Dr. Riva Ariella Ritvo created the RAADS-R (Ritvo Autism Asperger Diagnostic Scale-Revised) test to address the significant gap in autism screening services for adults. With the climbing rates of people diagnosed with Autism Spectrum Disorder (ASD) worldwide, autism research is addressing how many adults may have the condition and not even know it.
The fact that so many adults are searching for autism services shows how valuable an instrument the RAADS-R test can be in the eyes of some providers. However, it is vital to consider many doctors’ opinions when determining how you will screen for adult autism. Not everyone agrees that the RAADS-R test is the most comprehensive or accurate test for screening autism in adults.
This article will explore the RAADS-R test, its features, and the meaning of its scores while addressing the controversies surrounding its reception in the autism community. It will also touch on other autism screening tools.
What Does the RAADS-R Test for Autism Do?
The RAADS-R is a tool that can help clinicians diagnose the growing population of higher functioning adults with autism. The RAADS-R test is an altered version of the original RAADS test, which was initially developed to test individuals with 78 questions that assessed autism symptoms. The questions are designed to distinguish subjects with autism from their neurotypical peers. Areas targeted for review by the test were language, social relatedness, and sensory-motor function.
After a study of the original RAADS test, a revised 80-item version was developed (RAADS-R), which included the addition of a fourth symptom area that encompassed personal interests. Additionally, the test designers added two questions and changed several words for clarification. Like the original test, the RAAD-R is a self-reporting quiz designed for use by adults over 18 with average and above-average intelligence.
What Questions Are on the RAADS-R Test?
In most cases, the RAADS–R is a test you can take yourself. However, it clearly states that a clinician might help a participant understand the question and process it more clearly.
Questions on developmental symptoms include challenges in language, sensory and motor skills, social relatedness, and interests. For each of the 80 statements, the individual has four choices:
- True now, and when I was young
- True now only
- True only when I was younger than 16
- Never true
How Is the RAADS-R Test Scored?
The test uses two different scoring methods: automated and paper-based. The point system is described below:
- 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)
The point value system reverses for 17 of the questions that point to being neurotypical:
- 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)
What Does a RAADS-R Test Score Mean?
The test is scored between 0 and 240 points. If you receive a 65+, you may have Autism Spectrum Disorder. If you score below 65, you are most likely not on the autism spectrum. However, because no single test can be conclusive of autism without a comprehensive evaluation, the RAADS-R test must never be used as a stand-alone diagnostic tool.
Below are general interpretations of different scores on the RAADS-R test.
- RAADS-R score of 25: You do not meet the criteria for autism
- RAADS-R score of 50: You possess some traits of autism but do not likely have autism.
- RAADS-R score of 65: You are at the minimum score of what is considered autism.
- RAADS-R score of 90: You demonstrate strong indications that you have autism, although neurotypical individuals may also score highly.
- RAADS-R score of 130: The average autism score, signs that autism is present.
- RAADS-R score of 160: You demonstrate solid evidence for autism.
- RAADS-R score of 227: The maximum score for individuals with autism.
What Are the Subscales of the RAADS-R Test?
The subscales or symptom areas of the RAADS-R test are:
RAADS-R Language Section
The language subscale is composed of seven statements focusing on:
- Echolalia/Movie Talk: Family and friends notice the individual learned something new because they start using words and phrases associated with the television, movie, or programming.
- Small talk: The individual cannot engage in light conversation about unimportant topics with the person initiating the social interaction.
- Being literal: Individual experiences difficulties when “what is said” does not match “what is meant” language.
RAADS-R Social Relatedness Section
The social relatedness subscale consists of 39 statements focusing on:
- Mentalization: Difficulties related to what other people are thinking or feeling.
- Mutual interests: A preference to be around people with shared interests.
- Outsider feelings: feelings of being different or consistently out of place in a group.
- Bluntness: Being considered by others as being rude. An example of this may be asking inappropriate questions or pointing out errors at inopportune times.
- Dialectical reciprocity: Difficulty knowing when it is your turn to speak in a conversation. This impairment can take place in person or on the phone.
- Emotional reciprocity: The individual experiences challenges recognizing flirtatious behavior or romantic interest.
- Auditory processing issues: difficulty addressing several people at once.
- Object permanence: Not experiencing the emotion of missing someone when away or absent.
- Challenges maintaining relationships: Individual has difficulty establishing or sustaining friendships.
- Nonverbal communication: Individuals exhibit challenges related to the comprehension of body language and nonverbal cues.
- Lack of mimicry/imitation: The individual cannot copy another person’s behavior to fit in. These skills are especially imperative in dangerous situations where alertness and imitation are required.
- Camouflaging: Hiding involuntary behaviors to fit in with others.
RAADS-R Sensory-Motor Section
The sensory-motor subscale has 20 statements on:
- Voice volume challenges: Individuals may talk very loudly, not loudly enough, or significantly fluctuate between the two.
