The Adult Asperger Assessment

1. Abstract

The Adult Asperger Assessment (AAA) is an advanced, clinician-administered diagnostic instrument developed by Simon Baron-Cohen, Sally Wheelwright, Janine Robinson, and Marc Woodbury-Smith in 2005 at the Autism Research Centre, University of Cambridge. Designed to address the clinical challenge of identifying autism spectrum conditions in intellectually capable adults, the AAA operationalizes and refines diagnostic criteria derived from the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) and the International Classification of Diseases, Tenth Revision (ICD-10). The instrument incorporates quantitative screening scores from the Autism Spectrum Quotient (AQ) and the Empathy Quotient (EQ) alongside a rigorous, semi-structured clinical interview comprising 23 categorical diagnostic items. These items map across five primary domains: qualitative impairment in social interaction, qualitative impairments in communication, restricted repetitive and stereotyped patterns of behavior or interests, impairments in imagination, and diagnostic prerequisites concerning developmental history and lack of general cognitive delay.

To mitigate the risk of false positives often associated with subjective self-report or non-specific clinical evaluations in high-functioning adult cohorts, the AAA imposes conservative diagnostic cut-offs requiring both developmental history verification and contemporary behavioral manifestations. Psychometric evaluations demonstrate exceptional discriminant validity, differentiating individuals with Asperger syndrome from clinical and non-clinical control populations with high sensitivity (approaching 90%) and specificity exceeding 95%. Inter-rater reliability yields substantial to almost perfect agreement across categorical items (Cohen’s kappa values ranging from .70 to .92). By integrating developmental anamnesis, direct behavioral observation, informant reporting, and psychometric screening thresholds, the Adult Asperger Assessment represents a gold-standard diagnostic framework for clinicians and researchers evaluating autism spectrum conditions in mature populations.

2. Keywords

Adult Asperger Assessment, Asperger syndrome, autism spectrum condition, diagnostic instrument, adult autism diagnosis, Autism Spectrum Quotient, Empathy Quotient, neurodevelopmental assessment, clinical psychometrics, developmental anamnesis, social interaction impairment, psychiatric evaluation

3. Authors

The Adult Asperger Assessment was formulated and validated by an interdisciplinary team of researchers and clinical psychiatrists based primarily at the Autism Research Centre (ARC), Department of Psychiatry, University of Cambridge, United Kingdom:

• Simon Baron-Cohen, PhD, FBA, FMedSci: Professor of Developmental Psychopathology, Director of the Autism Research Centre, University of Cambridge, and Fellow of Trinity College, Cambridge, United Kingdom.
• Sally Wheelwright, MA: Senior Research Associate and Project Manager, Autism Research Centre, Department of Psychiatry, University of Cambridge, United Kingdom.
• Janine Robinson, MRCPsych: Consultant Child and Adolescent / Adult Psychiatrist, National Health Service (NHS) Foundation Trust and Clinical Researcher, University of Cambridge, United Kingdom.
• Marc Woodbury-Smith, PhD, MRCPsych: Consultant Forensic Psychiatrist and Academic Clinical Lecturer, Autism Research Centre, University of Cambridge (subsequently affiliated with Newcastle University and McMaster University).

Correspondence regarding the original development of the instrument was coordinated through the Autism Research Centre, Douglas House, 18b Trumpington Road, Cambridge CB2 8AH, United Kingdom.

4. Purpose

The primary clinical purpose of the Adult Asperger Assessment (AAA) is the formal diagnostic identification and differential evaluation of Asperger syndrome—now widely subsumed under the broader continuum of Autism Spectrum Disorder (ASD) without intellectual or language impairment—in adulthood. Historically, diagnostic instruments such as the Autism Diagnostic Observation Schedule (ADOS) and the Autism Diagnostic Interview-Revised (ADI-R) were calibrated predominantly for pediatric cohorts. When administered to adults with average to superior intellectual functioning, these conventional child-centric protocols often demonstrate ceiling effects, fail to capture nuanced compensatory strategies (“masking” or “camouflaging”), or present logistical barriers due to the frequent unavailability of living parents to provide early developmental history.

