

Taking the Test

To take the Aspie Quiz, start here. You have the choice to login/register or to proceed directly to the test. If you choose the former, you’ll be contributing to the test developer’s research regarding the stability of test scores over time (assuming you take the test more than once).

Once you’ve proceeded to the start of the test, you’ll first be asked some demographic questions. The information you share is used in the development of the test and has no impact on your scoring.

The test itself is 128 questions, answered on a Likert scale. The choices are: don’t know, no/never, a little, yes/often. The test will take about 20 minutes, so be sure you have enough time to finish it before starting.

Scoring the Test

At the end of the test, you’ll get neurodiverse and neurotypical scores, along with a “likely” prediction. Here are mine:

  • Your neurodiverse (Aspie) score: 156 of 200
  • Your neurotypical (non-autistic) score: 54 of 200
  • You are very likely neurodiverse (Aspie)

You’ll also get a nice spider web graphic and the option to download a PDF with more details, which I highly recommend doing. The PDF contains detailed information about which questions count toward which aspect of your score and includes some background information that may be helpful in interpreting your scores in each category.

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On the previous version of the test, I scored:

  • Your Aspie score: 170 of 200
  • Your neurotypical (non-autistic) score: 32 of 200
  • You are very likely an Aspie

Since the last time I took the quiz, there are quite a few new questions and in particular a batch of new questions about sexuality and relationships. Given that I scored so high in Neurotypical attachment (i.e. sexuality) and relatively low in the social and contact on the neurodiverse side, I suspect the relationship and sexuality questions are the biggest factors in shifting my scores toward neurotypical.

Some of the questions in those areas were hard to answer accurately because they’re worded as if the test taker is seeking a romantic relationship or interested in dating, an assumption that doesn’t apply to either those in a monogamous relationship or those who are aromantic or asexual.

Although the quiz avoids gender bias, a few of the questions are biased in the direction of heterosexuality or presumption of asexuality as a non-neurotypical “preference”. More careful wording of some of the new relationship/sexuality questions to encompass both LGBTQ test takers and those in monogamous relationships would help mitigate some of this problem.

But I also think that the role of romantic and sexual preferences in the test outcome would benefit from a different approach. It’s stereotypical and ableist to assume that neurotypical people are sexual and neurodiverse people are not. The neurodiverse people that I know are distributed over a wide spectrum of sexuality and sexual preferences, from asexual to hypersexual and everything in between, just like the neurotypical people that I know.

Looking at the Attachment category questions in the PDF, all of the Neurotypical Attachment traits are related to sex. The Neurodiverse Attachment traits, on the other hand, are questionable in their relevance to attachment versus things like language pragmatics and learning social skills through rules. Surely neurotypical people are interested in aspects of attachment other than sex. More importantly, it’s disappointing to see a test of neurodiversity ascribing typical autistic social traits to “attachment disorder.”

Overall the new questions are much like those of the earlier version that I took: a mix of the highly relatable with the expected, plus a few that I have trouble tying back to any known autistic traits.

I was amused by “Do you have a need to confess?” because I’m so bad at lying or concealing things from people and inevitably feel the need to spill my guts at the drop of a hat. There were a few perplexing ones, including the one about walking behind people and the one about examining people’s hair. (And I still don’t get the slowly flowing water question – though I suspect it identifies people who are visual stimmers in general.) I wasn’t sure how to interpret the “afraid in safe situations” question. Maybe it’s meant to reveal phobias or irrational anxiety?

Finally, the “criticism, correction, direction” question is repeated twice with slightly different wording (possibly as a check question).

The Bottom Line

Of all the online tests I’ve evaluated, the Aspie Quiz has always felt like the most accurate in overall scoring and the most comprehensive in variety of questions and that’s still the case. I’ll be curious to see how re-takers feel about their scores and what direction, if any, scores have shifted in.

 

Aspie and Female

Taking the Aspergers Quiz

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I discovered a new Aspergers quiz that wasn’t around (AFAIK) when I did the original Take a Test Tuesday series. At first I was excited because it says that it was created by an MD who is on the spectrum and the range and wording of the questions looked good at first glance.

