Centering the Inner Experience of Autism: Development of the Self-Assessment of Autistic Traits

Ratto, A. B., Bascom, J., daVanport, S., Strang, J. F., Anthony, L. G., Verbalis, A., Pugliese, C. E., Nadwodny, N., Brown, L. X. M. Z., Cruz, M., Hector, B. L., Kapp, S. K., Giwa Onaiwu, M., Raymaker, D. M., Robison, J. E., Stewart, C., Stone, R., Whetsell, E., Pelphrey, K. A., & Kenworthy, L. (2022). Centering the Inner Experience of Autism: Development of the Self-Assessment of Autistic Traits. Autism in Adulthood, 5(1), 93-105. https://doi.org/10.1089/aut.2021.0099

Publication date: 1 Nov 2022 Added to AutiHub: 4 Jul 2026 Type: Article Article language: English

This publication is integrated into AutiHub through:

Authors

Publication authors
20
Publication authors identified as autistic
12 / 20 (60.0%)

Abstract

Current tools for identifying autism are critiqued for their lack of specificity and sensitivity, especially in autistic people who are older, have higher verbal ability or significant compensatory skills, and are not cisgender boys. This may reflect the following: the historical focus of autism research on White (cisgender) male, upper and middle class children; limited interest in the inner, lived experience of autism; and the predominance of a deficit-based model of autism. We report here on the first attempt of which we are aware to develop a clinical self-report measure of autistic traits as described by autistic people. We believe this is an advance in methodology because prior work in the development of autistic trait/diagnostic measures has prioritized the perspectives of nonautistic clinicians and scientists. The measure was developed under the leadership of two autistic researchers and constructed by leveraging descriptions of autism by autistic people to generate items designed to encompass the range of the autistic experience, using strength-based, accessible language. The team utilized iterative feedback from a panel of autistic experts to refine and enhance the measure, called the Self Assessment of Autistic Traits (SAAT). It is intended for people 16 years or older and uses a format that is designed to increase its accessibility and acceptability for autistic respondents. Future work will report on the preliminary psychometrics of the SAAT, with a long-term goal of advancing our understanding of the inner autistic experience and enhancing the clinical and scientific assessment of autism.

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Bibliography inclusion overview

These indicators describe the cited bibliography imported for this publication. Cited-reference metrics use the cited-reference total as denominator. Cited-author metrics state whether they use all cited-author occurrences or only occurrences linked to authors already integrated in the AutiHub database. They use cached links between cited authors and authors integrated in the AutiHub database. Last computed: 16 Aug 2026 11:30.