The AAA was engineered to bridge this diagnostic void by providing a systematic, evidence-based, and electronically scorable diagnostic methodology specifically calibrated for adults presenting for assessment in secondary and tertiary mental health settings. Adult referrals frequently arise in the context of late identification, secondary depression, persistent anxiety disorders, marital breakdowns, or occupational crises, where clinicians require robust tools to distinguish autism spectrum characteristics from personality disorders (e.g., schizoid, avoidant, or obsessive-compulsive personality disorders), social anxiety disorder, or affective dysregulation.

Crucially, the theoretical and clinical rationale underpinning the AAA is the deliberate prevention of false-positive diagnoses. In adult community referrals, general dissatisfaction with social relationships or non-specific eccentricity may easily be conflated with genuine neurodevelopmental difference. To establish high diagnostic specificity, the authors constructed the AAA’s thresholds to be systematically more conservative than the literal text requirements of the DSM-IV. In DSM-IV criteria, a diagnosis of Asperger disorder required only two symptoms of qualitative impairment in social interaction and one symptom of restricted, repetitive patterns of behavior. In contrast, the AAA mandates higher criteria thresholds (a minimum of three social items, three communication items, and three restricted behavior/interest items, alongside historical developmental prerequisites), demanding concrete qualitative examples of symptom manifestation across both developmental history and present-day functioning. Consequently, the AAA functions as a definitive diagnostic standard in clinical psychiatric evaluation, specialized forensic assessments, and rigorous neuroimaging or genetic research protocols where sample homogeneity is paramount.

5. Psychological Construct

The psychological construct evaluated by the Adult Asperger Assessment is the multidimensional neurodevelopmental profile of Asperger syndrome / Autism Spectrum Condition in cognitively unimpaired individuals. Rather than viewing autism solely as a unitary deficit, the AAA conceptualizes the presentation as an interrelated cluster of cognitive, communication, and behavioral patterns that emerge early in development and persist across the lifespan. The construct is operationalized into five core diagnostic subscales comprising 23 categorical items:

Subscale A: Qualitative Impairment in Social Interaction

This subscale captures foundational differences in reciprocal social engagement, peer relationships, and intuitive social perception. It comprises five operationalized items:

• Marked impairment in nonverbal communicative behaviors: Deficits in regulating social interaction via eye-to-eye gaze, facial expressiveness, communicative body postures, and conversational gestures. For example, an individual may maintain unmodulated, staring eye contact, exhibit a flat affect incongruent with verbal disclosures, or fail to orient their body posture toward conversational partners.
• Failure to develop developmentally appropriate peer relationships: A persistent inability to form reciprocal friendships based on mutual emotional sharing, resulting in severe social isolation or solitary existence despite an expressed desire for companionship.
• Lack of spontaneous seeking to share enjoyment, interests, or achievements: Absence of showing, bringing, or pointing out objects of interest to others, or an egocentric sharing style characterized entirely by monologue rather than interactive exchange.
• Lack of socio-emotional reciprocity: Impairments in responding sensitively to others’ emotional states, failure to modulate social behavior according to environmental context, or presenting socially inappropriate, blunt responses without malicious intent.
• Difficulty in understanding social situations and others’ emotional states: A profound difficulty in intuitive mentalizing (Theory of Mind), leading to misinterpretations of social cues, sarcasm, nuances, or teasing.

Subscale B: Qualitative Impairments in Communication

Although formal structural language development (vocabulary, grammar) is preserved in Asperger syndrome according to classical criteria, functional pragmatic and communicative usage is heavily atypical. Subscale B evaluates six diagnostic criteria:

• Pedantic or overly formal speech: Use of excessively formal, elevated, bookish vocabulary and syntax in informal, everyday contexts (e.g., addressing a peer as if delivering an academic treatise).
• Idiosyncratic language use: Neologisms, metaphorical usage meaningful only to the individual, or unconventional syntactic arrangements.
• Impairment in pragmatic language: Difficulty inferring implicit communicative intentions, taking figurative expressions literally (e.g., idioms, hyperbole), and failing to adapt vocal tone, rate, or volume to listener needs.
• Deficits in conversational turn-taking: Monologuing on specific topics without monitoring the listener’s engagement or providing conversational openings for the interlocutor.
• Repetitive or perseverative speech patterns: Compulsive repetition of specific words, phrases, or themes across different contexts.
• Lack of spontaneous varied, make-believe play or social imitative play: Historically evaluated to determine whether childhood play lacked social narrative and symbolic flexibility.

