Predictive validity of self-report questionnaires in the assessment of autism spectrum disorders in adults
Open accessAbstract
While various screening instruments for autism spectrum disorders are widely used in diagnostic assessments, their psychometric properties have not been simultaneously evaluated in the outpatient setting where these instruments are used most. In this study, we tested the Ritvo Autism Asperger Diagnostic Scale–Revised and two short versions of the Autism-Spectrum Quotient, the AQ-28 and AQ-10, in 210 patients referred for autism spectrum disorder assessment and in 63 controls. Of the 210 patients, 139 received an autism spectrum disorder diagnosis and 71 received another psychiatric diagnosis. The positive predictive values indicate that these tests correctly identified autism spectrum disorder patients in almost 80% of the referred cases. However, the negative predictive values suggest that only half of the referred patients without autism spectrum disorder were correctly identified. The sensitivity and specificity of each of these instruments were much lower than the values reported in the literature. In this study, the sensitivity of the Ritvo Autism Asperger Diagnostic Scale–Revised was the highest (73%), and the Autism-Spectrum Quotient short forms had the highest specificity (70% and 72%). Based on the similar area under the curve values, there is no clear preference for any of the three instruments. None of these instruments have sufficient validity to reliably predict a diagnosis of autism spectrum disorder in outpatient settings.
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The clinical diagnosis of ASD will be verified using a cut-off ≥70 on the 28-item Short version of the AQ-28.
“To verify the clinical diagnosis of ASD, we will use a cut-off ≥70 on the 28-item Short version of the AQ-28 [43, 44].”
From The effect of dialectical behaviour therapy in autism spectrum patients with suicidality and/or self-destructive behaviour (DIASS): Study protocol for a multicentre randomised controlled trial (2020) · cites this paper as [44]
The Instruments section identifies the AQ-28 as a 28-item questionnaire, supporting the instrument description. But the Results section gives 80—not ≥70—as this study’s optimal AQ-28 cut-off, and the Discussion says its scores are not reliable enough to verify an ASD diagnosis on their own. Page numbers are not available in our copy. (LLM, conf=0.88)
Experimental — accuracy not yet measuredThe AQ-Short is a reliable instrument for a quick assessment of quantitative autistic traits.
“The AQ-Short is a reliable instrument for a quick assessment of quantitative autistic traits.”
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Percentages, sums and reported differences re-computed from the paper’s own numbers.
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- Authors
- Sizoo, B. B., Horwitz, E., Teunisse, J., Kan, C., Vissers, C., Forceville, E., Van Voorst, A., & Geurts, H.
- Affiliations
- Dimence (NL)
- University Medical Center Groningen (NL)
- Dr Leo Kannerhuis, The Netherlands
- Radboud University Medical Center (NL)
- Kentalis Academy, The Netherlands
- GGZ Noord-Holland-Noord (NL)
- GGz Centraal, The Netherlands
- Dimence, The Netherlands
- Corresponding author
- Sizoo, Bram B
- ORCID
- Sizoo, Bram B
- Venue
- Autism
- Publisher
- SAGE Publications
- Published
- 2015-06-18
- Volume
- 19
- Issue
- 7
- Pages
- 842-849
- ISSN
- 1362-3613 (ISSN-L)
- 1461-7005
- OpenAlex
- W2237420181
- Cited by
- 77
- References
- 14
- Citations by year
- 2026: 7 · 2025: 12 · 2024: 9 · 2023: 7 · 2022: 11 · 2021: 6 · 2020: 12 · 2019: 6 · 2018: 3 · 2017: 1 · 2016: 2 · 2015: 1
- FWCI
- 1.40
- Type
- journal article
- Language
- en
- Open access
- green
- handle.uba.uva.nl
- Locations
- Autism (publishedVersion)
- PubMed (publishedVersion)
- UvA-DARE (University of Amsterdam) (submittedVersion, other-oa)
- University of Groningen research database (University of Groningen / Centre for Information Technology) (submittedVersion)
- Radboud Repository (Radboud University) (submittedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion, other-oa)
- Funders
- Achmea
- Topics
- Life Sciences › Neuroscience › Cognitive Neuroscience › Autism Spectrum Disorder Research
- Social Sciences › Decision Sciences › Management Science and Operations Research › Psychometric Methodologies and Testing
- Social Sciences › Psychology › Applied Psychology › Psychological Testing and Assessment
- Keywords
- autism spectrum disorder, adults, predictive validity, Autism Spectrum Quotient, AQ-10, screening tool, sensitivity and specificity, outpatient diagnosis, self-report questionnaire
- MeSH terms
- Autism Spectrum Disorder, Adolescent, Adult, Female, Humans, Male, Middle Aged, Surveys and Questionnaires, Reproducibility of Results, Young Adult, Self Report
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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