Cited references
68
Total cited references integrated for this publication.
Cited references with an identified autistic author
12 / 68 (17.6%)
Cited author occurrences identified as autistic
24 / 367 (6.5%)
Among occurrences linked to AutiHub author records: 24 / 168 (14.3%). Distinct cited authors identified as autistic: 15 / 302 (5.0%).
Cited author occurrences linked to AutiHub author records
168 / 367 (45.8%)
Distinct linked cited authors: 109 / 302 (36.1%)
Linked cited-author occurrences not identified as autistic
144 / 168 (85.7%)
Among linked cited-author occurrences only. Across all cited-author occurrences: 144 / 367 (39.2%). Distinct linked cited authors not identified as autistic: 94 / 109 (86.2%).
  1. Susan Siklos , Kimberly A. Kerns (2007). Assessing the diagnostic experiences of a small sample of parents of children with autism spectrum disorders . Research in Developmental Disabilities, 28(1), 9-22. Elsevier BV.
    Crossref OpenAlex OpenCitations
  2. Meng-Chuan Lai , Michael Lombardo , Amber Ruigrok , Bhismadev Chakrabarti , Bonnie Auyeung , Péter Szatmári et al. (2017). Quantifying and exploring camouflaging in men and women with autism . Autism, 21(6), 690-702. SAGE Publications.
    Crossref OpenAlex OpenCitations
  3. Torbjörn Falkmer , Katie Anderson , Marita Falkmer , Chiara Horlin (2013). Diagnostic procedures in autism spectrum disorders: a systematic literature review . European Child & Adolescent Psychiatry, 22(6), 329-340. Springer Science and Business Media LLC.
    Crossref OpenAlex OpenCitations
  4. Susan E. Swedo , Gillian Baird , Edwin H. Cook , Francesca Happé , James C. Harris , Walter E. Kaufmann et al. (2012). Commentary from the DSM-5 Workgroup on Neurodevelopmental Disorders . Journal of the American Academy of Child & Adolescent Psychiatry, 51(4), 347-349. Elsevier BV.
    Crossref OpenAlex OpenCitations
  5. Aaron J. Kaat , Amy M. Shui , Sheila S. Ghods , Cristan A. Farmer , Amy N. Esler , Audrey Thurm et al. (2021). Sex differences in scores on standardized measures of autism symptoms: a multisite integrative data analysis . Journal of Child Psychology and Psychiatry, 62(1), 97-106. Wiley.
    Crossref OpenAlex OpenCitations
  6. Sander Begeer , David S. Mandell , Bernadette Wijnker-Holmes , Stance Venderbosch , Dorien Rem , Fred Stekelenburg et al. (2013). Sex Differences in the Timing of Identification Among Children and Adults with Autism Spectrum Disorders . Journal of Autism and Developmental Disorders, 43(5), 1151-1156. Springer Science and Business Media LLC.
    Crossref OpenAlex OpenCitations
  7. Alexandra Leedham , Andrew R. Thompson , Richard Smith , Megan Freeth (2020). ‘I was exhausted trying to figure it out’: The experiences of females receiving an autism diagnosis in middle to late adulthood . Autism, 24(1), 135-146. SAGE Publications.
    Crossref OpenAlex OpenCitations
  8. Riva Ariella Ritvo , Edward R. Ritvo , Donald Guthrie , Max J. Ritvo , Demetra H. Hufnagel , William McMahon et al. (2011). The Ritvo Autism Asperger Diagnostic Scale-Revised (RAADS-R): A Scale to Assist the Diagnosis of Autism Spectrum Disorder in Adults: An International Validation Study . Journal of Autism and Developmental Disorders, 41(8), 1076-1089. Springer Science and Business Media LLC.
    Crossref OpenAlex OpenCitations
  9. Susan Folstein (2008). Unstrange Minds: Remapping the World of Autism . Journal of Nervous & Mental Disease, 196(2), 173-174. Ovid Technologies (Wolters Kluwer Health).
    OpenAlex
  10. Tracy A. Becerra , Ondine S. von Ehrenstein , Julia E. Heck , Jorn Olsen , Onyebuchi A. Arah , Shafali S. Jeste et al. (2014). Autism Spectrum Disorders and Race, Ethnicity, and Nativity: A Population-Based Study . Pediatrics, 134(1), e63-e71. American Academy of Pediatrics (AAP).
    OpenAlex OpenCitations
  11. Johnny Blair , Frederick G. Conrad (2011). Sample Size for Cognitive Interview Pretesting . Public Opinion Quarterly, 75(4), 636-658. Oxford University Press (OUP).
    Crossref OpenAlex OpenCitations
  12. Gary Yu Hin Lam , Emily Holden , Megan Fitzpatrick , Linda Raffaele Mendez , Karen Berkman (2020). “Different but connected”: Participatory action research using Photovoice to explore well-being in autistic young adults . Autism, 24(5), 1246-1259. SAGE Publications.
    Crossref OpenAlex OpenCitations