- Voice differences: Speaking monotone, in a baby-like voice, or “silly” sounding voices.
- Motor control issues: an aptitude for clumsiness and being uncoordinated.
- Sensory: Sensory stimulation that may not bother others is painful and overwhelming for the tested individual. While the experience will be unique, anxiety and overstimulation are everyday experiences for the person.
RAADS-R Circumscribed Interests
The circumscribed interests subscale is composed of 14 statements on:
- Detail preferences: The individual will be tested on their understanding of details and conception of the bigger picture.
- The individual will be evaluated for distress when there is a disruption in routine.
- Any special interests: Speaking about interests and exploring if the individual struggles with any area.
Other Tests Used to Help Diagnose Autism
Diagnostic Interview for Social and Communication Disorders (DISCO)
DISCO is a dialogue-based test used to evaluate developmental behaviors by assessing daily functioning. Developmental experts use DISCO to diagnose ASD in adults and children. Disco is a beneficial screening tool for individuals who cannot provide a detailed history of their developmental behaviors. Tests typically require developmental history before an accurate diagnosis can be made. However, people should use the DISCO in conjunction with the standardized assessments in the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition).
Autism Diagnostic Interview-Revised (ADI-R)
The ADI-R is a screening tool used to help diagnose autism in children and adults. It focuses on quality of communication, social communication, and repetitive and restive behaviors when screening for autism.
Autism Diagnostic Observation Schedule, Second Edition (ADOS-2)
The ADOS-2 is a screening tool used to gauge social interactions and communication in individuals with autism spectrum and those who may have the condition. ADOS-2 is considered the gold standard in autism testing and can help with diagnosing autism in both children and adults. Another feature of ADOS-2 is that it can help individuals at any stage of autism. Even those with severe symptoms can benefit from the ADOS-2 assessment system.
Developmental, Dimensional, and Diagnostic Interview–Adult Version
This is an established tool for helping diagnose adults with autism. Its focus is on the individual’s communication and interaction within social contexts. It also assesses restricted interests, such as fixations with specific objects and other behaviors.
Social Responsiveness Scale (SRS-2)
This screening test employs 65-questions to measure the level of impairments in a person’s social skills. It is not used to diagnose autism.
Can You Diagnose Autism in Yourself?
Developmental experts do not advise individuals to make a conclusive autism diagnosis at home. Still, there are early signs to look out for, especially in children. Many established websites offer resources for adults that suspect they may have autism.
Self-screening tools for autism are questionnaires that someone can take on their own. Most are available for free online. They can’t conclusively confirm that you have autism, but they can help you decide if you should seek professional help.
Autism Spectrum Quotient (AQ-10): This is a 10-question screening tool created from a longer document called the Autism Spectrum Quotient (AQ). The AQ-10 is very popular, but research notes that it may not be reliable. It is available online.
Adult Repetitive Behaviors Questionnaire-2 (RBQ-2A): This is a 20-item questionnaire that focuses on repetitive and restricted behaviors. It is considered by many to be a highly efficient screening tool for autism that you can take online.
Autism Social Behavior Questionnaire (ASBQ): This 44-question test focuses on a broad range of autism features in adults. It is reportedly accurate at noting mild autism. It can be used as a self-test or be administered by another party.
What Are the Known Issues of the RAADS-R Test?
An assessment for autism must be evidence-based to provide adequate diagnostic outcomes. Providers must explore the credibility of every screening assessment they employ. If effective, these screening tools should accurately identify those who most likely have autism.
Based on data from different sources, results suggest that when implemented as a self-report screening tool, the RAADS-R test could not discriminate between those that had autism and those that did not. Variables such as inappropriate referrals or co-occurring conditions can influence findings of the RAADS-R and similar tests. These results show that a full diagnostic assessment, including behavioral history, is required for a conclusive and comprehensive autism diagnosis.
After a complete assessment of the information available on the RAADS-R test, it becomes evident that this test might be a handy aid for individuals who suspect they may have autism. This test’s accessibility makes it a good choice for individuals who want to know more about their learning style and how they relate to the world. But it should never be used as a stand-alone tool or without a doctor’s diagnosis. And it may not be the best first choice.
If you know an adult you suspect may have autism, this test may be a great jumping-off point to their treatment. Be sure to bring test results to a doctor and ask lots of questions!
ABA Therapy for Autism and Autism Diagnosis
At ABA Centers of America, we specialize in helping families create the brightest future possible. Our therapists are licensed and board-certified. We have experience with all forms of autism across the spectrum and with people of all ages.
If you’re in need of autism testing or an autism diagnosis, check out our autism diagnosis services. Call ABA Centers of America at 844-923-4222 for a free, no-obligation consultation. Or message us for more information.