To diagnose autism in a child, doctors look for, among other key symptoms, repetitive behaviors such as head banging and rocking. To help identify autism in adults, a first-ever self-assessment test also looks for repetitions — but adult-sized ones.
Maintaining an overly strict daily routine, for example, would be an adult-version of an autistic symptom. Importantly, this new self-assessment tool created at Cardiff University does not diagnose autism, it is simply a helpful tool.
Autism spectrum disorders occur in more than one in every 100 people. On the high functioning end of the spectrum is Asperger’s syndrome. Hallmarks of this disorder are difficulty with social interactions, a restricted range of interests, and repetitive behaviors. Compared with other forms of autism, Asperger’s does not impact cognitive development quite so much. For this reason, some children grow to be adults before they are diagnosed with the condition.
With increasing awareness, though, a growing number of adults are being diagnosed with this mild form of autism, and, aware of this fact, Dr. Sue Leekam, director of the Wales Autism Research Centre, and her colleagues felt the lack of a particular tool. What was needed, Leekam and her co-researchers theorized, was a broad measure of repetitive behavior that adults could complete on their own to give a fuller picture of the way such behaviors affect them. This would help their doctors diagnose them.
However, some problems existed. First, all adults have routines and habits, yet for the overwhelming majority, these daily repetitions do not signal a problem. Second, repetitive behaviors are symptoms of Parkinson’s disease, Obsessive-Compulsive Disorder, and Tourette syndrome. Any new test, then, would have to precisely identify and differentiate the problematic behaviors underlying autism from those that are either neurotypical or signs of another disorder or disease.
To develop a self-assessment for adults, the researchers turned to an older one designed for use by parents of very young children — the Repetitive Behaviors Questionnaire-2 (RBQ-2). After a thorough analysis of the RBQ-2, the team rephrased each item into an appropriate adult query. On the simplest level, words like “toys” and “teddy” were removed. On a more complex level, the researchers swapped out each childish symptom, such as hand-flapping, and exchanged it for an adult symptom, such as compulsively arranging objects.
The result is the RBQ-2A, a 20-item questionnaire. Having undergone validation testing in adults with and without autism, RBQ-2A was found to be a reliable and valid measure of autism. The test demonstrated adults without autism have a taste, so to speak, for routine and repetition, however, those with autism consistently scored higher — significantly so.
The test, Leekam and her colleagues say, cannot diagnose autism on its own because repetitive behaviors are only one criterion for a diagnosis of autism. Further research and data collection is ongoing. The next phase before implementing its use in clinics across the United Kingdom will be a test on people of all ages with autism. Meanwhile, anyone 18 or older may participate in the research by clicking here.