Question regarding the validity of aspie quiz

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Michel Ardan
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26 Aug 2021, 4:44 pm

@Something Profound I don’t know if your message is partly for me but you made me realised that I really need to talk about it to my psychiatrist. My diagnosis definitely feels right but still…



naturalplastic
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26 Aug 2021, 7:19 pm

The tests are made for entertainment purposes. And to get you thinking about it. Get you more curious if you are already wondering about it.

But they are not even screening tests, much less official diagnostic tests.

Ive taken it several times. And I answer it, not as my present day self, but as my more autistic acting ten year old self. And I get an ambiguous result. A split decision of "your not clearly NT or ND" or however they say it. But I took the exhaustive real test with a real doctor and was officially dxd with aspergers a few years ago.



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26 Aug 2021, 11:17 pm

@Michael Ardan, If there is any doubt, or concern, about a diagnosis, it doesn't hurt to discuss with your mental health professional. They can more adequately answer questions about the diagnostic process and your diagnosis than anyone on the internet can.



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27 Aug 2021, 11:56 am

Something Profound wrote:
@Michael Ardan, If there is any doubt, or concern, about a diagnosis, it doesn't hurt to discuss with your mental health professional. They can more adequately answer questions about the diagnostic process and your diagnosis than anyone on the internet can.

That may often be correct, though it depends on who you get.



Michel Ardan
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27 Aug 2021, 1:48 pm

ToughDiamond wrote:
Something Profound wrote:
@Michael Ardan, If there is any doubt, or concern, about a diagnosis, it doesn't hurt to discuss with your mental health professional. They can more adequately answer questions about the diagnostic process and your diagnosis than anyone on the internet can.

That may often be correct, though it depends on who you get.


What do you mean? Apart from the psychiatrist being trained for autism (mine is).

I tried to get an appointment today. The answering machine said the office is closed during August and to call again on Monday. Don’t come to France in August if you can avoid it :wink:



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27 Aug 2021, 3:48 pm

Michel Ardan wrote:
What do you mean? Apart from the psychiatrist being trained for autism (mine is).

I tried to get an appointment today. The answering machine said the office is closed during August and to call again on Monday. Don’t come to France in August if you can avoid it :wink:

I'm just saying that not all health professionals are entirely competent and honest, and that just because there's a lot of bad advice on the internet, it doesn't mean it's all bad advice. I know a case of one client who was told she didn't have ASD by one health professional. She tried another, who said she had the most severe level of ASD possible. Both professionals were presumably qualified. I'm not saying they're all useless, just that some clearly are.



Michel Ardan
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27 Aug 2021, 4:57 pm

Got it. You confirm my readings.



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27 Aug 2021, 5:41 pm

xxautisticfoolxx wrote:
How can this happen? I struggled to make a single friend in my life, have been bullied everywhere for being socially slow. I always suspected that I was autistic. Now this test says I am likely NT. I was honest while answering also. Can I trust this result?

I'm looking into a diagnosis as well. I guess it's important to find someone who's not only competent in diagnosing Autism in adults (the most important thing), but also being able to identify other conditions that may be co-morbid with Autism -or- accurately recognizing other conditions that may seem like Autism, even if the patient doesn't actually fit the criteria for Autism itself.



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29 Aug 2021, 5:40 pm

xxautisticfoolxx wrote:
I took the Autism Spectrum Quotient test and got 20. It says to suspect autism if you score above 25. Yeah, this test can't be trusted either. Also, what do you mean by having something more interesting than autism?


My first result on the AQ was low, because I was answering the questions literally. Which ironically is an Aspie trait and I should get a higher score for it. When I started being more self-aware (oh, I do stim, that's what that is) and answering questions less literally my score jumped 10 points and is now consistently up there. More or less depending on the stress in my life.

For my kind of ASD person, information is the currency. Bonus points for massive spreadsheets or mental collections. Also, taking hours to write an email (or post) is up there also.

