To date there have been few studies that examine screening and diagnostic instruments in adult populations referred for assessment of Autism Spectrum Disorder (ASD). The Autism Quotient (AQ) and Empathy Quotient (EQ) are designed for use in adult populations. It has been proposed that there are clinical advantages to using these instruments as they are less expensive and time consuming, and require less expertise to administer and interpret. However relatively little is known on how they perform in a ‘real world’ clinical setting
The aim of this study is to examine AQ and EQ scores in an adult clinical setting when compared to the outcome of ADOS and ADI..
Diagnostic assessment for 57 adults (11 females, 46 males, mean age 31.05) were reviewed. The participants were referred to the Behavioural Genetics Clinic (BGC) in the Maudsley Hospital, South London and Maudsley Trust for an assessment of ASD. Each participant had completed the AQ and EQ before assessment, and completed ADOS and / or ADI and a clinical interview during assessment.
For each measure, participants were categorized as above or below threshold for ASD on the ADOS and ADI using the algorithm scores. A score of under 30 on the EQ and of over 30 on the AQ were taken to indicate an ASD positive score.
In this sample, 39 met ASD criteria on the ADOS and 36 met on the ADI.
Sensitivity and specificity was calculated in comparison with the ADOS. In this the AQ had a sensitivity of 71.42% and specificity of 50%.The EQ had a sensitivity of 70.97% and specificity of 12.5%. Using the EQ and AQ together had a sensitivity of 50% and specificity of 50%.
Sensitivity and specificity was calculated in comparison with the ADI. In this the AQ had a sensitivity of 85.71% and specificity of 60%.The EQ had a sensitivity of 79.31% and specificity of 42.86%. Using the EQ and AQ together had a sensitivity of 66.67% and specificity of 60%.
Chi squared was used to find which measure distinguished most accurately between ASD positive results on both the ADOS and ADI. The AQ was found to be a significant predictor of a positive ADI: χ²=(1, 26) =4.75, p=.029. No other results were significant.
The AQ and EQ alone (at a threshold of 30) have relatively poor predictive power when used to aid diagnosis of ASD in adults within mainstream health care settings. We are currently investigating how using other thresholds on the AQ and EQ may improve performance.
See more of: Clinical Phenotype
See more of: Symptoms, Diagnosis & Phenotype