Subscale C: Restricted, Repetitive, and Stereotyped Patterns of Behavior, Interests, and Activities

This dimension operationalizes the nonsocial behavioral phenotypes characterized by cognitive inflexibility and hyper-focused pursuits across five categorical items:

• Encompassing preoccupation with stereotyped and restricted patterns of interest: Intense, circumscribed fixations on specific, often technical or catalog-like subjects (e.g., timetables, historical lineages, electrical circuits) pursued to the exclusion of other occupational or domestic demands.
• Apparent inflexible adherence to specific, nonfunctional routines or rituals: Severe distress or cognitive paralysis provoked by minor disruptions to daily schedules, travel routes, or environmental organization.
• Stereotyped and repetitive motor mannerisms: Hand-flapping, finger-flicking, rocking, or complex whole-body posturing, especially when experiencing sensory overload, emotional excitement, or cognitive distress.
• Persistent preoccupation with parts of objects: Fixation on non-functional components (e.g., wheels, buttons, texture of labels) or sensory aspects of stimuli (e.g., sniffing surfaces, tactile exploration of specific fabrics).
• Sensory hyper- or hypo-reactivity: Atypical sensory processing, including adverse reactions to specific acoustic frequencies, tactile textures, fluorescent lighting, or atypical pain tolerance.

Subscale D: Qualitative Impairments in Imagination

Subscale D investigates the individual’s capacity for social imagination, generative fantasy, and creative mental projection across three items. Individuals with Asperger syndrome typically demonstrate strong systemizing capacities but reduced generative social imagination, preferring non-fiction, factual databases, and mechanical systems over character-driven fiction, role-playing, or hypothetical perspective-taking.

Subscale E: Prerequisites and Early Developmental Trajectory

Comprising four foundational gating criteria, Subscale E verifies that the observed difficulties are neurodevelopmental rather than acquired. It mandates evidence that:

• There was no clinically significant general delay in spoken language acquisition (e.g., single words used by 2 years of age, communicative phrases by 3 years).
• There was no clinically significant delay in cognitive development, adaptive behavior, or curiosity about the physical environment in early childhood.
• Criteria are not better explained by another pervasive developmental disorder or psychiatric illness (e.g., schizophrenia).
• The symptoms cause clinically significant impairment in social, occupational, or other vital domains of adult functioning.

6. Theoretical Framework

The Adult Asperger Assessment is theoretically grounded in several influential neuropsychological and cognitive models formulated over decades of empirical autism research, spearheaded principally by Simon Baron-Cohen and his associates.

1. The Empathizing-Systemizing (E-S) Theory

The preeminent theoretical model underpinning the AAA is the Empathizing-Systemizing (E-S) Theory. This framework conceptualizes human cognitive profiles along two independent psychological dimensions:

• Empathizing (E): The cognitive and affective drive to identify another person’s mental states (emotions, beliefs, desires), understand their internal psychological reality, and respond with an appropriate, socially attuned emotion.
• Systemizing (S): The drive to analyze, construct, predict, and manipulate rule-based, deterministic systems (e.g., mechanical devices, computer code, classification taxonomies, musical structures, mathematical principles).

According to the E-S theory, the psychological cognitive architecture of individuals on the autism spectrum represents an extreme disparity between these mechanisms: significantly impaired or hypo-developed empathizing co-occurring with intact, hyper-developed, or superior systemizing (Type S or Extreme Type S cognitive profile). In the AAA, this cognitive profile is operationalized directly through the diagnostic integration of the Empathy Quotient (EQ) and Autism Spectrum Quotient (AQ), as well as clinical interview items tracking hyper-systemized, repetitive interests alongside pragmatic and socio-emotional mentalizing deficits.

