The Kolesky-ADHD-EFA®
A structured pre-consultation assessment instrument for adult ADHD.
What it is
The Kolesky-ADHD-EFA® is a comprehensive pre-consultation assessment instrument purpose-built for adult ADHD evaluation in Australian primary care.
It is completed by the patient at home, in their own time, before their consultation. It is also completed independently by someone who knows the patient well – a parent, partner, sibling, or long-term colleague. This second perspective is called a collateral informant, and the assessment uses both responses together to triangulate the clinical picture, especially in patients who have spent years masking their symptoms.
The assessment uses adaptive question logic, meaning it only asks what is clinically relevant to that respondent – patients are not made to wade through items that do not apply to them. By the time the patient arrives at the consultation, the responses have already been scored, severity bands calculated, and clinical flags raised.
The consultation is designed to start with the patient's clinical picture already outlined – comorbidity and safety considerations flagged, and the most relevant clinical questions identified. The work that the assessment does – gathering the patient's responses, capturing the collateral informant's independent perspective, scoring, banding, applying the diagnostic gate, raising the safety and comorbidity flags – would take far longer than a consultation can accommodate. Some of it could not be done in the consultation room at all.
The clinician is positioned to interpret, rather than gather.-
Developmental onset screen – childhood symptoms, age-of-onset evidence
Core ADHD symptom domains mapped to DSM-5-TR adult criteria
Functional impact across work, study, finances, relationships, daily life
Emotional dysregulation and rejection sensitivity (RSD)
Masking and compensatory functioning
Reward, novelty and disordered eating patterns
DSM-5-TR diagnostic gate
An independent collateral informant version (parent, partner, sibling, long-term colleague)
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Adult ADHD rarely presents alone. The instrument carries structured screens for the comorbidities and safety considerations that matter clinically before, during and after assessment – including mood, anxiety, sleep, cardiovascular risk, substance use, and others.
Each flag is designed as a screen requiring clinical judgement, not a diagnosis. The summary the clinician receives spells out what each flag means and what it implies for the consultation.
A complete list of clinical screens and decision-support architecture is provided to practitioners during the licensing discovery call.
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ADHD presents differently in women across the reproductive lifespan. The instrument includes a dedicated screen for female respondents, covering the hormonal patterns and reproductive lifespan factors that materially affect ADHD presentation, severity and treatment response.
This section appears only for respondents who identify their sex at birth as female. It does not affect the core ADHD scoring; it produces its own dedicated flags in the clinician summary.
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Before the patient is seen, the treating clinician receives a structured pre-consultation summary. This includes section scores across each symptom domain, an overall severity band classification (graded from Minimal through Moderate to Severe), the result of the DSM-5-TR diagnostic gate, the active clinical flags with inline guidance on what each flag means, the full collateral informant data alongside the patient's own responses, and a pre-formatted clinical summary suitable for the patient's record.
In short: the data, the scoring, the flags, and the suggested next steps – all delivered to the clinician before the consultation begins.
How to access it
As a practitioner
Practitioners and practices can licence the assessment to run their own branded copy within their clinic. Full details, including what's included and pricing, are on the practitioner licensing page.
As a patient
Patients access the assessment as part of a structured workflow with a registered medical practitioner. The fee is $250, paid once for the complete assessment. It includes:
The patient self-report form
The collateral informant form
Automated scoring and clinical summary
Delivery of the completed assessment to your treating practitioner
Important: the assessment is a structured screening instrument. It does not constitute a diagnosis. Clinical interpretation and all management decisions remain the responsibility of your treating practitioner.
Browse course
The clinical framework for interpreting the assessment is taught in ADHD Unmasked. The course can be taken on its own.
Why this instrument exists
Adult ADHD presents to general practice with consistent under-recognition – particularly in women, in high-functioning patients, in those with comorbid anxiety or affective disorders, and in those whose primary symptoms are emotional rather than behavioural.
Existing screening tools are typically validated, but short. They were not designed to carry the diagnostic load that Australian primary care – particularly under the recent state-level reforms expanding Specialist GP prescribing authority for adult ADHD – has now been asked to carry.
The Kolesky-ADHD-EFA® was built to fill that gap. It is the work of a Specialist GP who needed it for her own practice, refined through clinical use, and now made available to colleagues facing the same workload.
Compliance and clinical use
The instrument is intended for use by registered medical practitioners assessing adults aged 18 and over.
It is not validated for paediatric use.
Clinical interpretation and all management decisions remain the responsibility of the treating practitioner.
Use of the instrument by licensed practitioners is governed by the Practitioner Licence Agreement.
Frequently asked
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Most existing tools fall into one of two categories: brief self-report screeners, or structured diagnostic interviews administered by the clinician during the consultation.
The Kolesky-ADHD-EFA® is designed to sit between the two: it is a self-administered structured assessment completed by the patient before the consultation, with a paired collateral form completed by someone close to them.
The clinician is positioned to enter the consultation already oriented to the key diagnostic questions, the severity profile, the comorbidity flags, and the safety considerations. Consultation time can then be spent on clinical judgement, rather than data collection.
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The instrument is structured around DSM-5-TR diagnostic criteria for adult ADHD, and its symptom-severity domains draw on established self-report frameworks. It is offered as a clinical decision-support tool that supports clinical judgement – it does not replace it. Diagnosis remains the responsibility of the treating clinician.
The Kolesky-ADHD-EFA® is the first KME instrument. Further instruments may follow in clinical areas where structured pre-consultation assessment offers genuine workflow value.