I Scored High on the RAADS-R: What Happens Next: A Client-Facing Guide to Understanding Your Assessment Results
© 2024–2026 Raven LeFebvre. All rights reserved.
Written by: Raven LeFebvre, LCSW, LCSW-C, LICSW, MAC, CCTP-II
Owner and Founder, Silhouette Psychotherapy PLLC
Certified Clinical Trauma Professional Level 2 (CCTP-II)
PDA North America Level 1 Certified Clinician
Original Publication Date 10/23/2026
Copyright & Attribution Notice: © 2024–2026 Raven LeFebvre. All rights reserved. This publication, including its original text, selection, arrangement, and other original expressive content, is protected by applicable copyright law. You may cite or reference this publication with appropriate attribution where permitted by applicable law. Attribution alone, however, does not grant permission to copy, reproduce, distribute, display, publish, adapt, create derivative works from, or otherwise use copyrighted material beyond what is permitted by law. Except as permitted by applicable law, including fair use, please obtain prior written permission before reproducing, adapting, publishing, distributing, or otherwise using material from this publication. For permissions, licensing inquiries, or questions concerning use of this publication, please contact Silhouette Psychotherapy PLLC.
Raven's clinical practice is grounded in an anti-oppression and liberation-oriented therapeutic frame, recognizing that emotional, cognitive, and nervous system wellbeing cannot be understood apart from the social, relational, cultural, and systemic environments in which people live. This orientation emphasizes autonomy, self-determination, critical consciousness, and the right of clients to understand their experiences within the broader contexts of power, marginalization, identity, and relational conditioning. Her work considers how oppressive systems, interpersonal dynamics, internalized beliefs, and histories of adaptation can shape the ways people understand themselves and navigate relationships. She is collaborative, with intent to support greater agency, self-trust, authenticity, and freedom from patterns that require self-erasure in order to belong.
I Scored High on the RAADS-R: What Does It Mean, and What Happens Next?
As a clinician who conducts multiple comprehensive autism, ADHD, and AuDHD assessments each month for adults ages 18 to 79, I regularly work with individuals who are high-masking, high-achieving, twice-exceptional (2e), and experiencing burnout. Lately, I’ve received many questions about the RAADS-R. This article addresses those questions, explores what the assessment can and cannot tell us, and examines its role in understanding autism in adults.
The short answer: A high RAADS-R score means many of your answers resembled patterns seen in autistic adults. It does not mean you are autistic. The RAADS-R is a screening tool, and anxiety, OCD, depression, trauma, ADHD, and hormonal changes can all push scores up. The most reliable next step is a thorough assessment that checks what else could explain your answers. Learn more about our Autism, ADHD and AuDHD Assessments Here
What the RAADS-R Is
The Ritvo Autism Asperger Diagnostic Scale–Revised, usually called the RAADS-R, is an 80-item self-report questionnaire for adults 18 and older. It was developed in 2011 and covers four areas: language, social relatedness, sensory and motor experience, and circumscribed interests. It was designed to help clinicians in the diagnostic process. It was not designed to make a diagnosis on its own, and that distinction is the most important thing to hold onto if your score came back high.
What a High Score Does and Doesn't Mean
The score people usually hear about is 65. In the original 2011 validation study, that cutoff correctly flagged 97% of 201 autistic adults and none of 578 non-autistic adults. Those numbers look decisive, but they came from comparing people with a clear autism diagnosis to people with no concerns. Real life is messier. In studies of people in mental health services, a large share score above 65. One study reported specificity as low as 3%, and a 2020 evaluation in adult mental health services found that a much higher cutoff of 120 did a better job separating autism from other conditions. The French and Danish validation work also noted high false-positive rates in psychiatric populations. The lesson is not that the RAADS-R is useless. It is that what a score means depends on who is taking it, and a number alone cannot settle the question.
Why Scores Run High Without Autism
Many of the statements ask about social difficulty, sensory sensitivity, routines, and emotional experience. Those experiences are not unique to autism:
Anxiety can create avoidance, social exhaustion, and sensory overload.
OCD can look like a strong need for routine and sameness.
Depression can bring withdrawal, flat emotion, and difficulty connecting.
Complex trauma can bring hypervigilance, shutdown, and discomfort with closeness.
ADHD can bring social missteps, sensory sensitivity, and emotional intensity.
PMDD and perimenopause can cause sudden shifts in sensory tolerance, mood, and social energy.