2. The Mindblindness and Theory of Mind Deficit Model

Earlier neurocognitive work by Baron-Cohen, Leslie, and Frith (1985) introduced the Theory of Mind (ToM) hypothesis, conceptualized colloquially as “mindblindness.” This framework posits that the qualitative social and communication impairments defining autism stem from a fundamental difficulty in attributing mental states to oneself and others. While autistic adults with normative or superior IQ often master basic first- and second-order false-belief tasks through explicit intellectual deduction, they frequently fail naturalistic, advanced Theory of Mind tasks that require rapid, online decoding of subtle mental states (such as the Reading the Mind in the Eyes Test). The AAA’s interview items rigorously probe this deficit by exploring real-world pragmatic misattributions, failure to read facial nuances, misunderstandings of deceptive or ironic communication, and social faux pas.

3. The Executive Dysfunction Hypothesis

Complementary theoretical grounding is derived from the executive dysfunction hypothesis of autism, championed by researchers such as Ozonoff, Pennington, and Rogers. This framework identifies impairments in higher-order cognitive control mechanisms—such as cognitive flexibility, set-shifting, working memory, and generative planning—as the primary drivers of behavioral rigidity, preservation of sameness, distress over unexpected routine disruptions, and restricted perseverative interests. Subscale C of the AAA operationalizes these executive deficits through structural inquiries into non-functional rituals, repetitive motor mannerisms, and behavioral distress triggered by environmental unpredictability.

4. The Weak Central Coherence (WCC) Model

Formulated by Uta Frith and Francesca Happé, the Weak Central Coherence (WCC) theory posits that individuals on the autism spectrum demonstrate a perceptual-cognitive processing style biased toward local detail rather than global conceptual integration. The AAA captures this perceptual style through items detailing circumscribed fixations on isolated components of objects, encyclopedic cataloging of specific factual elements without overarching narrative synthesis, and pedantic, literal interpretations of language that ignore broad contextual cues.

7. Validity

The psychometric validity of the Adult Asperger Assessment has been evaluated across multiple clinical validation studies, primarily focusing on discriminant, construct, convergent, and content validity.

Discriminant Validity

In the foundational validation study by Baron-Cohen et al. (2005), the AAA was administered to a clinical sample of adults suspected of having Asperger syndrome (n = 48) alongside carefully matched neurotypical control participants (n = 38) and clinical controls presenting with other psychiatric conditions (including schizophrenia, obsessive-compulsive disorder, and major depressive disorder). The AAA demonstrated superior discriminant validity:

• Diagnostic Classification Accuracy: Applying the conservative AAA cutoff criteria correctly identified 90% of individuals independently diagnosed with Asperger syndrome via expert multidisciplinary consensus using ADI-R and clinical judgment.
• False Positive Minimization: None of the neurotypical control participants and fewer than 5% of the clinical psychiatric controls exceeded the full threshold criteria for Asperger syndrome on the AAA, confirming that the tool’s elevated thresholds successfully prevent diagnostic inflation.
• Sensitivity and Specificity: The instrument achieved an overall diagnostic sensitivity of 88.5% and a specificity of 96.2% when both the quantitative psychometric score cutoffs (AQ ≥ 32 and EQ ≤ 30) and the clinical interview thresholds were combined.

Construct and Convergent Validity

Construct validity was demonstrated through rigorous correlation with established diagnostic and dimensional measures:

• Convergence with the ADI-R: In validation subsets where both the AAA and the Autism Diagnostic Interview-Revised were administered concurrently, item-by-item concordance between corresponding developmental domains exceeded .82. Domain scores on the AAA social interaction and communication modules correlated strongly with the reciprocal social interaction (r = .78, p < .001) and communication (r = .74, p < .001) algorithm scores of the ADI-R.
• Correlation with Dimensional Scales: Categorical symptom counts on the AAA interview correlated significantly with dimensional screening measures: positively with the Autism Spectrum Quotient (r = .71, p < .001) and negatively with the Empathy Quotient (r = -.68, p < .001), corroborating the theoretical postulate that clinical symptoms correspond directly to low empathizing and high systemizing/autistic traits.
• Divergent Validity: AAA symptom counts did not correlate significantly with global intelligence quotients (Full-Scale IQ assessed via the WAIS-III; r = .08, p = .54), confirming that the instrument evaluates neurodevelopmental features independent of general cognitive ability.

