ASRS-v1.1 (Adult ADHD Self-Report Scale): Take It, Score It, Understand Your Results
The ASRS-v1.1 (Adult ADHD Self-Report Scale) is a 6-item brief screener (Part A) plus an optional 12-item Part B, developed by the World Health Organization in collaboration with researchers at Harvard Medical School and New York University. It is the most widely used self-report screening tool for adult ADHD worldwide, takes about 5 minutes to complete, and is free to use under WHO terms (Part A) with NYU licensing for the full 18-item Symptom Checklist. Part A produces a positive screen when four or more responses fall in the darkly shaded boxes — a result that warrants further evaluation by a qualified clinician. The ASRS is a screening tool, not a diagnosis.
What is the ASRS-v1.1?
The ASRS-v1.1 (Adult ADHD Self-Report Scale, version 1.1) is a brief adult ADHD screening tool developed by Dr. Ronald Kessler and colleagues at Harvard Medical School with the World Health Organization (WHO), first published in 2005. It was designed to map onto the 18 DSM-IV-TR symptoms of ADHD in adults, structured as a 6-item screener (Part A) plus an optional 12-item symptom severity scale (Part B). The Part A 6-item screener is the most cited version because it identifies the items that best discriminate ADHD from non-ADHD adults in epidemiological surveys. The ASRS is freely available for the Part A screener with citation; the full 18-item Symptom Checklist requires permission from NYU.
What the ASRS measures
The ASRS measures how often adults experience the 18 symptoms that make up the DSM-IV-TR criteria for ADHD, including inattention symptoms (such as difficulty sustaining attention, careless mistakes, losing things, distractibility, forgetfulness) and hyperactivity-impulsivity symptoms (such as fidgeting, restlessness, difficulty waiting your turn, interrupting). Each item asks how often you have experienced the symptom over the past six months, rated on a 5-point frequency scale from Never to Very Often. The 6-item Part A screener was selected because those items were the strongest predictors of ADHD in adults in the WHO World Mental Health Surveys, where ASRS performance was first validated against blinded clinician interviews.
How the ASRS is administered
The ASRS is a self-report questionnaire that takes about 5 minutes to complete (Part A alone is faster, often under 2 minutes). Each item asks how often you have experienced a symptom over the past six months, with five response options: Never, Rarely, Sometimes, Often, Very Often. Each option is mapped to a darkly shaded or unshaded box that depends on the item — for items 1-3, Sometimes/Often/Very Often are darkly shaded; for items 4-5, only Often/Very Often are shaded; for item 6, only Very Often is shaded. You can complete the ASRS on paper, on a screen, or with a clinician reading the items aloud. No special preparation is required.
Who uses the ASRS
The ASRS is used routinely in primary care, psychiatry, integrated behavioral health, college and university health services, occupational health programs, and clinical research worldwide. The 6-item Part A screener is the most commonly used adult ADHD screening tool in primary care because it is brief, free, and recommended in many clinical guidelines as an initial step before more in-depth evaluation. The U.S. Preventive Services Task Force does NOT have a current adult-ADHD screening recommendation (this distinguishes it from depression and anxiety screening, which are USPSTF Grade B). The ASRS is also used extensively in research, public health surveys, and digital mental-health platforms.
ASRS is a screening tool, not a diagnosis
The ASRS is a screening instrument — a positive Part A screen (four or more responses in darkly shaded boxes) indicates symptoms 'highly consistent with ADHD in adults' that warrant further investigation, but it does not by itself diagnose ADHD. A formal adult ADHD diagnosis requires a comprehensive evaluation by a qualified clinician that takes your full history into account, including symptom onset in childhood (typically by age 12), symptom presence across multiple settings (such as home and work), functional impairment, and ruling out other conditions that can mimic ADHD (such as anxiety, depression, sleep disorders, thyroid problems, or substance use). A negative screen does not rule out adult ADHD, especially if you have specific concerns about your attention or executive function. If you are concerned about your symptoms, talk to a clinician regardless of your screen result.
How to score and interpret your Part A results
Scoring the ASRS-v1.1 Part A is a counting exercise. You answer each of the six items on the five-point scale (Never, Rarely, Sometimes, Often, Very Often) about the past 6 months, then check whether your mark falls inside the darkly shaded box for that specific item. Each shaded mark counts as one positive response. If four or more of the six items are answered in the darkly shaded box, the screen is positive — meaning symptoms are “highly consistent with ADHD in adults and further investigation is warranted”.
