The Adult ADHD Self-Report Scale (ASRS): How It’s Scored and What It Can’t Tell You

The Adult ADHD Self-Report Scale (ASRS) is the most widely used ADHD screener for adults. Its short form, the ASRS v1.1 screener (also called Part A), has six questions about how often certain attention and restlessness problems have happened over the past six months. The classic scoring rule is simple: if four or more of your six answers fall in the darkly shaded boxes, your symptoms are “highly consistent with ADHD in adults” and further evaluation is warranted. That is a screening result, not a diagnosis. This guide explains what the questions cover, both scoring methods, the DSM-5 version, and what a score can’t settle.

What the ASRS is

The ASRS was developed by a World Health Organization workgroup on adult ADHD that included psychiatrist Lenard Adler (New York University), health-policy researcher Ronald Kessler (Harvard Medical School) and psychiatrist Thomas Spencer (Harvard). It was created alongside the WHO’s large international mental health survey interview, and the key validation paper was published in Psychological Medicine in 2005.

There are three versions you may come across:

• ASRS v1.1 Symptom Checklist: 18 questions, one for each DSM-IV symptom of ADHD. It is split into Part A (the six questions found most predictive) and Part B (the other twelve).
• ASRS v1.1 Screener: Part A on its own, six questions. This is what most people mean by “the ASRS test”, and it is meant for people 18 and older.
• ASRS-5: a separate six-question screener rebuilt in 2017 for the DSM-5 definition of adult ADHD (described below).

What the six Part A questions cover

The screener is copyrighted (© New York University and Ronald C. Kessler, PhD), so we describe its questions rather than reprint them. Each one asks how often something has happened over the past six months, with five answers: never, rarely, sometimes, often, very often.

Questions 1 to 4 sit on the inattention side of ADHD, and 5 and 6 on the hyperactive-restless side. Notice the different thresholds: the first three count from “sometimes”, while the last three only count at “often” or “very often”. The authors set it up that way because some experiences, like procrastinating on a dull report or fidgeting in a long meeting, are common enough that only high frequency carries information.

To see the exact wording, use the official screener from Harvard’s National Comorbidity Survey website. Its authors ask that copies keep all response options, the scoring and both levels of shading unaltered.

How Part A is scored: the shaded-box rule

On the official form, the boxes that count are shaded darker. Scoring takes about ten seconds:

1. For each of the six questions, check whether your answer landed in a dark box (questions 1–3: sometimes, often or very often; questions 4–6: often or very often).
2. Count the dark-box answers. The result is a number from 0 to 6.
3. 4 or more: a positive screen. In the checklist’s words, symptoms are highly consistent with ADHD in adults and further investigation is warranted. 3 or fewer: a negative screen.

An illustrative example (not a real patient): answers of often, very often, sometimes, rarely, often and sometimes. Questions 1, 2 and 3 count (all at “sometimes” or above), question 4 doesn’t (“rarely”), question 5 counts (“often”) and question 6 doesn’t (“sometimes” is below that item’s threshold). That is four dark boxes, a positive screen.

If you fill out the full 18-question checklist, Part B is not totaled. The instructions say its answers are used as extra prompts for the clinician to explore, with particular attention to answers in the dark boxes.

The newer 0–24 scoring

In February 2024 the Harvard team posted a scoring update. They explained that the 0–6 rule was designed to be quick in primary care, but that it gave high and inconsistent prevalence estimates in research. The alternative, described in a 2007 study of health-plan members, gives each answer points instead of a yes/no:

Adding the six answers gives a total from 0 to 24. 14 or more is a positive screen. The update groups totals into four bands: 0–9 low negative, 10–13 high negative, 14–17 low positive and 18–24 high positive. Our example above would total 3 + 4 + 2 + 1 + 3 + 2 = 15, a low positive.

The update describes the summed method as more robust and better suited to research. You may see either method used, so if a clinic or app gives you a number, ask which scale it is on: “4” means something very different on a 0–6 count than on a 0–24 sum.

