Psychometric Investigation of Preliminary Item-Set for the Self-Assessment of Autistic Traits

Abstract

Background:

This study presents the preliminary psychometrics of the Self-Assessment of Autistic Traits (SAAT) item pool, which is the first comprehensive self-report tool of autism traits for teens and adults coproduced with autistic people. Two autistic researchers led the SAAT item development and leveraged descriptions of autism by autistic people to generate items designed to encompass the internal experience of autism using strength-based accessible language.

Methods:

Autistic (N = 500) and non-autistic (n = 80) people, 16 years or older, completed the SAAT. The sample included community-ascertained autistic adult participants, as well as participants from a large academic medical center-based research network, which broadened the spectrum of participants studied to include more gender-diverse, older, and nonspeaking individuals.

Results:

Exploratory factor analysis followed by a unidimensional confirmatory factor analysis revealed four factors as follows: Modulation/Social Communication, Strengths/Passions, Brain–Body Disconnect, and Negative Community Context. Three of these factors are sensitive to autism in comparison with non-autistic people across age, gender identity, assigned gender at birth, and gender diversity status.

Discussion:

The SAAT shows promise as a multidimensional self-report tool that is reliable and valid with respect to the samples that we examined. The SAAT item-set may yield a useful screening tool for people of different gender identities, assigned gender at birth, and gender diversity status, from 16 years old through adulthood, who are questioning whether they may be autistic. In addition, it has potential as a phenotyping tool that captures individual strengths as well as challenges and could provide information that helps guide the creation of opportunities and supports that enable autistic people to thrive. Given the preliminary nature of the current study, a cross-validation study with respect to larger and diverse groups of the sample is the necessary next step to further develop and refine the set of items as a useful tool.

Community Brief

Why is this topic important?

Clinicians don’t always recognize when people are autistic, especially when these people are teens, adults, girls, women, or gender-divergent. Recognizing autism is important because it can give people access to supports and connection to autistic communities. So, we wrote the Self-Assessment of Autistic Traits (SAAT) to measure the internal experience of autism and help catch the people who clinicians don’t recognize. The SAAT is a self-report autism questionnaire. Autistic researchers and non-autistic researchers wrote the SAAT together. However, we still need to study if people answer questions on the SAAT the way we think they will.

What is the purpose of this article?

In this article, we analyzed if the SAAT works the way we thought it would.

What did the authors do?

First, we collected data from 500 autistic people and 80 non-autistic people. Next, we figured out how items on the SAAT group together can make factors. We also determined whether SAAT scores were higher for autistic people than for non-autistic people. Finally, we checked if a person’s age or gender would systematically impact their SAAT score.

What did the authors find?

We found that the SAAT has four groups of items, or factors, as follows:

Factor one: Modulation/Social Communication—the control of attention, sensory information, thinking and actions, and flexibility, including repetitive actions and switching to new thoughts, social-communication abilities and preferences, and feelings of overwhelm.

Factor two: Strengths/Passions—passionate interests, attention to detail, pattern recognition, preference for routine, and other preferences and strengths.

Factor three: Brain–Body Disconnect—a disconnect between an intention or desire and the motor movement needed to act on it, also difficulty with independent demonstration of daily living skills and variability in skills.

Factor four: Negative Community Context—experiences of being treated unfairly and invalidated.

We also found that autistic people have higher SAAT scores than non-autistic people on Factors one, three, and four. Autistic people and non-autistic people scored the same on factor two. Finally, we found that a person’s age or gender did not change their SAAT score.

Why are the findings important?

The SAAT works mostly how we thought it would. But we need to edit it before it is done. These findings mean that the SAAT could become a useful autism screener, especially for adults, girls, women, and gender-diverse people. What are the next steps for the SAAT?

First, we are going to rewrite some items that did not fit into any of the four factors. Second, we will write more items about Negative Community Context, since it only has four items right now. Finally, the new SAAT will be tested with autistic and non-autistic people of all races, ethnicities, and genders to check if it works for all kinds of people. After refining the final set of items based on a more fine-tuned measurement model in a new sample, we hope the SAAT will be ready for use as an autism screener and/or phenotyping measure.