Adult Self-Report Scale (ASRS-V1.1) for ADHD 6-Question Screener
Six-item ASRS v1.1 Part A screener for attention deficit-hyperactivity disorder (ADHD) symptoms in adults.
Creator
Dr. Lenard Adler, MDInstructions
Intended for patients ≥18 years old.
Select the response that best describes how you have felt and conducted yourself over the past 6 months.
Introduction
The Adult ADHD Self-Report Scale (ASRS-v1.1) Screener is a six-question survey that screens adults for attention-deficit/hyperactivity disorder (ADHD). It was developed in conjunction with the World Health Organization by a workgroup that included Ronald C. Kessler, PhD (Harvard Medical School), Lenard Adler, MD (NYU), and Thomas Spencer, MD (Harvard), and was published in 2005. The six questions are the ones from the full 18-question ASRS-v1.1 Symptom Checklist found to be the most predictive of symptoms consistent with ADHD. This screener is intended for people aged 18 years or older. It’s widely used in primary care, mental health services, and research. ADHD often goes unrecognized in adults, especially those never assessed as children, so a quick screen can show who needs a fuller evaluation.
What it asks
People rate how often over the past 6 months they’ve experienced six common ADHD symptoms: trouble wrapping up the final details of a project; difficulty getting things in order for tasks that require organization; problems remembering appointments or obligations; avoiding or delaying tasks that require a lot of thought; fidgeting or squirming when sitting for a long time; and feeling overly active, as if “driven by a motor.” Each question uses the same five answers: Never, Rarely, Sometimes, Often, or Very Often.
How it’s scored
Harvard notes that the original dichotomous scoring rule assigned 1 point for items scored above a certain threshold to create a 0-6 scale with a cut point of 4 or more to screen positive for ADHD. The following choices count as 1 point or as a clinically significant response: “Sometimes” or "Often" or "Very Often" for questions 1–3, and “Often” or "Very Often" for questions 4–6.
How results are interpreted
A score (sum the points) of >3 is a positive screen, meaning the person’s symptoms may be consistent with adult ADHD and a full evaluation by a qualified clinician is recommended.
Limitations
The ASRS is a screening tool, not a diagnosis. As the ASRS Screener v1.1 is only a screening scale, not a diagnostic test, diagnostic assessment by a trained clinician is needed to follow up on patients who screen positive. Many other conditions can cause similar symptoms, including anxiety, depression, sleep problems, trauma, and substance use, so these should be considered during an evaluation. An adult ADHD diagnosis also requires evidence that symptoms began in childhood.
All questions & possible results
ASRS Part A ItemsTitle not visible
Select the response that best describes how you have felt and conducted yourself over the past 6 months.
1. How often do you have trouble wrapping up the final details of a project, once the challenging parts have been done?
Select one option:
- Never
- Rarely
- Sometimes
- Often
- Very Often
2. How often do you have difficulty getting things in order when you have to do a task that requires organization?
Select one option:
- Never
- Rarely
- Sometimes
- Often
- Very Often
3. How often do you have problems remembering appointments or obligations?
Select one option:
- Never
- Rarely
- Sometimes
- Often
- Very Often
4. When you have a task that requires a lot of thought, how often do you avoid or delay getting started?
Select one option:
- Never
- Rarely
- Sometimes
- Often
- Very Often
5. How often do you fidget or squirm with your hands or feet when you have to sit down for a long time?
Select one option:
- Never
- Rarely
- Sometimes
- Often
- Very Often
6. How often do you feel overly active and compelled to do things, like you were driven by a motor?
Select one option:
- Never
- Rarely
- Sometimes
- Often
- Very Often
Possible results
ASRA V1.1 Screen: Positive - may be consistent with Adult ADHD (4-6 clinically significant responses).
Four or more responses fell in the clinically significant range.
Symptoms reported are highly consistent with ADHD in adults, and further investigation with a full clinical assessment is warranted.
This tool cannot be used alone for diagnosis.
ASRA V1.1 Screen: Negative - less likely to be consistent with Adult ADHD (<4 clinically significant responses)
Fewer than four responses fell in the clinically significant range.
Symptoms reported are not highly consistent with ADHD in adults on this screener.
Clinical judgement should guide any further assessment.
This tool cannot be used alone for diagnosis.
Citation
The 6-question Adult Self-Report Scale-Version1.1 (ASRS-V1.1) Screener is a subset of the 18-question Adult ADHD Self-Report Scale-Version1.1 (Adult ASRSV1.1) Symptom Checklist. © New York University and the President and Fellows of Harvard College.
The ASRS v1.1 Screener was created by Dr. Lenard Adler of NYU and Dr. Ronald Kessler of Harvard.
Kessler RC, Adler L, Ames M, et al. The World Health Organization Adult ADHD Self-Report Scale (ASRS): a short screening scale for use in the general population. Psychological Medicine. 2005;35(2):245-256.
Literature
Kessler RC, Adler L, Ames M, Demler O, Faraone S, Hiripi E, Howes MJ, Jin R, Secnik K, Spencer T, Ustun TB, Walters EE. The World Health Organization Adult ADHD Self-Report Scale (ASRS): a short screening scale for use in the general population. Psychol Med. 2005 Feb;35(2):245-56.
https://pubmed.ncbi.nlm.nih.gov/15841682/Adler LA, Spencer T, Faraone SV, Kessler RC, Howes MJ, Biederman J, Secnik K. Validity of pilot Adult ADHD Self- Report Scale (ASRS) to Rate Adult ADHD symptoms. Ann Clin Psychiatry. 2006 Jul-Sep;18(3):145-8.
https://pubmed.ncbi.nlm.nih.gov/16923651/Kessler RC, Adler LA, Gruber MJ, Sarawate CA, Spencer T, Van Brunt DL. Validity of the World Health Organization Adult ADHD Self-Report Scale (ASRS) Screener in a representative sample of health plan members. Int J Methods Psychiatr Res. 2007;16(2):52-65.
https://pubmed.ncbi.nlm.nih.gov/17623385/
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