ASDASQ screening questionnaire

About ASDASQ

The ASDASQ was designed for use in a study of the prevalence of autism spectrum disorders (ASD) in adult psychiatric out-patients (1), since no screening tool for ASD in this population existed.

Factors considered important for a usable screening questionnaire were that:
1) it should be brief and simple, allowing high compliance and response rates,
2) it must be appropriate for psychiatric staff members of different professional backgrounds,
3) the content should be concerned with the patient’s observable behaviour, not thoughts or feelings,
4) the items should be based on operationalised diagnostic criteria for Asperger’s syndrome and autism (and symptoms relating to these), and
5) it must have acceptable inter-rater and test-retest reliability.

The ASDASQ thus consists of nine symptom/impairment-orientated questions concerning diagnostic issues, plus one item relating to previous contact with child and adolescent psychiatric services. All items are of the ‘yes’/‘no’ variety, except the one relating to contact with child and adolescent psychiatry, for which a third alternative (‘not known’) is included.

How the ASDASQ is scored

The ASDASQ can be completed by staff members of different professions. The first nine items are scored as 0 (‘no’) or 1 (‘yes’) and collapsed to provide a summary symptom score (range 0-9; 9 indicating problems in all areas screened).

Psychometric properties

In the study of psychometric properties, fair-moderate reliability was achieved across raters; within raters moderate-good reliability, although one item (no. 9, concerning uneven abilities) showed considerably poorer reliability. This might be due to the screenings being performed in an out-patient setting, where staff have only limited possibility to observe a patient’s abilities. Internal consistency was excellent.

Usefulness

Patients with high scores (5 or higher) should be examined for ASD while bearing in mind that not all high scorers will be found to meet criteria for ASD, and that some adults with ASD and IQs in the normal range may score low on the ASDASQ. Since the ASD diagnosis is based on behaviours rather than on the patient’s inner experiences, it may be useful to screen for observable deviations of behaviour. The ASDASQ can thus be useful, not for diagnosis, but as a screening instrument for ASD in psychiatric populations.

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