The effect can also run the other way. Adults who have masked for years may score lower than their inner experience would suggest, because they answer for the version of themselves they present. A screener captures what you report, not what it costs you to appear that way.
What to Do Next
Treat the number as a question, not an answer. It tells you the topic is worth exploring.
Note which statements stood out. Patterns across sensory, social, and interest items tell a clinician more than the total.
Collect your history. School reports, old teacher comments, family memories, and photos or videos from childhood can help.
Think about what else could be going on. Consider anxiety, OCD, mood, past trauma, your cycle, perimenopause, and physical health, including conditions such as EDS, POTS, and MCAS.
Decide what you need. A screening report, a full diagnostic assessment, or simply the clarity of understanding your own patterns are different goals.
Choose an assessor carefully. The questions below will help.
Ready to talk it through? Request an evaluation with Silhouette Psychotherapy PLLC
Screener vs. Thorough Assessment
A screener like the RAADS-R | A thorough assessment | |
What it tells you | Whether your answers resemble autistic patterns | Whether autism, ADHD, both, or something else best explains your history |
How it works | Self-report, usually under half an hour | Detailed history, structured interview, standardized measures, and clinical judgment |
Looks at other conditions | No | Yes: anxiety, OCD, depression, trauma, hormonal and physical factors |
Accounts for masking | Not well | Yes, through history and interview |
What you receive | A score | An explanation of the findings and the reasoning behind them |
If You're High-Masking, High-Achieving, or Twice-Exceptional
A strong career, good grades, and a polished social presence do not rule out autism. For many adults, they are the reason it went unseen. If you are twice-exceptional, strengths and difficulties can disguise each other, and a short screener flattens that complexity. A thorough assessment asks about the effort behind the performance, not just the performance.
Questions to Ask Any Assessor
What is your license, and what diagnoses are you qualified to give?
What does your assessment include, and how long does it take?
How do you separate autism and ADHD from anxiety, OCD, trauma, and hormonal changes?
Do you ask about cycles, perimenopause, and physical health conditions?
How do you account for masking?
What will I receive at the end, and what can the diagnosis be used for?
Have you worked with late-identified adults?
Frequently Asked Questions
Does a high RAADS-R score mean I'm autistic?
No. It means your answers resembled patterns seen in autistic adults. A score is a reason to look closer, not a diagnosis.
What is a good score on the RAADS-R?
There is no "good" or "bad" score. The original cutoff is 65, but research in clinical settings suggests that cutoff produces many false positives, and some studies favor higher thresholds.
Can anxiety cause a high RAADS-R score?
Yes. Anxiety, OCD, depression, trauma, and ADHD can all lead to answers that look like autism on a screener.
Can ADHD cause a high RAADS-R score?
It can raise it, and ADHD and autism also frequently occur together. A thorough assessment can tell whether one, the other, or both fit.
Can perimenopause or PMDD affect my score?
Hormonal changes can affect sensory tolerance, emotional regulation, and social energy, which can influence how you answer.
Is the RAADS-R accurate?
It performs well in the group it was validated on, but less well in people attending mental health services. It is best used as one input, alongside a full assessment.
How do I get diagnosed after taking the RAADS-R?
Seek a clinician who assesses adults for autism and can explain their process. The questions in this article will help you compare options.
Do I need a diagnosis to understand myself as autistic?
No. Self-identification is valid. An assessment is a tool for people who want a detailed, professional answer.
The Bottom Line
A high RAADS-R score is a prompt, not a conclusion. It tells you that autism may be worth exploring, and it leaves open everything a thorough assessment is built to sort out. If you want a precise answer, especially if you have masked for years or live with anxiety, trauma, hormonal changes, or physical conditions like EDS, POTS, or MCAS, a differential assessment can untangle the pieces.
Request an evaluation with Silhouette Psychotherapy PLLC
What the RAADS-R Measures
The RAADS-R (Ritvo Autism Asperger Diagnostic Scale – Revised) is a self-report questionnaire designed to help identify autism in adults. It's an 80-item assessment that explores how you experience the world across four key areas: Social Relatedness, which examines how you navigate relationships, read social cues, and understand unwritten social rules; Circumscribed Interests, which looks at whether you have intense, focused interests and how you respond to changes in routine; Language, which explores how you process and use language, including understanding figurative speech and managing conversations; and Sensory-Motor experiences, which addresses your sensory sensitivities to sounds, textures, lights, and other stimuli, as well as your physical experiences and coordination. What makes the RAADS-R particularly valuable is that it asks about both your current experiences and your experiences before age 16. This dual timeframe helps identify patterns that may have been present throughout your life, which is important because autism is a lifelong neurodevelopmental difference—not something that develops in adulthood, but something that has always been part of how your brain is wired and how you experience the world.
