Abstract
Autism spectrum disorders are diagnosed globally, but recognition, interpretation and reporting may vary across cultures. To compare autism across cultures it is important to investigate whether the tools used are conceptually equivalent across cultures. This study evaluated the factor structure of the parent-reported Autism Spectrum Quotient Short Form in autistic children from China (n = 327; 3 to 17 years) and the Netherlands (n = 694; 6 to 16 years). Confirmatory factor analysis did not support the two-factor hierarchical model previously identified. Exploratory factor analysis indicated culturally variant factor structures between China and the Netherlands, which may hamper cross-cultural comparisons. Several items loaded onto different factors in the two samples, indicating substantial variation in parent-reported autistic traits between China and the Netherlands.
Similar content being viewed by others
References
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders. American Psychiatric Association. https://doi.org/10.1176/appi.books.9780890425596
Austin, E. J. (2005). Personality correlates of the broader autism phenotype as assessed by the autism spectrum quotient (AQ). Personality and Individual Differences, 38(2), 451–460. https://doi.org/10.1016/j.paid.2004.04.022
Auyeung, B., Baron-Cohen, S., Wheelwright, S., & Allison, C. (2007). The autism spectrum quotient: Children’s version (AQ-Child). Journal of Autism and Developmental Disorders, 38(7), 1230–1240. https://doi.org/10.1007/s10803-007-0504-z
Baron-Cohen, S., Leslie, A. M., & Frith, U. (1985). Does the autistic child have a “Theory of Mind”? Cognition, 21(1), 37–46. https://doi.org/10.1016/0010-0277(85)90022-8
Baron-Cohen, S., Scott, F. J., Allison, C., Williams, J., Bolton, P., Matthews, F. E., & Brayne, C. (2009). Prevalence of autism-spectrum conditions: UK school-based population study. British Journal of Psychiatry, 194(6), 500–509. https://doi.org/10.1192/bjp.bp.108.059345
Baron-Cohen, S., Wheelwright, S., Skinner, R., Martin, J., & Clubley, E. (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. https://doi.org/10.1023/a:1005653411471
Benjamini, Y., & Hochberg, Y. (1995). Controlling the false discovery rate: A practical and powerful approach to multiple testing. Journal of the Royal Statistical Society: Series B (methodological), 57(1), 289–300. https://doi.org/10.1111/j.2517-6161.1995.tb02031.x
Bishop-Fitzpatrick, L., & Kind, A. J. H. (2017). A scoping review of health disparities in autism spectrum disorder. Journal of Autism and Developmental Disorders, 47(11), 3380–3391. https://doi.org/10.1007/s10803-017-3251-9
Browne, M. W., & Cudeck, R. (1993). Alternative ways of assessing model fit. In K. A. Bollen & J. S. Long (Eds.), Testing structural equation models (pp. 136–162). Newbury Park, CA: Sage.
Bujang, M. A., & Baharum, N. (2016). Sample size guideline for correlation analysis. World Journal of Social Science Research, 3(1), 37. https://doi.org/10.22158/wjssr.v3n1p37
Cohen, J. (2013). Statistical power analysis for the behavioral sciences. Routledge. https://doi.org/10.4324/9780203771587
Colbert, A. M., Webber, J., & Graham, R. (2017). Factors that influence autism knowledge in Hispanic cultures: A pilot study. Journal of Racial and Ethnic Health Disparities, 4(2), 156–164. https://doi.org/10.1007/s40615-016-0213-4
Costello, A. B., & Osborne, J. W. (2005). Best practices in exploratory factor analysis: Four recommendations for getting the most from your analysis. Practical Assessment, Research and Evaluation, 10(7), 1–9.
