Ritvo Autism Asperger Diagnostic Scale – Revised (RAADS-R)

Foundational Context

Adults seeking autism assessment often present with complex developmental histories or co-occurring conditions that obscure autistic traits. The RAADS-R was developed to address this gap by mapping self-reported behavior across domains aligned with DSM-IV and DSM-5 conceptualizations of autism. Its focus on both childhood and adult functioning helps clinicians detect long-standing patterns.

The measure was validated across multiple clinical sites and demonstrated strong sensitivity and specificity for distinguishing autistic adults from clinical comparison groups. It is widely used in diagnostic pathways, particularly for late-diagnosed adults and those whose traits were previously overlooked due to masking or compensatory strategies.

What the Assessment Measures

The RAADS-R evaluates autistic traits across four domains:

• Social Relatedness: Challenges with reciprocity, emotional understanding, social intuition, and forming/maintaining relationships.
• Circumscribed Interests: Intense, focused interests, routine preference, and difficulty shifting focus.
• Language: Pragmatic language differences, literal interpretation, and communication patterns.
• Sensory–Motor: Sensory sensitivities, hypo/hyper-reactivity, motor stereotypies, and coordination differences.

Items are scored from 0–3 based on whether the trait is present now, was present only in childhood, or was never present.

Interpretation Guidelines

The RAADS-R yields:

• Total score: 0–240
• Four subscale scores (summed separately and combined in the total)

Common interpretation (research-based):

• ≥65: Elevated autistic traits warranting comprehensive ASD assessment
• <65: Below the traditional threshold, though autism cannot be ruled out

Interpretation Notes:

• RAADS-R should never be used alone for diagnosis
• High scores are associated with autistic traits but may also overlap with ADHD, social anxiety, trauma histories, or masking fatigue
• Insight, masking, and self-awareness significantly influence self-report accuracy
• Clinicians should integrate RAADS-R findings with developmental history, clinical interview, collateral information, and functional assessment

Psychometric Properties

Reliability

• High internal consistency across all subscales
• Strong test–retest reliability
• Consistent measurement across clinical sites

Validity

• Good discriminant validity distinguishing autistic from non-autistic clinical groups
• Strong convergent validity with other autism measures (e.g., AQ, SRS-2)
• Validity strongest in adults with typical or high verbal ability

Administration Considerations

• Well-suited for adult diagnostic evaluations, especially late-identified or high-masking individuals
• May be challenging for individuals with limited insight or alexithymia
• Works best when paired with structured interviews (e.g., ADOS-2, ADI-R) or developmental questionnaires
• Should be administered with clarity about its purpose to avoid misinterpretation as definitive

Limitations

• Self-report format may underrepresent traits in individuals who mask heavily
• May overidentify traits in those with complex trauma, social anxiety, or OCD
• Less validated in culturally diverse samples
• Not intended for treatment planning or outcome monitoring