Wishing you well on your journey.



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29 Aug 2021, 6:06 pm

^
It wouldn't be so bad if the test was just treated with appropriate suspicion, but I've heard of the UK health service denying a full assessment on the grounds that the client didn't score high enough on the AQ questionnaire. So I think they're using it as a screening test and assuming that if it turns out negative, the client doesn't have ASD. If that's the case, it would be prudent for a UK patient to get familiar with the questions and the scoring system, and to avoid being pathologically honest or too literal when they answer them. Of course that undermines the function of the AQ test, but if it's not reliable and they're using it to turn people away, in some cases wrongly, (a full DX costs the NHS money), then what else can you do to try to secure a fair assessment? Still, I don't know that it's common practice, it's only anecdotal evidence, and I can't find the source now. It was somewhere on WP, a few years ago.



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29 Aug 2021, 8:02 pm

ToughDiamond wrote:
^
It wouldn't be so bad if the test was just treated with appropriate suspicion, but I've heard of the UK health service denying a full assessment on the grounds that the client didn't score high enough on the AQ questionnaire. ...

Oh, no!

I had a separate post poking holes in the AQ and others. I did pay for evaluations and I "passed" the current golden standard ADOS2 (as not ASD) and my daughter "passed" the BOSA (as not ASD). Thankfully my evaluator was experienced in diagnosing adult women, so I was diagnosed correctly (with ASD). We were not so fortunate in my daughter's case (whose dr gave her six different diagnosis, not ASD). So it's definitely not straight forward even when one pays.

Making fun of the AQ:

"I prefer to do things with others rather than on my own." A resounding YES for me: an extraverted ASD (not NT). So, if yes, ASD points for "...but I find myself alone in any case (can't relate to most others) --- or I relate better to other people on the Outside..."

"I am often the last to understand the point of a joke." Bonus ASD points if you understand the point of the "joke" but do not like it (and hence don't truly "understand" it), e.g. it's not funny b/c it hurts another class of human being. Or if you don't understand b/c it's referring to some popular TV sitcom. Or if all the jokes regarding wordplay or play on literal interpretations are hilarious to you...



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29 Aug 2021, 9:18 pm

Possibly of interest--WebMD: "Conditions That May Look Like Autism, but Aren’t"

I scored a 40 on the AQ. As a sanity check I asked my bride to take it for me, answering the questions the way she thought I should answer them--she got a 39 for me. Those scores didn't convince me I was on the Spectrum, they convinced me it was reasonable for me to wonder if I was.

Though I admit when we went to the Psychologist to hear the formal diagnosis I went in wondering if I was almost Autistic or barely Autistic. Anything else would've surprised me...and given me something new to be interested in!


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30 Aug 2021, 12:51 am

SharonB wrote:
I had a separate post poking holes in the AQ and others. I did pay for evaluations and I "passed" the current golden standard ADOS2 (as not ASD) and my daughter "passed" the BOSA (as not ASD). Thankfully my evaluator was experienced in diagnosing adult women, so I was diagnosed correctly (with ASD). We were not so fortunate in my daughter's case (whose dr gave her six different diagnosis, not ASD). So it's definitely not straight forward even when one pays.



My step-daughter's experiences with ASD assessments that were paid for (chiefly by health insurance) in the USA were more than just wildly inconsistent. In the first one, they'd done a barrage of tests, and on their report they indicated they'd spent an hour testing for ASD. Yet there is no breakdown of the ASD test results there (though for all the others there is), and she can't remember any specific ASD testing. Also strangely, during the preliminary assessment they said they thought she probably had ASD, but subsequently changed their minds.



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30 Aug 2021, 12:55 am

SharonB wrote:
"I prefer to do things with others rather than on my own." A resounding YES for me: an extraverted .........