Unfortunately, that’s about all there is to like about it. I’m hesitant to link to the site because of the way it talks about Aspergers. Lots of pathologizing language and functioning labels and pandering to the search engines along with some blatant misinformation. It’s also visually overwhelming and loaded with ads.

Consider yourself forewarned if you want to check it out anyway.

The Aspergers Quiz

The Aspergers Quiz website says that the quiz was created by Dr. Logan Cook from the University of Michigan. My Google-fu failed to turn up any further information about Dr. Cook or any research the quiz might have been based on, so I’m assuming that it’s based solely on the creator’s anecdotal evidence or personal experience. If that’s the case, it’s the only AS “screening” quiz that I’ve reviewed here that isn’t based on any sort of statistical analysis at all.

The site states upfront that it’s an informational quiz and not diagnostic, which is good. But it also presents the results in terms of a “percentage chance you might have Asperger’s”, which in the absence of any underlying statistical testing, is completely baseless. Answering a screening quiz 75% positive is totally different from having a 75% chance of having a condition. It’s great that there’s a disclaimer at the top of the page, but giving a specific percentage result at the end of quiz without disclosing how that percentage was arrived at is irresponsible.  Continue reading Taking the Aspergers Quiz →

Diagnosis

Adult ASD: Waiting for a Diagnosis

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This is Part 10 in the I Think I Might Be Autistic series. 

If you’ve read through the components of my ASD evaluation, you might be wondering but what about the Asperger’s questionnaire?

There wasn’t one. I didn’t complete a written screening or diagnostic test like the RAADS-R or AQ. My ASD diagnosis was based on the diagnostic interview, the outcomes of the cognitive/neuropsychological testing and behavioral observations made by Dr. H and B during my visit.

However, between the diagnostic interview and the behavioral observation, the key questions on the screening instruments were addressed in detail. The diagnostic interview covered questions on my special interests, relationships, social preferences, sensory sensitivities, attention, language pragmatics and fine motor skills. The behavioral observation included general presentation (grooming and dress), gait, speech (rhythm, rate and volume), demeanor, verbal skills, eye contact, movement patterns and conversation habits.

The interview and testing took about five and half hours. It was exhausting. We went straight through lunch, though both B and Dr. H told me that I could ask for a break at any time. The thing is, when I’m that engaged in something, I forget that I need to eat. I may be hungry, but the hunger signal gets muted.

So, exhausted and hungry, wishing I’d taken The Scientist up on his offer of a ride, I scheduled my follow-up appointment and stumbled out to the car. My evaluation was done. In three weeks I’d have a diagnosis.

Or not.

A vague sense of panic settled in as I started rehashing every detail of the appointment. Worse, I knew that I had three weeks ahead of me to perseverate on what I’d said and done and not said and not done. Three weeks to wonder if I’d done “too well” on the cognitive tests, if I’d instinctively made an effort to “pass” in the interview, if I’d withheld key details or reflexively covered my weaknesses.

Three whole weeks to alternately tell myself that this had been the best and the worst thing I’d ever done for myself.

The days passed about as quickly as you’d expect. I was restless and unsettled, plagued by a string of nightmares. The idea that Asperger’s might be something I’d talked myself into or imagined haunted me. My biggest fear–the one I couldn’t shake–was that Dr. H would tell me I wasn’t autistic, that in fact there was nothing wrong with me.

Then what? I’d found this explanation that fit so well. If someone “officially” took it away from me, I would be lost again, left to start over in search of a new, better explanation.

Next up: The Follow-up Appointment – Receiving a Diagnosis

Asperger's Tests

Taking the Famous Faces Test

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This week I took the Famous Faces, which tests for prosopagnosia or faceblindness.

Prosopagnosia, commonly known as faceblindness or facial agnosia, is an impairment in the ability to recognize faces. Although there isn’t a lot of research to support a conclusive link between ASD and prosopagnosia, some degree of faceblindness seems to be common in people with Asperger’s.

