Tag Archives: asperger’s tests

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 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.

Taking the Autism Spectrum Quotient (AQ) Test

This week for Take-a-Test Tuesday, I took the Autism Spectrum Quotient (AQ) test. The AQ is used as a clinical screening instrument so in addition to taking the test, I read two of the studies that have been done to validate it. The write up that resulted is rather geeky.

The Autism-Spectrum Quotient (AQ) was developed by the Autism Research Centre at the University of Cambridge and first published in 2001. While the test has “Autism Spectrum” in its title, it’s geared toward identifying adults with Asperger’s Syndrome. It has been tested on adults with normal intelligence who had been diagnosed with AS or HFA*. While the AQ isn’t considered a diagnostic instrument, the 2005 study referenced later in this post did recommend that it be used by family doctors/general practitioners to determine whether to refer an adult patient for an in-depth Asperger’s Syndrome evaluation.

The AQ is composed of 50 short questions, 10 each on:

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

The 2001 study that was used to develop the AQ has some interesting data about the validity of the individual questions. If you’ve always disagreed with the idea that autistics lack imagination or can’t see the point of “the phone number question” on the AQ, you might find the individual item analysis revealing. Go take a look for yourself (Table IV, especially items 3, 8, and 29).

I’ll spare everyone else the gruesome details.

Pros and Cons of the AQ

Pros:

  • Short, can be taken quickly
  • Self-scoring
  • Includes questions phrased as both preferences and perceived competencies
  • Clinically tested (statistical data available on sensitivity, specificity, test-retest reliability, internal consistency, etc.)
  • Adult, adolescent and child versions are available

Cons:

  • Possible gender bias
  • Single score outcome
  • Choice of questions may be biased toward creator’s theory of autism
  • No subscale scores
  • Uncertainty regarding what a mid-range score might mean due to multiple recommended cutoff scores

Taking the Test

There are many places that you can take the test online. I took it at Wired.com. To get started, read the questions and choose one of the four answers for each. Don’t spend too much time agonizing over the slightly or definitely wording. The scoring is based on your choice of agree or disagree with no weight given to how strongly you feel it.

When you’ve answered all of the questions, click the “Calculate Score” button to get your AQ score. You’ll see your score on the next page along with a list of which items you scored positively on. Each positive item (i.e. item that indicates an autistic trait) equals one point, so a higher score indicates the presence of more autistic traits.

Scoring the Test

The possible scoring range is 0-50. The 2001 study found that 80% of people with Asperger’s who took the test scored 32 or higher. A subsequent 2005 study proposed a cutoff score of 26 be used when screening adults for Asperger’s in a clinical setting. The second study found that of 100 people who completed the AQ, the test correctly classified 83% of them as having Asperger’s or not. The 2005 study states that using the higher score of 32 as the cutoff would minimize false positives, so there really isn’t a clear consensus on how useful the midrange scores are.

Here is a graph comparing the scores of people with Asperger’s to the scores of neurotypical controls in the 2001 study:

From “The Autism-Spectrum Quotient (AQ): Evidence from Asperger Syndrome/High-Functioning Autism, Males and Females, Scientists and Mathematicians” by S. Baron-Cohen et. al.

The graph shows a fairly clear difference in the distribution of scores between those with Asperger’s/HFA and the control group. However, it also shows some overlap in the middle of the scoring range. Some people who were clinically diagnosed with Asperger’s/HFA scored in the teens, well below the cutoff of 32, and some neurotypical people scored in the thirties.

The original study also has some interesting outcomes for gender. In the AS/HFA group, the mean score for women was higher than for men, while in the control group, the reverse was true. In fact, the mean score for women with Asperger’s was 38.1 (vs. 35.1 for males) while not a single woman in the control group scored above 33 (highest score for male controls was 37).

Oh yeah, my score was 41.

The Bottom Line

Unless you score at one extreme or the other, you may find this test raises more questions for you than it answers.