[excuse me not quoting in full - CloudFront wouldn't let me :evil: ]

I wonder whether the obvious problems with the wording of the questions weaken the robustness of the test?
It's clear that even the authors admit to a 20% false negative rate - indeed they seem to think it's acceptable, though it's not clear to me what purpose they had in mind for the test:
"Baron-Cohen et al. [5] recommended a cut-off point for Total AQ score of 32, which they found should capture 80% of those diagnosed with ASD, but with a 2% false positive rate."
https://www.hindawi.com/journals/aurt/2013/984205/
So if clinicians really use that cutoff point to deny people a full diagnosis, that's throwing one Aspie in five to the wolves.

As has already been suggested, it would be interesting to see how much the diagnostic power of the test might be improved if the medical professionals saw Aspies less as lab rats and more as consultants, and were interested in our recommendations for better questions. Frankly, judging by my own perusal of the questions as they are, I'm surprised they have any diagnostic power at all. There seems to be something not quite right somewhere. I wonder whether those of us who have objections to the questions represent only a small subset of people with ASD, and if the majority would sail through them without any trouble?



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30 Aug 2021, 5:33 am

I have actual cases of autistic people scoring 13 on the AQ. It doesn't mean that they are not autistic, just that the AQ (and all these tests) is not designed to test for autism. Autism has no biomarkers meaning it is impossible to (currently) diagnose it on anything physical so all diagnoses are down to clinician decisions. Clinicians are not always good at their job. I was just hearing about one who misdiagnosed autism as PTSD, which is surely impossible given the symptoms/traits of both.

My research has found that self-diagnosed people do tend to score lower on the AQ than diagnosed people but they also have a much higher rate of alexithymia, which makes it hard for them to understand their feelings, which I suspect is why they think they're autistic (no offense to anyone without a diagnosis, I'm not saying this applies to everyone). My research and tons of other research is ongoing (pending funding!) so please support us by completing surveys or volunteering for research when you can (so long as we don't ask for your dna!).



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30 Aug 2021, 5:43 am

ToughDiamond wrote:
SharonB wrote:
"I prefer to do things with others rather than on my own." A resounding YES for me: an extraverted .........


[excuse me not quoting in full - CloudFront wouldn't let me :evil: ]

I wonder whether the obvious problems with the wording of the questions weaken the robustness of the test?
It's clear that even the authors admit to a 20% false negative rate - indeed they seem to think it's acceptable, though it's not clear to me what purpose they had in mind for the test:
"Baron-Cohen et al. [5] recommended a cut-off point for Total AQ score of 32, which they found should capture 80% of those diagnosed with ASD, but with a 2% false positive rate."
https://www.hindawi.com/journals/aurt/2013/984205/
So if clinicians really use that cutoff point to deny people a full diagnosis, that's throwing one Aspie in five to the wolves.

As has already been suggested, it would be interesting to see how much the diagnostic power of the test might be improved if the medical professionals saw Aspies less as lab rats and more as consultants, and were interested in our recommendations for better questions. Frankly, judging by my own perusal of the questions as they are, I'm surprised they have any diagnostic power at all. There seems to be something not quite right somewhere. I wonder whether those of us who have objections to the questions represent only a small subset of people with ASD, and if the majority would sail through them without any trouble?


Sorry for the second post in a row but I wanted to mention things like sensitivity and specificity, both elements of psychometric tests and the AQ is by far the highest in the field (which is upsetting for those of us who prefer to use scales from actually autistic people).

I just wanted to mention with regards to the previous, quoted, comment, the AQ is not diagnostic, it has 0 diagnostic power. Nothing should be diagnosed on the result of it and if anyone's diagnosis or lack of is because of their AQ score, you need to report that clinician because they are so bad at doing their job, they should probably stop! Autism should only be diagnosed after many in depth interviews and I know there's controversy about it (I personally was against it at first and it turned out to be the thing that sealed my diagnosis) but interviews with parents/old friends etc should also be used (I think it was Luciano et al. who did a recent study of misdiagnosis of autism and found that not having good enough history was key in misdiagnosis).