The ADHD Screening (ASRS) Explained
The ASRS v1.1 is a short, WHO-developed questionnaire that helps identify adults whose experiences may be worth exploring through a formal ADHD assessment. It is a screening tool, not a diagnosis: a positive result means a full assessment could be worthwhile, nothing more.
What the ASRS is
The Adult ADHD Self-Report Scale (ASRS v1.1) is an 18-item questionnaire developed in collaboration with the World Health Organization to help adults recognise symptoms that may be consistent with ADHD. The first six questions (Part A) form the core screener; these were identified as the most predictive of an ADHD diagnosis.
Sources: Kessler et al. 2005 (WHO Adult ADHD Self-Report Scale); Kessler et al. 2007 (Part A items most predictive).
How we score it
ThinkBetter sums the six Part A items on a 0 to 24 scale, and a score of 14 or above is treated as a positive screen. This sum-based approach has validation support showing roughly 90% sensitivity and 88% specificity for identifying adults who warrant a full assessment.
Source: Brevik et al. 2020 (ASRS diagnostic accuracy, sum-based cutoff).
What a positive screen means, and what it doesn't
A positive screen does not mean you have ADHD. It means your responses are consistent with patterns often seen in adults with ADHD, and that a formal assessment with a qualified clinician could be worthwhile. Equally, a low score does not rule ADHD out: adults who have developed strong coping strategies, and women in particular, can under-report symptoms on self-report scales. The ASRS cannot, on its own, diagnose or exclude ADHD.
Sources: Sachs Center ASRS interpretation (low score does not rule out); MDCalc ASRS (screener cannot be used alone for diagnosis).
What happens next
If your screen is positive, the next step is a formal assessment. ADHD can only be diagnosed through a full clinical assessment; it cannot be diagnosed from a questionnaire alone.
Source: NICE NG87 — diagnosis of ADHD is a clinical diagnosis and cannot be based on rating scales alone.
Screening compared with a formal assessment
| Screening (ASRS) | Formal assessment | |
|---|---|---|
| What it is | An 18-item questionnaire, Part A scored | A structured clinical evaluation by a specialist |
| What it tells you | Whether a full assessment may be worthwhile | Whether you meet diagnostic criteria for ADHD |
| Who runs it | Self-completed, free on ThinkBetter | A qualified specialist clinician |
| Can it diagnose? | No | Yes |
Frequently asked questions
Is the ASRS a diagnosis?
A positive screen does not mean you have ADHD. It means your responses are consistent with patterns often seen in adults with ADHD, and that a formal assessment with a qualified clinician could be worthwhile.
What score means I might have ADHD?
ThinkBetter sums the six Part A items on a 0 to 24 scale, and a score of 14 or above is treated as a positive screen.
Can I have ADHD with a low ASRS score?
Equally, a low score does not rule ADHD out: adults who have developed strong coping strategies, and women in particular, can under-report symptoms on self-report scales.
What happens after a positive screen?
If your screen is positive, the next step is a formal assessment. ADHD can only be diagnosed through a full clinical assessment; it cannot be diagnosed from a questionnaire alone.