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.
|Authors:||Riva Ariella Ritvo et al.|
|Seminal paper:||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)|
|Seminal paper:||A Scale to Assist the Diagnosis of Autism and Asperger’s Disorder in Adults (RAADS): A Pilot Study (Ritvo et al., 2008)|
Take the test here:
Who the test is designed for
- Adults (age 16+) with ASD level 1 or subclinical autism.
- Adults with IQ in the normal range (IQ >=80).((A Scale to Assist the Diagnosis of Autism and Asperger’s Disorder in Adults (RAADS): A Pilot Study (Ritvo et al., 2008)))
Versions & translations
The RAADS–R has been translated into Swedish, and was also available in most languages through Google Translate. But as of 13 January 2022, it seems the online RAADS–R tests have been taken down. As far as we know, we are currently the only ones who host the RAADS–R online, albeit in English only.
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 (Language, Social relatedness, Sensory–motor) as well as a fourth subscale, 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 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:
- Paper-based if you want documentation of your answers (you can find the scoring key at the bottom of the PDF)
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:((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.
The language subscale is made up of 7 statements. The focus of these statements 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.
The social relatedness subscale is made up of 39 statements. The focus of these statements is on:
- Mentalization: Challenges with understanding what others are thinking or feeling.
- Mutual interests: Preferring to be with people with whom you share interests.
- Outsider: Being considered ‘different’.
- Bluntness: Being called rude; or that you have asked embarrassing questions; or pointed out when others have made an error.
- Dialectical reciprocity: Challenges knowing when it is your turn to talk, in a conversation or on the phone.
- Emotional reciprocity: Difficulty knowing when a person is flirting with you.
- Auditory processing issues: Challenges talking with several people at the same time.
- Object permanence: Not missing people when they’re absent.
- Maintaining relationships: Challenges making or keeping friends.
- Nonverbal communication: Challenges understanding body language.
- Mimicry/imitation: Copying others’ behaviour to fit in.
- Camouflaging: Hiding your automatic behaviours to fit in with others.
The sensory–motor subscale is made up of 20 statements. The focus of these statements is on:
- Voice volume challenges: Talking very loud, not loud enough, or significant fluctuations between the two.
- Voice differences: Speaking monotone, like a child, or in silly voices.
- Motor control issues: Clumsiness and being uncoordinated.
- 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.
The circumscribed interests subscale is made up of 14 statements. The focus of these statements 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…
The table below shows the average total scores and subscores for people taking the RAADS-R online, divided by autistic people, suspected autistic people, and non-autistic people (neurotypicals).
Average RAADS-R scores
|Total score||Language||Social |
|Autism threshold |
|Suspected autistic |
|Suspected autistic |
You might ask, “If the threshold score is 65, and no neurotypicals scored higher than 64 in the research, then why are the average neurotypical scores above 80?” Excellent question!
The answer is in how the data is being collected. The table above is based on people taking the RAADS–R online, which for research purposes starts with the question as to whether you are diagnosed with autism, suspect you’re autistic, or are not autistic. But some people that answered the latter will—contrary to their own expectations—end up scoring in the autistic range. Due to this misattribution, their scores get counted as neurotypical scores despite scoring in the autistic range, thus skewing the results.
In other words, the average neurotypical scores as reported by the online RAADS–R (on Aspietests.org) are almost certainly too high. The average scores you can find in the research literature are more reliable, given that they use genuine neurotypicals as a control group. In the article below, you can find a table with average scores that I have taken from the research literature.
Because the table with average scores is based on skewed data, let me also present the mean scores from Ritvo’s seminal paper:((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)))
Mean RAADS–R scores
|Mean total||Range||Language||Social |
|Autistic spectrum (n = 66)||133.83||44–227||11.08||67.89||32.82||28.11|
|Asperger (n = 135)||—||—||10.06||65.07||28.96||27.44|
|Controls (n = 276)||25.95||0–65||1.86||9.24||5.26||5.03|
The RAADS–R is a reliable instrument to assist the diagnosis of autistic adults.((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)))
- No neurotypical who took the test scored above the autism threshold.
- Only 3% of the autistic group did not score over 65.
- Test–retest reliability was high, particularly for the autistic group.((Table 7 – Test-retest data statistical analysis | 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)))
Here is how the RAADS–R measures up:
|Sensitivity||97%||Test’s ability to identify positive results|
|Specificity||100%||Test’s ability to identify negative results|
|Concurrent validity||96%||Test’s validity compared with ADOS Module 4, SRS|
|Test–retest reliability||.987||Test’s agreement between results of successive measurements|
A total RAADS–R score of 65 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.((The Ritvo Autism Asperger Diagnostic Scale-Revised (RAADS–R)))
Dr. Natalie Engelbrecht:
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 are characteristic of alexithymia rather than autism (e.g. the ones on lack of compassion and empathy). While alexithymia correlates strongly with autism, it should not be confused with 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.((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 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((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.
That said, the test has a close to 100% success rate in differentiating autism from non-autism, despite these limitations.
Please read each statement below and choose the answer that best fits your experiences during social interactions.