de Leeuw, A., Happé, F., & Hoekstra, R. A. (2020). A conceptual framework for understanding the cultural and contextual factors on autism across the globe. Autism Research. https://doi.org/10.1002/aur.2276
Durkin, M. S., Elsabbagh, M., Barbaro, J., Gladstone, M., Happe, F., Hoekstra, R. A., Lee, L.-C., Rattazzi, A., Stapel-Wax, J., Stone, W. L., Tager-Flusberg, H., Thurm, A., Tomlinson, M., & Shih, A. (2015). Autism screening and diagnosis in low resource settings: Challenges and opportunities to enhance research and services worldwide. Autism Research, 8(5), 473–476. https://doi.org/10.1002/aur.1575
Fountain, C., Winter, A. S., & Bearman, P. S. (2012). Six developmental trajectories characterize children with autism. Pediatrics, 129(5), e1112–e1120. https://doi.org/10.1542/peds.2011-1601
Freeth, M., Milne, E., Sheppard, E., & Ramachandran, R. (2014). Autism across cultures: perspectives from non-western cultures and implications for research. Handbook of Autism and Pervasive Developmental Disorders, Fourth Edition. https://doi.org/10.1002/9781118911389.hautc43
Gomez, R., Stavropoulos, V., & Vance, A. (2018). Psychometric properties of the autism spectrum quotient: Children’s version (AQ-Child). Journal of Autism and Developmental Disorders, 49(2), 468–480. https://doi.org/10.1007/s10803-018-3713-8
Grove, R., Hoekstra, R. A., Wierda, M., & Begeer, S. (2016). Exploring sex differences in autistic traits: A factor analytic study of adults with autism. Autism, 21(6), 760–768. https://doi.org/10.1177/1362361316667283
Guthrie, W., Wallis, K., Bennett, A., Brooks, E., Dudley, J., Gerdes, M., Pandey, J., Levy, S. E., Schultz, R. T., & Miller, J. S. (2019). Accuracy of autism screening in a large pediatric network. Pediatrics. https://doi.org/10.1542/peds.2018-3963
Hall, D. A., Zaragoza Domingo, S., Hamdache, L. Z., Manchaiah, V., Thammaiah, S., Evans, C., & Wong, L. L. N. (2017). A good practice guide for translating and adapting hearing-related questionnaires for different languages and cultures. International Journal of Audiology, 57(3), 161–175. https://doi.org/10.1080/14992027.2017.1393565
Hattier, M. A., Matson, J. L., Tureck, K., & Horovitz, M. (2011). The effects of gender and age on repetitive and/or restricted behaviors and interests in adults with autism spectrum disorders and intellectual disability. Research in Developmental Disabilities, 32(6), 2346–2351. https://doi.org/10.1016/j.ridd.2011.07.028
Henrich, J., Heine, S. J., & Norenzayan, A. (2010). Most people are not WEIRD. Nature, 466(7302), 29–29. https://doi.org/10.1038/466029a
Hiller, R. M., Young, R. L., & Weber, N. (2015). Sex differences in pre-diagnosis concerns for children later diagnosed with autism spectrum disorder. Autism, 20(1), 75–84. https://doi.org/10.1177/1362361314568899
Hoekstra, R. A., Bartels, M., Cath, D. C., & Boomsma, D. I. (2008). Factor structure, reliability and criterion validity of the Autism-Spectrum Quotient (AQ): a study in Dutch population and patient groups. Journal of Autism and Developmental Disorders, 38(8), 1555–1566. https://doi.org/10.1007/s10803-008-0538-x
Hoekstra, R. A., Vinkhuyzen, A. A. E., Wheelwright, S., Bartels, M., Boomsma, D. I., Baron-Cohen, S., Posthuma, D., & van der Sluis, S. (2011). The construction and validation of an abridged version of the autism-spectrum quotient (AQ-Short). Journal of Autism and Developmental Disorders, 41(5), 589–596. https://doi.org/10.1007/s10803-010-1073-0
Hu, L., & Bentler, P. M. (1998). Fit indices in covariance structure modeling: Sensitivity to underparameterized model misspecification. Psychological Methods, 3(4), 424–453. https://doi.org/10.1037/1082-989x.3.4.424
