Autism Diagnostic Interview-Revised Within DSM-5 Framework: Test of Reliability and Validity in Chinese Children.
The Hong Kong Chinese Autism-Spectrum Quotient spots autism and sidesteps ADHD false alarms.
01Research in Context
What this study did
The team translated the Autism-Spectrum Quotient into Hong Kong Chinese. They gave the AQ-Child and AQ-Adolescent forms to parents of kids with autism, ADHD, and typical development. Then they checked if the scores cleanly split the three groups under DSM-5 rules.
No new tasks or teaching happened. Parents simply answered questions about their child’s social habits, attention to detail, and flexibility.
What they found
The Chinese AQ forms flagged almost every child who already had an autism diagnosis. Crucially, they rarely gave high scores to kids with ADHD or to typically developing peers.
In plain words: the screen caught autism and did not confuse it with ADHD.
How this fits with other research
Johnston et al. (2017) did the same kind of cultural tuning earlier. They showed that an Afrikaans ADOS-2 keeps its reliability after small language tweaks. Mammarella et al. (2022) now repeats that story for a parent questionnaire in Chinese, stretching the idea across tools and continents.
Li et al. (2015) seems to disagree. They found that cooperation during dental screening hinged on developmental level, not the autism label itself. The clash is only surface-deep: Y’s preschool sample was younger and focused on behavior, while C’s school-age sample focused on accurate diagnosis. Different questions, different answers.
Hilton et al. (2010) also looks contradictory. Brief play checks were clouded by IQ; diagnosis added little. Again, the difference is method. Play samples mix ability and autism traits, but the AQ asks directly about autism-specific behaviors, so it keeps a clear line between ASD and ADHD.
Why it matters
If you assess Mandarin- or Cantonese-speaking children, you can trust the Chinese AQ to screen for autism without crying “wolf” for ADHD. Add the forms to your intake packet, score them, and use the cut-offs to decide who needs a fuller evaluation. One clean tool saves hours later.
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02At a glance
03Original abstract
The Autism-Spectrum Quotient is a 50-item questionnaire developed to assess autistic symptoms in adults, adolescents and children. Its original version and others in different countries are known to be effective tools in identifying individuals with autism spectrum disorder. This study examined whether the Hong Kong Chinese versions of the Autism-Spectrum Quotient-Child and Autism-Spectrum Quotient-Adolescent were effective in identifying autism spectrum disorder children and adolescents. On top of comparing them with their typically developing peers, this study also included a group of children/adolescents with attention deficit/hyperactivity disorder, a disorder with similar social difficulties as autism spectrum disorder. Results showed that both the Autism-Spectrum Quotient questionnaires were effective in differentiating the autism spectrum disorder group from the typically developing and attention-deficit/hyperactivity disorder groups, separately and jointly. On the contrary, they could not identify the attention-deficit/hyperactivity disorder group from the typically developing group so that they were not misclassifying attention-deficit/hyperactivity disorder as autism spectrum disorder. These findings supported that both the Autism-Spectrum Quotient-Child and Autism-Spectrum Quotient-Adolescent were not general measures of child and adolescent psychopathology, but could claim to be specific measures of autism spectrum disorder. Such capability would enormously enhance their utility in clinical practice for identifying autism spectrum disorder children/adolescents from their typically developing peers and from those with attention-deficit/hyperactivity disorder. This is because, the latter is a common neurodevelopmental disorder frequently presented to child psychiatric clinics alongside with autism spectrum disorder.
Journal of autism and developmental disorders, 2022 · doi:10.1177/13623613211003740