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    Autism · 14 items · 0–42 · Eriksson, Andersen & Bejerot (2013), abridged from the Ritvo Autism Asperger Diagnostic Scale-Revised.

    RAADS-14 Screen: Scoring, Cutoffs & Interpretation

    A 14-item self-report screen for autism spectrum disorder in adults already in contact with psychiatric services.

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    Attribution required. The RAADS-14 Screen is published as an additional file to an open-access article distributed under the Creative Commons Attribution License 2.0, which permits unrestricted use, distribution and reproduction in any medium provided the original work is properly cited. The items and response options below are reproduced verbatim from that file. RAADS-14-Screen is an abridged version of Ritvo Autism and Asperger Diagnostic Scale-Revised (RAADS-R). Cite: Eriksson JM, Andersen MJ, Bejerot S. RAADS-14 Screen: validity of a screening tool for Autism Spectrum Disorder in an adult psychiatric population. Molecular Autism 2013; 4:49. https://doi.org/10.1186/2040-2392-4-49 - Reproduced under CC BY 2.0: https://creativecommons.org/licenses/by/2.0/

    RAADS-140 / 14

    Please answer the questions according to what is true for you. Choose one option per statement.

    01

    It is difficult for me to understand how other people are feeling when we are talking.

    Item score-
    02

    Some ordinary textures that do not bother others feel very offensive when they touch my skin.

    Item score-
    03

    It is very difficult for me to work and function in groups.

    Item score-
    04

    It is difficult to figure out what other people expect of me.

    Item score-
    05

    I often don’t know how to act in social situations.

    Item score-
    06

    I can chat and make small talk with people.

    Item score-
    07

    When I feel overwhelmed by my senses, I have to isolate myself to shut them down.

    Item score-
    08

    How to make friends and socialize is a mystery to me.

    Item score-
    09

    When talking to someone, I have a hard time telling when it is my turn to talk or to listen.

    Item score-
    10

    Sometimes I have to cover my ears to block out painful noises (like vacuum cleaners or people talking too much or too loudly).

    Item score-
    11

    It can be very hard to read someone’s face, hand, and body movements when we are talking.

    Item score-
    12

    I focus on details rather than the overall idea.

    Item score-
    13

    I take things too literally, so I often miss what people are trying to say.

    Item score-
    14

    I get extremely upset when the way I like to do things is suddenly changed

    Item score-
    0 of 14 answered0 / 42

    02 - The clinician's brief

    Last reviewed: · Reviewed by Lotte Kjær Svalberg

    01 - Scoring & cutoffs

    How scoring works.

    Add the fourteen item scores for a total between 0 and 42. Item 6 is worded in the opposite direction to the rest and is reverse-scored. A total of 14 or above is the published threshold for a positive screen. The measure also has three subdomains - mentalizing deficits (items 1, 4, 9, 11, 12, 13 and 14), social anxiety (items 3, 5, 6 and 8) and sensory reactivity (items 2, 7 and 10) - but a later independent study could not reproduce this three-factor structure, so the subdomain scores should be read as descriptive rather than as separate measurements.

    Score
    Severity
    Interpretation
    0–13
    Below the screening threshold
    Below the published cut-off of 14. In the validation study the median score was 3 among non-psychiatric controls. A negative screen does not rule out autism, particularly in people who have learned to mask, and clinical judgement takes precedence over the score.
    14–42
    At or above the screening threshold
    At or above the published cut-off of 14, which is the point at which further assessment was recommended. This is not a diagnosis, and the false-positive rate is high in people who already have a psychiatric diagnosis - see the accuracy note below. In the validation study the median was 32 in adults with autism, 15 in adults with ADHD and 11 in adults with other psychiatric disorders.

    This is a screening questionnaire, not a diagnostic test, and a result here is not a diagnosis of autism. An autism assessment in adults involves a developmental history and clinical interview that no questionnaire can replace. The developers recommend that a clinician review the answers with the person completing it.

    02 - Confidence & precision

    Reading the score with care.

    At the cut-off of 14, the RAADS-14 Screen detected 97% of adults with autism, but its specificity varied sharply by group: 46% among adults with ADHD, 64% among adults with other psychiatric disorders, and 95% among people with no psychiatric diagnosis. In practice this means a positive result is close to uninformative in someone who already has a mental health diagnosis, and it is precisely that group most likely to be completing this questionnaire. A score at or above the threshold is a reason to seek assessment, not evidence of autism.

    03 - Limitations

    What it cannot tell you.

    The screen was developed and validated in a Swedish adult psychiatric sample of 1,233 people under DSM-IV-TR, before the DSM-5 criteria for autism were introduced, and no formal translation and back-translation procedure is described for the English version. Specificity is poor in adults with ADHD and modest in adults with other psychiatric diagnoses. An independent New Zealand validation in 387 adults could not reproduce the three-factor structure and found specificity of 70%. Two items did not distinguish autistic adults from adults with social anxiety disorder. Test-retest reliability has not been reported, and the original study reports no correlation with the RAADS-R, the AQ or the ADOS - its validity rests on differences between diagnostic groups. It is a screening instrument and cannot establish a diagnosis.

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