How useful are the Adult Asperger Assessment and AQ-10 within an adult clinical population of all intellectual abilities?

Abstract

Purpose-The Adult Asperger Assessment (AAA) was designed to be a screening tool to identify adults with Asperger syndrome and/or high-functioning autism. The AAA includes three questionnaires; the Autism Quotient (AQ), the Empathy Quotient (EQ) and the Relatives Questionnaire (RQ). The Autism Quotient-10 (AQ-10) was designed to be a "red flag" for healthcare professionals considering referral for ASD assessment. The purpose of this paper is to determine the usefulness of the AAA and AQ-10 as part of an adult autism diagnostic pathway that includes patients of all intellectual ability. Design/methodology/approach-Results were obtained for all patients who had received a clinical decision at Leeds Autism Diagnostic Service, which is a service that assesses patients of all intellectual ability, during 2015, n¼214. Of these 132 were included in the analysis, 77 patients were excluded for not completing the AAA and four were excluded for not receiving a clinical decision. Findings-Results suggest that patients diagnosed with ASD without intellectual disabilities score on average 35 on the AQ, 17 on the EQ and 20 on the RQ. Those not diagnosed with ASD score on average 33 on the AQ, 22 on the EQ and 15 on the RQ. Patients with intellectual disabilities, scores are lower on the AQ, and higher on the EQ and RQ than those without intellectual disabilities. These results are the same regardless of diagnosis of ASD. The RQ is the only questionnaire to result in a significant difference between those diagnosed and not diagnosed. Results suggest that the AQ-10 is not useful in this clinical population. Research limitations/implications-This study was undertaken as part of a service development improvement process. The specific demographics of this clinical population may have influenced the findings. The process will need to be repeated to ensure that the results are consistent across time and increased sample size. The population of patients with an intellectual disability is small, further studies into the use of the AAA or the design of other intellectual disability specific screening tools should be pursued. It is of note that the AAA was never intended for use within an intellectual disability population. Originality/value-This is an original paper as it will be the first to consider the usefulness of each of the aspects of the AAA collectively. It will be the first to assess: the AQ-10 alongside the AAA, the usefulness of the AAA regardless of intellectual ability and the usefulness of the AAA within a clinical population by using the diagnostic outcome as the benchmark of the usefulness of the AAA scores. This paper will only be discussing the scores generated by the AAA, and the correlation of these scores with a diagnosis.

AAA screening in adults with ASD: a retrospective cohort study

“…However, the RQ was able to significantly predict diagnostic outcome. We make similar inferences as Kenny and Stansfield Alison (2016) who found no consistency between diagnostic outcome and AAA scores, apart from scores on the RQ. Our findings are also in line with Ashwood et al (2016) who found the AQ failed to predict receipt of a diagnosis in a clinical setting.…”

“…To the best of our knowledge, only one study has explored the usefulness of the AAA. Kenny and Stansfield Alison (2016) explored the AAA and AQ-10 in an adult sample ( n = 132) of individuals with varying intellectual ability, referred for diagnostic assessment to a specialist autism service. The authors found no difference in AQ, AQ-10 or EQ scores, regardless of ASD/non-ASD diagnosis (after full assessment) of both average and below average intelligence.…”

The Effectiveness of RAADS-R as a Screening Tool for Adult ASD Populations

“…In general, this should be deemed supportive of the effectiveness of the RAADS-R. However, there are serious questions surrounding the validity of the AQ as a screening measure for ASD populations [ 20 , 22 , 39 ] which is of considerable concern for tools measuring against the AQ.…”

“…It is commonly used in research studies for participant inclusion and exclusion purposes [ 17 ] and reports high sensitivity and specificity [ 16 , 18 ]. Clinically, it has been noted to be useful in the screening process by identifying the extent of autistic symptoms an individual demonstrates [ 19 ], although there is good evidence to suggest it has weaknesses [ 20 – 22 ].…”

What is the association between ADI-R scores and final diagnosis of autism in an all IQ adult autism diagnostic service?

“…The team at LADS have previously tested clinical tools suggested by guidance to ensure their usefulness in the population catered for by the team. Kenny and Stansfield (2016) looked at the use of the AAA questionnaires in a similar population. (The AAA is part of the postal questionnaires sent prior to a screening assessment, consisting of Autism Quotient (AQ), Empathy Quotient (EQ), and Relatives Questionnaire (RQ).…”