AQ-10 scoring and referral thresholds

The AQ-10 is simple to score, which is exactly why it is so easy to over-read. Ten answers become one small number, and that number can feel definitive. It was designed for something narrower: helping a busy professional decide whether a longer look is worthwhile.

How the points work

Each statement has four answers: definitely agree, slightly agree, slightly disagree and definitely disagree. For some statements, agreeing is the trait direction. For others, disagreeing is. You get one point when your answer falls on the trait side, and the strength of your answer does not change the point. No statement can earn more than one point.

We do not list which statements score in which direction. The scoring key belongs with the official form, which you can find on the University of Cambridge ARC website. Reproducing it here, even partly, would mean reproducing a licensed instrument.

The threshold of 6

The official form tells the professional to consider referring someone for a specialist diagnostic assessment if they score 6 or above. NICE guidance in the UK uses the same number for offering a comprehensive assessment. The wording on both is about referral and assessment, never about diagnosis.

A positive predictive value depends heavily on how common autism is in the group being tested. In the development study, about a third of adult participants were autistic. In a general practice waiting room, far fewer would be. The same score of 6 therefore carries much less certainty there than the study figure suggests.

What different scores mean

When a low score is misleading

Short screeners struggle with people whose traits are less visible to themselves. Adults who have masked for years, people who struggle to describe their own inner states, and those who answer based on what they have learned is expected can all score lower than their experience would suggest.

When a high score is misleading

Anxiety, low mood, ADHD and some personality traits can push answers toward the trait side. Someone who is socially exhausted after a hard year may agree with statements they would have disagreed with five years earlier. The AQ-10 asks about how you are now and has no way to separate lifelong traits from recent struggles.

What the number cannot tell you

An AQ-10 total says nothing about strengths, about how much effort daily life costs you, or about whether another condition better explains your experiences. It also cannot show change over time or the difference between how you are at home and at work. Those questions are the substance of a real assessment, and they take conversation, history and sometimes input from people who know you well.

Why online versions may score differently

Unofficial online copies sometimes reword statements, change the answer options or apply the scoring incorrectly. A small change in wording can shift which way people answer, and a scoring error can move a total by several points. If a number matters to you, use the official form from the Cambridge ARC website or ask a clinician to give it to you.

What to do next

• If you scored 6 or more, consider asking your doctor about an assessment and bring examples.
• If you scored under 6 but strongly recognize autistic experiences, you can still ask; describe why.
• Write down childhood memories or ask a relative, since assessments look for lifelong patterns.
• Keep a short list of situations that drain you and what helps you recover, with recent examples from work and home.
• Ask your doctor what the local assessment pathway looks like and how long the wait is, so you can plan.