Autism Spectrum Screening Questionnaire ASSQ
Autism Spectrum Screening Questionnaire ASSQ overview
Creator and Context
The Autism Spectrum Screening Questionnaire (ASSQ) is a 27 item parent or teacher report screener for autism in school aged children and young people.
It was developed by Stephan Ehlers, Christopher Gillberg and Lorna Wing and published in 1999. It is maintained by the Gillberg Neuropsychiatry Centre at the University of Gothenburg.
The Centre prohibits digitisation of the ASSQ, and access is moving to a paid licensing arrangement. Any digital use requires a licence.
Presenting Conditions
The 27 items cover social interaction difficulties, communication problems, restricted and repetitive behaviour, motor clumsiness and associated features such as tics.
It is scored as a single total and has no official subscales.
A revised version, the ASSQ-REV, adds 18 items and was developed specifically to improve identification of autistic girls.
Administration
Completed by a parent or a teacher. Each item is rated Not true (0), Somewhat true (1) or Certainly true (2).
Desired Audience
Parents and teachers of school aged children and adolescents. It was originally designed to identify Asperger syndrome and high functioning autism in mainstream school populations.
The ASSQ was designed for children without intellectual disability, which is precisely the group whose autism gets missed for years because they cope, mask and pass. It is short, and it can be completed by a teacher, which brings in the setting where difficulties are usually most visible.
Considerations
A screener, not a diagnostic instrument.
The cut off is not portable. It varies by country, by informant and by whether the setting is clinical or general population. A single hard coded threshold is clinically wrong.
The standard ASSQ under captures the female autism phenotype, which is why the ASSQ-REV was developed. The evidence base for the revised version is still preliminary.
The Gillberg Neuropsychiatry Centre states that digitising the ASSQ is strictly prohibited, and access is moving to a paid licensing model. Do not deploy it digitally without a licence.
How to score the Autism Spectrum Screening Questionnaire ASSQ
Conducting the assessment
The parent or teacher rates 27 items on the 0 to 2 scale, giving a total from 0 to 54.
Interpretation
Scores range from 0 to 54. Higher scores indicate more autistic traits.
Published cut offs vary by setting and country:
In Sweden, 15 is used in non clinical populations and 19 in clinical populations
In Norway, a cut off of 17 gave sensitivity of 0.91 and specificity of 0.86
Test retest reliability is high: 0.90 to 0.94 for teachers and 0.96 for parents, with parent to teacher agreement of 0.79.
Clinical Considerations
Choose the cut off deliberately to match your setting and population. Do not import a threshold from another country's norms.
Collect both parent and teacher report where possible. Agreement is good but not complete, and the difference is informative.
Be alert to the female phenotype. A below threshold score in a girl does not rule autism out.
Autism Spectrum Screening Questionnaire ASSQ use cases
Screening for autism in school aged children without intellectual disability
Gathering a teacher perspective alongside parent report
Identifying children who warrant a full diagnostic assessment
Research and epidemiology
Category
Autism
Research Summary
Ehlers, S., Gillberg, C., & Wing, L. (1999). A screening questionnaire for Asperger syndrome and other high functioning autism spectrum disorders in school age children. Journal of Autism and Developmental Disorders, 29(2), 129 to 141.
Posserud, M. B., Lundervold, A. J., & Gillberg, C. (2009). Validation of the Autism Spectrum Screening Questionnaire in a total population sample. Journal of Autism and Developmental Disorders, 39(1), 126 to 134.
Kopp, S., & Gillberg, C. (2011). The Autism Spectrum Screening Questionnaire (ASSQ) Revised Extended Version: An instrument for better capturing the autism phenotype in girls. Research in Developmental Disabilities, 32(6), 2875 to 2888.
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Note on Assessment licensing
Some assessments are copyright protected and require a licence or the copyright holder's permission for clinical, commercial or digital use. Where that applies, obtaining and maintaining that permission is the responsibility of the practice or organisation using the assessment. Tacklit provides the digital administration, scoring and reporting. We do not grant, transfer or supply rights to the underlying instrument.