Some of the signs of prosopagnosia:

  1. Failure to recognize a friend or family member, especially when you encounter them unexpectedly
  2. Tendency to remember or recognize people based on their hairstyle, gait, voice or other defining non-facial feature
  3. Relying features like hair style/color, facial hair or eyeglasses to recognize people you know well
  4. Failure to recognize people out of context
  5. Failure to recognize yourself in the mirror or in photos

I have all of these except the last one. If my daughter changes her hairstyle or I haven’t seen her in a while, I won’t recognize her right away. I locate my husband in a crowded place by the way he walks, what he’s wearing or his voice.

I rarely recognize people out of context and have actually said to more than one person, “Sorry, I didn’t recognize you out of context.” And that was before I knew anything about faceblindness.

For now, I’ll leave the background on faceblindness short because in researching this test, I found enough information for at least one more post.

Measuring Prosopagnosia

I’ve seen three different types of tests that “measure” prosopagnosia. One is a famous faces test which removes hair and other identifying features from the faces of famous people, requiring you to identity them by facial features alone.

Another type of test shows a series of faces and asks you to identify which of them belong to a set of 20 faces viewed at the start of the test. I took one online (sadly it’s no longer available) and came out in the bottom 20% of scores. My poor working memory probably didn’t help.

Finally, there is a type of test that digitally alters a face and asks you identify what is “wrong” with the face or which face among three (1 altered and 2 not) is different. This measures your ability to recognize “normal” vs. “abnormal” facial structure, a task that is easier for people who aren’t faceblind.

For example, can you tell at a glance what is wrong with two of the three faces below (answer in the caption):

The face on the left has closer-set eyes and the face on the right has a raised mouth. The middle face is unaltered. (Barton et al, 2004)
The face on the left has closer-set eyes and the face on the right has a raised mouth. The middle face is unaltered. (Barton et al, 2004)

All of these tests obviously have flaws. A better test might be a series of questions based on the list of prosopagnosia traits, but that doesn’t seem to exist. There is a visual test that is supposed to be accurate at diagnosing prosopagnosia but it’s more time-consuming–we can take that one if folks are interested.

Taking the Test

You can take the Famous Faces test at Test My Brain. Choose it from the list of available tests, agree to the terms and answer the short demographic survey. There are 20 celebrities to identify–it took me about 10 minutes to finish but some of the faces I needed to study for a while, trying to picture them with varying hairstyles, before I could come up with a guess.

Scoring the Test

I did well, but my results may have been influenced by the fact that I’ve taken this test before.

I scored slightly above average but I had an advantage because I've taken the test before.
I scored slightly above average but I had an advantage because I’ve taken the test before.

The first time I took Famous Faces, I thought George Clooney was Sean Connery and I mistook Nicole Kidman for Rosie O’Donnell. This time around I got George Clooney right but still missed Nicole Kidman. I also got Angelina Jolie, David Beckham, Fred Astaire, John F Kennedy Jr, Uma Thurman and Susan Sarandon wrong. If the photos had included hair I probably would have missed Uma Thurman, Nicole Kidman (because most blonde white actresses look alike to me) and David Beckham (unless his tattooed torso was included!).

The Bottom Line

The reliability of using famous faces tests to actually diagnose prosopagnosia is poor, but a low score may be indicative of some degree of faceblindness. If there’s enough interest, I’ll hunt down and do a write up on a more reliable test that’s used for clinical diagnosis of prosopagnosia.

Asperger's Tests

Taking the The Systemising Quotient (SQ)

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This week for Take a Test Tuesday I took the revised Systemising Quotient (SQ-R) test.

Systemizing refers to the drive to understand, construct, predict and/or control the rules of a system. Simon Baron-Cohen, in his desire to wedge autistics into his extreme male brain theory, contrasts systemizing with empathizing as the two primary ways in which humans make sense of their worlds.

The basic premise of the extreme male brain theory is that neurotypical males are better at systemizing and neurotypical females are better at empathizing. Hence, brains can be classified as either male or female according to these aptitudes. Autistic males and females are both better at systemizing, therefore, autistic people have “male brains” and autism is a condition of extreme male neurology.

Using that logic you could also make the case that female basketball players have “male bodies” (i.e. male bodies are on average taller than female bodies, female basketball players have taller bodies on average than females in general, therefore, female basketball players have “male bodies”).

