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Psychologist Form

Adult ADHD Self-Report Scale

A downloadable Psychologist form for healthcare professionals.
Auto-fill with HeidiBrowse templates

Specialty

Psychologist

Downloads

53 times

Type

Form

Last edited

7/24/2026

Created by

Heidi Team

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About this form

The Adult ADHD Self-Report Scale supports clinical documentation and decision-making when assessing ADHD symptoms in adults. It is used to evaluate symptom severity and functional impact in line with clinical guidelines. The form captures key information such as patient demographics, symptom patterns, and daily functioning, supporting a comprehensive assessment. Completing this form in Heidi helps improve clarity, reduce missing information, and keep documentation organised.

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Frequently asked questions

What is the purpose of the Adult ADHD Self-Report Scale PDF?

The purpose of the Adult ADHD Self-Report Scale PDF is to serve as an 18-item screening tool for adult ADHD symptoms. Developed by the World Health Organization and based on DSM-IV criteria, this self-report checklist helps psychologists and other clinicians in CA evaluate symptom severity and functional impact. It supports clinical documentation and decision-making when assessing adults for ADHD by capturing key information about symptom patterns and daily functioning in line with clinical guidelines.

Who uses the Adult ADHD Self-Report Scale PDF?

Your patient uses this form to self-report the frequency of their ADHD symptoms over the past six months. They complete the 18-item checklist by rating each item on a five-level scale, from "Never" to "Very Often," and give the completed form to you. As the clinician, you then interpret the results. A positive screen on the first part of the form indicates the patient warrants a full evaluation for adult ADHD, which you would then discuss during the visit.

What is included in a Adult ADHD Self-Report Scale PDF?

An Adult ADHD Self-Report Scale PDF includes patient identifiers and a two-part, 18-item symptom checklist.

  • Patient name and date completed
  • Part A: A six-item symptom checklist with a five-level frequency rating
  • Part B: A twelve-item symptom checklist with the same five-level rating scale
  • Part A scoring section with shaded threshold responses

Common Problems of Completing Adult ADHD Self-Report Scale PDFs

The Non-Obvious Scoring Rule Is Often Misapplied

The scoring rule for Part A is complex and a frequent source of error. Not all items have the same threshold for a "positive" response; some require a rating of "Often" or "Very Often" to count, while others only need "Sometimes." Misapplying this shaded-response rule can lead to an incorrect conclusion about whether the patient has screened positive, potentially resulting in either unnecessary further evaluation or a missed opportunity to investigate genuine ADHD symptoms.

Positive Screens Do Not Confirm an ADHD Diagnosis

This form is a screener, not a diagnostic tool. A score of four or more on Part A only indicates that a patient warrants a full clinical evaluation, not that they have ADHD. The symptoms on the checklist overlap significantly with anxiety, depression, sleep disorders and substance use. A positive screen is the beginning of the differential workup, which requires clinical judgment the form itself cannot provide.

Symptoms Can Be Masked in Certain Patient Groups

Women and high-functioning adults with ADHD often develop sophisticated compensation strategies that can mask their underlying symptoms. As a result, they may score below the screening threshold on this instrument despite having genuine ADHD that impacts their functioning. Relying solely on the score without considering the patient's presentation and history can lead to under-detection in these specific populations who present for assessment.

Benefits of Using Heidi to Auto-Fill Adult ADHD Self-Report Scale PDFs

The Scoring Rule Applied Correctly, Every Time

The complex scoring rule for Part A is easy to misapply under pressure, with different items having different thresholds. If you administer the questions conversationally, Heidi documents the responses and automatically applies the correct scoring logic. This provides an accurate starting point for your review, ensuring the screen is interpreted correctly without you needing to manually check the specific rule for each item.

Differential Reasoning Structured Directly in the Note

When a screen is positive, the next step is the differential workup. Heidi structures the clinical reasoning for conditions that mimic ADHD, such as anxiety, sleep disorders, substance use and mood disorders, directly into your clinical note. This helps organize your documentation around the necessary next steps for a comprehensive evaluation, reflecting the full scope of your clinical judgment.

A Flag for Potential Under-Detection in the Profile

For certain patients, such as women or high-functioning adults with a late presentation, this screening tool can under-detect genuine ADHD. Based on the patient profile, Heidi flags this possibility in the documentation it prepares for your review. This serves as a reminder to consider the patient's unique history and potential compensation strategies as part of your overall assessment, ensuring your final note is nuanced and complete.

How to use this form

1

Auto-fill with Heidi

Click "Auto-fill Form with Heidi" to open the form in Heidi and complete the fields straight from your note, no copying and pasting.

2

Review and edit

Check the pre-filled details and make any changes before finalising the form.

3

Download or save

Download the completed form or save it directly into your patient records and workflows.

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