————-

*I used HFA (High Functioning Autism) throughout this post because it was used in the 2001 study to describe the diagnosis of some of the study participants.

Taking The Aspie Quiz

There are quite a few online Asperger’s Syndrome tests. I thought it might be fun to take each of them and then do a little write up.

So, welcome to “Take a Test Tuesday,” a new series that will go on for as many weeks as I can continue digging up new tests to take.

I’m going to kick it off with my favorite online Asperger’s test, The Aspie Quiz, but first a few words about online tests in general. Although some of the tests you’ll find on the internet are used as part of a diagnostic battery, it’s important to remember than an official diagnosis includes additional elements such as neuropsychological testing, observation by a psychiatrist, an assessment of childhood development and interviews with family members.

While you can take these quizzes and get a result that says you’re “most likely an aspie,” they aren’t diagnostic instruments. A formal diagnosis can only be made by a qualified doctor.

With that in mind, let’s get started.

The Aspie Quiz

The Aspie Quiz was developed by Rdos. It’s been through many revisions over the years, with the addition and subtraction of questions based on, among other things, how well the questions correlate with the answers of diagnosed individuals. If you’re interested in statistics or how tests like this are developed, you’ll love the Aspie Quiz Evaluation page. It has a wealth of information on the rationale for which questions have been included or dropped as well as the correlation between quiz scores and various diagnoses.

The Aspie Quiz is not used in any official diagnostic capacity and is billed as a test to be taken for fun, but you’ll often find aspies quoting their scores in their signatures at places like Wrong Planet. Rdos has also written about how the Aspie Quiz compares to the Autism-Spectrum Quotient (AQ) test, which has high validity as a diagnostic instrument.

The Aspie Quiz is made up of 150 questions that fall into six domains: talent, compulsion, social, perception, communication and hunting. That last category isn’t one you’ll see on any other Asperger’s test. There is a short explanation about the “hunting” questions in the detailed quiz results, tying the questions to cooperative vs. passive hunting traits. However, the explanation also states that the hunting questions have no “diagnostic relation.” The other five domains cover topics more commonly thought of as differentiating aspies from NTs, such as special interests, adherence to routine, and social preferences.

Pros and Cons of the Aspie Quiz

Pros

  • Very detailed
  • Self-scoring
  • A wide range of question types
  • Extensive statistical data available online
  • Results include both Aspie and NT scoring scales
  • Detailed scores in 12 subscales, including scoring rationale
  • Commonly referred to in online Asperger’s communities
  • Visual, quantitative and qualitative results

Cons

  • Longer than most online Asperger’s tests
  • Has not been independently validated in a clinical setting
  • May be biased toward the developer’s own theory of Asperger’s
  • Not officially recognized by medical establishment

Taking the Test

To take the test, begin here. You don’t need to register if you prefer not to. Just click the “I accept” button. On the next screen you’ll see some questions that the developer is using to validate the test items. Select the appropriate answers and click the “Go to Quiz” button to begin the quiz.

There are a lot of questions, but they’re fairly straightforward. It took me about 20 minutes to complete the quiz. Once you submit your answers, you’ll get a basic results page with your Aspie and NT scores as well as a graphical spiderweb representation of your subscale scores.

You can click the “Detailed results suitable for printing (PDF)” link to get a PDF file with your aspie and NT scores, your spiderweb, and a detailed explanation of your scores on the various subscales.

Scoring the Test

You’ll get two scores: ____ out of a possible 200 for the Aspie score and ____ out of a possible 200 for the neurotypical score. The Aspie score tells you how high you scored on items indicative of Asperger’s traits. The neurotypical score tells you how high you scored on items that describe common non-autistic (neurotypical) traits. Based on the combination of the two scores, the final line of the results will state that you’re “likely an aspie” or “likely neurotypical” or that you “have aspie traits and neurotypical traits.”

