The Adult ADHD Self-Report Scale (ASRS-v1.1) is a questionnaire developed by the World Health Organization (WHO) and the Workgroup on Adult ADHD to assist in the identification of symptoms consistent with Attention Deficit Hyperactivity Disorder in adults. ADHD often persists into or is first recognized during adulthood, presenting with a different symptom profile than in childhood. The ASRS-v1.1 serves as a self-report instrument designed to screen individuals for the presence of these symptoms over the past six months, which can then inform the need for a professional evaluation. The scale is intended strictly as a screening tool, not as a standalone diagnostic instrument.
Structure of the ASRS-v1.1
The ASRS-v1.1 consists of 18 questions, adapted from the criteria for ADHD outlined in the American Psychiatric Association’s diagnostic manual. These questions are divided into two sections for screening purposes. Part A comprises the first six questions, which clinical research identified as the most highly predictive of an ADHD diagnosis in adults. These six items are drawn from the symptom domains of inattention and hyperactivity-impulsivity.
The remaining twelve questions form Part B, covering supplementary symptoms that provide a broader picture of an individual’s clinical presentation. While Part A is designed for a quick initial assessment, Part B contributes to a more comprehensive understanding of the overall symptom burden. The complete 18-question instrument offers a detailed self-report of symptom frequency, which is beneficial for clinicians during a full diagnostic assessment.
Scoring the Initial Screening Questions
The scoring procedure for the six questions in Part A determines the likelihood of symptoms consistent with adult ADHD. Each question asks the respondent to rate the frequency of a symptom over the past six months using a five-point scale: Never, Rarely, Sometimes, Often, or Very Often. To score this section, one must identify which responses count as a “Positive Response” for each item.
For four of the six questions, a rating of “Often” or “Very Often” is considered a positive finding, as these frequencies are highly correlated with the disorder. However, for the remaining two questions concerning hyperactivity and feeling “driven by a motor,” the threshold is lower. For these two items, “Sometimes,” “Often,” and “Very Often” all count as positive.
Once the positive responses are tallied, a screening threshold is applied. If an individual has four or more positive responses out of the six questions in Part A, the result indicates a positive screen. This suggests the individual has symptoms highly consistent with adult ADHD and warrants further, comprehensive investigation by a healthcare professional.
Calculating Overall Symptom Burden
All 18 questions of the ASRS-v1.1 can be used to quantify the overall symptom burden, providing a more nuanced measure of severity. This involves applying a frequency weighting to every item across both Part A and Part B. In this scoring method, the five frequency responses are converted into numerical values, with “Never” typically scoring zero, and the subsequent responses—Rarely, Sometimes, Often, and Very Often—receiving progressively higher point values.
This Likert-based approach assigns a score of up to four points for the most frequent response, making the maximum possible total score for the full 18-item checklist 72. By summing the scores from all 18 questions, a single total score is generated that reflects the cumulative load of symptoms.
The total symptom score aids a clinician in understanding the severity of the inattentive versus the hyperactive/impulsive presentation. Furthermore, this quantitative approach allows the scale to be used as a tool to track changes in symptom load over time, such as in response to treatment.
Interpreting Results and Next Steps
A positive screen on Part A or a high total symptom burden score from the full 18-item checklist is an indicator that warrants attention. The ASRS-v1.1 is designed to have high sensitivity; however, it is fundamentally a screening instrument and cannot, by itself, provide a medical diagnosis of ADHD.
The appropriate next step following a positive screen or a high score is to seek a comprehensive diagnostic evaluation from a qualified healthcare professional. This specialist is typically a psychiatrist, clinical psychologist, or physician with expertise in adult ADHD. The professional will use the ASRS-v1.1 results as one piece of information, combining it with a detailed clinical interview, a review of personal history, and an assessment of symptom impairment across multiple life settings.
Since the ASRS-v1.1 is a self-report measure, its accuracy depends on the individual’s self-awareness and honest reflection. A high score may reflect symptoms of other conditions, such as anxiety or mood disorders, which can overlap with ADHD symptoms. Therefore, the screening result serves as a prompt for professional scrutiny, ensuring that any potential underlying issues are correctly identified and addressed.