ASRS-6 Calculator

The Adult ADHD Self-Report Scale v1.1 Screener (ASRS-6) is a six-item self-report screening tool for attention deficit hyperactivity disorder (ADHD) in adults. Developed by the World Health Organization (WHO) in collaboration with researchers at Harvard Medical School and New York University, the ASRS-6 was designed to identify adults who may benefit from further evaluation for ADHD.

The six items assess core ADHD symptoms across two domains: inattention (four items) and hyperactivity/impulsivity (two items). Each item is scored on a five-point scale from 0 ("Never") to 4 ("Very Often"), yielding a total score between 0 and 24. The ASRS-6 is derived from the 18-item ASRS v1.1 and serves as its screening component.

The ASRS-6 was developed by Kessler, Adler, Ames, and colleagues as part of the WHO Adult ADHD Self-Report Scale project, published in Psychological Medicine in 2005. The six screening items were selected from the full 18-item ASRS using stepwise logistic regression to identify the items with the highest concordance with clinical ADHD diagnoses.

The original validation study demonstrated that the ASRS-6 had strong screening properties, with a sensitivity of 68.7% and specificity of 99.5% using the original dichotomous scoring method. When using the expanded continuous scoring approach (summing raw scores), the instrument provides a more nuanced severity estimate.

The ASRS-6 has been validated across multiple populations and languages. It is used in clinical practice, workplace screening programs, and epidemiological research. The WHO's involvement in its development has facilitated worldwide adoption and translation.

The ASRS-6 uses a five-point frequency scale for each item:

0 = Never 1 = Rarely 2 = Sometimes 3 = Often 4 = Very Often

This calculator applies the WHO/Harvard Medical School shaded-box scoring convention (Kessler et al. 2005). Each of the six items has a per-item threshold that, when met or exceeded, contributes 1 to the total. Items 1-3 use a threshold of "Sometimes" or higher; items 4-6 use a threshold of "Often" or higher. The total is therefore a count between 0 and 6 — not a 0-24 severity sum.

0-3: Below the screening threshold 4-6: Highly consistent with adult ADHD — comprehensive clinical evaluation recommended

The six items cover two symptom domains: Inattention (items 1-4): Difficulty completing tasks, organising, remembering obligations, and avoiding procrastination Hyperactivity/Impulsivity (items 5-6): Fidgeting and feeling driven or restless

The six-month timeframe of the questions captures the persistent nature of ADHD symptoms, distinguishing them from transient attention difficulties.

The ASRS-6 is used as a first-step screening tool for adult ADHD in clinical and community settings. Its primary applications include:

Primary care screening, where adult ADHD is common but often unrecognised. The ASRS-6 can be administered as part of routine assessment when ADHD is suspected.

Mental health assessment, where the ASRS-6 helps identify ADHD symptoms that may co-occur with or mimic other conditions such as anxiety, depression, or substance use difficulties.

Workplace and occupational health programs, where ADHD symptoms may affect performance, organisation, and task completion.

Research and epidemiological studies, where the ASRS-6 provides a standardised, brief measure of adult ADHD symptoms.

A positive screen on the ASRS-6 does not indicate a diagnosis of ADHD. Comprehensive evaluation typically involves detailed clinical interview, developmental history, collateral information, and consideration of alternative explanations for symptoms.

In Australia, the ASRS-6 is widely used by psychologists, psychiatrists, and GPs as part of the assessment process for adult ADHD. Recognition of adult ADHD in Australia has grown significantly in recent years, and the ASRS-6 provides a validated, accessible screening tool.

Australian clinical practice guidelines for ADHD assessment reference the ASRS as a recommended screening instrument. The ASRS-6 is commonly used as an initial step in the assessment pathway, with positive screens leading to comprehensive evaluation that may include structured diagnostic interviews, cognitive testing, and collateral history.

The instrument is freely available for clinical, research, and commercial use with attribution, making it accessible across Australian healthcare settings. Its inclusion of both inattention and hyperactivity/impulsivity domains supports screening across all ADHD presentations.