Here are my scores:

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

For comparison, I asked The Scientist, who is neurotypical, to take the quiz. He generously agreed to let me use his results. Here they are:

  • Your Aspie score: 85 of 200
  • Your neurotypical (non-autistic) score: 158 of 200
  • You are very likely neurotypical

Finally, our adult daughter volunteered to share her results as well:

  • Your Aspie score: 77 of 200
  • Your neurotypical (non-autistic) score: 143 of 200
  • You are very likely neurotypical

As you can see, I scored much higher on the aspie items and much lower on the NT items, while The Scientist and our daugther scored quite high on the neurotypical items and lower on the aspie items. I find it interesting that my scores are more widely distributed than theirs.

Obviously there are questions on the Aspie Quiz that are aspie indicators but will be answered positively by NTs. For example, when The Scientist is interested in something, he gets deeply absorbed in it, much like an aspie with a special interest. The same will be true of aspies having some qualities that are more commonly associated with NTs.

The distribution of scores between aspie and NT becomes most obvious when you look at the spiderwebs.

Mine:

My spiderweb results (The Aspie Quiz)

The Scientist’s:

The Scientist’s spiderweb results (The Aspie Quiz)

Our daughter’s:

Our daughter's spiderweb (The Aspie Quiz)
Our daughter’s spiderweb results (The Aspie Quiz)

My high scores fall almost exclusively on the aspie (right) side of the web and my NT family members’ are weighted toward the NT (left) side of the web, with some moderate scores on the aspie side as well.

The Bottom Line

While the Aspie Quiz isn’t an officially recognized test, it does seem to be an accurate reflection of neurotype and you get a pretty picture when you’re done.

Eye Contact: The Conversation within the Conversation

Making eye contact–or more precisely, not making eye contact–is a big issue for people with Asperger’s. Neurotypical people seem to be especially frustrated and confused by this aspect of aspie behavior.

Even the professionals, who can offer up all sorts of theories as to why we don’t make eye contact, don’t seem to get the fundamental issue. In one study, the author pointed out that people with AS don’t make use of expressive information in the facial region of the eyes, “even when it’s available.”

That last part made me laugh. That’s like giving a Russian/Japanese dictionary to a person that can’t read either language and asking them why they aren’t using it. Just like that dictionary, the part of the facial expression around the eyes is a foreign language to an aspie.

Reading Expressions: The Eyes Test

I’m moderately good at reading facial expressions. I get the biggies like happiness, sadness, surprise, anger, and confusion. More subtle expressions–those that rely most heavily on the use of the eyes and the area around the eyes–are much harder for me. For example, on this list of 30 facial expressions, I would not have correctly identified the ashamed, concerned and contempt faces.

It’s important to note that “reading the mind in the eyes” (as the professionals call it) involves more than just the eyeballs themselves. It requires understanding how the subtle changes in the muscles around the eyes convey emotion. This becomes more obvious when you take the creatively named “Eyes Test” which requires you to use just the portion of the face between the nose and forehead. If you’re curious, you can find and take the test here:

Instructions (scroll all the way to the bottom of this file for the record sheet and scoring key)
Eyes Test Part 1
Eyes Test Part 2

(You can also find an interactive version called Reading the Mind in the Eyes at Test My Brain but you need to enter some demographic information to take it.)

I did surprisingly well on the test and here’s why: I cheated.

I suspect that most NTs taking this test would look at an expression and spontaneously have an idea of what the expression was. This is probably why the instructions say to choose an answer as quickly as possible.

How did I cheat? Before even looking at the expressions, I found myself reading all four possible answers. Then I looked at the expression and began the process of elimination. Here’s one of the expressions from the test with the four possible answers:

A sample question from the Eyes Test

My process of elimination: I know right away that it’s not dominant or horrified. It looks more like friendly than guilty, so the answer is friendly. If I hadn’t been given four choices for each expression, there is no way I would have spontaneously provided some of the more subtle answers like insisting or uneasy.

