The Abridged Version of the Autism-Spectrum Quotient in Chinese People with Autism

Background: The Autism-Spectrum Quotient (AQ: Baron-Cohen et al. 2001) is among the most widely used scales assessing autistic traits in the general population. Hoekstra et al. (2011) reported that the 28-item abridged Version of the Autism-Spectrum Quotient (AQ-28) had high sensitivity and specificity which made the AQ-28 a useful alternative to the full 50-item version of AQ. Few studies have examined the psychometric properties of the 28 items among Chinese population.

Objectives: This study measured the distribution of autistic traits using AQ-28 in a big sample from Chinese people with autism spectrum disorders (ASD) and examined the measurement ability and convergent validity.

Methods: Total AQ-28 scores were collected from 6223 children and adults with ASD from all over China (except Tibet, Taiwan, Macau and Hong Kong), including 5073 ASD children (younger than 16 years old) (4255 males, M_age=8.7418,SD=3.4093, and 818 females, M_age=8.7083,SD=3.4567, Male: Female = 5:1) and 1150 ASD adults (older than 16 years old) (958 males, M_age=20.0120, SD=3.8738, and 192 females, M_age=20.4761,SD=4.6734, Male: Female = 5:1). 64.04% of the participants were recruited from urban areas, while 16.73% were living in suburbs and 19.22 % in rural areas. We examined the effects of groups (child and adult) and home areas (urban, suburb, rural) on AQ-28 total scores. The item severity and item discrimination was assessed using item response theory. In addition, we tested for sex differences in both groups. Besides, the caregivers of all the participants also filled a questionnaire about the characteristics of the people with ASD, comorbidities, service encounters, monthly cost for intervention/education and caregiver perceptions.

Results: The results showed that there was no gender difference in the ASD individuals on the AQ-28 scores but a correlation between age and AQ score was found (ASD children: M_male=77.9457,SD_male=10.6048, M_female=79.0880,SD_female=11.4374; ASD adults: M_male=76.1033, SD_male=11.0202, M_female=77.8750, SD_female=11.9456). In this study, 87.43% of the participants had received or were receiving various therapies/interventions, while 37.33% of people with ASD were in service centers, 42.68% were attending typical or special schools and 19.31% were staying at home, but only 41 participants (0.67%) got a job. It was found that participants' current status had significant correlation with AQ-28 scores.

Conclusions: This study confirms that AQ-28 has adequate validity to be used in health surveys as a measure of autistic traits.