The Adult ADHD Self-Report Scale (ASRS) Symptom Checklist was developed by the World Health Organization (WHO) to provide a valid self-assessment of current ADHD symptoms in adults. A growing body of literature supports the ASRS as a screening tool in both general and clinical populations. The scale consists of 18 items that correspond directly to the 18 DSM-IV symptoms for both inattention and hyperactivity. Its brevity and simplicity mean it is easy to administer and score. The ASRS is not a diagnostic tool. It does not provide information on childhood symptoms, which is necessary in making an ADHD diagnosis. The scale also only assesses frequency, not the functional impact of symptoms. It is more suitable as a screening or symptom tracking tool and should not be used as the sole basis for clinical diagnosis.
The initial validation study by Kessler and colleagues was conducted with a community-based sample of 154 US adults, each of whom completing a structured, clinician-administered interview, followed by the ASRS. The authors found adequate sensitivity (56%), excellent specificity (98%), and excellent classification accuracy (97%).
The items were deliberately worded to reflect ADHD symptoms in a more suitable context for adults. The focus on frequency, rather than severity of symptom, simplifies instructions. Respondents are asked to indicate how often a particular ADHD symptom has occurred over the past six months on a five-point response scale ranging from 0 – 4. The ASRS does not utilize total or scale scores to indicate diagnostic likelihood. Instead, the authors of the scale recommend counting the number of items the respondent endorses. Part A consists of 6 of the most predictive items of ADHD. The authors suggest that four or more responses in Part A warrant further investigation. The frequency scores on Part B provide additional cues and can serve as further probes into the patient’s symptoms. No total score or diagnostic likelihood is utilized in Part B. It has been found that the six questions in Part A are the most predictive of the disorder and comprise a reliable and valid screening instrument.