  13. Laura Hull , Meng-Chuan Lai , Simon Baron-Cohen , Carrie Allison , Paula Smith , KV Petrides et al. (2020). Gender differences in self-reported camouflaging in autistic and non-autistic adults . Autism, 24(2), 352-363. SAGE Publications.
    Crossref OpenAlex OpenCitations
  14. Francesca Happé , Uta Frith (2006). The Weak Coherence Account: Detail-focused Cognitive Style in Autism Spectrum Disorders . Journal of Autism and Developmental Disorders, 36(1), 5-25. Springer Science and Business Media LLC.
    Crossref OpenAlex OpenCitations
  15. Courtenay Frazier Norbury , Alison Sparks (2013). Difference or disorder? Cultural issues in understanding neurodevelopmental disorders. Developmental Psychology, 49(1), 45-58. American Psychological Association (APA).
    Type: Article DOI: 10.1037/a0027446 OpenAlex: https://openalex.org/W2018185691
    Crossref OpenAlex OpenCitations
  16. Francesca Happé , Uta Frith (2020). Annual Research Review: Looking back to look forward – changes in the concept of autism and implications for future research . Journal of Child Psychology and Psychiatry, 61(3), 218-232. Wiley.
    Crossref OpenAlex OpenCitations
  17. Carla A. Mazefsky , J. Kao , D.P. Oswald (2011). Preliminary evidence suggesting caution in the use of psychiatric self-report measures with adolescents with high-functioning autism spectrum disorders . Research in Autism Spectrum Disorders, 5(1), 164-174. Elsevier BV.
    Crossref OpenAlex OpenCitations
  18. Sandra Soto , Keri Linas , Diane Jacobstein , Matthew Biel , Talia Migdal , Bruno J Anthony (2015). A review of cultural adaptations of screening tools for autism spectrum disorders . Autism, 19(6), 646-661. SAGE Publications.
    Crossref OpenAlex OpenCitations
  19. Jessica M. Keith , Jeremy P. Jamieson , Loisa Bennetto (2019). The Importance of Adolescent Self-Report in Autism Spectrum Disorder: Integration of Questionnaire and Autonomic Measures . Journal of Abnormal Child Psychology, 47(4), 741-754. Springer Science and Business Media LLC.
    Crossref OpenAlex OpenCitations
  20. David S. Mandell , Knashawn H. Morales , Ming Xie , Lindsay J. Lawer , Aubyn C. Stahmer , Steven C. Marcus (2010). Age of Diagnosis Among Medicaid-Enrolled Children With Autism, 2001–2004 . Psychiatric Services, 61(8), 822-829. American Psychiatric Association Publishing.
    Crossref OpenAlex OpenCitations
  21. THOMAS S. SZASZ (1974). The Myth of Mental Illness . In Perspectives in Abnormal Behavior (pp. 4-11). Elsevier.
    Type: Book chapter DOI: 10.1016/b978-0-08-017738-0.50007-7
    Crossref OpenCitations
  22. Jeroen Dewinter , H. De Graaf , Sander Begeer (2017). Sexual Orientation, Gender Identity, and Romantic Relationships in Adolescents and Adults with Autism Spectrum Disorder . Journal of Autism and Developmental Disorders, 47(9), 2927-2934. Springer Science and Business Media LLC.
    Crossref OpenAlex OpenCitations
  23. Paul Shattuck , Maureen Durkin , Matthew Maenner , Craig Newschaffer , David S. Mandell , Lisa Wiggins et al. (2009). Timing of Identification Among Children With an Autism Spectrum Disorder: Findings From a Population-Based Surveillance Study . Journal of the American Academy of Child & Adolescent Psychiatry, 48(5), 474-483. Elsevier BV.
    Crossref OpenAlex OpenCitations
  24. Grinker RR (2007). Unstrange Minds: Remapping the World of Autism . Unstrange Minds: Remapping the World of Autism.
    Type: Other
    Crossref
  25. Lee A Santore , Alan H. Gerber , Ayla N Gioia , Rebecca Bianchi , Fanny Talledo , Tara S Peris et al. (2020). Felt but not seen: Observed restricted repetitive behaviors are associated with self-report—but not parent-report—obsessive-compulsive disorder symptoms in youth with autism spectrum disorder . Autism, 24(4), 983-994. SAGE Publications.
    Crossref OpenAlex OpenCitations
  26. Simon Baron-Cohen , Sally Wheelwright , Richard Skinner , Joanne Martin , Emma Clubley (2001). The Autism-Spectrum Quotient (AQ): Evidence from Asperger Syndrome/High-Functioning Autism, Males and Females, Scientists and Mathematicians . Journal of Autism and Developmental Disorders, 31(1), 5-17. Springer Science and Business Media LLC.
    Crossref OpenAlex OpenCitations
  27. Roy Richard Grinker (2020). Autism, “Stigma,” Disability . Current Anthropology, 61(S21), S55-S67. University of Chicago Press.
