ADHD-50

What ADHD-50 measures

Fifty short yes-or-no questions about how life actually goes. It counts how many of the fifty experiences you recognise, and it shows you how those recognitions fall across five groupings. There is no pass mark, because this instrument does not have one.

The five groupings are attention and focus with nine questions, restlessness and acting on impulse with twelve, feelings and reactions with twelve, senses, time and coordination with seven and a wider life pattern with ten.

The range of the count is nought to fifty. What a count of thirty-one means is that you recognised thirty-one of the fifty experiences. A count is not a percentage of ADHD. It is not a severity rating either, and it does not place you against a norm group, because no norm group has been published for this instrument.

ADHD-50 was written by Dr Lucas Fortaleza around how ADHD often shows up in women and non-binary adults. It is an EchoMind instrument in validation. Your answers are anonymous and are kept for twelve months to help validate the instrument.

Who it is designed for

People whose experience of ADHD is not mainly about concentration. The fifty questions cover attention, and then they carry on into mood swings, impatience, low frustration tolerance, hypersensitivity to criticism, sleep, substance use, work performance, relationships, self-esteem, spatial orientation, handwriting and family history.

That range is the point. Adults arriving for a first assessment rarely open with inattention. They open with the exhaustion. Or the reactions they cannot explain. Or the jobs that went well and then did not. Or the sense of having performed below what they are capable of for twenty years. Those are the things this instrument asks about directly.

It suits people who have been told they cannot have ADHD because they did well at school or because they hold a demanding job. Academic results and job titles are not part of this instrument. What it asks about is how much that outcome cost you, and how many of the fifty experiences you recognise from the inside.

It was written around the female presentation, so some questions are about experiences a short ADHD screener never raises: premenstrual tension intensifying symptoms, variable sexuality, holding more than one job at once and a playful and imaginative side that stayed. One question asks about strong creativity and intuition as a strength, and it is reported back to you as part of the same picture rather than treated as separate.

Because it is female-focused by design, a few questions will not apply to everyone. Every item ships anyway, since removing items would make it a different instrument. Answer no where a question does not apply to you.

Why there is no pass mark, and why we left it that way

The honest reason is that no validated cutoff exists for this instrument yet. It is in validation, there are no published cut scores and no severity bands, so putting a threshold on the page would mean inventing one.

We could have picked a number that looked reasonable. That is what makes an unvalidated screener actively harmful. A person who recognises twenty-eight of fifty experiences and is told they fall below a made-up line has been given a false negative with a number attached to it, and false reassurance is harder to recover from than no answer at all.

So the result reports the count and the shape, and it never issues a negative screen. An instrument with no validated cutoff can neither rule ADHD in nor rule it out. That is the absence of a threshold rather than a threshold set at zero, and if validation produces real cut scores they will appear here.

The five groupings come with the same caution. They are a best-inference structure pending the factor analysis, so read them as a rough map of where your recognitions cluster rather than as measured subscales.

This is the same reason the questions are yes or no rather than a scale. A binary answer supports an honest count. It does not support a weighted score, and pretending otherwise would add precision that the underlying work has not earned yet.

The five groupings, and what each one covers

Attention and focus has nine questions. Being pulled off task by something minor, catching fragments of what people say, everyday disorganisation with keys and bills and appointments, going blank mid-sentence, hyperfocus, leaving things half-finished and long delays starting work.

Restlessness and acting on impulse has twelve. Interrupting, difficulty staying seated, constant movement in your hands or feet, running several projects at once, answering before the question finishes, saying things without filtering, impulsivity around spending or jobs or relationships and seeking strong stimulation.

Feelings and reactions has twelve. A constant sense of restlessness, mulling things over, low frustration tolerance, marked impatience, reacting sharply to criticism or rejection, hypersensitivity to an offhand comment, abrupt mood swings, low stress tolerance and depressive episodes arising from cognitive exhaustion.

Senses, time and coordination has seven. Absorbing other people's feelings, agitation in noisy or crowded places, hypersensitivity to repetitive sound, tripping or knocking things over, hard-to-read handwriting, difficulty with spatial orientation, a sense of time that does not match real time and an inverted sleep schedule.

