Calculators / ADHD
ASRS v1.1 (6-item)
Adult ADHD Self-Report Scale v1.1, Part A screener. Adult ADHD screening.
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The ASRS v1.1 (6-item) calculator is in the Library.
Every rating scale calculator comes with the Library, along with the prescribing guides, medication handouts, DSM-5 criteria and sheets, and the Guide Builder.
Use it for
- A quick first look at whether adult ADHD is worth a full evaluation.
- Opening a conversation with a patient who suspects they have ADHD.
- Population or primary care screening, where its high specificity keeps false positives low.
Do not use it for
- Diagnosing ADHD. The diagnosis needs symptoms from childhood, impairment in more than one setting, and exclusion of other causes.
- Ruling ADHD out. About a third of people with ADHD screened negative in the validation study.
- Measuring severity or tracking treatment response. Use a symptom rating scale for that.
Ask the person to rate how they have felt and behaved over the past 6 months on each of the six items.
ASRS v1.1 (6-item)
Answer the questions to see the result.
This calculator adds up the score in your browser. Nothing you enter is stored or sent.
More about the ASRS v1.1 (6-item)
About the ASRS v1.1 (6-item)What it is and what it is for
The ASRS v1.1 was developed with the World Health Organization to screen adults for ADHD. Part A holds the six questions that best separated people with and without ADHD in the original validation work. Each question is scored as positive or not, depending on how often the symptom occurs. Four or more positives is a positive screen.
Items 1 to 3 count at "sometimes" or more often. Items 4 to 6 count only at "often" or "very often". The lower bar on the first three is deliberate, so the page applies each item's own threshold for you. Part B of the full scale (items 7 to 18) adds detail but is not part of the screening score.
How to use itGiving it and scoring it
Ask the person to answer each item for the past six months. For items 1 to 3, a response of sometimes, often or very often counts. For items 4 to 6, only often or very often counts. Count the items that reach their threshold. Four or more is a positive screen.
The scoring page shows how many items reached threshold, not a sum of the raw responses.
Interpreting the scoreScore ranges and what they suggest
| Items at threshold | What it suggests | Usual response |
|---|---|---|
| 0 to 3 | Negative screenFewer than 4 items at or above their threshold. | No further ADHD work-up from the screen alone. Evaluate anyway if the history is suggestive. |
| 4 to 6 | Positive screenSymptoms highly consistent with adult ADHD. | Schedule a full ADHD evaluation. |
Thresholds: items 1 to 3 count at sometimes, often or very often. Items 4 to 6 count at often or very often.
Pearls and pitfallsTips and common mistakes
- The scale is a screen. Its job is to decide who gets a full evaluation.
- A cutoff of 4 gave the best balance in the original work. A person with 3 and a convincing history still deserves an evaluation.
- Positive screens are common in anxiety, depression, bipolar disorder, sleep deprivation and substance use. Do not stop at the screen.
- Collateral history from a parent, partner or old report cards often settles the question of childhood onset.
- If a stimulant is started, record the baseline and use a rating scale to judge response.
EvidenceAccuracy and reliability
- Original validation (Kessler 2005): the six-item screener had sensitivity 68.7%, specificity 99.5% and total classification accuracy 97.9% against a clinician-rated diagnosis, and it outperformed the full 18-item scale on sensitivity.
- Accuracy varies by setting. Studies in health plan and clinic samples report a wider range for sensitivity and specificity than the original work (see Kessler 2007).
- The scale is available in many languages and has been used widely in primary care and occupational settings.
Source, license and referencesWhere it comes from
The ASRS v1.1 was developed by the World Health Organization with Ronald C. Kessler (Harvard Medical School) and Lenard Adler (New York University) and is copyrighted by the WHO. It is distributed free for clinical use. Check with the copyright holders before using it in research or in a commercial product.
- Kessler RC, Adler L, Ames M, et al. The World Health Organization Adult ADHD Self-Report Scale (ASRS): a short screening scale for use in the general population. Psychol Med. 2005;35(2):245-256.
- Kessler RC, Adler LA, Gruber MJ, Sarawate CA, Spencer T, Van Brunt DL. Validity of the World Health Organization Adult ADHD Self-Report Scale (ASRS) Screener in a representative sample of health plan members. Int J Methods Psychiatr Res. 2007;16(2):52-65.
- Ustun B, Adler LA, Rudin C, et al. The World Health Organization Adult Attention-Deficit/Hyperactivity Disorder Self-Report Screening Scale for DSM-5. JAMA Psychiatry. 2017;74(5):520-526.