The assessment was developed specifically for adults because autism often looks different in adults than it does in children, and because many autistic adults—particularly women and gender-diverse people—were not identified in childhood. You may have developed sophisticated coping strategies over the years, or your autism may have been masked or overlooked. The RAADS-R helps capture these adult presentations by asking about real-world experiences and long-standing patterns rather than relying solely on childhood diagnostic criteria that may not have applied to you.
Understanding Your Score
Your RAADS-R score falls into one of four categories that help your clinician understand what your responses suggest about your likelihood of autism. A score below 65 suggests a lower likelihood of autism based on this assessment alone. A score between 65 and 105 indicates that some autistic traits are present, but the pattern isn't clearly consistent with autism—this might suggest that further exploration is needed, or that your autistic traits are present alongside other factors. A score between 106 and 139 is considered consistent with autism and warrants a comprehensive assessment to explore whether an autism diagnosis is appropriate for you. Finally, a score of 140 or higher indicates pronounced autism traits and suggests a strong indication for autism that should definitely be explored through comprehensive diagnostic evaluation.
If your score is 106 or higher, your responses suggest traits and patterns that align with how autistic adults typically present on this measure. This is important information, but it's crucial to understand that this score doesn't constitute a diagnosis on its own. A diagnosis of autism requires a comprehensive assessment conducted by a qualified clinician who considers your developmental history, current functioning, family history, and clinical presentation across multiple domains. What your high score does mean is that your clinician should recommend moving forward with a more thorough diagnostic evaluation to determine whether autism is an accurate and helpful framework for understanding your neurology and your life experiences.
What a High Score Does and Doesn't Mean
A high RAADS-R score carries important meaning, but it's equally important to understand what it doesn't mean. What it does mean is that your experiences align with common autism presentations—the way you've described your social experiences, your sensory world, your interests, and your language processing matches patterns that are frequently seen in autistic adults. It means that a more thorough diagnostic evaluation is warranted and would be a reasonable next step in your care. It also means that you may benefit from understanding yourself through an autism lens, which can be profoundly validating and clarifying for many people. There are likely explanations for experiences you've had throughout your life that previously felt confusing, isolating, or like personal failures—experiences that might make much more sense when understood as part of how your autistic brain works.
However, what a high score doesn't mean is equally important to hold onto. It does not mean you have a diagnosis—only a comprehensive assessment conducted by a qualified clinician can establish an autism diagnosis. It does not mean something is wrong with you or that you need to be fixed. Autism is a neurodevelopmental difference, not a disorder or a deficiency. It does not mean your score determines your worth, your capabilities, or your potential. Autistic people are successful, creative, intelligent, and valuable members of society, and autism exists across all intelligence levels, all socioeconomic backgrounds, and all walks of life. Additionally, a high RAADS-R score does not mean you must pursue a formal diagnosis if you don't want to. Some people find that understanding themselves as autistic is helpful even without an official diagnosis. Others pursue formal diagnosis for practical reasons like accessing accommodations or services. The choice about what to do with this information is ultimately yours, and your clinician is here to support whatever path feels right for you.
Your Subscale Breakdown
Your clinician will review your scores across the four domains—Social Relatedness, Circumscribed Interests, Language, and Sensory-Motor—to understand your unique autistic profile. This is important because people don't experience autism the same way. Autism is not a one-size-fits-all presentation. Your particular pattern of strengths and challenges is individual to you, and understanding where your scores fall across these domains helps paint a more complete picture of how autism shows up in your specific life.
For example, you might have significant sensory sensitivities—perhaps certain sounds are overwhelming, or certain textures feel intolerable—but fewer social difficulties than the average person on this measure. Conversely, you might struggle considerably with social reciprocity and reading unwritten social rules, but have relatively flexible interests and don't experience the intense, focused interests that characterize circumscribed interests for some autistic people. Your language processing might be very literal, and you might find figurative speech confusing or exhausting, or you might navigate that area more easily while struggling more in other domains. You might have motor coordination differences or significant sensory sensitivities, or these areas might not be as prominent for you. These patterns matter tremendously for understanding how autism shows up in your life, what your genuine needs and challenges are, and what kinds of accommodations or strategies might be most helpful for you. Your clinician will help you explore what your specific profile means for your daily functioning, your relationships, your work, and your overall wellbeing.
