Self-Report in Adolescents and Adults with ASD: Implications for Diagnostic Assessment and for Evaluation of the Broader Autism Phenotype

As a result of rises in the prevalence and public awareness of ASD, more children than ever are entering adulthood with a diagnosis of ASD, and increasing numbers of adults are presenting for initial evaluations with concerns about ASD.  However, because ASD is normally diagnosed during childhood, relatively little is known about assessment of adolescents and adults with the disorder.  Most empirically derived assessment tools have been primarily validated for use in children with ASD.  Parent report measures, which are central to assessment of ASD in children, may not always be appropriate for assessing older individuals.  Thus, both in terms of measuring ASD symptoms, as well as evaluating comorbid psychopathology, more work is needed to establish best practice guidelines for assessment of adults with ASD. 

Until recently, standardized self-report measures were not available for adolescents and adults with ASD.  Unlike assessment of other types of adult psychopathology, such as mood and anxiety disorders, where standardized self-report measures are a primary component of diagnostic evaluations, self-report has not traditionally been part of assessment of ASD.  There remains much work to be done in order to understand how best to employ self-report instruments in the assessment of individuals with ASD.  It will be important to investigate the extent to which adolescents and adults with ASD can provide valid reports of their own symptoms, and whether certain types of self-report measures are better at ascertaining an individual’s true level of impairment.

This presentation will explore the potential uses of self-report measures in adolescents and adults with ASD, including assessing ASD symptoms, evaluating comorbid psychiatric disorders, and obtaining information about quality of life.  Recent findings from longitudinal investigations and from clinical samples will illustrate advantages and limitations of the use of self-report measures in adolescents and adults with ASD.  Implications of these findings for conceptualizing and evaluating the broader autism phenotype will also be discussed.