Obviously, in a real-time social interaction, no one is going to have four possible emotional options floating around their head to help me guess at what they’re feeling. Like most aspies, I’ve learned to use other information to try to fill in the blanks when it comes to facial expressions. I often focus on a person’s mouth, which I find conveys emotions more explicitly to me than the eyes.

I can gather some additional data from a person’s voice, especially when I know the person well. When my daughter calls me, I can tell from the way she says “hi” what kind of mood she’s in and what the conversation will likely be about. Unfortunately this only works with people I know well.

Over time I build up a databank of voice qualities for a person. With enough conversations in the databank, I need only a few words to recognize the happy voice, the lying voice or the you’re-not-gonna-like-this voice.

Why Learning to Read the Eyes is Challenging for Aspies

If we can learn all of these work-arounds and hacks for reading emotion in others, why can’t adult aspies just learn to read the eyes?

There are programs to teach children how to do interpret facial expressions. But for adult aspies, it’s a bit more complicated. We’ve grown up and spent decades of our lives not making eye contact.

Are we unable to read the eyes because we don’t make eye contact and therefore don’t have a rich enough data bank to draw on?

Or . . .

Do we not make eye contact because we discovered early on that the eye region doesn’t hold any useful data for us and our limited data gathering abilities are better “spent” on areas like (in my case) the mouth or voice?

It sounds like a classic “chicken and egg” scenario, doesn’t it?

Add to that level of discomfort that many aspies feel when it comes to making eye contact and it’s easy to see why learning to use and read the eyes in social interaction can feel like such an overwhelming prospect.

Is Making Eye Contact Multi-Tasking?

More than once I’ve read the suggestion that autistic people don’t make eye contact because we have trouble doing two things at the same time. This strikes me as ridiculous. Is making eye contact and talking really the equivalent of doing two things at once? If that’s the case, what about walking and talking? Running and talking? Driving and talking? I can do all of these things with no trouble. Sometimes I even talk while walking and chewing gum. How’s that for multitasking?

Moving on . . .

The wrong kind of eye contact!

When Eye Contact Becomes Too Much

The level of discomfort that people on the spectrum experience when it comes to eye contact varies from mild to unbearable. The discomfort also varies from situation to situation. I’m more comfortable making eye contact with people I know very well or hardly at all. People who I know somewhat (professors, fellow students, business acquaintances) are the ones who make me most uncomfortable when it comes to eye contact.

The discomfort goes beyond simply feeling weird. It’s a physical sensation. I physically feel like I can’t continue to look into the person’s eyes a second longer. If I do sustain eye contact beyond that point, I get a strong sensation of needing to flee the room.

The classic “fight or flight” symptoms suggest that my brain is perceiving sustained eye contact with certain people as a threat. Why is this? And why does it happen most strongly with people who I consider acquaintances but not strangers or intimates?

Perhaps it’s because I’m self-conscious about the uneven balance of social power in these situations? The other person is clearly gathering social data from my eyes but I’m not able to do the same. Ironically, given my small range of often inappropriate expressions, what they’re gathering is probably as useless as the fragments of nonverbal communication that I’m picking up from them.

Eye contact with strangers tends to be fleeting and meaningless. The exchange of information feels limited and safe. Eye contact with my husband or daughter, on the other hand, carries none of the social balance of power issues that I feel with acquaintances. I don’t need to worry about what they might be discovering about me or whether I’m missing some key nonverbal cue (because if I am, they’ll tell me).

Acquaintances, however, are still (or sometimes perpetually) in the “getting to know you” stage. We’re feeling each other out, gathering data that will determine the course of future interactions and cement our perceptions of each other.

For NTs, eye contact is a rich and layered language. It’s the conversation within the conversation. As aspies, we’re largely deaf to this language. It’s no wonder it makes us so uncomfortable when others try to “speak” to us with their eyes.