Self- and Informant Report in a First-Time Diagnosis of Autism Spectrum Disorder in Adulthood: the Role of Females

Objectives

The diagnosis of autism spectrum disorder (ASD) in adulthood is a growing area of research and practice as the number of adults seeking a first-time diagnosis has increased. Informants are often utilized to aid in the evaluation of ASD in childhood. Little is known regarding the convergence of self- and informant-report measures of ASD in adults and whether gender differences exist. We explored the convergence of self-report and informant ratings on two commonly used rating scales and a clinician observation measure for the diagnosis of ASD.

Methods

The present study explored the convergence of two commonly used measures (SRS-2 & AQ) and a clinician observation measure for the diagnosis of ASD in adulthood 155 pairs of adults (41.3% female; mean age = 33.19, SD = 11.46) and their informants (total sample, n = 310).

Results

Overall, self-report AQ and SRS-2 scores were significantly higher than informants. Gender was the most important predictor of poor convergence on AQ and SRS-2, with informants of females reporting significantly fewer ASD symptoms compared to males with a first-time diagnosis of ASD in adulthood. Informant report also did not significantly predict key functional outcomes (i.e., employment, living situation) over and above self-report alone. The present study also found no significant differences in measures regardless of the informant utilized (e.g., parents, spouses).

Conclusions

Gender is an important factor in the assessment of ASD in adulthood. Thus, practitioners assessing female adults ought to interpret discrepant informant-report results with caution. Researchers ought to continue to examine how ASD measures perform for females and ensure they are normed appropriately with females and males. A wider variety of informants such as a sibling or a friend may be appropriate if a parent or spouse is unavailable.