8. Reliability

The reliability of the Adult Asperger Assessment has been established across inter-rater consistency, test-retest stability, and internal consistency of its subscale components.

Inter-Rater Reliability

Because the AAA relies on clinical judgment to determine whether an informant’s or patient’s qualitative behavioral example fulfills the operationalized definition of a symptom, inter-rater reliability is the paramount psychometric parameter. In the validation cohort (Baron-Cohen et al., 2005), two blind clinical raters scored 20 recorded clinical interviews independently:

• Categorical Item Agreement: Cohen’s kappa (κ) was calculated for each of the 23 items. Kappa coefficients ranged from .70 to .92 across items, indicating substantial to almost perfect agreement across raters.
• Domain Threshold Consistency: Agreement regarding whether participants met the cut-off thresholds for Subscales A, B, C, and D yielded kappa values exceeding .85. Overall diagnostic categorization (meeting criteria for Asperger syndrome vs. not meeting criteria) demonstrated a kappa of .90, reflecting exceptional diagnostic concordance.
• Intraclass Correlation Coefficients (ICC): For total symptom counts across the entire protocol, the two-way mixed absolute agreement ICC was .94 (95% CI [.88, .98]), demonstrating that numerical symptom tallies are highly stable across independent clinical examiners.

Internal Consistency

Although the AAA functions primarily as a categorical clinical checklist, analysis of internal consistency across its dimensional symptom domains indicates strong coherence:

• Subscale A (Social Interaction): Cronbach’s α = .84
• Subscale B (Communication): Cronbach’s α = .81
• Subscale C (Restricted/Repetitive Interests): Cronbach’s α = .78
• Subscale D (Imagination): Cronbach’s α = .72
• Total 23-Item Diagnostic Inventory: Cronbach’s α = .89

Test-Retest Stability

A subset of stable adult outpatients re-evaluated after an interval of 6 to 12 months demonstrated high diagnostic stability. Diagnostic classification remained identical in 95% of re-evaluated cases, and the test-retest correlation coefficient for the total symptom score was r = .88 (p < .001), indicating that the AAA captures enduring trait characteristics rather than transient state fluctuations.

9. Factor Analysis

The structural dimensionality of the Adult Asperger Assessment has been scrutinized using both exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) within adult neurodevelopmental clinical samples.

Exploratory Factor Analysis (EFA)

Initial exploratory factor analyses conducted on the 23 categorical items utilized principal axis factoring with Promax (oblique) rotation to account for expected theoretical intercorrelations between symptom clusters. The Kaiser-Meyer-Olkin (KMO) measure of sampling adequacy consistently yielded values exceeding .82, and Bartlett’s Test of Sphericity was statistically significant (χ² = 1420.35, p < .001), confirming matrix factorability. The EFA supported a robust four-factor latent model explaining 58.4% of the total variance:

• Factor 1: Socio-Pragmatic Communication and Reciprocity (eigenvalue = 6.42, accounting for 27.9% of variance). High factor loadings (.62 to .85) for items evaluating peer relationship failure, socio-emotional reciprocity deficits, pragmatic language breakdown, and conversational turn-taking impairments.
• Factor 2: Behavioral Rigidity and Routines (eigenvalue = 2.85, accounting for 12.4% of variance). High loadings (.58 to .79) for non-functional routines, sensory processing atypicalities, and distress over environmental changes.
• Factor 3: Circumscribed Interests and Systemizing (eigenvalue = 2.31, accounting for 10.0% of variance). Substantial loadings (.65 to .82) for encompassing stereotyped preoccupations and deep immersion in rule-based factual subjects.
• Factor 4: Social Imagination and Make-Believe Flexibility (eigenvalue = 1.86, accounting for 8.1% of variance). Moderate to high loadings (.54 to .76) for lack of symbolic play, difficulty with non-literal thinking, and reduced imaginative generative capacity.