Hu, L., & Bentler, P. M. (1999). Cutoff criteria for fit indexes in covariance structure analysis: Conventional criteria versus new alternatives. Structural Equation Modeling: A Multidisciplinary Journal, 6(1), 1–55. https://doi.org/10.1080/10705519909540118
Inada, N., Koyama, T., Inokuchi, E., Kuroda, M., & Kamio, Y. (2011). Reliability and validity of the Japanese version of the modified checklist for autism in toddlers (M-CHAT). Research in Autism Spectrum Disorders, 5(1), 330–336. https://doi.org/10.1016/j.rasd.2010.04.016
Jorgenson, C., Lewis, T., Rose, C., & Kanne, S. (2020). Social camouflaging in autistic and neurotypical adolescents: A pilot study of differences by sex and diagnosis. Journal of Autism and Developmental Disorders. https://doi.org/10.1007/s10803-020-04491-7
Kamio, Y., Inada, N., Koyama, T., Inokuchi, E., Tsuchiya, K., & Kuroda, M. (2014). Effectiveness of using the modified checklist for autism in toddlers in two-stage screening of autism spectrum disorder at the 18-month health check-up in Japan. Journal of Autism and Developmental Disorders, 44(1), 194–203. https://doi.org/10.1007/s10803-013-1864-1
Khowaja, M. K., Hazzard, A. P., & Robins, D. L. (2014). Sociodemographic barriers to early detection of autism: Screening and evaluation using the M-CHAT, M-CHAT-R, and follow-up. Journal of Autism and Developmental Disorders, 45(6), 1797–1808. https://doi.org/10.1007/s10803-014-2339-8
Kitazoe, N., Fujita, N., Izumoto, Y., Terada, S., & Hatakenaka, Y. (2017). Whether the autism spectrum quotient consists of two different subgroups? Cluster analysis of the autism spectrum quotient in general population. Autism, 21(3), 323–332. https://doi.org/10.1177/1362361316638787
Kloosterman, P. H., Keefer, K. V., Kelley, E. A., Summerfeldt, L. J., & Parker, J. D. A. (2011). Evaluation of the factor structure of the autism-spectrum quotient. Personality and Individual Differences, 50(2), 310–314. https://doi.org/10.1016/j.paid.2010.10.015
Kuenssberg, R., Murray, A. L., Booth, T., & McKenzie, K. (2014). Structural validation of the abridged autism spectrum quotient-short form in a clinical sample of people with autism spectrum disorders. Autism, 18(2), 69–75. https://doi.org/10.1177/1362361312467708
Lai, M.-C., Lombardo, M. V., Pasco, G., Ruigrok, A. N. V., Wheelwright, S. J., Sadek, S. A., Chakrabarti, B., & Baron-Cohen, S. (2011). A behavioral comparison of male and female adults with high functioning autism spectrum conditions. PLoS ONE, 6(6), e20835. https://doi.org/10.1371/journal.pone.0020835
Lai, M.-C., Lombardo, M. V., Ruigrok, A. N., Chakrabarti, B., Auyeung, B., Szatmari, P., Happé, F., & Baron-Cohen, S. (2016). Quantifying and exploring camouflaging in men and women with autism. Autism, 21(6), 690–702. https://doi.org/10.1177/1362361316671012
Lau, W.Y.-P., Gau, S.S.-F., Chiu, Y.-N., Wu, Y.-Y., Chou, W.-J., Liu, S.-K., & Chou, M.-C. (2013). Psychometric properties of the Chinese version of the autism spectrum quotient (AQ). Research in Developmental Disabilities, 34(1), 294–305. https://doi.org/10.1016/j.ridd.2012.08.005
Louwerse, A., Eussen, M. L. J. M., Van der Ende, J., de Nijs, P. F. A., Van Gool, A. R., Dekker, L. P., Verheij, C., Verheij, F., Verhulst, F. C., & Greaves-Lord, K. (2015). ASD symptom severity in adolescence of individuals diagnosed with PDD-NOS in childhood: Stability and the relation with psychiatric comorbidity and societal participation. Journal of Autism and Developmental Disorders, 45(12), 3908–3918. https://doi.org/10.1007/s10803-015-2595-2
Maenner, M. J., Shaw, K. A., Baio, J., 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. https://doi.org/10.15585/mmwr.ss6904a1
