April 4, 2020

RAADS-R

Last updated on May 29, 2021

The Ritvo Autism Asperger Diagnostic Scale-Revised (RAADS-R) is a self-report questionnaire designed to identify adult autistics who “escape diagnosis” due to a subclinical level presentation.

Note: the original RAADS was published in 2008. You can find the paper here: Ritvo et al. (2008)

 

Dr. Natalie’s rating: 1 star for appropriate and respectful wording, 2 stars for clarity & lack of ambiguity, and 3 stars for testing accuracy.
*The test has good reliability when self-administered, but drops down to 30% when clinicians administer it.

Take the test here:


Who the test is designed for


Versions & translations

  • The RAADS-R has been translated into Swedish.
  • The RAADS-R is also available in most languages through Google Translate.

Taking the test

The RAADS-R is a self-report instrument. However, the authors mention that a clinician might help a participant interpret items if they have difficulty understanding the question.

The test assesses developmental symptoms correlating with the three DSM-5 diagnostic categories (Social Relatedness, Language, Sensory-Motor) as well as a fourth sub-scale, Circumscribed Interests. It consists of 80 statements, giving you 4 choices for each statement:

  • True now and when I was young
  • True now only
  • True only when I was younger than 16
  • Never true

If you decide to take the test, please consider the Discussion section below.


Scoring

  • Scoring range: 0–240
  • Threshold score: 65
  • 65+ you are likely autistic (no neurotypical scored above 64 in the research)
  • <65 you are likely not autistic (97% chance of not being autistic)

 

You can take the test using two methods:

 

The scoring of most of the statements (63) is as follows:

  • True now and when I was young (3 points)
  • True now only (2 points)
  • True only when I was younger than 16 (1 point)
  • Never true (0 points)

However, the point value is reversed for the 17 so-called normative questions:[2]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 (Ritvo et al., 2011)

  • True now and when I was young (0 points)
  • True now only (1 point)
  • True only when I was younger than 16 (2 points)
  • Never true (3 points)

Below you can see an example of the first 3 questions, the first of which (denoted by an asterisk) is normative and thus has reversed scoring.

Example questions of the RAADS-R (‘I am a sympathetic person’, ‘I often use words and phrases from movies and television in conversations’, ‘I am often surprised when others tell me I have been rude’).


Subscores

Language

The Language Subscore is made up of 7 questions. The focus of these questions is on:

  • Movie Talk: friends notice you’ve heard something new because you start using the word or phrase regularly
  • Small talk: a light conversation about unimportant things that people make during social interactions—instead of topics that are actually interesting and fun to talk about
  • Being literal: having challenges when ‘what is said’ language does not match ‘what is meant’ language

Circumscribed interests

The circumscribed subscore is made up of 14 Questions. The focus of these questions is on:

  • Details Preference: focuses on details before the big picture, but can do both
  • Upset when the unexpected occurs: a dislike of someone changing your routine—this does not mean that you stick to your own routine, just that you dislike someone else changing YOUR routine.
  • Special interests: Speaking about them, having them…

Social relatedness

The social relatedness subscore is made up of 39 Questions. The focus of these questions is on:

  • Mentalizing: Challenges with understanding what others are thinking or feeling.
  • Preferring to be with people with whom you share interests
  • Being considered ‘different’
  • Bluntness: being called rude; or that you have asked embarrassing questions; or pointed out when others have made an error
  • Challenges knowing when it is your turn to talk: in a conversation or on the phone
  • Difficulty knowing when a person is flirting with you
  • Challenges talking with several people at the same time
  • Not missing people when they’re absent
  • Challenges making or keeping friends
  • Challenges understanding body language
  • Mimicking: copying others behaviour to fit in
  • Camouflaging: hiding your automatic behaviours to fit in with others

Sensory-motor

The sensory-motor subscore is made up of 20 Questions. The focus of these questions is on:

  • Voice volume challenges
  • Voice differences: speaking monotone, like a child, or in silly voices
  • Clumsiness
  • Sensory: Sensory stimulation that doesn’t bother others can be painful and overwhelming. The experience can differ significantly at various times or be context-dependent. You may get anxious when overstimulated.

Validity

A total RAADS-R score of 64 or higher is consistent with the diagnosis of autism and supports a clinician’s diagnosis. However, if there is a difference between the clinician’s diagnosis and the RAADS-R diagnostic assignment, the clinician’s diagnosis should take precedent. This is because symptoms may be revealed only during an interview. Also, the RAADS-R standardization study reported that many autism subjects, particularly those in their late teens and early twenties, failed to acknowledge the presence of symptoms that their families said were present and which were readily observed by the diagnostician. [5]The Ritvo Autism Asperger Diagnostic Scale-Revised (RAADS-R).


