ASRS-5 Adult ADHD Self-Report Scale: Scoring and Interpretation

A six-item DSM-5 adult ADHD screener that takes two minutes and tells you who needs a full evaluation.

What the ASRS-5 measures

The Adult ADHD Self-Report Scale (ASRS) screener is the standard brief self-report tool for adult ADHD. The DSM-5 version — the ASRS-5 — uses six items, each rated for how often the problem has occurred over the past six months, and produces a single screen-positive or screen-negative result.

It exists because adult ADHD is both common and commonly missed. Adults rarely present saying they are hyperactive; they present with disorganisation, missed deadlines, chronic lateness, unfinished projects, emotional reactivity, and a long history of underperforming relative to ability.

The ASRS-5 is a screen and nothing more. A positive result means a full diagnostic evaluation is warranted — developmental history, evidence of childhood onset, cross-setting impairment, collateral report, and differential diagnosis.

How to score the ASRS-5

Score range: 0-24 on the ASRS-5 (six items scored 0-4); positive screen at 14 or higher

1Rate each of the six items 0 = never, 1 = rarely, 2 = sometimes, 3 = often, 4 = very often, for the past six months.
2Add the six items for a total from 0 to 24.
3A total of 14 or higher is a positive screen and indicates that a full ADHD evaluation is warranted.
4If you are using the older 6-item ASRS Part A instead, count the responses that fall in the darkly shaded boxes; four or more is a positive screen.

ASRS-5 score interpretation

ASRS-5 score ranges and their clinical meaning
Score	Severity	What it means clinically
0-13	Screen negative	ADHD is unlikely to be the primary explanation. If impairment is real, look at anxiety, depression, sleep, substance use, trauma or a learning disorder — all of which impair attention.
14-18	Screen positive	Symptoms consistent with adult ADHD. Proceed to full evaluation: developmental history, childhood evidence, impairment across at least two settings, and differential diagnosis.
19-24	Strongly screen positive	High symptom burden. Full evaluation is clearly indicated, and comorbidity is likely — anxiety, depression, substance use and sleep disorders are all common alongside adult ADHD.

What specific ASRS-5 scores mean

What ASRS-5 score is positive?

Fourteen or higher out of 24 on the six-item DSM-5 version is a positive screen, indicating that a full diagnostic evaluation is warranted.

Does a positive ASRS mean I have ADHD?

No. It means your reported symptoms are consistent with ADHD and a full evaluation is justified. Diagnosis requires evidence of childhood onset, impairment in at least two settings, and exclusion of other explanations such as anxiety, depression, sleep disorder or substance use.

Can an online ADHD self-assessment diagnose ADHD?

No self-assessment can. Screeners are useful for deciding whether to seek an evaluation and for organising what to tell a clinician. Diagnosis and any treatment decision require a clinician who can take a developmental history and rule out alternatives.

Why a positive screen is only the start

Childhood onset must be established. Adult-onset attention problems are usually something else.
Impairment must appear in at least two settings — work and home, for example — not just one demanding job.
Anxiety, depression, sleep deprivation, trauma and stimulant or alcohol use all impair attention and can produce a positive screen on their own.
Collateral report changes the picture in a meaningful proportion of cases, in both directions.

ADHD and treatment-resistant mood problems

Undiagnosed ADHD is a recognisable pattern behind anxiety and depression that does not respond as expected: the patient improves on the mood measure but continues to miss appointments, lose paperwork, and fall behind, and then becomes demoralised again.

Screening for ADHD at intake — and again when treatment stalls — is cheap and occasionally changes the entire formulation.

What to measure alongside

Run a PHQ-9 and GAD-7 with any ADHD screen, and add an Insomnia Severity Index where sleep is short or irregular. Chronic short sleep produces an attention profile that is genuinely difficult to distinguish from ADHD on self-report alone.

Who the ASRS-5 is for

Adults reporting lifelong difficulty with attention, organisation, follow-through or restlessness
Behavioural health intake, where ADHD frequently sits underneath treatment-resistant anxiety and depression
Substance-use services, where untreated ADHD raises relapse risk
Primary care needing a two-minute screen before deciding whether to refer for full evaluation

Administration and re-testing

Self-report over the past six months. ADHD is a chronic condition, so the timeframe is deliberately long.
Score using the DSM-5 ASRS-5 threshold: a total of 14 or more on the six items indicates a positive screen. Older ASRS Part A versions instead count four or more darkly shaded responses.
Where possible, add collateral report from a partner, parent or close friend. Adults systematically under-report their own inattention and over-report their own control.
A positive screen is a referral trigger, not a diagnosis and never a prescription decision on its own.

Reliability and validity

The ASRS-5 was derived from the National Comorbidity Survey Replication data and optimised against DSM-5 adult ADHD criteria.
Reported sensitivity and specificity at the 14-point threshold are both high — approximately 91% sensitivity and 96% specificity in the derivation work — with lower positive predictive value in low-prevalence general populations.
The earlier 6-item ASRS Part A screener showed 68.7% sensitivity and 99.5% specificity in the original WHO validation work.
As with any self-report screen, accuracy falls when the base rate is low, which is why the tool is used for triage rather than diagnosis.

Licensing and use

The ASRS was developed with the World Health Organization and is available free for clinical and research use.

Frequently asked questions

How is the ASRS-5 scored?

Rate six items from 0 (never) to 4 (very often) over the past six months and add them for a total from 0 to 24. Fourteen or higher is a positive screen.

Is the ASRS an ADHD diagnosis?

No. It is a screening tool. A positive result indicates that a full diagnostic evaluation is warranted.

Is the ASRS free to use?

Yes. It was developed with the World Health Organization and is freely available for clinical and research use.

What is the difference between the ASRS-5 and ASRS v1.1?

ASRS v1.1 is the older 18-item scale, whose first six items form the Part A screener scored by counting darkly shaded responses. The ASRS-5 is the six-item DSM-5 version scored 0-24 with a threshold of 14.

What should I do with a positive screen?

Seek a full evaluation with a clinician who can take a developmental history, gather collateral report, and rule out anxiety, depression, sleep disorder and substance use as alternative explanations.

References

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This page is clinical reference information for professionals and the public. It is not medical advice, and no assessment score is a diagnosis. Discuss any result with a licensed clinician. Read our medical disclaimer.