Marsh, H. W., Hau, K.-T., & Wen, Z. (2004). In search of golden rules: Comment on hypothesis-testing approaches to setting cutoff values for fit indexes and dangers in overgeneralizing Hu and Bentler’s (1999) findings. Structural Equation Modeling: A Multidisciplinary Journal, 11(3), 320–341. https://doi.org/10.1207/s15328007sem1103_2
Masuda, T., Ellsworth, P. C., Mesquita, B., Leu, J., Tanida, S., & Van de Veerdonk, E. (2008). Placing the face in context: Cultural differences in the perception of facial emotion. Journal of Personality and Social Psychology, 94(3), 365–381. https://doi.org/10.1037/0022-3514.94.3.365
Murray, A. L., Booth, T., McKenzie, K., Kuenssberg, R., & O’Donnell, M. (2013). Are autistic traits measured equivalently in individuals with and without an autism spectrum disorder? An invariance analysis of the autism spectrum quotient short form. Journal of Autism and Developmental Disorders, 44(1), 55–64. https://doi.org/10.1007/s10803-013-1851-6
Muthén, L. K., & Muthén, B. O. (2012). Mplus (7th ed.). Muthén and Muthén.
National Bureau of Statistics of China (2019). Per Capita Income and Consumption Expenditure Nationwide. Retrieved September 11, 2021 from http://www.stats.gov.cn/tjsj/ndsj/2019/indexch.htm
Norbury, C. F., & Sparks, A. (2013). Difference or disorder? Cultural issues in understanding neurodevelopmental disorders. Developmental Psychology, 49(1), 45–58. https://doi.org/10.1037/a0027446
Norris, M., & Lecavalier, L. (2010). Evaluating the use of exploratory factor analysis in developmental disability psychological research. Journal of Autism and Developmental Disorders, 40(1), 8–20. https://doi.org/10.1007/s10803-009-0816-2
Nunnally, J. C. (1975). Psychometric theory— 25 Years ago and now. Educational Researcher, 4(10), 7–21. https://doi.org/10.3102/0013189x004010007
Pang, Y., Lee, C. M., Wright, M., Shen, J., Shen, B., & Bo, J. (2018). Challenges of case identification and diagnosis of autism spectrum disorders in China: A critical review of procedures, assessment, and diagnostic criteria. Research in Autism Spectrum Disorders, 53, 53–66. https://doi.org/10.1016/j.rasd.2018.06.003
Ratto, A. B., Reznick, J. S., & Turner-Brown, L. (2016). Cultural effects on the diagnosis of autism spectrum disorder among Latinos. Focus on Autism and Other Developmental Disabilities, 31(4), 275–283. https://doi.org/10.1177/1088357615587501
Robins, D. L., Fein, D., Barton, M. L., & Green, J. A. (2001). The modified checklist for autism in toddlers: An initial study investigating the early detection of autism and pervasive developmental disorders. Journal of Autism and Developmental Disorders, 31(2), 131–144. https://doi.org/10.1023/a:1010738829569
Saito, A., Stickley, A., Haraguchi, H., Takahashi, H., Ishitobi, M., & Kamio, Y. (2017). Association between autistic traits in preschool children and later emotional/behavioral outcomes. Journal of Autism and Developmental Disorders, 47(11), 3333–3346. https://doi.org/10.1007/s10803-017-3245-7
Scarpa, A., Reyes, N. M., Patriquin, M. A., Lorenzi, J., Hassenfeldt, T. A., Desai, V. J., & Kerkering, K. W. (2013). The modified checklist for autism in toddlers: Reliability in a diverse rural American sample. Journal of Autism and Developmental Disorders, 43(10), 2269–2279. https://doi.org/10.1007/s10803-013-1779-x
Scheeren, A. M., Koot, H. M., & Begeer, S. (2019). Stability and change in social interaction style of children with autism spectrum disorder: A 4-year follow-up study. Autism Research. https://doi.org/10.1002/aur.2201
Statistics Netherlands (CBS). (2019). Retrieved September 11, 2021 from https://opendata.cbs.nl/statline/#/CBS/nl/dataset/83932NED/table?%20ts=1565008102724
Steiger, J. H., & Lind, J. M. (1980). Statistically based tests for the number of common factors. Paper presented at Meeting of the psychometric society.
