[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"assessment-acos-sr":3,"all-assessments-nav":182,"related-assessments-query":829},{"id":4,"title":5,"body":6,"category":146,"categoryTitle":147,"clinicalCitations":148,"copyright":152,"description":153,"disclaimer":154,"downloadLink":146,"extension":155,"faqs":156,"featured":169,"i18nReady":169,"icon":146,"interpreter":146,"lastReviewed":170,"meta":171,"navigation":172,"path":173,"permissionsNote":174,"published":172,"recommendedFrequency":175,"relatedCodes":146,"relatedConditions":146,"reviewedBy":146,"seo":176,"slug":177,"stem":178,"summary":179,"takeaways":146,"timeline":146,"type":180,"usedToDiagnose":146,"__hash__":181},"assessments\u002Fassessments\u002Facos-sr.md","ADHD Clinical Outcome Scale, Self-Report (ACOS-SR)",{"type":7,"value":8,"toc":137},"minimark",[9,14,18,21,25,28,57,60,64,86,90,93,119,122,126],[10,11,13],"h3",{"id":12},"foundational-context","Foundational Context",[15,16,17],"p",{},"The ADHD Clinical Outcome Scale (ACOS) was developed by Adamis and colleagues (2024) to address a practical gap: adult ADHD clinics needed a brief, repeatable way to measure clinical outcomes that captures not just core symptoms but the comorbidities and functional difficulties that commonly accompany adult ADHD. Earlier outcome work in these services relied mainly on functional or quality-of-life scales.",[15,19,20],{},"The ACOS is clinician-rated, and the authors also evaluated a modified version completed by the patient — the self-report form referred to here as the ACOS-SR. Comparing the two gives clinicians both an independent rating and the patient's own perspective on their functioning.",[10,22,24],{"id":23},"what-the-assessment-measures","What the Assessment Measures",[15,26,27],{},"Factor analysis of the ACOS identified four areas:",[29,30,31,39,45,51],"ul",{},[32,33,34,38],"li",{},[35,36,37],"strong",{},"Attentional and organizational problems"," — sustaining focus, distractibility, planning, and task follow-through",[32,40,41,44],{},[35,42,43],{},"Hyperactivity and impulsivity"," — restlessness and acting without reflection",[32,46,47,50],{},[35,48,49],{},"Comorbidities"," — co-occurring clinical problems that frequently accompany adult ADHD",[32,52,53,56],{},[35,54,55],{},"Substance use, self-harm, and relationships"," — alcohol or drug use, self-harm, and tension in close relationships",[15,58,59],{},"The 15 items are rated on a Likert scale. Including typically co-occurring clinical domains is what makes the scale suited to repeated use at routine clinic contacts.",[10,61,63],{"id":62},"interpretation-guidelines","Interpretation Guidelines",[29,65,66,73,80,83],{},[32,67,68,69,72],{},"The ACOS-SR is an ",[35,70,71],{},"outcome-monitoring measure, not a diagnostic tool",".",[32,74,75,76,79],{},"As a recently published scale (2024), it does ",[35,77,78],{},"not yet have widely established total-score cut-offs","; tracking change over time is more informative than any single score.",[32,81,82],{},"The clinician-rated and self-report versions can diverge — the patient's perspective (ACOS-SR) is a complement to, not a replacement for, the clinical rating.",[32,84,85],{},"When ADHD is being assessed for the first time, pair the ACOS-SR with diagnostic tools and a full clinical evaluation.",[10,87,89],{"id":88},"psychometric-properties","Psychometric Properties",[15,91,92],{},"In the initial validation (148 adults attending an ADHD clinic; mean age 30.1):",[29,94,95,101,107,113],{},[32,96,97,100],{},[35,98,99],{},"Interrater reliability"," between two clinicians was high (r = 0.868).",[32,102,103,106],{},[35,104,105],{},"Agreement between the patient and clinician versions"," was moderate (r = 0.663).",[32,108,109,112],{},[35,110,111],{},"Internal consistency"," was good (intraclass correlation coefficient = 0.829).",[32,114,115,118],{},[35,116,117],{},"Concurrent validity"," was supported by correlations with the Adult ADHD Quality of Life Questionnaire (AAQoL, r = −0.573) and the Weiss Functional Impairment Rating Scale (WFIRS, r = 0.477).",[15,120,121],{},"The authors describe the psychometrics as promising and the scale as suitable for clinician-rated outcome monitoring at every patient