Screening
Two free questionnaires are used by most adults before they seek an assessment. Here is what each one measures, what the scores mean, and where they are unreliable.
Adult Autism Assessment Perth arranges autism and ADHD assessments for adults and adolescents across Perth and WA. Screeners are where most people start, so they are worth understanding properly.
A screener is a triage instrument. It asks whether the question is worth taking further. It cannot diagnose anybody, and no reputable clinician treats a score as a diagnosis.
That is not a disclaimer to skim past. Screeners were designed to sort large groups efficiently, which means they accept a rate of error that would be unacceptable in an individual diagnosis.
The Ritvo Autism Asperger Diagnostic Scale – Revised. Eighty statements, each rated for whether it is true now, was true only when you were younger, or was never true. That "only when I was younger" option is the useful part: autism is developmental, so when a trait first appeared matters as much as whether it is present today.
It covers four areas: language, social relatedness, sensory-motor experience, and circumscribed interests.
The RAADS-R was validated on people already attending a clinic, not on the general population, so its accuracy in a self-selected online sample is lower than the headline figures suggest. It also over-identifies in people with anxiety, social anxiety and some personality disorders, whose answers legitimately resemble autistic ones for different reasons.
The Autism Spectrum Quotient. Fifty statements, agree or disagree, developed at the Autism Research Centre in Cambridge. Faster than the RAADS-R and far more widely circulated.
The AQ asks about the present tense only. An adult who has spent thirty years learning to manage social situations answers about the person they have become, not the child they were — so a long-masking adult can score lower than their history warrants. It is also transparent: it is obvious what each question is driving at, which makes it easy to answer as you wish to be seen, in either direction.
This is the part that matters most, and it is the reason we do not publish a scored quiz on this site.
Masking is a learned skill. Adults who were told early that copying other people keeps them safe become good at it, and both instruments ask you to report on behaviour you have spent decades adjusting. A person who scores 28 on the AQ and has a file full of burnout, failed social situations and sensory shutdowns is not ruled out by that number.
The reverse is also true. A high score on either instrument is a reason to ask the question properly, not an answer to it.
A clinical assessment does three things a questionnaire cannot. It takes a developmental history, so childhood is assessed rather than remembered. It considers the alternatives — ADHD, anxiety, trauma, giftedness — which overlap heavily and are regularly mistaken for autism. And it weighs how traits actually affect your life, which no cut-off score can measure.
See what happens in an assessment for the full process.
Both instruments are published in the peer-reviewed literature: the RAADS-R by Ritvo and colleagues (2011) and the AQ by Baron-Cohen and colleagues (2001). The National Guideline for the Assessment and Diagnosis of Autism in Australia sets out how screening instruments sit within a proper assessment.
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