What Happens Next: The Diagnostic Assessment
A high RAADS-R score typically leads to a comprehensive autism diagnostic assessment, which is a more thorough process than a single screening measure. This comprehensive assessment generally includes several components working together to create a complete clinical picture.
The first component is usually a detailed developmental history interview. Your clinician will ask comprehensive questions about your childhood, adolescence, and adulthood—not just surface-level questions, but detailed exploration of how you experienced social situations, how you communicated with peers, what your interests were and how intense they were, whether you had sensory sensitivities as a child, how you responded to changes in routine, and how these patterns have evolved over time. They'll explore your early social development and whether you sought out peer relationships or preferred solitude. They'll ask about your communication style—whether you talked early or late, whether you had particular speech patterns, whether you understood jokes and sarcasm, whether you had difficulty with back-and-forth conversation. They may ask about family history, as autism often runs in families, and understanding whether other family members have autistic traits can be informative. They'll want to understand your educational history, your work history, your relationships, and how you've navigated major life transitions. This isn't just gathering facts; it's understanding the trajectory of your life through an autism-informed lens.
The second component is clinical observation. How you communicate, interact, and present during sessions provides valuable clinical information. Your clinician notices things like your speech patterns, your eye contact preferences (or lack thereof), how you process information and respond to questions, whether you seem to pick up on social cues in the room, how you transition between topics, and how you manage the social demands of the clinical interaction itself. They observe whether you seem comfortable with silence or whether you feel pressure to fill it. They notice whether you seem to understand their implicit meanings or whether you prefer explicit, direct communication. They observe your body language, your facial expressions, and your overall presentation. This observational data, combined with what you report about yourself, helps create a more complete picture.
The third component often involves collateral information. Sometimes clinicians request information from family members—parents, siblings, or long-term partners who have known you across different life stages and settings. They might ask these people about your childhood, your social development, your interests, and how you've always been. Your clinician might also review school records if available, as these can provide objective information about your early development and how teachers and peers perceived you. This collateral information helps confirm patterns across different settings and time periods, which is important because autism is pervasive—it shows up across contexts, not just in one particular situation.
The fourth component may include additional assessments. Your clinician might recommend other standardized measures to explore co-occurring experiences like anxiety, depression, ADHD, or trauma, as these conditions frequently co-occur with autism and can affect how autism presents. They might use other autism-specific measures to triangulate findings. They might assess your cognitive functioning or adaptive functioning depending on what seems clinically relevant. These additional assessments help rule out other conditions that might produce similar presentations and help create a comprehensive understanding of your overall mental health and neurodevelopmental profile.
Important Context: Why the RAADS-R Alone Isn't Enough
The RAADS-R is a screening tool—a helpful starting point and an important piece of information, but not a diagnostic instrument on its own. Understanding why this distinction matters can help you appreciate the comprehensive assessment process and why your clinician won't make a diagnosis based solely on this one measure.
Self-awareness varies considerably among individuals, and this affects how people respond to self-report measures. Some autistic people have developed coping strategies so effective and so automatic that they've internalized them as "normal" and may actually underestimate their autistic traits when reflecting on their experiences. They might not realize that their way of managing social situations is a strategy rather than natural ease. Others may overendorse items on the RAADS-R due to general distress, anxiety, depression, or trauma—these conditions can produce responses that look similar to autism on a screening measure but may not reflect an autistic neurology. Still others may have significant insight into their differences and respond very accurately. The point is that self-report measures capture how people perceive and report their experiences, which is valuable but not the complete picture.
Autism also presents differently across individuals, across genders, and across cultures in ways that screening measures can't fully capture. Women and gender-diverse people often present differently than men, sometimes with more subtle social difficulties or better-camouflaged social strategies. Autism in people of color may be expressed differently and may be understood differently within their cultural context. Autism in people with high intelligence may look different than autism in people with intellectual disability. A high score on the RAADS-R suggests autism is worth exploring, but clinical judgment—the experienced, nuanced understanding of a qualified clinician who knows you and understands autism—matters tremendously.
Additionally, other conditions can produce similar responses on screening measures. Anxiety can create social avoidance that looks like social difficulty. Trauma can create sensory sensitivities and difficulty with social trust. ADHD can create difficulty with social reciprocity and intense interests. Depression can create social withdrawal. These conditions can co-occur with autism, or they can exist independently. A comprehensive assessment helps distinguish between these possibilities and understand what's actually going on for you.
