The Effectiveness of RAADS-R as a Screening Tool for Adult ASD Populations.

Sarah L Jones,Maria Johnson,Marios Adamou,Bronwen Alty

doi:10.1155/2021/9974791

Abstract

Adult referrals to specialist autism spectrum disorder diagnostic services have increased in recent years, placing strain on existing services. It was proposed that the Ritvo Autism Asperger's Diagnostic Scale could be used as a screening tool, in order to identify and prioritise patients most likely to receive an ASD diagnosis. This study evaluates the validity of the RAADS-R as a screening tool for ASD in an adult population. Retrospective case note analysis was used to evaluate the efficacy of the RAADS-R as a screening tool to predict ASD diagnostic outcomes in 50 service users of a NHS specialist autism service. Results indicate no association between RAADS-R scores and clinical diagnostic outcome, suggesting the RAADS-R is not an effective screening tool for identifying service users most likely to receive an ASD diagnosis. In conclusion, used as a self-report measure pre-full diagnostic assessment, the RAADS-R lacks predictive validity and is not a suitable screening tool for adults awaiting autism assessments. Future research should aim to identify reliable screening tools for this purpose.

Highlights

Autism spectrum disorders (ASD) are lifelong neurodevelopmental conditions characterised by a clinically significant impairment in reciprocal social interaction and communication, alongside restricted interest and repetitive behaviours [1]
Considering that diagnostic services are bound by long and lengthy waiting lists, this study aims to evaluate the predictive validity of the RAADS-R as a self-report screening tool for patients referred for an ASD assessment to the Adult ADHD and Autism Service, South West Yorkshire Partnership NHS Foundation Trust. e implications of which could aid with informing the pathway to diagnosis for patients, contributing to more effective service
Receiver Operating Characteristic. e validity of the RAADS-R in predicting an ASD diagnosis in this adult sample was calculated using an receiver operating characteristic (ROC) curve (Figure 1). e area under the curve (AUC) can be interpreted as a measure of predictive validity by indicating the predictive value of a diagnostic test. e AUC was an unacceptable level of discriminaative ability (AUC 0.45; 95% CI, 0.285 to 0.612), in line with the null hypothesis

Summary

Introduction

Autism spectrum disorders (ASD) are lifelong neurodevelopmental conditions characterised by a clinically significant impairment in reciprocal social interaction and communication, alongside restricted interest and repetitive behaviours [1]. ASD is typically diagnosed in childhood, there has been a marked increase in the number of adults referred for assessment over recent years [2], which has placed greater demand on local services and resources. Because of this demand, the time for diagnosis is rather long and one report found 29% of adults with autism and 46% of those with Asperger’s disorder did not receive a diagnosis until adulthood [3]. Despite this, waiting times for diagnostic assessments of ASD in adults are still lengthy. Despite this, waiting times for diagnostic assessments of ASD in adults are still lengthy. erefore, there is a clear necessity to alleviate the pressures on diagnostic services by screening the waiting lists to identify and prioritise those at a greater probability of receiving a diagnosis using standardised methods [15]

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Conclusion