Discussion

The test has been validated and cited in the medical literature numerous times. However, as both an autistic and a psychotherapist, I have some concerns with the RAADS-R:

  • Quite a few of the statements are not actually characteristic of autism and are likely going to be experienced as demeaning (e.g. I am NEVER a compassionate type of person).
  • A few questions (e.g. the ones on lack of compassion and empathy) are characteristic of alexithymia rather than autism. While alexithymia correlates strongly with autism, it should not be confused for autism itself.
  • Two-thirds of autistic adults were incorrectly identified by clinicians when they used this test, despite the fact that the test has strong validity.[6]Examining the Diagnostic Validity of Autism Measures Among Adults in an Outpatient Clinic Sample (Conner, Cramer, & McGonigle, 2019) I suspect the reason for this is that the normative questions that indicate what we ought to be like are outdated. I contacted Dr. Ritvo regarding this, but she has declined to respond.

My RAADS-R test results, indicating a total score of 178.

My test results are above. And it did identify me as autistic, which I am. The test is based on the DSM-5 diagnostic criteria for autism[7]Diagnostic Criteria for Autism Spectrum Disorder | CDC which views us as having deficits, deficits, deficits!

I find many of the questions insensitive and lacking in understanding about what is normative in regards to autistics. The test claims that a clinician ‘ought’ to see the following characteristics if a person is autistic:

  • A lack of compassion
  • A dislike of close friendships
  • Monotonous speech
  • An inability to manage small-talk.

Of the 80 statements in the RAADS-R, the following 17 are normative. And remember, according to the RAADS-R, ‘never true’ gives the highest score (3) for these statements. Statements that are unlikely to be ‘never true’ for most autistic people, are in bold.

  • 1. I am a sympathetic person
  • 6. I can “put myself in other people’s shoes”
  • 11. I miss my best friends or family when we are apart for a long time.
  • 18. I understand when friends need to be comforted.
  • 23. Meeting new people is usually easy for me.
  • 26. I like having a conversation with several people, for instance around a dinner table, at school or at work.
  • 33. I speak with a normal rhythm.
  • 37. I am an understanding type of person.
  • 43. I like to talk things over with my friends.
  • 47. I feel very comfortable dating or being in social situations with others.
  • 48. I try to be as helpful as I can when other people tell me their personal problems.
  • 53. I am considered a compassionate type of person.
  • 58. I can chat and make small talk with people.
  • 62. I usually speak in a normal tone.
  • 68. I can tell when someone says one thing but means something else.
  • 72. I enjoy spending time eating and talking with my family and friends.
  • 77. I like to have close friends.

These descriptions are so lacking in nuance and are not at all representative of who I am. This is probably my least favourite autism test for that reason alone.

A significant percentage of the statements are nearly impossible for me to answer or, have no appropriate answer. It feels like throwing a dart at times; no choice is accurate, just slightly more or less accurate. (Kendall)

That said, the test has a close to 100% success rate in differentiating autism from non-autism despite these limitations.


Questions in more detail

  • Social Relatedness—total of 39 statements: 1, 3, 5, 6, 8, 11, 12, 14, 17, 18, 20, 21, 22, 23, 25, 26, 28, 31, 37, 38, 39, 43, 44, 45, 47, 48, 53, 54, 55, 60, 61, 64, 68, 69, 72, 77, 76, 79, 80
  • Language—total of 7 statements: 2, 7, 15, 27, 35, 58, 66
  • Sensory Motor—total of 20 statements: 4, 10, 16, 19, 29, 33, 34, 36, 42, 46, 49, 51, 57, 59, 62, 65, 67, 71, 73, 74
  • Circumscribed Interests—total of 14 statements: 9, 13, 24, 30, 32, 40, 41, 50, 52, 56, 63, 70, 75, 78

Recommended next steps

After the RAADS-R, consider taking one of the tests below.

Autism Spectrum Quotient

A simple screening test that is used as a basis
for pursuing a formal autism evaluation

CAT-Q

Measures camouflaging, and can account
for lower scores on other autism tests

Aspie Quiz

Identifies neurodivergence and
potential co-occurring conditions

Online autism tests can play an essential role in the process of self-discovery, and may inform your decision to pursue a formal diagnosis. For a formal assessment, please see a knowledgeable medical professional trained in assessing autism.


An illustration of a clipboard with a checklist or assessment.

If you are looking for an autism assessment,
have a look at the following post:

Online autism assessments
This article
was written by:
dr-engelbrecht-and-kendall-jones

Dr. Natalie Engelbrecht RP ND is a dually licensed registered psychotherapist and naturopathic doctor, and a Canadian leader in trauma and PTSD, and she happens to be autistic; she got diagnosed at 48.

And not only does she happens to be autistic, but her autism plays a significant role in who she is as a doctor and how she interacts with her patients and clients.

Kendall Jones is a musician and sound engineer from Louisiana, with an affinity for both music and language. He was diagnosed late in life, at 61.

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