ASD – Adult Autism Spectrum Quotient (AQ)

If you have been advised by the surgery to submit an AQ form or an adult autism spectrum quotient, please use this form.

Adult Autism Spectrum Quotient (16 Years Plus)

Please complete all the questions below. These are needed before your GP can refer you to the neurodevelopmental service, who carry out a thorough assessment.

We will contact you if we require more information, or let you know if we have completed a referral to the neurodevelopmental service. If you have not heard from us in the next two weeks, please contact us though the practice website.

The waiting times are particularly long for the neurodevelopmental clinic. You can read more about this, including details of the assessment process, waiting times and information about additional support on the Sussex Partnership NHS website.

Please let us know if you are seeking a private assessment.

Do you already have a diagnosis of Autistic Spectrum Condition, ADHD, Tourettes, Dyslexia or learning disability? *
Did you have any difficulties at school or attend a special school? *
Have you had any difficulties at work or University? *
Do you have any physical health conditions or high blood pressure? *
Do you take any medications? *
Do you take illicit drugs? *
Do you have a current or past history of mental health problems? *

Reason you are requesting an assessment

Please specify your reasons based on the following questions

What characteristics and behaviours do you have that have made you consider this diagnosis?

Are these issues life-long or has there been a recent onset or change in behaviour?

Do these characteristics affect all areas of your life?

How would the process and outcome of this assessment be of benefit to your emotional and mental wellbeing?

AQ Questions

For each statement, please select the option that best suits you.

I often notice small sounds when others do not. *
I usually concentrate more on the whole picture, rather than the small details. *
I find it easy to do more than one thing at once. *
If there is an interruption, I can switch back to what I was doing very quickly. *
I find it easy to “read between the lines” when someone is talking to me. *
I know how to tell if someone listening to me is getting bored. *
When I’m reading a story, I can easily imagine what the characters might look like. *
I like to collect information about categories of things (e.g. types of car, types of bird, types of train, types of plant, etc.). *
I find it easy to work out what someone is thinking or feeling just by looking at their face. *
I find it difficult to work out people’s intentions. *

Interpreting Your AQ Score