ASRS v1.1

What the ASRS measures

The ASRS is a screening questionnaire, not a diagnostic test. It was developed with the World Health Organisation and published by Kessler and colleagues in 2005, and it has been in clinical and research use ever since. Its eighteen questions follow the adult wording of the ADHD criteria. Nine ask about attention. Nine ask about hyperactivity and impulsivity.

Every question asks the same underlying thing in a different way: how often has this happened over the last six months. Not how bad it felt. Not why it happened. Only how often. That is deliberate. Most people can report the frequency of their own experience with reasonable accuracy. Almost nobody can reliably report the cause of it.

Six of the eighteen questions form the screening set, known as Part A. Those six were selected because they separated adults with ADHD from adults without ADHD more sharply than the other twelve did. The remaining twelve, Part B, fill in the shape of your attention and your restlessness. They do not decide the screen.

How your result was worked out

You were given two results, and they are calculated in two different ways.

The Part A screen is scored question by question. Each of the six questions carries its own threshold, because some of these experiences are common in the general population and some are not. Four of them count once you answer Sometimes or more often. The other two count only at Often or more often. If four or more of the six cross their own threshold, the screen is positive. That rule comes from the original 2005 publication.

The total is simpler. Each answer scores 0 for Never up to 4 for Very Often, across all eighteen questions, giving a range of 0 to 72. The bands come from Adler and colleagues in 2019. A total of 17 marks the start of the mild range, 24 the moderate range and 37 the high range.

The two results can disagree, and often do. A positive Part A screen alongside a total in the mild range usually means a small number of experiences are happening very often indeed. A negative screen alongside a moderate total usually means a lot is happening at a lower frequency. Both are shown to you because both say something real, and neither one is the whole answer.

What a positive screen means, and what it does not

A positive screen means your answers resemble the answers given by adults who have a diagnosis. It does not mean you have ADHD. A negative screen does not mean you do not.

The distance between a screener and a diagnosis is not really about accuracy. It is about scope. A questionnaire asks how often you experience something now. A diagnostic assessment asks four further questions that no questionnaire can answer on its own. Were these traits present in childhood, since ADHD is neurodevelopmental rather than something that begins in adult life. Do they show up in more than one setting, at home and at work and in relationships. Do they cost you something real. And is there another explanation that fits better, such as sleep, thyroid function, chronic stress, anxiety or depression.

A good assessment takes the last question as seriously as the first. Some people come through the process and learn that what they have been living with is something other than ADHD, and that is a useful answer rather than a failed one.

What the ASRS was built to see

Read back over the questions and a pattern shows up. Several of them ask about behaviour other people can watch you do. Fidgeting when you have to sit for a long time. Leaving your seat when you are expected to stay in it. Talking too much in social situations. Finishing other people's sentences. Interrupting someone who is busy. Feeling driven by a motor.

Those items exist because the description of ADHD they were written against came mainly from observing children, and mainly boys, who were noticed precisely because their behaviour was visible to a teacher or a parent. It is a real presentation and the ASRS describes it accurately. It is simply not the only one.

What the ASRS can miss

Restlessness that runs inwards. There is one question about feeling restless or fidgety, and a person whose restlessness is a racing mind in a still body may or may not read that question as theirs. The rest of the hyperactivity questions are about movement other people can see.

Effort that has already solved the problem. The ASRS asks about outcomes. Someone who runs three calendars, sets alarms for everything and starts each task the night before it is due can answer these questions honestly and score low, because the outcome is under control. The work that keeps it under control is not asked about anywhere on the form.

Masking. If you learned early that being visibly distracted or visibly restless brought a cost, you probably learned to hide it. The questions ask what you do, not what it takes to look the way you look.

Change across the month. Many people report that their attention, their patience and their tolerance for noise shift across the menstrual cycle. The ASRS asks for a single frequency covering six months, so a pattern that comes and goes tends to average out into a middle answer.

None of this makes the ASRS a poor screener. It makes it a screener with a shape. It is worth knowing that shape before you accept the number as your answer.

If the result does not match your experience

Then trust the experience and keep looking. A low total on a screener that was built around externalised presentation is weak evidence against a presentation it was not built to see.

Three other free screeners on this site were designed for different questions. The Female-Presentation ADHD Screener asks about attention that runs inwards, effort that stays hidden and patterns that shift across the month. MASC asks about camouflage itself, the work of watching and adjusting and rehearsing yourself, and it was validated on an initial cohort of women and non-binary adults. The ADHD-50 covers daily life, emotional regulation, relationships and work rather than the classic classroom traits.

None of these is proven better than the ASRS, and each carries its validation status on its own page so you can see what has been tested and what has not. They ask different questions of the same life. Where two of them disagree about you is usually the most interesting thing you can bring to a clinician.

How to answer it accurately if you take it again

Answer for a typical six months rather than your best fortnight. The instinct to describe yourself at your most capable is strong, and it produces a tidy result that helps nobody.

Answer for life as it actually runs, including the systems. Then, if you want, read the questions a second time and ask what the answer would be without the alarms, the lists and the person at home who reminds you. The distance between those two readings is worth writing down and bringing with you.

If you take medication that affects attention, the questions get harder. Answering for how things are on it describes a treated picture, and answering for how things were before describes an untreated one. Either is usable as long as you tell your clinician which one you did.

What a full assessment adds

Validated questionnaires before your appointment, so the interview time is spent on you rather than on paperwork. A structured clinical interview covering six areas: childhood history, family history, relationships, daily life, emotional regulation and physical and mental health. Input from someone who has known you a long time. A specialist team of two to three practitioners rather than a single opinion.

You receive a detailed NICE-compliant report within six weeks of your first appointment, valid for submission to the HSE or the NHS, with a clear outcome and practical recommendations. No GP referral is required at any point.

A screener like this one is a good place to start and a poor place to stop. If these questions described your life, the next step is a conversation with a clinician who assesses the person in front of them rather than a stereotype.

Common questions

Can the ASRS diagnose ADHD?

No. The ASRS is a screening questionnaire. It tells you whether your answers resemble the answers adults with ADHD gave, which is a reason to look further rather than an outcome. A diagnosis needs a clinical assessment that examines childhood history, more than one setting, the real cost to you and whether something else explains the pattern better.

Can I score low on the ASRS and still have ADHD?

Yes. The ASRS asks about behaviour that other people can see, and it asks about outcomes rather than effort. If your restlessness is internal, or if you have built systems that keep your life running, you can answer every question honestly and still land in a low band. That is why we also offer screeners designed for internalised and masked presentation.

Why does the ASRS ask about the last six months?

Because ADHD is a persistent pattern rather than a bad week. Six months is long enough to look past a stressful patch and short enough that most people can remember it accurately. It does mean a pattern that comes and goes, such as one that shifts across the menstrual cycle, tends to average out into a middle answer.

What is the difference between Part A and the total score?

Part A is the six-question screen from the original 2005 publication. Each of those six has its own threshold, and four or more crossing it makes the screen positive. The total is the sum of all eighteen answers out of 72, read against the bands published by Adler and colleagues in 2019. The two can disagree, and you are shown both.

How is the ASRS different from your own ADHD screeners?

The ASRS is the established WHO screener and it maps closely to the diagnostic criteria, which is exactly why it is here. Our own instruments were designed for questions it does not ask: internalised attention, hidden effort, change across the month and camouflage. They are not proven better than the ASRS, and each states its validation status on its page. Taking both and comparing the results tells you more than either one alone.