Clinical Characteristics of Female Adult Autism Spectrum Disorders (ASD): (I) Development of the Adult ASD Self-Rating Scale (A-ASD)

Background: The assessment of the Adult Autism Spectrum Disorders (ASD) is so important.

Objectives:  We developed the Adult Autism Spectrum Disorders Self-Rating Scale (A-ASD) and examined the reliability and validity of the A-ASD. At the same time, we also specified clinical characteristics of female adult ASD patients without intellectual disabilities.

Methods: The subjects were 29,525 psychiatric outpatients in Minami-Aoyama Antique Street Clinic (recent 13 years). Among them, we drew 246 ASD patients (178 males and 68 females) without intellectual disabilities. After obtaining their informed consent, we administered the A-ASD. It consists of 35 items. It has three factors, autism spectrum disorders (Factor 1), psychiatric comorbidity (Factor 2), and other neurodevelopmental disorders including ADHD (Factor 3)

Results:  Cronbach alpha was approximately 0.9, indicating that internal consistency was adequate. There were significantly positive rest-retest correlations. Both the sensitivity and specificity were more than 80%. Thus, the reliability and validity were supported although we could not examine all types of the reliability and validity. However, both the sensitivity and specificity in females were less than 70%. We added 3 items on feminine emotions and behaviors to the same-sex women and reexamined the reliability and validity in female adult ASD patients. As a result, they were 78% and 80%, respectively. Finally, two different versions by gender were completed.

Conclusions: We have to pay close attention to female-specific characteristics to same-sex women when we perform a psychiatric diagnosis of female adult ASD without intellectual disabilities.