ADHD screeners and tests explained: ASRS, DIVA, CPT and QbTest

Somewhere between a first suspicion and a diagnosis, most adults meet at least one named instrument: a questionnaire in a waiting room, a quiz online, a computer task that tracks attention. The names blur together, and marketing sometimes implies more than the tools can deliver. This article sorts them by what each one is for and reports the accuracy figures that have been published.

Four kinds of tool

The ASRS: what the accuracy numbers mean

The ASRS is the World Health Organization's adult ADHD screening scale. Its current screener, written for DSM-5 criteria, has six questions. An earlier version, ASRS v1.1, was based on DSM-IV. The accuracy figures below belong to the DSM-5 screener only; this guide does not report figures for the older form.

The DSM-5 screener was tested in two settings and published in JAMA Psychiatry in 2017:

Those are strong results for six questions. The figure that matters most to someone holding a positive result is the positive predictive value. At 67.3% in the general population, about one in three people who screened positive did not have ADHD when given a full interview.

The clinic column shows a second point. Among people who had already come to an adult ADHD program, specificity fell to 74.0%: about one in four of those who turned out not to have ADHD screened positive anyway. A likely reason is that people who seek help for attention problems share many of the complaints the screener asks about, whatever the cause. The same questionnaire performs differently in different rooms.

A negative screen is not a clearance either. Sensitivity of 91.4% means a small share of adults with ADHD score below the cutoff.

Rating scales and structured interviews

Longer rating scales such as the CAARS 2 are used inside an evaluation. The second edition is a revision of the 1999 original, is designed for adults 18 and older, and comes in full, short and index forms. It added validity scales that flag response patterns suggesting the answers may not be reliable. The publisher describes it as something that "aids in the diagnostic process" together with other information.

DIVA-5 is a structured diagnostic interview for adult ADHD published by the DIVA Foundation. A structured interview gives the clinician a set sequence of questions so that nothing in the criteria is skipped. It organizes the conversation. The clinician still has to weigh impairment and decide whether another condition explains the symptoms better. On the DIVA Foundation page reviewed for this guide, the interview's cost and administration rules were not stated, so ask a clinician who uses it how it fits into their evaluation.

Guidance for clinicians treats these instruments as one ingredient. A 2024 review in American Family Physician describes diagnosis as requiring a thorough clinical history, symptom and functional assessment with validated instruments, and collateral information.

Computerized tests: CPTs and QbTest

A continuous performance test is a computerized test of sustained attention. Several versions are sold, and each yields one piece of data about performance on one task on one day. Attention can suffer for many reasons: the CDC lists sleep disorders, anxiety, depression and some learning disabilities among conditions that can produce symptoms similar to ADHD, so a weak score does not say why attention was weak.

QbTest is a computerized test made by Qbtech AB. Its regulatory status is often misdescribed, so here is what the FDA record shows:

• 510(k) number K133382, applicant Qbtech AB, decision dated March 24, 2014;
• product code LQD, "Recorder, attention task performance";
• decision: "substantially equivalent."

A 510(k) clearance means the FDA found the device substantially equivalent to an earlier legally marketed device, for use as an aid. It is not FDA "approval," it is not a finding that the test diagnoses ADHD, and it does not replace the clinical interview.

Why a positive result is not a diagnosis

The CDC's statement is short: "There is no single test to diagnose ADHD." The diagnostic criteria ask for things no questionnaire or computer task can establish alone: several symptoms before age 12, symptoms in two or more settings, clear impairment, and a clinician's judgment that another condition does not explain the picture better.

Institutions in New York draw the same line. The state bar examiners' handbook says checklists and surveys "by themselves are not adequate for the diagnosis of ADHD." Binghamton University's campus psychiatry service says a self-screening tool "will not suffice" as proof of a diagnosis.

Full neuropsychological testing is a separate category from everything on this page, with its own uses and costs. See clinical evaluation or neuropsychological testing.

How to use a screener well

• Use it as a reason to book an evaluation, and bring the completed form with you.
• Answer for how you usually are, not for your worst week.
• Expect the clinician to ask about childhood, work, home and other conditions regardless of your score.
• Be cautious with any service that issues a diagnosis or a prescription from a questionnaire alone.

If you have taken an online quiz already, ADHD self-test for adults: what your results mean explains how to read the result. The next practical step is gathering what an evaluator will ask for, covered in how to prepare for an adult ADHD evaluation. What the visit involves is described on the adult ADHD evaluation page.