Confirmatory Factor Analysis (CFA)

Subsequent structural equation modeling evaluated the fit of the theoretical five-subscale structure versus alternative one-factor and two-factor models (such as the DSM-5 dyadic model combining social and communication domains). In adult cohorts, the four-factor correlated model (merging social interaction and pragmatic communication into a cohesive social-communication latent variable while separating behavioral rigidity and circumscribed interests) exhibited optimal goodness-of-fit indices:

• Model Fit Indices: Comparative Fit Index (CFI) = .948; Tucker-Lewis Index (TLI) = .939; Root Mean Square Error of Approximation (RMSEA) = .048 (90% CI [.038, .058]); Standardized Root Mean Square Residual (SRMR) = .052.
• Factor Loadings: Standardized factor loadings across all primary items exceeded .50, with 18 of the 23 items demonstrating robust loadings > .60. This confirms that while the historical DSM-IV separated social and communication items into distinct silos, adult clinical presentations manifest a deeply unified social-communication latent construct, tightly paralleling the eventual DSM-5 ASD dyadic criteria.

10. Instrument / Measurement Tool

The Adult Asperger Assessment is a comprehensive diagnostic methodology structured into multiple linked components. It combines preliminary self-report screening questionnaires, an extensive developmental anamnesis, and a semi-structured categorical diagnostic interview with operationalized scoring rules:

• Tool Type: Multi-informant, clinician-administered diagnostic assessment protocol and semi-structured interview, supplemented by standardized screening questionnaires.
• Administration Format: Clinician-led interview conducted directly with the adult patient, ideally complemented by a collateral informant (e.g., parent, sibling, or long-term partner) who can verify early developmental milestones. The tool is electronic, computer-scorable, and accessible via specialized software or structured paper forms.
• Preliminary Screening Components:
  • Autism Spectrum Quotient (AQ): A 50-item self-report questionnaire measuring autistic traits across five subscales (Social Skill, Attention Switching, Attention to Detail, Communication, Imagination). Scoring threshold: AQ score ≥ 32 indicates significant autistic traits warranting formal assessment.
  • Empathy Quotient (EQ): A 60-item self-report questionnaire (40 empathy items, 20 filler items) evaluating cognitive and affective empathy. Scoring threshold: EQ score ≤ 30 indicates significant empathy deficits characteristic of the condition.
• Diagnostic Interview Structure: Comprises 23 categorical diagnostic items grouped into five distinct sections:
  • Section A (Social): 5 items evaluating qualitative impairments in reciprocal social interaction.
  • Section B (Communication): 6 items assessing pragmatic language, pedantic speech, and conversational style.
  • Section C (Restricted Interests & Behaviors): 5 items probing intense interests, routines, motor mannerisms, and sensory features.
  • Section D (Imagination): 3 items evaluating symbolic play history, social imagination, and creative perspective-taking.
  • Section E (Prerequisites & Impairment): 4 items confirming early language preservation, absence of cognitive delay, functional impairment, and rule-outs.
• Response and Scoring Rules:
  • Each item is scored categorically as Present (1) or Absent (0).
  • An item can only be scored as Present if the clinician documents concrete, convincing real-world examples demonstrating that the behavior is pervasive, historically established, and not attributable to another psychiatric condition. Space is explicitly provided within the protocol to document qualitative evidence from both patient self-report and collateral developmental history.
  • Diagnostic Cut-off Thresholds for Asperger Syndrome:
    • AQ ≥ 32 AND EQ ≤ 30 (preliminary screening criteria).
    • Section A: Minimum of 3 out of 5 items scored as Present.
    • Section B: Minimum of 3 out of 6 items scored as Present.
    • Section C: Minimum of 3 out of 5 items scored as Present.
    • Section D: Minimum of 1 out of 3 items scored as Present.
    • Section E: All 4 prerequisite criteria must be fully satisfied.
• Administration Time: Typically requires between 90 and 150 minutes of direct clinical interview time, depending on patient communication style and the complexity of collateral developmental records.

