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How to use the ASRS to assess ADHD

Learn more about the ASRS assessment and how you can incorporate it into your practice.

To effectively treat your clients, an important step is an accurate diagnosis. Assessments are a helpful way to better understand someone’s symptoms and track a client’s progress over time. One common assessment used by therapists is the Adult ADHD Self-Report Scale, or the ASRS. 

Through an 18-question checklist, clients can rank the severity of some common symptoms, giving you a better idea of whether ADHD is an appropriate diagnosis. Below, learn more about the ASRS assessment and how you can use it in your practice.

ASRS assessment

The ASRS assessment includes the following questions and prompts clients to mark “never,” “rarely,” “sometimes,” “often,” or “very often.” The assessment consists of two parts.

Part A

  1. How often do you have trouble wrapping up the final details of a project, once the challenging parts have been done? 
  2. How often do you have difficulty getting things in order when you have to do a task that requires organization? 
  3. How often do you have problems remembering appointments or obligations?
  4. When you have a task that requires a lot of thought, how often do you avoid or delay getting started?
  5. How often do you fidget or squirm with your hands or feet when you have to sit down for a long time?
  6. How often do you feel overly active and compelled to do things, like you were driven by a motor? 


Part B

  1. How often do you make careless mistakes when you have to work on a boring or difficult project?
  2. How often do you have difficulty keeping your attention when you are doing boring or repetitive work?
  3. How often do you have difficulty concentrating on what people say to you, even when they are speaking to you directly?
  4. How often do you misplace or have difficulty finding things at home or at work?
  5. How often are you distracted by activity or noise around you?
  6. How often do you leave your seat in meetings or other situations in which you are expected to remain seated?
  7. How often do you feel restless or fidgety?
  8. How often do you have difficulty unwinding and relaxing when you have time to yourself?
  9. How often do you find yourself talking too much when you are in social situations?
  10. When you’re in a conversation, how often do you find yourself finishing the sentences of the people you are talking to, before they can finish them themselves?
  11. How often do you have difficulty waiting your turn in situations when turn taking is required?
  12. How often do you interrupt others when they are busy?

ASRS scoring

The ASRS doesn’t use a total score model. Instead, how your clients answer should give you an objective idea of their ADHD symptoms and whether they impair your client’s life. 

If four or more checks appear in the shaded boxes within Part A of the assessment shown here, then your client has symptoms that are very consistent with adult ADHD. Part B helps to give you additional insight into a client’s symptoms. 

Keep in mind, as with all assessments, the ASRS is meant to be a tool that helps you better understand a client’s experience. While assessments help inform therapists how symptoms impact someone’s daily life, you should still conduct a clinical interview that includes a thorough history. Be sure to ask your client about their experience with these or similar symptoms during childhood, as many adults with ADHD also had earlier undiagnosed symptoms.

The value of screening for ADHD

While ADHD is a common mental health disorder, it can be difficult to diagnose in adults. People with undiagnosed, untreated ADHD may begin to struggle with other symptoms, such as anxiety and depression. And vice versa, anxiety and depression can sometimes present with symptoms similar to ADHD, such as difficulty concentrating. That’s why a robust, holistic assessment can help you really understand a person’s experience. Screening for — and treating — ADHD can help ensure positive mental health outcomes in your adult clients, ensuring they can thrive in their personal, social, and professional lives.

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Compliance and documentation