contact.",[10,123,125],{"id":124},"limitations","Limitations",[29,127,128,131,134],{},[32,129,130],{},"Not a diagnostic assessment.",[32,132,133],{},"A recently published scale with a smaller evidence base than long-established measures such as the ASRS.",[32,135,136],{},"Should be interpreted alongside other clinical information, not in isolation.",{"title":138,"searchDepth":139,"depth":139,"links":140},"",3,[141,142,143,144,145],{"id":12,"depth":139,"text":13},{"id":23,"depth":139,"text":24},{"id":62,"depth":139,"text":63},{"id":88,"depth":139,"text":89},{"id":124,"depth":139,"text":125},null,"ADHD & Attention",[149],{"text":150,"link":151},"Adamis D, Singh J, Coada I, Wrigley M, Gavin B, McNicholas F. Measuring clinical outcomes in adult ADHD clinics: psychometrics of a new scale, the adult ADHD Clinical Outcome Scale. BJPsych Open. 2024;10(6):e180.","https:\u002F\u002Fpubmed.ncbi.nlm.nih.gov\u002F39397668\u002F","ADHD Clinical Outcome Scale (ACOS) © the authors. Published open access in BJPsych Open (2024) under a Creative Commons licence. HiBoop is not affiliated with the authors.","ACOS-SR: the self-report version of the 15-item adult ADHD Clinical Outcome Scale (Adamis et al., 2024). Likert-rated outcome-monitoring measure across four clinical domains.","This summary is for informational purposes only. The ACOS-SR is an outcome-monitoring measure and does not replace clinical judgment or a full diagnostic assessment. HiBoop does not interpret responses; use must align with organizational protocols.","md",[157,160,163,166],{"question":158,"answer":159},"Is the ACOS-SR self-administered or clinician-administered?","The ACOS was developed as a clinician-rated scale, and a modified version is completed by the patient (the self-report form, ACOS-SR). Using both lets clinicians compare the patient's own perspective with an independent clinical rating; in the validation study the two versions correlated moderately (r ≈ 0.66).",{"question":161,"answer":162},"What does the ACOS-SR measure?","Factor analysis of the ACOS identified four areas: attentional and organizational problems; hyperactivity and impulsivity; co-occurring problems (comorbidities); and alcohol or drug use, self-harm, and tension in relationships. It is designed as a routine outcome-monitoring measure for adult ADHD clinics, not a diagnostic screener.",{"question":164,"answer":165},"How is the ACOS-SR scored?","The ACOS consists of 15 items rated on a Likert scale. As a recently published scale (2024), it does not yet have widely established total-score cut-offs; it is intended to be tracked over time within a course of care rather than interpreted against a fixed threshold.",{"question":167,"answer":168},"Can the ACOS-SR be used to diagnose ADHD?","No. The ACOS-SR is an outcome-monitoring measure, not a diagnostic assessment. A diagnosis of ADHD requires a comprehensive clinical evaluation including diagnostic interview, developmental and symptom history, and collateral information.",false,"2026-06-03",{},true,"\u002Fassessments\u002Facos-sr","The ACOS and its self-report version were developed by Adamis et al. (University of Galway \u002F Sligo Mental Health Services and colleagues). The validation paper is open access in BJPsych Open; cite the original publication when using the scale.","At baseline, to establish a starting point\n\nEvery 4–12 weeks during active treatment or medication titration\n\nAt follow-up visits, to track change over time\n",{"title":5,"description":153},"acos-sr","assessments\u002Facos-sr","The ADHD Clinical Outcome Scale (ACOS) is a 15-item clinician-rated measure developed by Adamis and colleagues (2024) for routine outcome monitoring in adult ADHD clinics; a modified patient-completed version is the self-report form (ACOS-SR). Items are rated on a Likert scale and span four areas: attentional\u002Forganizational problems, hyperactivity\u002Fimpulsivity, comorbidities, and substance use, self-harm, and relationship difficulties.\n\nBecause it captures typically co-occurring clinical domains rather than DSM symptom counts alone, the ACOS is intended to be administered repeatedly across a course of care to track change. 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