RAADS-14 Screen
RAADS-14 Screen overview
Creator and Context
The RAADS-14 Screen is a 14 item self report screener for autism in adults, abridged from the Ritvo Autism and Asperger Diagnostic Scale Revised.
It was developed by Jonna Eriksson, Lina Andersen and Susanne Bejerot and published in Molecular Autism in 2013. It was designed and validated specifically in adult psychiatric settings, which is where adult autism most often goes unrecognised.
Presenting Conditions
The RAADS-14 produces three subscales:
Mentalising deficits
Social anxiety
Sensory reactivity
Administration
Self administered. Each item is answered on a four option scale distinguishing whether the statement is true now and when the person was young, true only now, true only when they were younger than 16, or never true. Items score 3 to 0, with one item reverse scored.
The response format spans the lifespan rather than a fixed recall window, which is what allows it to capture developmental history.
Desired Audience
Adults of normal intelligence. It was validated in an adult psychiatric population against both psychiatric and non psychiatric comparison groups.
Adults referred to mental health services with anxiety, depression or emotional instability are the group in which autism is most often missed. The RAADS-14 is short enough to run at intake in exactly that setting, and it asks about childhood as well as the present, which is what a developmental condition requires.
Considerations
Specificity collapses within psychiatric populations. It was 0.95 against non psychiatric controls but only 0.46 against people with ADHD and 0.64 against other psychiatric disorders. It separates autism from no psychiatric condition well, and autism from other psychiatric conditions poorly.
It is a screener, not a diagnostic instrument. Nine of 135 diagnosed autistic adults in the validation scored below the cut off.
Real world performance in ordinary outpatient clinics has been reported as materially worse than in validation studies.
Subscale profiles differ by sex, with autistic women scoring higher on sensory reactivity.
How to score the RAADS-14 Screen
Conducting the assessment
The person answers all 14 items using the four option lifespan format, giving a total from 0 to 42.
Interpretation
Items are summed to give a total from 0 to 42.
The cut off is 14 or above, which gave sensitivity of 0.97 in the validation study. Specificity depends heavily on the comparison group: 0.95 against non psychiatric controls, 0.64 against other psychiatric disorders and 0.46 against ADHD.
Median scores in the validation were 32 for the autistic group, 15 for ADHD, 11 for other psychiatric conditions and 3 for non psychiatric controls.
Clinical Considerations
Use it to decide who needs assessment, not to decide who is autistic.
Interpret a positive screen in a psychiatric population with care. Many people with ADHD and other conditions will screen positive.
Be alert to false negatives, particularly in women, where the presentation the instrument was normed on may not fit.
RAADS-14 Screen use cases
Screening adults for autism, particularly in psychiatric settings
Identifying who warrants a full diagnostic assessment
Research into adult autism identification
Category
Autism
Research Summary
Eriksson, J. M., Andersen, L. M. J., & Bejerot, S. (2013). RAADS-14 Screen: Validity of a screening tool for autism spectrum disorder in an adult psychiatric population. Molecular Autism, 4, 49.
Jones, S. L., et al. (2023). Validity of the RAADS-R in an outpatient clinical sample. Journal of Autism and Developmental Disorders.
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