The Autism Spectrum Screening Questionnaire (ASSQ) is a 27-item screening tool developed by Ehlers and Gillberg (1993) at the University of Gothenburg, later refined with Lorna Wing. It is completed by a parent or teacher about a child or adolescent aged 6–17 years. Each of the 27 statements is rated on a 3-point scale: "Not True" (0), "Somewhat True" (1), or "Certainly True" (2), producing a total score ranging from 0 to 54. A cutoff score of ≥13 in non-clinical populations and ≥19 in clinical populations indicates probable autism spectrum disorder. The ASSQ demonstrates strong psychometric properties with test-retest reliability of 0.90–0.94 for teacher ratings and 0.96 for parent ratings, and inter-rater reliability of 0.79 between parents and teachers (Ehlers, Gillberg, & Wing, 1999). Zentake’s digital ASSQ auto-scores parent and teacher responses instantly and integrates with your EMR for streamlined developmental screening workflows.
The ASSQ uses a straightforward 3-point Likert scoring system across all 27 items. Each statement describes a behavior or trait associated with autism spectrum conditions. The respondent—either a parent or teacher—rates each item as "Not True" (0 points), "Somewhat True" (1 point), or "Certainly True" (2 points). All 27 item scores are summed to produce a total score ranging from 0 to 54.
Zentake automatically calculates the ASSQ total score upon form submission, eliminating manual summation across 27 items and delivering instant results to clinicians.
Step 1: Confirm the child’s age and select the informant. The ASSQ is designed for children and adolescents aged 6–17 years. It can be completed by a parent or teacher who knows the child well. Both informant perspectives are valuable—teacher and parent forms can be administered in parallel for a more complete picture. Zentake allows you to send separate forms to each informant.
Step 2: Deliver the questionnaire. Send the ASSQ digitally via Zentake’s secure patient/informant link, QR code, or waiting room tablet. The parent or teacher reads each of the 27 statements and rates how well it describes the child.
Step 3: Allow adequate time. Most informants complete the ASSQ in 10–15 minutes. There is no time limit. Ensure the respondent understands they should rate each behavior based on how the child generally behaves, not a single incident.
Step 4: Review auto-scored results. Zentake automatically calculates the total score and flags results at or above the appropriate clinical cutoff. If both parent and teacher forms are completed, scores appear side by side in the clinician dashboard for comparison.
Step 5: Interpret and act. A score of ≥13 (non-clinical population) or ≥19 (clinical population) warrants referral for comprehensive diagnostic evaluation. Document the score, informant type, clinical observations, and referral decision. The ASSQ is a screening tool and should be used alongside clinical observation and developmental history.
Scoring: Paper requires manual summation across 27 items. Zentake auto-scores instantly with zero calculation errors.
Completion: Paper forms require printing and distributing to parents and teachers separately. Zentake delivers unique links to each informant for independent completion.
Delivery: Paper is limited to in-person distribution. Zentake enables remote completion from any device, making it easy to collect teacher ratings without requiring a school visit.
Data Storage: Paper forms require physical filing and manual data entry. Zentake stores all responses in a HIPAA-compliant cloud environment with automatic backups.
Longitudinal Tracking: Comparing paper scores over time requires manual chart review. Zentake graphs ASSQ scores across sessions and informants for instant trend visualization.
Security: Paper forms risk loss, theft, or unauthorized access. Zentake encrypts all data in transit and at rest with HIPAA-compliant security controls.
Integration: Paper scores must be manually entered into the EMR. Zentake integrates directly with systems like Elation, pushing scores automatically.
Cost: Paper involves ongoing printing, storage, and staff time costs. Zentake eliminates these with unlimited digital form delivery.
What does the ASSQ measure?
The ASSQ measures behaviors and traits associated with autism spectrum conditions in children and adolescents aged 6–17 years. It covers social interaction difficulties, communication differences, and restricted or repetitive behavioral patterns as observed by parents or teachers. It was originally developed to screen for Asperger’s syndrome and high-functioning autism spectrum disorders.
How do you score the ASSQ?
Each of the 27 items is rated on a 3-point scale: "Not True" (0), "Somewhat True" (1), or "Certainly True" (2). All item scores are summed for a total ranging from 0 to 54. A score of ≥13 indicates probable ASD in non-clinical populations; ≥19 is used in clinical populations. Zentake calculates this automatically.
How long does the ASSQ take to complete?
The ASSQ typically takes 10–15 minutes for a parent or teacher to complete. It is longer than brief screeners like the AQ-10 but provides more comprehensive behavioral coverage across 27 items.
Is the ASSQ free to use?
The ASSQ is freely available for clinical and research use. The original questionnaire was published by Ehlers and Gillberg (1993) and is distributed through the Gillberg Neuropsychiatry Centre at the University of Gothenburg. Zentake provides a ready-to-use digital version with automated scoring, HIPAA-compliant data storage, and EMR integration.
What age group is the ASSQ designed for?
The ASSQ is validated for children and adolescents aged 6–17 years. It is completed by a parent or teacher, not the child. A preschool adaptation has been developed for younger children (Kopp & Gillberg, 2011), and a revised version (ASSQ-REV) with 45 items was created to better capture the autism phenotype in girls.
Who should administer the ASSQ?
Any healthcare or educational professional can administer the ASSQ. It is commonly used by child psychologists, pediatricians, school counselors, and developmental specialists. The parent or teacher who knows the child well completes the questionnaire as the informant.
Can the ASSQ diagnose autism?
No. The ASSQ is a screening tool designed to identify children who may benefit from comprehensive diagnostic assessment. A positive screen should be followed by multi-disciplinary evaluation including developmental history, behavioral observation, and standardized diagnostic instruments such as the ADOS-2.
What is the difference between the ASSQ and the ASSQ-REV?
The ASSQ-REV (Revised Extended Version) contains 45 items compared to the original 27. It was developed by Kopp and Gillberg (2011) to better capture the autism phenotype in girls, who may present with different behavioral patterns than boys. The additional items focus on female-typical symptom expression.
Can both parents and teachers complete the ASSQ?
Yes. The ASSQ is designed to be completed by either a parent or a teacher, and collecting ratings from both informants is recommended for a more comprehensive picture. Inter-rater reliability between parents and teachers is 0.79, and discrepancies can provide clinically useful information about how the child presents across settings.
1. Ehlers, S., Gillberg, C., & Wing, L. (1999). A screening questionnaire for Asperger syndrome and other high-functioning autism spectrum disorders in school age children. Journal of Autism and Developmental Disorders, 29(2), 129–141.
2. Ehlers, S., & Gillberg, C. (1993). The epidemiology of Asperger syndrome: A total population study. Journal of Child Psychology and Psychiatry, 34(8), 1327–1350.
3. Kopp, S., & Gillberg, C. (2011). The Autism Spectrum Screening Questionnaire (ASSQ)—Revised Extended Version (ASSQ-REV): An instrument for better capturing the autism phenotype in girls? Research in Developmental Disabilities, 32(6), 2875–2888.
Last updated: April 2026
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