The shading is not uniform. The threshold gets stricter from item 1 to item 6 — simply counting “Often” or “Very Often” answers does not reproduce the scoring rule.
Per-item shaded thresholds
| Item | Symptom area | Darkly shaded responses |
|---|---|---|
| 1. Wrapping up final details of a project | Inattention | Sometimes, Often, Very Often |
| 2. Getting things in order for an organized task | Inattention | Sometimes, Often, Very Often |
| 3. Remembering appointments or obligations | Inattention | Sometimes, Often, Very Often |
| 4. Avoiding or delaying tasks requiring a lot of thought | Inattention | Often, Very Often |
| 5. Fidgeting or squirming when seated for long periods | Hyperactivity | Often, Very Often |
| 6. Feeling overly active, “driven by a motor” | Hyperactivity | Very Often |
Source: ASRS-v1.1.
A worked example
Suppose you answered: item 1 “Often,” item 2 “Sometimes,” item 3 “Rarely,” item 4 “Often,” item 5 “Very Often,” item 6 “Often.” Items 1, 2, 4, and 5 land in their shaded zones — four positive marks, a positive Part A. Item 3 (“Rarely”) and item 6 (“Often” — only “Very Often” is shaded for item 6) do not count. A positive Part A is a screening result, not a diagnosis; the next step is a conversation with a clinician.
The 6 Part A items and 12 Part B items: the full instrument
The ASRS-v1.1 Symptom Checklist contains 18 items mapped to the DSM-IV-TR symptom criteria for ADHD. The six Part A items were selected via stepwise logistic regression as the strongest predictors of an adult ADHD diagnosis in the US National Comorbidity Survey Replication; the remaining twelve became Part B. Each item asks how often you have experienced the symptom over the past 6 months.
Part A — the 6-item screener
- How often do you have trouble wrapping up the final details of a project, once the challenging parts have been done?
- How often do you have difficulty getting things in order when you have to do a task that requires organization?
- How often do you have problems remembering appointments or obligations?
- When you have a task that requires a lot of thought, how often do you avoid or delay getting started?
- How often do you fidget or squirm with your hands or feet when you have to sit down for a long time?
- How often do you feel overly active and compelled to do things, like you were driven by a motor?
Items 1–4 probe inattention and executive function; items 5–6 probe hyperactivity and inner restlessness.
Part B — the additional 12 items
- Careless mistakes on boring or difficult projects.
- Difficulty keeping attention during boring or repetitive work.
- Difficulty concentrating on what people say to you, even when they are speaking directly to you.
- Misplacing things or having difficulty finding things at home or work.
- Being distracted by activity or noise around you.
- Leaving your seat in meetings or situations where you are expected to stay seated.
- Feeling restless or fidgety.
- Difficulty unwinding and relaxing in your downtime.
- Talking too much in social situations.
- Finishing other people’s sentences before they finish them.
- Difficulty waiting your turn when turn-taking is required.
- Interrupting others when they are busy.
Part B gives clinicians additional cues about symptom pattern and severity. However, no total score and no diagnostic likelihood is generated from Part B — it is a probe, not a screen. Kessler and colleagues found the 6-item Part A outperformed the full 18-item instrument on every concordance metric against blinded interview.
What a positive Part A means — and what it doesn’t
The official wording matters. A positive Part A screen indicates “symptoms highly consistent with ADHD in adults and further investigation is warranted”. It does not establish a diagnosis, and it does not estimate how likely you are to have ADHD as a percentage. Adult ADHD is a clinical diagnosis made by a qualified professional after a structured evaluation — the screen is the door, not the room.
A positive screen is most useful when it triggers two parallel questions: do my symptoms reflect ADHD or something that looks like ADHD, and how much are they actually affecting my daily life? The first is about rule-outs. The second is about impairment, which the ASRS deliberately separates from symptom frequency.
