What Psychologists Should Know Before Choosing an ADHD Assessment Screener

When it comes to assessing ADHD—particularly in adults or individuals with internalised presentations—many psychologists rely on screening tools as part of the process. And while screeners can be useful, they’re only as good as the context in which they’re used.

If you’ve ever asked, “Which ADHD screener should I be using?”—you’re not alone. But the better question might be: “Is this screener appropriate for the client in front of me?”

Let’s unpack what psychologists really need to consider before choosing a screener—and why this isn’t as straightforward as it seems.

The Problem With Standard ADHD Assessment Screeners

Many ADHD screeners were developed using samples of young boys with observable externalising behaviours. They weren’t designed with internalised presentations, high-masking individuals, or adults in mind—let alone females, AFAB individuals, or those with co-occurring presentations.

What does this mean? It means your client could complete a screener, fall short of the clinical cut-off, and still meet full diagnostic criteria when a comprehensive assessment is done.

💡 This is why ADHD assessments need to go beyond “what tools to use” and focus on how to interpret results critically. Which is exactly why I emphasise in my ADHD assessment training not just how to select tools, but how to interpret them critically, and understand them in the context of complex presentations.

Common Limitations of ADHD Screening Tools

Some of the issues I see with commonly used screeners include:

• False negatives in individuals who have more internalised traits or a higher IQ

• Questions that rely heavily on observable physical hyperactivity rather than executive functioning issues

• Items that lack relevance for adults (e.g. they are focused on school-based items, behavioural disruptions)

• A lack of sensitivity to masking, particularly among autistic individuals with ADHD traits

• Over-reliance on symptom count without context (e.g. no consideration for how long symptoms have been present, or how they function across settings)
  

None of this means screeners are useless. But it does mean we need to stop treating them as standalone diagnostic tools. They’re one data point—nothing more.

So, What Should You Use?

It depends on who you’re assessing. For adult clients with suspected ADHD (especially those who are female, non-binary, culturally diverse, or have a high IQ), I recommend:

✔ Pairing any screener with a robust clinical interview that explores developmental history, compensatory strategies and executive functioning differences. ✔ Using screeners normed for adults while being mindful of their limitations for minority groups

✔ Ensure you are using executive functioning specific measures (such as the BRIEF or BROWN). Weschler scales are not reliable measures of executive dysfunction in ADHD.

✔ Assessing for co-occuring Autism due to the high statistical likelihood that both neurotypes will be present. When someone is AuDHD (Autistic + ADHD) there is significant diagnostic overshadowing that occurs, resulting in a higher likelihood that you will 'miss' the traits of ADHD.

In my ADHD assessment training, I cover this in more detail—including which screeners I use, how I supplement them, and the intake questions I always ask to uncover hidden presentations.

Intake Matters Just as Much as the Tools

If you fail to ask the right questions in your intake process or in the clinical interview, you’ll still miss important information (even with the right tools). That’s why I created my custom ADHD Intake Form for Adults—designed with neurodivergent clients in mind. These are the exact questionnaires I use in my own diagnostic assessments.

It includes:

• Questions that uncover executive dysfunction

• Prompts to identify masking and internalised symptoms

• Sections tailored presentations often overlooked in traditional assessment
  

💡 If you're looking to improve the quality of your ADHD assessments, your intake is a great place to start. You can check out my editable intake forms here.

ADHD Diagnostic Intake Questionnaire Bundle

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Final Thoughts: ADHD Screeners Are Tools—Not Answers

Screeners are helpful, but they should never be the sole basis for diagnosis. Understanding their limitations, particularly for underrepresented presentations, is part of ethical and affirming practice. If you're relying on tools without critical interpretation, there's a risk of misdiagnosis—or worse, dismissal of a client who actually needs support.

If you want to develop more confidence in this area, my ADHD Assessment Training for Psychologists dives deep into tools, frameworks, and neurodiversity-affirming approaches for identifying ADHD across diverse populations. And don’t forget—my intake forms are designed to save you time and improve the quality of your clinical data.