    Type: Article DOI: 10.1086/705748 OpenAlex: https://openalex.org/W2981477278
    Crossref OpenAlex OpenCitations
  28. Rosanna Edey , Jennifer Cook , Rebecca Brewer , Mark H. Johnson , Geoffrey Bird , Clare Press (2016). Interaction takes two: Typical adults exhibit mind-blindness towards those with autism spectrum disorder. Journal of Abnormal Psychology, 125(7), 879-885. American Psychological Association (APA).
    Crossref OpenAlex OpenCitations
  29. Brian C. Kavanaugh , Christine A. Schremp , Richard N. Jones , Carrie R. Best , Stephen J. Sheinkopf , Eric M. Morrow (2023). Moderators of Age of Diagnosis in > 20,000 Females with Autism in Two Large US Studies . Journal of Autism and Developmental Disorders, 53(2), 864-869. Springer Science and Business Media LLC.
    OpenAlex OpenCitations
  30. Amy M Daniels , David S. Mandell (2014). Explaining differences in age at autism spectrum disorder diagnosis: A critical review . Autism, 18(5), 583-597. SAGE Publications.
    Crossref OpenAlex OpenCitations
  31. Carl Erick Hagmann , Bradley Wyble , Nicole Shea , Megan LeBlanc , Wendy R. Kates , Natalie Russo (2016). Children with Autism Detect Targets at Very Rapid Presentation Rates with Similar Accuracy as Adults . Journal of Autism and Developmental Disorders, 46(5), 1762-1772. Springer Science and Business Media LLC.
    Crossref OpenAlex OpenCitations
  32. Justin Kopec , Carl Hagmann , Nicole Shea , Alyssa Prawl , Daniel Batkin , Natalie Russo (2020). Examining the Temporal Limits of Enhanced Visual Feature Detection in Children With Autism . Autism Research, 13(9), 1561-1572. Wiley.
    Type: Article DOI: 10.1002/aur.2361 OpenAlex: https://openalex.org/W3083865644
    Crossref OpenAlex OpenCitations
  33. Eve-Marie Quintin (2019). Music-Evoked Reward and Emotion: Relative Strengths and Response to Intervention of People With ASD . Frontiers in Neural Circuits, 13, 49-49. Frontiers Media SA.
    Crossref OpenAlex OpenCitations
  34. Éric Fombonne (2020). Camouflage and autism . Journal of Child Psychology and Psychiatry, 61(7), 735-738. Wiley.
    Crossref OpenAlex OpenCitations
  35. Craig C. Lundberg , Ian I. Mitroff , Harold A. Linstone , Richard O. Mason , Christine M. Pearson (1996). The Unbounded Mind: Breaking the Chains of Traditional Business Thinking. Administrative Science Quarterly, 41(3), 532. JSTOR.
    Type: Article DOI: 10.2307/2393942 OpenAlex: https://openalex.org/W2319578797
    OpenAlex
  36. Laura Foran Lewis (2016). Exploring the Experience of Self-Diagnosis of Autism Spectrum Disorder in Adults . Archives of Psychiatric Nursing, 30(5), 575-580. Elsevier BV.
    Crossref OpenAlex OpenCitations
  37. Matthew J. Maenner , Kelly A. Shaw , Jon Baio , EdS1 , Anita Washington , Mary Patrick et al. (2020). Prevalence of Autism Spectrum Disorder Among Children Aged 8 Years — Autism and Developmental Disabilities Monitoring Network, 11 Sites, United States, 2016 . MMWR. Surveillance Summaries, 69(4), 1-12. Centers for Disease Control MMWR Office.
    Crossref OpenAlex OpenCitations
  38. Micah Mazurek , Benjamin L. Handen , Ericka L. Wodka , Lisa Nowinski , Eric Butter , Christopher R. Engelhardt (2014). Age at First Autism Spectrum Disorder Diagnosis . Journal of Developmental & Behavioral Pediatrics, 35(9), 561-569. Ovid Technologies (Wolters Kluwer Health).
    Crossref OpenAlex OpenCitations
  39. Chandni Parikh , Margaret Kurzius-Spencer , Ann M. Mastergeorge , Sydney Pettygrove (2018). Characterizing Health Disparities in the Age of Autism Diagnosis in a Study of 8-Year-Old Children . Journal of Autism and Developmental Disorders, 48(7), 2396-2407. Springer Science and Business Media LLC.
    Crossref OpenAlex OpenCitations
  40. Allison B. Ratto , Lauren Kenworthy , Benjamin E. Yerys , Julia Bascom *Autistic author. Learn more… , Andrea Trubanova Wieckowski , Susan W. White et al. (2018). What About the Girls? Sex-Based Differences in Autistic Traits and Adaptive Skills . Journal of Autism and Developmental Disorders, 48(5), 1698-1711. Springer Science and Business Media LLC.
    AutiHub · Autistic Scholars Crossref OpenAlex OpenCitations
  41. Rachel Loomes , Laura Hull , Will Mandy (2017). What Is the Male-to-Female Ratio in Autism Spectrum Disorder? A Systematic Review and Meta-Analysis . Journal of the American Academy of Child & Adolescent Psychiatry, 56(6), 466-474. Elsevier BV.