Conditions that can mimic or coexist with adult ADHD
Inattention, restlessness, and difficulty concentrating are not unique to ADHD. The Wikipedia entry on the ASRS notes that the scale “cannot rule out other medical conditions or mood disorders with overlapping symptoms, and does not account for comorbidities or substance use”. NIMH highlights that ADHD “frequently co-occurs with conduct problems, learning disabilities, sleep disturbances, anxiety, or depression”. Common considerations a clinician will weigh include:
- Anxiety disorders — chronic worry disrupts concentration and produces visible restlessness.
- Depressive disorders — low motivation and slowed cognition can imitate inattentive ADHD.
- Sleep disturbances — poor sleep mimics most ADHD daytime symptoms.
- Substance use — stimulants and depressants can both produce ADHD-like presentations.
- Other medical conditions and learning differences that overlap with the symptom list.
A positive Part A means it is reasonable to seek a clinical evaluation — it is a screening, not a diagnosis.
How accurate is the ASRS? Sensitivity, specificity, and what they mean for your result
The original validation study by Kessler and colleagues (2005) tested the ASRS against the Adult ADHD Clinical Diagnostic Scale — a clinician-administered gold-standard interview — in 154 respondents from the US National Comorbidity Survey Replication.
What the numbers were
| Version | Sensitivity | Specificity | Classification accuracy | Cohen’s kappa |
|---|---|---|---|---|
| 6-item Part A screener | 68.7% | 99.5% | 97.9% | 0.76 |
| Full 18-item ASRS | 56.3% | 98.3% | 96.2% | 0.58 |
Source: Kessler et al., 2005.
What those numbers actually mean
Specificity around 99% is unusually high for a self-report screener. When the Part A screen is positive in a sample with a meaningful base rate of ADHD, false positives are uncommon — most people who screen positive do, on follow-up clinical evaluation, look consistent with adult ADHD.
Sensitivity of about 69% is moderate. Roughly three in ten adults who actually meet criteria for ADHD on structured clinical interview will be missed by Part A. This is the single most important reason a negative screen does not rule out adult ADHD if symptoms or impairment are present.
A counter-intuitive Kessler finding: the 6-item Part A outperformed the full 18-item instrument on every concordance metric, which is why the authors concluded “the unweighted screener should be preferred to the full ASRS, both in community surveys and in clinical outreach and case-finding initiatives”.
Limitations of the ASRS-v1.1 and what they mean for your interpretation
No screening tool is perfect; the ASRS-v1.1 has limitations worth knowing.
Anchored to DSM-IV-TR, not DSM-5
The ASRS-v1.1 was built from the 18 DSM-IV-TR criteria for ADHD. The DSM-5, published later, updated several aspects of the adult ADHD criteria, including symptom thresholds for older adolescents and adults. A separate instrument, the ASRS-5, is a DSM-5 aligned screener with a proprietary weighted-scoring algorithm, licensed through NYU; it is not interchangeable with the ASRS-v1.1.
Self-report over a 6-month window
All ASRS items ask you to characterize behavior over the past six months. Memory and self-perception introduce noise, and the instrument does not include collateral input from a partner, family member, or employer.
Validated in a US sample
The original Kessler validation drew on 154 NCS-R respondents in the United States. The ASRS has since been translated into roughly twenty languages, including Arabic, Mandarin, French, German, Japanese, Russian, and Spanish, but performance varies by version and cultural context.
Symptom frequency is not impairment
The instrument’s own guidance is explicit: scoring tells you symptom frequency, but evaluating impairment — at work or school, in social settings, and in family relationships — is a separate step.
What to do with your results: the adult ADHD diagnostic process
A clinician’s evaluation brings history, context, and rule-outs to the picture.
What a clinical evaluation typically includes
- A structured clinical interview covering current symptoms, daily functioning, and developmental history.
- Childhood-onset history — the instrument notes “some significant symptoms should have been present in childhood, but full symptomology is not necessary”; an adult need not have been formally diagnosed as a child.
- Confirmation of symptoms across multiple settings (for example, both work and home) over time.
- Functional impairment assessment — how symptoms affect work, study, relationships, and self-care.
- Rule-outs for anxiety, depression, sleep disorders, and substance use.
- Collateral information from a partner, family member, or longstanding contact, where helpful.
DSM-5 criteria, as summarized by MedlinePlus, require several symptoms beginning before age 12 and persisting at least 6 months across multiple settings, with 5 or more current symptoms for older adolescents and adults.
