The Role of Online Quizzes in Identifying Autism: A Critical Review of Screening Tools and Self-Diagnosis Trends
The increase of online self-screening tools for Autism Spectrum Disorder (ASD), especially those on platforms like TikTok, has influenced how individuals conceptualize neurodevelopmental conditions. While these tools can serve as initial points of reflection, they are not substitutes for clinical assessment.
Social Media and Self-Diagnosis
A growing number of adolescents and young adults are reporting suspected autism diagnoses based on content consumed through social media. Studies have shown that TikTok and similar platforms play a key role in shaping identity and self-perception around neurodivergence. Individuals, particularly women and gender-diverse users, report discovering ASD through viewing videos featuring symptom checklists or personal narratives (Lupton & Southerton, 2024), (Skafle et al., 2024).
While this visibility can reduce stigma and promote self-awareness, it may also lead to misinterpretation of symptoms. Clinical reports describe increasing referrals from individuals whose self-diagnosis is informed entirely by online content. In some cases, formal evaluations reveal alternative explanations, such as anxiety or trauma-related disorders (Fisher et al., 2024).
Limitations of Common Online Screening Tools
Many online screeners are based on the Autism-Spectrum Quotient (AQ) or its abbreviated version, the AQ10. These tools were originally designed to assist clinicians in identifying individuals who may need further assessment. However, their application in non-clinical, self-administered contexts deserves examination.
A 2016 study assessing the AQ in a clinical population found that the tool had significant limitations: approximately 64% of individuals with confirmed ASD scored below the recommended cut-off, indicating a high false-negative rate. Conversely, individuals with anxiety or other mental health conditions often scored above threshold despite not meeting ASD diagnostic criteria (false-positive) (Ashwood et al., 2016).
Further psychometric analysis has raised concerns about the AQ’s structure and reliability. The AQ10, a short questionnaire often used in online autism quizzes, has been shown to produce inconsistent results. In a large study with over 6,500 people, researchers found that the test didn’t reliably measure autism traits and wasn’t consistent enough to be used outside of a clinical setting (Taylor et al., 2020).
Other widely used tools, like the Ritvo Autism Asperger Diagnostic Scale-Revised (RAADS–R), have similar issues, especially when used with adults who don’t have intellectual disabilities. A review of these screeners found that their accuracy and reliability vary significantly, which means online test results should be viewed with caution (Wigham et al., 2018).
The Role of Misinformation
In addition to the structural limitations of screening tools, misinformation on social media further complicates the issue. A review of TikTok health-related content reported that up to 84% of autism and ADHD-related videos contained misleading or inaccurate information (Kaseda & Kirsch, 2023). While many creators aim to raise awareness, the oversimplification of complex diagnostic criteria can lead to self-misdiagnosis and misapplication of clinical labels.
Diagnostic Evaluation Remains Essential
ASD is a neurodevelopmental condition that affects how people think, communicate, and behave, and it can look very different from person to person.
Formal diagnosis requires comprehensive evaluation, including developmental history, direct behavioral observation, and consideration of differential diagnoses. Screening instruments, even when validated, are only one component of the diagnostic process.
The appeal of self-screening and online communities is understandable, particularly for individuals who feel that their symptoms were previously dismissed or overlooked. However, self-identification should not be considered equivalent to diagnosis. Access to appropriate care and support, whether for ASD or another condition, depends on accurate, evidence-based assessment.
Conclusion
While online screeners and social media content may increase awareness of autism spectrum presentations, they are not suitable for diagnostic purposes. Tools such as the AQ or AQ10 have documented limitations when used outside clinical settings, and content shared on platforms like TikTok often lacks clinical accuracy. Individuals concerned about ASD should seek evaluation from qualified professionals who can conduct a thorough, individualized assessment.
References
Ashwood, K. L., Gillan, N., Horder, J., Hayward, H., Woodhouse, E., McEwen, F. S., ... & Murphy, D. G. (2016). Predicting the diagnosis of autism in adults using the Autism-Spectrum Quotient (AQ) questionnaire. Autism Research, 9(3), 275–284. https://doi.org/10.1002/aur.1529
Fisher, D. L., Lewandowski, L. J., & Betjemann, R. S. (2024). The clinical utility of neuropsychological assessment for autism spectrum disorder among young adults presenting with self-diagnosis. Journal of the International Neuropsychological Society, 30(S1), 1.
Kaseda, E. T., & Kirsch, N. L. (2023). TikTok as a health communication platform in pediatric neuropsychology: Potential and pitfalls. Journal of Pediatric Neuropsychology, 9(1), 64.
Lupton, D., & Southerton, C. (2024). Self-diagnosis on TikTok: Mental health, identity and algorithmic content. Health Sociology Review, 49(3).
Skafle, I., Torsvik, I. K., & Stendal, K. (2024). Social media shaping autism perception and identity: A qualitative exploration. Autism in Adulthood, 6(1), 50–61.
Taylor, E. C., Livingston, L. A., & Happé, F. (2020). Psychometric concerns with the 10‐item Autism‐Spectrum Quotient (AQ10) as a measure of trait autism in the general population. Clinical Autism Research, 10(4), 228–238.
Wigham, S., Baucke, R., & Parr, J. R. (2018). Psychometric properties of questionnaires and diagnostic measures for autism spectrum disorders in adults: A systematic review. Research in Autism Spectrum Disorders, 48, 1–15.
A Note from Me
I’m a clinical psychology postdoctoral fellow. I work with autistic people, disordered eating, and gender identity. I conduct comprehensive psychological evaluations to help people understand themselves more clearly, psychotherapy for ongoing support, and group therapy for autistic young people looking for community and skill-building.
Many neurodivergent people feel overwhelmed and are trying to figure out what works for them. Sometimes, therapy and/or assessment can help. These strategies are not about changing who you are. They can help you feel more like yourself.
Reach out if you'd like support or have questions.
Drew Dixon Karris, Psy.D.