Streiner, D. L. (2003). Starting at the beginning: An introduction to coefficient alpha and internal consistency. Journal of Personality Assessment, 80(1), 99–103. https://doi.org/10.1207/s15327752jpa8001_18
Su, S., Paynter, J., & Gilmore, L. (2019). Chinese parents’ understanding of autism spectrum disorder. International Journal of Disability, Development and Education. https://doi.org/10.1080/1034912x.2019.1687857
Sun, F., Dai, M., Lin, L., Sun, X., Murray, A. L., Auyeung, B., & Jing, J. (2019). Psychometric properties of the chinese version of autism spectrum quotient-children’s version: A sex-specific analysis. Autism Research, 12(2), 303–315. https://doi.org/10.1002/aur.2053
Sun, X., Allison, C., Auyeung, B., Matthews, F. E., Baron-Cohen, S., & Brayne, C. (2013). Service provision for autism in mainland China: Preliminary mapping of service pathways. Social Science and Medicine, 98, 87–94. https://doi.org/10.1016/j.socscimed.2013.08.016
Szatmari, P., Liu, X., Goldberg, J., Zwaigenbaum, L., Paterson, A. D., Woodbury-Smith, M., Georgiades, S., Duku, E., & Thompson, A. (2012). Sex differences in repetitive stereotyped behaviors in autism: Implications for genetic liability. American Journal of Medical Genetics Part B: Neuropsychiatric Genetics, 159B(1), 5–12. https://doi.org/10.1002/ajmg.b.31238
Tabachnick, B. G., & Fidell, L. S. (2007). Using multivariate statistics. Pearson Education, Cop.
Tucker, L. R., & Lewis, C. (1973). A reliability coefficient for maximum likelihood factor analysis. Psychometrika, 38(1), 1–10. https://doi.org/10.1007/bf02291170
van Rentergem, J. A. A., Lever, A. G., & Geurts, H. M. (2019). Negatively phrased items of the autism spectrum quotient function differently for groups with and without autism. Autism, 23(7), 1752–1764. https://doi.org/10.1177/1362361319828361
Waizbard-Bartov, E., Ferrer, E., Young, G. S., Heath, B., Rogers, S., Wu Nordahl, C., Solomon, M., & Amaral, D. G. (2020). Trajectories of autism symptom severity change during early childhood. Journal of Autism and Developmental Disorders. https://doi.org/10.1007/s10803-020-04526-z
Wakabayashi, A., Baron-Cohen, S., Uchiyama, T., Yoshida, Y., Tojo, Y., Kuroda, M., & Wheelwright, S. (2006a). The autism-spectrum quotient (AQ) children’s version in japan: A cross-cultural comparison. Journal of Autism and Developmental Disorders, 37(3), 491–500. https://doi.org/10.1007/s10803-006-0181-3
Wakabayashi, A., Baron-Cohen, S., & Wheelwright, S. (2006b). Are autistic traits an independent personality dimension? A study of the autism-spectrum quotient (AQ) and the NEO-PI-R. Personality and Individual Differences, 41(5), 873–883. https://doi.org/10.1016/j.paid.2006.04.003
Ward, J., Ren, Z., & Qiu, J. (2021). Autistic traits in the neurotypical Chinese population: A Chinese version of Glasgow sensory questionnaire and a cross-cultural difference in attention-to-detail. Journal of Autism and Developmental Disorders. https://doi.org/10.1007/s10803-020-04829-1
West, E. A., Travers, J. C., Kemper, T. D., Liberty, L. M., Cote, D. L., McCollow, M. M., & Stansberry Brusnahan, L. L. (2016). Racial and ethnic diversity of participants in research supporting evidence-based practices for learners with autism spectrum disorder. The Journal of Special Education, 50(3), 151–163. https://doi.org/10.1177/0022466916632495
