Adult ADHD Self-Report Scale (ASRS)

Please answer the questions below, rating yourself on each of the criteria shown using the scale

on the right side of the page. As you answer each question, circle the correct number that best

describes how you have felt and conducted yourself over the past 6 months. Please give this

completed questionnaire to your healthcare professional to discuss during today’s appointment.

Patient Name ________________ Today’s Date ______

                    Never, Rarely, Sometimes, Often, Very Often

1. How often do you make careless mistakes when you have to work on a boring or

difficult project?                                                             0                 1                 2                    3                 4

2. How often do you have difficulty keeping your attention when you are doing boring

or repetitive work?                                                         0                 1                 2                    3                 4

3. How often do you have difficulty concentrating on what people say to you,

even when they are speaking to you directly?                  0                 1                 2                    3                 4

4. How often do you have trouble wrapping up the final details of a project,

once the challenging parts have been done?                     0                 1                 2                    3                 4

5. How often do you have difficulty getting things in order when you have to do

a task that requires organization?                                    0                 1                 2                    3                 4

6. When you have a task that requires a lot of thought, how often do you avoid

or delay getting started?                                                 0                 1                 2                    3                 4

7. How often do you misplace or have difficulty finding things at home or at work?

                                                                                    0                 1                 2                    3                 4

8. How often are you distracted by activity or noise around you?

                                                                                    0                 1                 2                    3                 4

9. How often do you have problems remembering appointments or obligations?

                                                                                    0                 1                 2                    3                 4

10. How often do you fidget or squirm with your hands or feet when you have

to sit down for a long time?                                            0                 1                 2                    3                 4

11. How often do you leave your seat in meetings or other situations in which

you are expected to remain seated?                             0                 1                 2                    3                 4

12. How often do you feel restless or fidgety?              0                 1                 2                    3                 4

13. How often do you have difficulty unwinding and relaxing when you have time

to yourself?                                                                 0                 1                 2                    3                 4

14. How often do you feel overly active and compelled to do things, like you

were driven by a motor?                                             0                 1                 2                    3                 4

15. How often do you find yourself talking too much when you are in social situations?

                                                                                    0                 1                 2                    3                 4

16. 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?                                                      0                 1                 2                    3                 4

17. How often do you have difficulty waiting your turn in situations when

 turn taking is required?                                             0                 1                 2                    3                 4

18. How often do you interrupt others when they are busy?

                                                                                    0                 1                 2                    3                 4

24 or over = highly likely ADHD according to author

17-23 = possible to likely ADHD

The Adult ADHD Self-Report Scale (ASRS) was developed in conjunction with the World Health Organization and the Workgroup on Adult ADHD that included Lenard Adler, M.D., of New York Univ. Med School, Ronald Kessler, PhD, Harvard Med, and Thomas Spencer, M.D., Harvard Med. The questions are based on DSM-IV modified for adults.

For the diagnosis of adult ADHD, there should be a history of childhood ADHD although it may have been undiagnosed at the time.