    Crossref OpenAlex OpenCitations
  42. Laura Hull , K. V. Petrides , Carrie Allison , Paula Smith , Simon Baron-Cohen , Meng-Chuan Lai et al. (2017). “Putting on My Best Normal”: Social Camouflaging in Adults with Autism Spectrum Conditions . Journal of Autism and Developmental Disorders, 47(8), 2519-2534. Springer Science and Business Media LLC.
    Crossref OpenAlex OpenCitations
  43. Kavanaugh B (n.d.). Kavanaugh B,, Schremp CA,, Jones RN, et al. Moderators of age of diagnosis in >20,000 females with autism in two large US studies. J Autism Dev Disord. 2021. J Autism Dev Disord.
    Type: Other
    Crossref
  44. Varun Warrier , David M. Greenberg , Elizabeth M Weir , Clara Buckingham , Paula Smith , Meng-Chuan Lai et al. (2020). Elevated rates of autism, other neurodevelopmental and psychiatric diagnoses, and autistic traits in transgender and gender-diverse individuals . Nature Communications, 11(1), 3959-3959. Springer Science and Business Media LLC.
    Crossref OpenAlex OpenCitations
  45. Sandra Martin Lorenzo , Valérie Nalesso , Claire Chevalier , Marie-Christine Birling , Yann Herault (2021). Targeting the RHOA pathway improves learning and memory in adult Kctd13 and 16p11.2 deletion mouse models . Molecular Autism, 12(1), 1-1. Springer Science and Business Media LLC.
    OpenAlex OpenCitations
  46. Amy N. Esler , Jennifer Hall-Lande , Amy Hewitt (2017). Phenotypic Characteristics of Autism Spectrum Disorder in a Diverse Sample of Somali and Other Children . Journal of Autism and Developmental Disorders, 47(10), 3150-3165. Springer Science and Business Media LLC.
    Crossref OpenAlex OpenCitations
  47. Reubs J. Walsh , Lydia Krabbendam , Jeroen Dewinter , Sander Begeer (2018). Brief Report: Gender Identity Differences in Autistic Adults: Associations with Perceptual and Socio-cognitive Profiles . Journal of Autism and Developmental Disorders, 48(12), 4070-4078. Springer Science and Business Media LLC.
    Crossref OpenAlex OpenCitations
  48. Laura Hull , Will Mandy , Meng-Chuan Lai , Simon Baron-Cohen , Carrie Allison , Paula Smith et al. (2019). Development and Validation of the Camouflaging Autistic Traits Questionnaire (CAT-Q) . Journal of Autism and Developmental Disorders, 49(3), 819-833. Springer Science and Business Media LLC.
    Crossref OpenAlex OpenCitations
  49. Allison B. Ratto (2021). Commentary: What’s so special about girls on the autism spectrum? – a commentary on Kaat et al. (2020) . Journal of Child Psychology and Psychiatry, 62(1), 107-109. Wiley.
    Crossref OpenAlex OpenCitations
  50. Constantino JN (2012). Social Responsiveness Scale Second Edition (SRS-2): Manual . Social Responsiveness Scale Second Edition (SRS-2): Manual.
    Type: Other
    Crossref
  51. Lucy Anne Livingston , Punit Shah , Francesca Happé (2019). Compensatory strategies below the behavioural surface in autism: a qualitative study . The Lancet Psychiatry, 6(9), 766-777. Elsevier BV.
    Crossref OpenAlex OpenCitations
  52. Sarah Wigham , Barry Ingham , Ann Le Couteur , Tom Berney , Ian Ensum , Jeremy R. Parr (2020). Development and Initial Utility of the Autism Clinical Interview for Adults: A New Adult Autism Diagnostic Measure . Autism in Adulthood, 2(1), 42-47. SAGE Publications.
    Crossref OpenAlex OpenCitations
  53. Michael C. W. English , Gilles E. Gignac , Troy A. W. Visser , Andrew Whitehouse , James T. Enns , Murray T. Maybery (2021). The Comprehensive Autistic Trait Inventory (CATI): development and validation of a new measure of autistic traits in the general population . Molecular Autism, 12(1), 37. Springer Science and Business Media LLC.
    Crossref OpenAlex
  54. Meng-Chuan Lai , Laura Hull , Will Mandy , Bhismadev Chakrabarti , Christine Wu Nordahl , Michael Lombardo et al. (2021). Commentary: ‘Camouflaging’ in autistic people – reflection on Fombonne (2020) . Journal of Child Psychology and Psychiatry, 62(8). Wiley.
    Crossref OpenAlex
  55. Mitroff II (1995). The Unbounded Mind: Breaking the Chains of Traditional Business Thinking . The Unbounded Mind: Breaking the Chains of Traditional Business Thinking.
    Type: Other
    Crossref
  56. Hsu C-C (2007). The Delphi technique: Making sense of consensus . Pract Assess Res Eval, 12(10), 1.
    Type: Other
    Crossref