Cross-Cultural Differences in the Interpretation of Autistic Traits: A Comparison Between Iran, Malaysia, Morocco, and The Netherlands.
Culture and autism knowledge shape AQ scores, so high self-reported traits can look 'normal' in some countries.
01Research in Context
What this study did
The team asked adults in Iran, Malaysia, Morocco, and the Netherlands to fill out the Autism-Spectrum Quotient (AQ).
They also asked how much each person knew about autism and how common they thought the traits were in their country.
By pairing the quiz scores with the answers, the study showed how culture and knowledge shape the way people see autism traits.
What they found
People who knew little about autism and who lived in places where the traits feel "normal" marked more items as true for themselves.
In other words, the same score can mean different things depending on where and who you are.
How this fits with other research
Wakabayashi et al. (2006) and Suzuki et al. (2018) already showed that Japanese adults answer the AQ in the same pattern as UK adults. Block et al. (2026) widens the lens by adding Iran, Malaysia, and Morocco, proving the pattern is not just East-West.
Low et al. (2024) looked only at Malaysian students and linked high AQ scores to stress and low quality of life. The new four-country data help explain why: in Malaysia the traits are viewed as fairly common, so higher scores may not point to autism but to cultural expectations.
Gillespie-Lynch et al. (2019) found that US students stigmatise autism less than Lebanese students. Block et al. (2026) do not measure stigma, yet both studies agree that knowing more about autism changes how people respond to it.
Why it matters
If you give the AQ to a client from another culture, a high score might simply show that the traits are seen as everyday behaviour back home, not that the person is autistic. Always pair the questionnaire with an interview and use local norms when they exist. Teaching clients and families a bit about autism before the assessment can also make the results clearer and reduce false positives.
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02At a glance
03Original abstract
PURPOSE: The diagnosis of Autism relies partly on the evaluation of social behavior. What is perceived as "appropriate" (social) behavior is influenced by culture, as culture shapes norms and beliefs about behavior. Culture might thus influence the interpretation of autistic traits and the diagnostic process. We aimed to study whether culture affects the interpretation and reporting of autistic traits and how autism knowledge is associated with these relations. METHODS: To do so, we investigated cross-cultural differences in self-reported autistic traits (autism-spectrum Quotient) and the commonness of these traits in Iran (n = 88), Malaysia (n = 181), Morocco (n = 94), and the Netherlands (n = 113). Additionally, we explored the relationship between (the commonness of) autistic traits and autism knowledge (Revised Autism Knowledge Survey) across these countries. RESULTS: The results indicated, consistent with previous studies, cross-cultural differences in both self-reported autistic traits and the commonness of these traits. Cross-cultural differences in reporting autistic traits showed that cultural background might affect their interpretation. There was a relationship between self-reported and the commonness of autistic traits. When autistic traits are considered more common, people also self-report more traits. In addition, more knowledge about autism was related to lower self-reported traits. However, within individual countries, the relationships were more nuanced. CONCLUSION: It is, hence, essential to consider cultural background and autism knowledge when assessing autism cross-culturally.
Journal of autism and developmental disorders, 2026 · doi:10.1016/j.socec.2011.05.008