Autism Spectrum Screening Questionnaire (ASSQ)

Instructions:

Please read the statement below and indicate by tapping, no, Somewhat, or Yes if this child stands out as different from other children of his/her age in the following ways:

No Somewhat Yes
1 is old-fashioned or precocious 0 1 2
2 is regarded as an “eccentric professor” by the other children 0 1 2
lives somewhat in a world of his/her own with restricted idiosyncratic intellectual interests 0 1 2
3
accumulates facts on certain subjects (good rote memory) but does not really understand the meaning 0 1 2
4
5 has a literal understanding of ambiguous and metaphorical language has a deviant style of communication 0 1 2
0 1 2
6 with a formal, fussy, old-fashioned or “robot like” language
7 invents idiosyncratic words and expressions 0 1 2
8 has a different voice or speech 0 1 2
9 expresses sounds involuntarily; clears throat, grunts, smacks, cries or screams 0 1 2
10 is surprisingly good at some things and surprisingly poor at others uses language freely but fails to make 0 1 2
0 1 2
11 adjustment to fit social contexts or the needs of different listeners
12 lacks empathy 0 1 2
13 makes naive and embarrassing remarks 0 1 2
14 has a deviant style of gaze 0 1 2
15 wishes to be sociable but fails to make relationships with peers 0 1 2
16 can be with other children but only on his/her terms 0 1 2
17 lacks best friend 0 1 2
No Somewhat Yes
18 lacks common sense 0 1 2
19 is poor at games: no idea of cooperating in a team, scores “own goals” 0 1 2
20 has clumsy, ill coordinated, ungainly, awkward movements or gestures 0 1 2
21 has involuntary face or body movements has difficulties in completing simple daily 0 1 2
0 1 2
22 activities because of compulsory repetition of certain actions or thoughts
23 has special routines: insists on no change 0 1 2
24 shows idiosyncratic attachment to objects 0 1 2
25 is bullied by other children 0 1 2
26 has markedly unusual facial expression 0 1 2
27 has markedly unusual posture 0 1 2

The ASSQ is a 27 question assessment filled in by parents or teachers of children or adolescents (6 to 17 years of age). It is designed to be an initial screen for Autism Spectrum Disorder (ASD) especially in those with high or normal IQ, or those with only mild intellectual disability. It can be used with boys and girls and uses the older conceptualisation of Aspergers syndrome to describe people on the milder end of the autism spectrum. It is not appropriate for people with moderate or severe intellectual disability.

Validity and Reliability

In a sample of 87 boys and 23 girls aged 6 to 17 it was found that autism spectrum disorder (DSM-IV Aspergers) validation sample scored an average of 25.1 (SD 7.3) (Ehlers, Gillberg, Wing, 1999). These scores were similar to those of the autism spectrum disorder group in the main sample. The subjects in the validation sample were independently diagnosed with ASD (DSM-IV Aspergers) by a psychologist specializing in the disorder and a child psychiatrist. Moderately and severely intellectually disabled children were excluded due to the fact that the ASSQ does not tap features characteristic for such low-functioning subjects.

Convergent validity was determined by a Pearson correlation between parent ratings on the ASSQ and Rutter scale was r = .75 n = 107; p < .0001. The mean interrater difference (i.e., between parent and teacher scoring) on the ASSQ (paired t test) was -1.96; t(104) = -2.39; p = .0188. No significant gender differences or differences across normal and intellectually disabled subjects were found regarding mean total score on the ASSQ.

Scoring and Interpretation

Results consist of a total score between 0 and 54, where higher scores indicate that many characteristics of ASD were reported. A score of 13 and above indicates ASD is probable, with a true positive rate of 90% and a false positive rate of 22% (Ehlers, Gillberg, Wing, 1999).

In addition, a percentile based on Ebler, Gillberg and Wing (1999) sample of ASD children is presented.  A percentile of around 50 would indicate that this individual scored at a similar level to the validation sample who were independently diagnosed with ASD (DSM-IV Aspergers). A percentile of 4.9 corresponds to the the cutoff raw score of 13. See developer reference for further details.

Developer Reference:

Ehlers, S., Gillberg, C., & Wing, L. (1999). A screening questionnaire for Asperger syndrome and other high-functioning autism spectrum disorders in school age children. Journal of autism and developmental disorders, 29(2), 129-141.

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