Several tests for autism exist in order to help with screening and diagnosis, but one that proves promising with its accuracy is the RAADS-R test, otherwise known as the Ritvo Autism Asperger's Diagnostic Scale. With more and more adults being referred for a potential autism diagnosis, the RAADS-R test may be a helpful clinical tool.

Here, we are looking at what this test is and who it’s for, why it exists, how it works, how accurate it might be, how the scoring system works, the challenges of obtaining an adult autism diagnosis, and how to begin the process if you think you may be autistic.

At Augmentive, we aim to provide holistic, tailored mental health support to everyone so they can live their life to the fullest, so if you have questions about autism, we can help.

What is autism?  

Autism is a neurodevelopmental condition that affects how people interact with other people and the world around them, and how they understand and respond to sensory information. Autistic people may experience things like common sensory issues, negative reactions to specific triggers, difficulties with social communication and interaction, restricted or repetitive behaviours or interests, alternative ways of learning, moving or paying attention, and more. 

While the above are common for autistic people, every person with autism has their own unique traits and symptoms, which is what makes diagnosis and support more difficult.

Some of the main symptoms and traits of autism in adults include things like:

• Trouble reading social cues and participating in conversations
• Trouble relating to the thoughts and feelings of others 
• Difficulty building and maintaining friendships 
• An inability to read body language or facial expressions 
• The use of robotic or monotone speaking patterns that don’t convey true emotions 
• Avoidance of eye contact during conversations
• Restrictive and repetitive behaviours used often 
• Trouble regulating emotions 
• Difficulty with changes to routine, especially if they are last-minute
• Fixation on one or two favourite subjects that the individual cares deeply about or is extremely skilled in 
• Sensitivity to sensory input such as pain, sound or touch

What is the RAADS-R test?

The RAADS-R test is a revised version of the original RAADS test (Ritvo Autism Asperger's Diagnostic Scale), which was developed in order to provide further screening services for adults who may be on the autism spectrum. Since its inception, it has proved to be a largely accurate diagnostic tool, as it has been able to successfully identify those with autism from comparison subjects. Other versions have been explored in more recent years, such as the RAADS-14 Screen, which is an abridged version aiming to help identify autism in adults. 

How does the RAADS-R test work?

The RAADS-R test differs from other tests for autism – such as the Autism-Spectrum Quotient (AQ) – in that it is designed to be administered by an autism specialist with relevant qualifications in the appropriate setting, such as a clinic. The test has been found to be best used alongside other assessment procedures, as well as the expertise of a specialist who can ascertain whether or not an adult has autism.

The test works by assessing four key elements of an autism diagnosis; language, social relatedness, sensory-motor, and circumscribed interests. Most of these categories were chosen due to characteristics of autism as described in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). 

The test consists of 80 statements with 4 multiple choice options:

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

Is the RAADS-R test effective?

Although thought of as effective, it is important to acknowledge that the test has not been deemed effective in all cases, with one 2021 study suggesting the test “lacks predictive validity”, and a 2018 article suggesting that it is less able to pick up on symptoms of autism that are specific to women – for example, autistic women are thought to present with fewer social difficulties than autistic men. 

While the questions on the test do not cover all possible answers from subjects, and the test has been met with some criticism for the lack of nuance in its answer options, overall it has been considered a favourable and successful tool in screening for autism in many studies and cases, and continues to be used in the diagnostic process today. 

Who is the RAADS-R test for?

The RAADS-R test is designed for adults aged 18 or over who are considered to have average or above-average intelligence levels (often this means an IQ score of above 80). The test is also thought to be suitable for those aged 16 or over who are believed to have autism after undergoing previous evaluations with a specialist. 

How does the RAADS-R test scoring system work?

The scoring system on the RAADS-R test ranges from 0 to 240; a score of 65 or over indicates that a person is likely autistic, and a score of 64 or lower indicates that a person is likely not autistic. 

A 2024 study found a contrast in the way different groups responded to the questions. For example, officially diagnosed autistic people and undiagnosed people who believed they may have autism responded in a similar way, while those who were unsure about their potential autism responded differently. 

For each subsection of the test, certain criteria are explored to determine whether or not a person has autism or not. 

Language

The ‘Language’ section consists of 7 statements that look at things like:

• How you handle and relate to small talk in social situations 
• How you navigate what someone says versus what they actually mean, and other conversational challenges – autistic people may struggle with social and communication difficulties
• Whether or not people in your life notice you using a new word or phrase frequently after hearing it for the first time 

For ‘Language’, the threshold score is 4, and the maximum score is 21. 

Social Relatedness

The ‘Social Relatedness’ section consists of 39 statements that look at things like:

• How you understand what other people are thinking or feeling 
• How you respond to people with shared interest versus those you have less in common with – communication challenges can be a feature of autism, so autistic people may struggle by fixating on one topic in conversation 
• Whether or not you have ever been called rude, have asked embarrassing questions, or have acknowledged people’s mistakes – some autistic people may unintentionally misspeak and commit what are usually considered social faux pas 
• Whether or not you know when it is the right time to talk and when to listen 
• How you handle making and maintaining friendships – autistic people may find it difficult to build and maintain friendships  
• How you handle talking to multiple people at once – studies show that autistic people have significantly higher rates of social anxiety, which can make interacting with big groups of people challenging 
• Whether or not you miss loved ones when they are not around 
• Whether or not you understand body language 
• If you find yourself copying the behaviours of others to fit in, or hiding your natural behaviours 

For ‘Social Relatedness’, the threshold score is 31, and the maximum score is 117. 