The wider life pattern has ten. Performing below your capability at work, difficulty maintaining intimate relationships, low self-esteem carried from years of criticism, substance dependence, holding more than one job, a childlike and imaginative side that stayed, premenstrual tension intensifying symptoms, variable sexuality, strong creativity and intuition and family history of ADHD.

How to read your result

Start with the five groupings rather than the count. Recognising twenty of the fifty experiences means something quite different when they are concentrated in one grouping than when they are spread evenly across all five, and that difference is the useful part.

Each grouping shows how many of its own questions you recognised, so nine out of twelve in feelings and reactions is directly readable. There is no band word attached to it, because no bands exist for this instrument.

Your total is a count of recognised statements out of fifty. It carries no verdict. A high count is not a diagnosis and a low count is not a clearance, and this screener never issues a negative result for that reason.

One note on the yes-or-no format. A statement is either something you recognise or it is not, so answer for how life usually goes rather than for your best week. People tend to answer no to statements they have found a way around, which understates the count. If you recognise the experience and you have built a workaround for it, that is still a yes. The workaround is the part a clinician most wants to hear about.

If you answered no to several questions because they did not apply to you rather than because the experience is absent, your count sits lower than your experience does. That is a known limit of running a female-focused instrument as an open screener, and it is another reason to read the groupings.

The strongest signal here is not numerical. If reading the fifty statements felt like reading a description of your life, that is worth taking seriously whatever the count says.

What to do next

Bring the shape of your answers to a full assessment. A count of recognised statements is not a diagnosis, and only an assessment that looks at your history and your context can give you an answer.

What it does give you is a starting point that is difficult to dismiss. People routinely arrive at a first appointment having minimised everything, because the alternative feels like making excuses. Fifty specific statements you recognised is more useful to a clinician than a general sense that things are harder than they should be.

Booking needs no GP referral and appointments are available immediately. Two to three practitioners review your case together, and your written report arrives within 6 weeks of your first appointment. The report is NICE-compliant, and the HSE and the NHS both accept it. Our psychiatrist handles the medication question if you want to look at it, including the titration period afterwards. You also get your EchoMind AI profile free with any booking, worth €97 or £97 depending on your region.

If you want a second view before booking, the female-presentation ADHD screener covers the internalised pattern with a five-point scale rather than yes or no. MASC covers masking. The AuDHD screener covers ADHD and autistic traits together.

Common questions

What score means I have ADHD?

There is no such score on this instrument. ADHD-50 is in validation, it has no published cutoffs and it deliberately reports no severity band, so no count here means ADHD and no count rules it out. What it gives you is how many of the fifty experiences you recognised and where those recognitions cluster across five groupings.

Why does it never tell me the result is negative?

Because an instrument with no validated cutoff cannot rule ADHD out. Issuing a negative screen from an unvalidated scale would give false reassurance with a number attached to it. So the result shows your pattern and keeps the conversation open instead.

Some questions do not apply to me. What should I answer?

Answer no. The instrument was written around how ADHD shows up in women and non-binary adults, so a few questions, including one about premenstrual tension, will not apply to everyone. Every item is kept because removing items would make it a different instrument. Where you answered no for that reason, read the groupings rather than the count.

Why is one of the questions about creativity?

Because strong creativity and intuition belongs in the same description rather than outside it. If you recognise that statement, your result says so. It is reported and never weighted, since there is no scoring model here to weight it in.

How is this different from the female-presentation ADHD screener?

ADHD-50 is fifty yes-or-no questions and reports a count of recognised statements across five groupings. The female-presentation ADHD screener is twenty-five questions on a five-point scale and reports a score out of 100 with a band description for each of seven areas. ADHD-50 covers more of life. The other one reads intensity more finely. Both are NeurAtip instruments in validation and both are free.

Are my answers stored?

Yes. Your answers and result are saved against a private link, with no name and no account attached, so you can keep it, print it or email it to yourself. Anyone holding the link can see the result. Everything is deleted after twelve months.