The ASRS-5 for DSM-5

The DSM-5, published in 2013, defines adult ADHD more broadly than the DSM-IV the original ASRS was built on. Under DSM-5, adults need five or more current symptoms, with several present before age 12. In 2017 a team including Kessler and Adler used a machine-learning method to build a new six-question screener against the DSM-5 definition, published in JAMA Psychiatry.

• Four of its questions map to DSM-5 symptoms: following what people say when they speak to you directly, staying seated when expected to, unwinding in free time, and finishing other people’s sentences.
• Two are not DSM symptoms but turned out to predict the diagnosis: leaving things until the last minute, and relying on other people to keep your life and details in order.
• Each answer carries a different weight depending on the question, for a total from 0 to 25, and 14 or more is the screening threshold.

In the general-population samples, a score of 14 or more caught 91.4% of people who met DSM-5 criteria on a research interview and correctly cleared 96.0% of those who did not. In a sample of adults who had come to a specialty ADHD clinic, it still caught 91.9%, but specificity fell to 74.0%, meaning about a quarter of people without ADHD in that clinic also screened positive. The ASRS-5 is not free to reprint in the same way as the v1.1 screener; its authors ask for a permission request.

How well it works, and why positive doesn’t mean ADHD

The 2005 validation study compared the six-question screener with blind clinical interviews in 154 adults from a national U.S. survey. The screener correctly cleared 99.5% of people without ADHD but picked up only 68.7% of those with it. In other words, in that community sample a positive screen was rarely wrong, but roughly three in ten adults with ADHD were missed. Results in clinics, where many people with attention trouble have something else going on, can look different, as the ASRS-5 clinic data show.

A screener has four blind spots that matter for ADHD in particular:

• Childhood. ADHD must have started in childhood, with several symptoms before age 12. The ASRS only asks about the last six months.
• More than one setting. The questions don’t ask whether problems show up at work and home alike.
• Look-alikes. Anxiety, depression, poor sleep, thyroid problems, substances and burnout can all produce the same answers. A high GAD-7 or PHQ-9 next to a positive ASRS is a reason to slow down, not a sign of three separate conditions.
• Impairment. Many people procrastinate and fidget. The diagnosis needs symptoms that genuinely interfere with life.

Our adult ADHD evaluation guide explains how a clinician works through each of these, including the role of report cards and a parent’s or partner’s view. If you see yourself in these questions as a successful adult who has coped by working twice as hard, ADHD in high-performing adults may also ring true.

Teens, Creyos, and taking the next step

The ASRS v1.1 screener is intended for adults 18 and older. For children and teens, clinicians use parent- and teacher-rated scales instead. Creyos, a platform that combines computerized cognitive tasks with standard questionnaires, offers the ASRS Part A labelled for ages 18 and up, and in its ADHD protocol it pairs ages 6–11 with the Vanderbilt parent scale and ages 12–17 with the SWAN. Our pages on the questionnaires in a Creyos assessment and Creyos in an ADHD assessment explain how a questionnaire and cognitive tasks fit together; the Creyos cognitive assessment guide covers the platform, which measures attention, memory and reasoning but does not diagnose ADHD.

If you screened positive, or you screened negative but the questions described your life, the useful next step is a full evaluation rather than another online quiz. At Willow & Stone, an adult ADHD question is assessed within a 90-minute evaluation with Dr. Stacey Forbes, DNP, APRN, PMHNP-BC, that also looks at sleep, mood, anxiety and medical history. Bring your ASRS answers and anything that shows what you were like as a child. Start with the adult ADHD evaluation page or book a consultation.

Common Questions

Sources & Further Reading

• Kessler RC et al. The World Health Organization Adult ADHD Self-Report Scale (ASRS): a short screening scale for use in the general population. Psychol Med, 2005 (PubMed)
• Ustun B et al. The WHO Adult ADHD Self-Report Screening Scale for DSM-5. JAMA Psychiatry, 2017 (PMC)
• Creyos — ADHD Report Science Guide (PDF)
• Creyos — Standardized Questionnaires list (PDF)

This article is general education, not a diagnosis or advice for your situation. Creyos results support, and never replace, a clinical evaluation; only a clinician who has evaluated you can diagnose a condition or recommend treatment. Do not start, stop, or change a medication without talking to the clinician who prescribes it.