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The AdAS Spectrum includes 160 items exploring the wide spectrum of manifestation of autism. The instrument is organized into 7 domains. The Childhood/adolescence domain (Domain I) describes symptoms occurring during early developmental phases, such as being very quiet or unable to speak at all, avoiding eating or playing with other children at school or being teased or bullied by schoolmates. The Verbal communication domain (Domain II) covers the features encompassing the tendency to not speak much or to speak in a very low voice or in a strange or monotonous way, the preference for communicating via e-mail or text messages rather than speaking to someone on the phone or in person, difficulty in intervening in or ending a conversation, and the habit of butting into a conversation inopportunely. The Non-verbal communication domain (Domain III) explores difficulties in looking others straight in the eyes, feelings of discomfort about hugging, kissing or holding someone by the hand, and the tendency to take on a role to feel more at ease when interacting with other people or to flare up in a rage without reason. The Empathy domain (Domain IV) explores impairment in understanding and interpreting the facial expressions, intentions or thoughts of others but also the presence of greater attachment to pets or objects rather than people. The Inflexibility and adherence to routine domain (Domain V) includes difficulties in understanding the nuances of things, difficulty in changing one's daily habits or methods of work, unwillingness to get rid of useless objects, and tendency to follow precise procedures or patterns, to write lists or to always wear the same type of clothes. The Restricted interests and rumination domain (Domain VI) encompasses some typical symptoms such as talking only about a few preferred topics and being fascinated by numbers and systematic information about certain things, but also the proneness to brood over the same thoughts, the incapacity to be concise, and the tendency to waste time over detail, to lose track of time and to take refuge in day-dreaming. The Hyper– and hyporeactivity to sensory input domain (Domain VII) explores in detail the tendency to over- or under-react to noises, textures, pain or temperature. This domain covers a broad range of manifestations, from being able to hear very low noises to perceiving noises as amplified or unbearable; from having high pain threshold to complaining about recurrent aches; and from feeling uneasy, anxious or frightened in environments full of noise, smells and bright lights to feeling immobilized like a block of ice.


The AdAS Spectrum consists of 160 items. Items responses are coded in a dichotomous way (yes/ no) and domain scores are obtained by counting the number of positive answers.

Psychometric Properties

Dell'Osso L, Gesi C, Massimetti E, Cremone IM, Barbuti M, Maccariello G, Moroni I, Barlati S, Castellini G, Luciano M, Bossini L, Rocchetti M, Signorelli M, Aguglia E, Fagiolini A, Politi P, Ricca V, Vita A, Carmassi C, Maj M. Adult Autism Subthreshold Spectrum (AdAS Spectrum): Validation of a questionnaire investigating subthreshold autism spectrum. Compr Psychiatry. 2017 Feb;73:61-83.

Dell'Osso L, Dalle Luche R, Maj M. Adult autism spectrum as a transnosographic dimension. CNS Spectr. 2016 Apr;21(2):131-3. PMID:26349624 Dell'Osso L, Dalle Luche R, Maj M. Adult autism spectrum as a transnosographic dimension. CNS Spectr. 2016 Apr;21(2):131-3. PMID:26349624

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Note: each items is scored as "0" (NO), "1" (YES).
(1) Childhood/adolescence sum of items 1-21
(2) Verbal communication sum of items 22 - 39
(3) Non-verbal communication sum of items 40 - 67
(4) Empathy sum of items 68 - 79
(5) Inflexibility and adherence to routine sum of items 80-122
(6) Restricted interests and rumination sum of items 123-143
(7) Hyper– and hyporeactivity to sensory input sum of items 144-160