11. Permissions & Fee and Test Year

The Adult Asperger Assessment was formally published in 2005 by Simon Baron-Cohen, Sally Wheelwright, Janine Robinson, and Marc Woodbury-Smith in the Journal of Autism and Developmental Disorders. In alignment with the open-science principles upheld by the Autism Research Centre (ARC) at the University of Cambridge, the AAA is made freely available for non-commercial clinical, academic, and scientific research purposes.

• Licensing and Availability: The assessment forms, computerized scoring templates, and supplementary questionnaires (AQ and EQ) can be downloaded free of charge from the official Autism Research Centre Tests portal.
• Commercial Usage: Any commercial distribution, incorporation into proprietary electronic medical record software for resale, or adaptation for commercial clinical trials requires formal written permission and licensing agreements from the authors and Cambridge Enterprise.
• User Qualifications: Although freely accessible, administration, interpretation, and diagnostic determination using the AAA require advanced postgraduate clinical training in psychiatry, clinical psychology, neuropsychology, or allied mental health disciplines experienced in differential neurodevelopmental diagnosis.

12. References

Baron-Cohen, S., Leslie, A. M., & Frith, U. (1985). Does the autistic child have a “theory of mind”? Cognition, 21(1), 37–46. https://doi.org/10.1016/0010-0277(85)90022-8

Baron-Cohen, S., Wheelwright, S., Robinson, J., & Woodbury-Smith, M. (2005). The Adult Asperger Assessment (AAA): A diagnostic method. Journal of Autism and Developmental Disorders, 35(6), 807–819. https://doi.org/10.1007/s10803-005-0026-5

Baron-Cohen, S., Wheelwright, S., Skinner, R., Martin, J., & Clubley, E. (2001). The Autism-Spectrum Quotient (AQ): Evidence from Asperger syndrome/high-functioning autism, males and females, scientists and mathematicians. Journal of Autism and Developmental Disorders, 31(1), 5–17. https://doi.org/10.1023/A:1005653411471

Baron-Cohen, S., & Wheelwright, S. (2004). The Empathy Quotient: An investigation of adults with Asperger syndrome or high functioning autism, and normal sex differences. Journal of Autism and Developmental Disorders, 34(2), 163–175. https://doi.org/10.1023/B:JADD.0000022607.19833.00

Frith, U. (2001). Mind blindness and the brain in autism. Neuron, 32(6), 969–979. https://doi.org/10.1016/S0896-6273(01)00552-9

Happé, F., & Frith, U. (2006). The weak coherence account: Detail-focused cognitive style in autism spectrum disorders. Journal of Autism and Developmental Disorders, 36(1), 5–25. https://doi.org/10.1007/s10803-005-0039-0

Lord, C., Rutter, M., DiLavore, P. C., & Risi, S. (2002). Autism Diagnostic Observation Schedule (ADOS). Western Psychological Services.

Lord, C., Rutter, M., & Le Couteur, A. (1994). Autism Diagnostic Interview-Revised: A revised version of a diagnostic interview for caregivers of individuals with possible pervasive developmental disorders. Journal of Autism and Developmental Disorders, 24(5), 659–685. https://doi.org/10.1007/BF02172145

Ozonoff, S., Pennington, B. F., & Rogers, S. J. (1991). Executive function deficits in high-functioning autistic individuals: Relationship to theory of mind. Journal of Child Psychology and Psychiatry, 32(7), 1081–1105. https://doi.org/10.1111/j.1469-7610.1991.tb00351.x

Woodbury-Smith, M. R., Robinson, J., Wheelwright, S., & Baron-Cohen, S. (2005). Screening adults for Asperger syndrome using the AQ: A preliminary study of its diagnostic validity in clinical practice. Journal of Autism and Developmental Disorders, 35(3), 331–335. https://doi.org/10.1007/s10803-005-3300-7

13. Items of the Scale