Setting aside the extreme male brain theory, what can we learn from the SQ? The SQ is the subject of several research papers and each time the data show people with ASD generally scoring lower on the EQ and higher on the SQ.

The SQ attempts to measure systemizing in daily life, asking questions about how organized you are when it comes to your financial records, collections or favorite books/music. While the creators tried to avoid introducing bias in terms of subject matter, the test is still vulnerable to this. For example, I want to know the specs of new computer because that’s a topic I’m fairly familiar with.

I’m less interested in the specs of my car’s engine because that’s a subject I know (and care) little about. The same goes for knowing the species of animals and trees or the make-up of committees and governments. Those aren’t subjects I find highly interesting so regardless of how much of a systemizer I am, I’m only going to have a passing curiosity about them

Much of this still relies on personal interests, though perhaps it balances out in the end. The questions about how I bag my groceries and what my closet looks like made me laugh. I bag groceries by type because that makes them easier to put away at home. I hang my clothes in the closet by type so I can find what I’m looking for quickly.

My theory about systemizing? It all comes down to the fact that when you’re autistic, systemizing isn’t simply a preferred way of thinking, it’s a survival mechanism. Without systems and routines, we’d be constantly getting lost in the details.

One final note before we take the test. A lot has been written about gender bias in the EQ and SQ. It struck me as very telling that when the SQ was revised to remove some of the questions that were in “traditionally male domains” and add more questions that might be relevant to females, they removed questions related to investing, religion and culture and added questions related to shopping, cleaning, music and clothing.

Taking the Test

You can take the SQ-R (2005 revised version of the SQ) at the Aspie Tests site. Click on The Systemising Quotient (SQ) link and follow the prompts to get to the test page. I’m assuming you know the drill by now. There are 75 questions and you’re required to choose among strongly agree, slightly agree, slightly disagree and strongly disagree. Positive “strongly” answers score two points and “slightly” answers score one point. Possible scores range from 0 to 150.

It took me a little over 10 minutes to complete.

Scoring the Test

I scored an 85. Not surprising. I’m super organized, have a good memory for details and am insatiably curious about how things work.

I don’t think the SQ is binary in the way that EQ is. For example, on the EQ a positive answer to “I get emotionally involved with a friend’s problems” suggests empathizing. A negative answer suggests remaining detached or perhaps taking a logical problem-solving approach to the friend’s problems. This could be roughly construed as systemizing if we continue to look at it in a strictly binary way.

On the SQ, a negative answer to “I do not follow any particular system when I’m cleaning at home” suggests that one prefers using a system for housecleaning. But what does the opposite answer suggest? Certainly not anything to do with empathizing.

However, the EQ-SQ model sets the two tests up as “complementary” and goes so far as to demonstrate that a composite of EQ-SQ scores is steady across all groups (i.e. my EQ+SQ will be relatively equal to yours and everyone else’s, across all neurotypes). That suggests a strong negative correlation between the two tests.

When you look at the relationship between the AQ, EQ and SQ, it becomes evident that both the EQ and SQ act as a sort of proxy for AQ scores. In other words, they aren’t tests of empathizing and systemizing so much as they’re tests of the traits of autism. Of course autistic people will score higher than average on a test that asks a lot of questions closely related to core autistic traits and lower than average on a test that asks a lot of questions about social skills.

For reference, here are the mean scores from the 2005 SQ-R study:

ASD Male 77.8
ASD Female 76.4
ASD Total 77.2

Typical Male  61.2
Typical Female 51.7
Typical Total 55.6

(I prefer looking at the means from the original studies because the means provided by the Aspie Test site are based on self-reported neurological status, which may not be accurate.)

The Bottom Line

The SQ is an interesting measure of how dependent an individual is on routine, systems and categorization, but the use of the SQ as “proof” of the extreme male brain theory is highly suspect.

Asperger's Tests

Taking the CAM Face-Voice Battery

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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.

Asperger's Tests

Taking the Friendship Questionnaire (FQ)

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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.

Asperger's Tests

Taking the Alexithymia Questionnaire

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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.

Asperger's Tests

Taking the Empathy Quotient Test

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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.

Asperger's Tests

The Broad Autism Phenotype Questionnaire

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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?