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.