Treatment categories (clinician-led)
If a diagnosis is made, treatment for adult ADHD typically combines medication and psychosocial approaches. Categories include:
- Stimulant medications, the most studied class for ADHD, prescribed and monitored by a clinician.
- Non-stimulant medications, an option for people who cannot or prefer not to use stimulants.
- Cognitive behavioral therapy and other behavioral interventions.
- Coaching, skills training, and accommodations in workplace or academic settings.
- Lifestyle approaches such as regular exercise and adequate sleep, alongside other treatments.
This page does not recommend specific drugs, doses, or treatment plans — those are clinical decisions made with a qualified professional. The ASRS is a screening tool, not a diagnosis.
When to talk to a clinician about adult ADHD
A positive Part A is a clear cue to schedule a clinical evaluation, but it is not the only signal worth acting on. Because Part A misses roughly 31% of adults who meet criteria for ADHD on structured interview, a negative screen does not close the question if impairment is present.
Consider talking to a clinician — your primary care doctor, a psychiatrist, or a qualified mental health professional — if any of the following apply:
- Your Part A screen is positive (four or more darkly shaded responses).
- Your screen is negative, but attention, organization, or restlessness symptoms cause real difficulty at work, school, or home — NIMH notes ADHD symptoms “interfere with school, work, or other activities; and strain social relationships”.
- You suspect ADHD-like symptoms have been present since childhood. The ASRS guidance asks clinicians to look for “early-appearing and long-standing problems with attention or self-control”.
- Symptoms cross multiple settings rather than appearing in only one situation.
- You are also experiencing low mood, persistent worry, sleep problems, or using alcohol or other substances to manage symptoms, since ADHD commonly co-occurs with mood, anxiety, sleep, and substance-use conditions. Brief screens such as the PHQ-9 for depression, the GAD-7 for anxiety, and the AUDIT for alcohol use can help you bring an organized picture to that conversation.
- You are seeking a formal diagnosis for accommodations at work or in education — accommodations typically require clinical documentation.
Bring the completed ASRS, your scoring, and notes about how symptoms affect daily life — a clinician will use that as a starting point.
Frequently asked questions
How do I score the ASRS-v1.1?
Answer the six Part A items on the Never/Rarely/Sometimes/Often/Very Often scale. Count answers in the darkly shaded box for that specific item — thresholds differ by item. Four or more shaded marks is a positive screen warranting further evaluation.
Where can I download the ASRS-v1.1 PDF?
The official instrument is hosted by the Harvard NCS portal at hcp.med.harvard.edu/ncs/asrs.php, with widely circulated mirrors of the WHO/Harvard/NYU Symptom Checklist. The Harvard page also lists translations and licensing terms.
Is the ASRS-v1.1 free to use?
The 6-item Part A screener is free if you cite the foundational article, include the copyright notice, notify developers of published applications, and preserve the response options, scoring, and shading. The full 18-item Symptom Checklist requires NYU permission.
What does a positive Part A screen mean?
It means symptoms are “highly consistent with ADHD in adults and further investigation is warranted” — the verbatim phrasing in the instrument. It is a screening signal, not a diagnosis. A clinician’s evaluation is needed to confirm ADHD and rule out conditions with overlapping symptoms.
Does a negative Part A screen rule out adult ADHD?
No. The 6-item Part A has a sensitivity of about 68.7%, meaning roughly three in ten adults who meet criteria for ADHD on a clinical interview will screen negative. If symptoms cause real impairment, talk to a clinician regardless of your screen result.
How long does the ASRS take?
The full 18-item Symptom Checklist takes about 5 minutes; Part A alone is faster. The brevity is one reason the ASRS is so widely used in primary care and research.
What is the difference between ASRS-v1.1 and ASRS-5?
The ASRS-v1.1 is mapped to DSM-IV-TR criteria and uses simple shaded-box counting on Part A. The ASRS-5 is a separate DSM-5 aligned screener with a proprietary weighted-scoring algorithm, licensed through NYU. They are not interchangeable.
Can I use the ASRS in my research or app?
For the 6-item screener, follow the citation, copyright-notice, notification, and preservation requirements on the Harvard NCS portal. For the full 18-item Symptom Checklist or any DSM-5 ASRS-5 use, request permission through the NYU licensing platform.