Sensory–Motor

The ‘Sensory–Motor’ section consists of 20 statements that look at things like:

• How loudly or quietly you speak, and how your voice fluctuates 
• The tone of your speaking (i.e. whether you speak in a monotone voice) – autistic people may sometimes speak too loudly, too quietly, or in a monotone voice
• Whether or not you would be considered clumsy or uncoordinated 
• Whether or not you find certain sensory stimuli overwhelming – autistic people may experience sensory issues that can cause a negative reaction, such as heat intolerance

For ‘Sensory–Motor’, the threshold score is 16, and the maximum score is 60. 

Circumscribed Interests

The ‘Circumscribed Interests’ section consists of 14 statements that look at things like:

• Whether you tend to focus on small details or the overall big picture
• How you handle unexpected changes in plans, or interruptions to your routine
• The kinds of special interests you have and how you speak about them – autistic people can appear to obsess over things they enjoy and excel in certain subjects as a result 

For ‘Circumscribed Interests’, the threshold score is 15, and the maximum score is 42.

Keep in mind that no singular autism test is considered 100% accurate, so more than one test is usually recommended, as well as input from an autism specialist who has experience in diagnosing. 

Why was the RAADS-R test created?

The original RAADS test was created in 2008 by Dr. Riva Ariella Ritvo-Slifka, PhD and her colleagues. Dr. Riva Ariella Ritvo-Slifka has worked as a child therapist and researcher, and is currently Assistant Clinical Professor at the Child Study Center at Yale School of Medicine. Ritvo-Slifka has published multiple papers on autism, as well as creating the Ritvo Autism Asperger Diagnostic Scale (Revised), which is known in short as RAADS-R. The test has been cited in medical literature many times, and continues to be adapted and translated into other languages in order to be used around the world. 

The reasoning for the development of the RAADS-R test was a perceived lack of accuracy in other diagnostic tests for adult autism. There are multiple autism tests available for both children and adults, however only one scale – The Autism-Spectrum Quotient (AQ) – has been developed for the sole purpose of diagnosing adults, and this was created with the intention of being a screening tool rather than a diagnostic tool. 

The original RAADS test contained 78 questions to assess certain elements of a person’s potential autism based on criteria from the American Psychiatric Association and the World Health Organization (WHO). It was widely understood that more accuracy was needed, so the RAADS–R test came into existence as an alternative way of assisting the diagnostic process for adults with autism. 

The success of the test is evident from the result that no neurotypical person who has undergone the RAADS-R test has scored above the autism threshold, and only 3% of autistic people taking the test scored lower than the autism threshold.

What are the challenges associated with an adult autism diagnosis?

An adult autism diagnosis can be difficult at multiple stages. Some of the challenges faced include things like:

• Late recognition of (or difficulty identifying) symptoms and traits of potential autism 
• Navigating the healthcare system to seek a diagnosis
• Lack of tests designed for adults – even with the RAADS-R test, despite being overseen by a specialist, the self-report nature of the test may mean those lacking capacity to reflect on themselves may score low despite having diagnosable autism

• Long wait times for autism testing
• Heavily ingrained coping mechanisms after many years of masking symptoms
• Lack of support structures for adults (most cater to children) in navigating the diagnostic process and the results 
• Difficulty gaining access to the resources required to obtain an official diagnosis
• Lack of subsequent support from clinicians after a diagnosis is made
• Social stigma attached to an adult autism diagnosis, which can cause issues in employment, relationships, daily interactions and more

How do I obtain an autism diagnosis as an adult?

If you are interested in taking a version of the RAADS–R test, you can find it online at Aspietests.org, where you can answer all of the questions and gain information about what this may mean for you. However, if you are looking to gain an official diagnosis for potential autism, you will need to reach out to a specialist with appropriate credentials and experience in diagnosing autism in adults. 

You may wish to start by reaching out to your GP for advice and an initial conversation about the process. While you can go down this route, many people in the UK find the wait times for autism assessments are very long, and may choose to seek a private assessment instead. 

You can learn more about what to expect from an adult autism assessment here, but essentially this means meeting with a multidisciplinary team of psychologists, mental health nurses, and/or psychiatrists who specialise in autism, and undergoing an assessment that lasts anywhere from 90 minutes to 3 hours. This will involve you being observed to assess your behaviour, interactions and responses to various tasks and activities. 

If you are diagnosed with autism, the leading psychiatrist looking after you will create a plan to help support you with any areas of life that you find particularly difficult, and may recommend psychoeducation, different types of therapy, coaching, support groups, or medication to help manage certain symptoms related to your diagnosis.

At Augmentive, we believe advice and support for autistic people should always be bespoke and tailored to the individual to help with their specific symptoms and traits. So whether you’re feeling off-kilter or want to shake up your routine, our state-of-the-art mental wellbeing platform gives you quick and seamless access to world-class support on your terms, from a private adult autism assessment to help finding an autism specialist near you to support you on your journey.

If you have a question about mental health, like what the relationship is between ARFID and autism, we’re here to assist on your journey. Our free 15 minute consultation can guide you to the most relevant specialists to answer your questions and discuss next steps.