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ASD AQ10 Screening Form

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PLEASE ASK THE GP TO SEND A 'GP REFERRAL LETTER' TO US WITH THIS

FORM. OTHERWISE, YOUR REFERRAL WILL NOT BE ACCEPTED.

AQ-10
Autism Spectrum Quotient (AQ)
A quick referral guide for adults with suspected autism who do not have a learning disability.

Definitely Slightly Slightly Definitely


Please tick one option per question only: agree agree disagree disagree
I often notice small sounds when others
1
do not.
I usually concentrate more on the whole
2
picture, rather than the small details.
I find it easy to do more than one thing at
3
once
If there is an interruption, I can switch
4
back to what I was doing very quickly
I find it easy to ‘read between the lines’
5
when someone is talking to me
I know how to tell if someone listening to
6
me is getting bored
When I’m reading a story I find it difficult
7
to work out the characters’ intentions
I like to collect information about
8 categories of things (e.g. types of car,
bird, train, plant etc.)
I find it easy to work out what someone is
9 thinking or feeling just by looking at their
face
I find it difficult to work out people’s
10
intentions

This test is recommended in ‘Autism: recognition, referral, diagnosis and management of adults on
the autism spectrum’ (NICE clinical guideline CG142). www.nice.org.uk/CG142

Key reference: Allison C, Auyeung B, and Baron-Cohen S, (2012) Journal of the American Academy
of Child and Adolescent Psychiatry 51(2):202-12.

© SBC/CA/BA/ARC/Cambridge University 1/5/12

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