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Adult ADHD Self-Report Scale (ASRS-v1.1) Symptom Checklist Instructions. The questions on the back page are designed to stimulate dialogue between you and your patients and to help confirm if they may be suffering from the symptoms of attention-deficit/hyperactivity disorder (ADHD).
The Adult ADHD Self-Report Scale (ASRS v1.1) and scoring system were developed in conjunction with the World Health Organization (WHO) and the Workgroup on Adult ADHD to help healthcare professionals to screen their patients for adult ADHD.
The questions in the ASRS v1.1 are consistent with DSM-IV criteria and address the manifestations of ADHD symptoms in adults. The content of the questionnaire also reflects the importance that DSM-IV places on symptoms, impairments, and history for a correct diagnosis.
The following questionnaire can be used as a starting point to help you recognize the signs/symptoms of Adult ADHD but is not meant to replace consultation with a trained healthcare professional. An accurate diagnosis can only be made through a clinical evaluation.
ADULT ADHD SELF-REPORT SCALE (ASRS-V1.1) SYMPTOM CHECKLIST. Please answer the questions below, rating yourself on each of the criteria shown using the scale on the right side of the page.
Adult ADHD Self-Report Scale (ASRS) Symptom Checklist. 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, place an X in the box that best describes how you have felt and conducted yourself over the past 6 months. Never.
The Adult ADHD Self-Report Scale (ASRS-v1.1) may be used as a tool to help screen for attention-deficit/hyperactivity disorder (ADHD) in adult patients. The checklist takes about 5 minutes to complete.