World Bank’s Gini coefficient in the Netherlands https://data.worldbank.org/indicator/SI.POV.GINI?locations=NL and in China https://data.worldbank.org/indicator/SI.POV.GINI?locations=CN
Xu, G., Strathearn, L., Liu, B., & Bao, W. (2018). Corrected prevalence of autism spectrum disorder among US children and adolescents. JAMA, 319(5), 505. https://doi.org/10.1001/jama.2018.0001
Zhang, M.-X., Yang, P.-Y., Hu, X., Guo, K.-F., Situ, M.-J., & Huang, Y. (2018). Reliability and validity of the abridged Chinese version of autism spectrum quotient-child form in China. Journal of Sichuan University, 49(4), 599–603.
Zhou, H., Xu, X., Yan, W., Zou, X., Wu, L., Luo, X., Li, T., Huang, Y., Guan, H., Chen, X., Mao, M., Xia, K., Zhang, L., Li, E., Ge, X., Zhang, L., Li, C., Zhang, X., Zhou, Y., & Ding, D. (2020). Prevalence of autism spectrum disorder in china: A nationwide multi-center population-based study among children aged 6 to 12 years. Neuroscience Bulletin, 36(9), 961–971. https://doi.org/10.1007/s12264-020-00530-6
Acknowledgments
The author is grateful to all the participants and their families, service centers for their participation in this study.
Funding
FL is funded by China Scholarship Council for the study at Vrije Universiteit Amsterdam. AMS is funded by Aut.17.006, The Netherlands Organization for Scientific Research (NWO). RAH receives support from the National Institute of Health Research (NIHR200842) using UK aid from the UK Government. The views expressed in this publication are those of the authors and not necessarily those of the NIHR or the Department of Health and Social Care. CW is funded by the grants from the Humanities and Social Sciences Youth Foundation of the Ministry of Education of China (13YJCZH167). The funding bodies did not have a role in the design of the study, data collection, analysis or interpretation of data, or the drafting of the manuscript.
Author information
Authors and Affiliations
Contributions
FL, AMS, SB and CW developed the research questions. SB, AMS, KW, DG and CW were responsible for the data collection. FL analyzed the data. AMS, RG, RAH, CW and SB were involved in interpreting the results. FL was responsible for writing with all authors contributing to edits. All authors read and approved the final manuscript.
Corresponding author
Ethics declarations
Conflict of interest
The authors declared no potential conflicts of interest with respect of the research, authorship, and/or publication of this article.
Ethical Approval
Ethical requirements were in accordance with Nankai University Department of Social Psychology and the NAR. The Ethical Committee of the Vrije Universiteit Amsterdam approved this research (E1321MW, VCWE-2020-041).
Informed Consent
All parents provided informed consent before joining the study.
Additional information
Publisher's Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Supplementary Information
Below is the link to the electronic supplementary material.
Rights and permissions
About this article
Cite this article
Liu, F., Scheeren, A.M., Grove, R. et al. Exploring Cultural Differences in Autistic Traits: A Factor Analytic Study of Children with Autism in China and the Netherlands. J Autism Dev Disord 52, 4750–4762 (2022). https://doi.org/10.1007/s10803-021-05342-9
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10803-021-05342-9