Your clinician uses the RAADS-R as one piece of a larger clinical puzzle. The screening measure opens the door to deeper exploration, but the comprehensive assessment is what allows your clinician to understand your full picture and make an informed determination about whether autism is an accurate diagnosis for you.
Questions to Ask Your Clinician
As you move forward with this process, there are several important questions worth discussing with your clinician. You might ask, "What does my subscale breakdown tell us about how autism might show up in my life?" This helps you understand your specific profile rather than thinking about autism in general terms. You could ask, "What's the next step in getting a comprehensive assessment, and what does that process look like?" Understanding the timeline and process can help you feel more prepared and less uncertain. You might ask, "Are there other assessments or information that would be helpful to gather?" This invites your clinician to explain their thinking about what additional information might be relevant. You could ask, "How does this fit with other things we've discussed in therapy?" This helps integrate this new information with what you already understand about yourself. You might ask, "What would a diagnosis mean for me, practically speaking?" Understanding the concrete implications—access to accommodations, validation, community, or simply a framework for self-understanding—can help you think about whether pursuing diagnosis feels important. Finally, you could ask, "Do I need to pursue a formal diagnosis, or can we work with this information as is?" This acknowledges that diagnosis is not always necessary for benefit and that you have agency in this process.
A Note on Autism and Identity
A high RAADS-R score can feel significant in multiple ways simultaneously. For some people, it feels validating—finally, an explanation for experiences that have felt confusing or isolating for years. For others, it feels overwhelming—the realization that something fundamental about how they experience the world is different from how many other people experience it. For many people, it feels like both at once, and the feelings may shift over time. You may recognize yourself in descriptions of autism for the first time, and that recognition can be powerful. You may feel grief about years of not understanding yourself, about times you blamed yourself for social difficulties that were actually about neurodevelopmental differences, about masking or camouflaging that cost you energy and authenticity. You may feel relief that there's an explanation and that you're not simply broken or deficient. You may feel fear about what this means for your future, your relationships, or your identity. You may feel excitement about connecting with autistic community and learning from others who share your neurology. All of these responses are normal and valid.
Whether or not you pursue a formal diagnosis, understanding yourself as potentially autistic can be profoundly powerful and transformative. Many autistic adults find that this framework helps them make sense of lifelong experiences in ways that feel deeply true. It can help reduce shame and self-blame—realizing that social difficulties weren't personal failures but rather mismatches between your neurology and neurotypical social expectations. It can help you identify genuine needs and accommodations that actually work for you rather than trying to force yourself into approaches designed for non-autistic people. It can help you connect with community—with other autistic people who understand what your experience is like in ways that non-autistic people often cannot. It can transform your approach to self-compassion, helping you accept yourself as you are rather than constantly trying to be different. It can help you make decisions about work, relationships, and life that honor your actual needs and strengths rather than trying to fit into a mold that doesn't fit.
Your clinician is here to support you through this exploration, whatever direction feels right for you. There's no rush, no pressure, and no single "right" way to move forward. This is your journey, and you get to decide what role autism understanding plays in your life.
Resources
As you learn more about autism and explore what a high RAADS-R score might mean for you, there are several types of resources that can be valuable. Autistic self-advocacy organizations and communities—groups run by and for autistic people—offer perspectives grounded in lived experience rather than clinical or pathologizing frameworks. Books and articles written by autistic adults about their experiences can help you see yourself reflected in others' stories and understand autism from the inside out. Information about autism in adults, particularly in women and gender-diverse people, can be especially valuable because autism presentations vary significantly across gender, and much of the early diagnostic criteria were based on how autism presents in boys and men. Your clinician can recommend reputable resources and help you navigate the vast amount of information available, some of which is more helpful and accurate than other sources.
Remember: A high RAADS-R score is information, not a verdict. It's an invitation to understand yourself more deeply, with professional support, in whatever way feels meaningful and helpful to you.
Sources
Ritvo RA, et al. "The Ritvo Autism Asperger Diagnostic Scale-Revised (RAADS-R): A Scale to Assist the Diagnosis of Autism Spectrum Disorder in Adults: An International Validation Study." Journal of Autism and Developmental Disorders, 2011.
Brugha T, et al. 2020 evaluation of the RAADS-R in adult mental health services, and Jones et al. 2021, as summarized on NovoPsych's RAADS-R page (novopsych.com).
Danish and French RAADS-R validation studies, as summarized in Ugeskrift for Laeger (ugeskriftet.dk).
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