The Adult ADHD Self-Report Scale (ASRS) is a validated, patient-reported screening tool developed by the World Health Organization and Harvard Medical School. It captures core symptoms of Attention-Deficit/Hyperactivity Disorder (ADHD) in adults while keeping administration brief and clinically practical.
Why Use the ASRS?
- Brief & validated: Items are directly tied to the most predictive symptoms of adult ADHD.
- Supports diagnostic clarity: Can uncover attention and impulsivity concerns that may otherwise go unspoken.
- Useful for monitoring: When re-administered periodically, it helps track symptoms and treatment response over time.
Step 1: Introduce the Tool
Goal: Reduce stigma and clarify purpose before asking questions.
Suggested language:
“Some people find that difficulties with focus, organization, or restlessness impact daily life. These questions help us see whether those experiences may be affecting your well-being, so we can decide together what support might help.”
Step 2: Administer the ASRS (6 items)
The ASRS consists of two parts:
- Part A (6 items) – The short screener; identifies the most predictive ADHD symptoms.
- Part B (12 items) – Expands to the full 18-item scale; provides additional detail about frequency and breadth of symptoms for ongoing assessment.
Each item is rated:
- Never
- Rarely
- Sometimes
- Often
- Very often
Domains & sample items covered:
- Trouble wrapping up details after completing major tasks (Inattention).
- Difficulty getting things in order when tasks require organization (Inattention).
- Problems remembering appointments or obligations (Inattention).
- Avoiding/disliking tasks requiring sustained mental effort (Inattention).
- Feeling fidgety or restless (Hyperactivity/Impulsivity).
- Feeling overly active or driven (Hyperactivity/Impulsivity).
Step 3: Scoring & Interpretation
Scoring method (Part A):
Responses of “Often” or “Very often” on 4+ items are highly predictive of ADHD.
| Score Pattern | Interpretation | Clinical Implications | Recommended Actions |
| 0-13 | Minimal indication | Unlikely ADHD diagnosis | Normalize coping; provide psychoeducation on focus strategies; consider other causes (sleep, mood, stress). |
| 14-24 | Clinically significant | Possible ADHD diagnosis; elevated scores warrant further clinical assessment but do not confirm ADHD | All of the above, plus: consider full ADHD evaluation, discuss evidence-based treatment options (medication, CBT for ADHD, coaching, skills training). |
Part B (12 additional items; Scores range from 0 to 48)
- Not used for initial screening, but helps assess severity, impact, and change over time.
- Particularly useful for ongoing symptom monitoring, informing treatment adjustments, and tracking functional impacts to address medical necessity of care.
Scores ranging from 27-48 are considered clinically significant, indicating functional impairment.
Important: The ASRS is a screening tool, not diagnostic. Always interpret results within the context of a full clinical interview, history, and your clinical judgment.
How often should I re-administer?
- At intake, to identify ADHD symptoms early.
- Every 8–12 weeks, to track change and functional impact.
- After major life or treatment events, such as new medication or work transitions.
Step 4: Supporting Safety & Reducing Harm
For clients with elevated symptoms:
- Explore functional impact: Ask about school, work, relationships, or daily living.
- Assess for risk behaviors: ADHD symptoms can increase impulsivity (e.g., unsafe driving, risky spending, substance use).
- Normalize coping strategies: Many clients develop their own methods of compensating (reminders, checklists, routines). Highlight strengths while exploring areas of struggle.
- Reduce stigma: Frame ADHD symptoms as differences in brain function, not laziness or lack of willpower.
ADHD symptoms often overlap with anxiety, depression, and trauma. Screen broadly, and consider comorbidities in care planning.
Step 5: Documentation
Example phrasing for chart notes:
- Score & interpretation: “ASRS: 5 items endorsed by patient, suggesting clinically significant ADHD symptoms.”
- Functional impact: “Client reports difficulties with organization and sustaining attention, interfering with work productivity.”
- Plan/next steps: “Provided psychoeducation on ADHD; discussed coping strategies and possible referral for full ADHD evaluation.”
The ASRS offers a quick, evidence-based way to bring ADHD symptoms into the therapeutic conversation. By integrating it thoughtfully, therapists can identify patterns that impact daily functioning, reduce stigma, and guide clients toward next steps with clarity. While not diagnostic, it serves as a powerful entry point for collaborative care, helping clients feel seen, validated, and supported in building strategies that improve focus, organization, and overall quality of life.
Updated