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Existing tools often prioritize symptom severity or isolated domains (e.g., executive function, academics, and behaviors), lacking a multidimensional, school-contextualized assessment. This study introduces the Adaptive Functioning in School Questionnaire (AFSQ), a teacher-reported measure designed to identify adaptive functioning challenges students face in school by assessing the following five domains: 1) social and behavioral adaptation; 2) practical organization; 3) academic task management; 4) emotional comprehension and expression; and 5) emotion regulation and conflict resolution. Participants included 564 students with ADHD (<jats:italic>M<\/jats:italic> age = 9.42 years) and 93 community peers (90% non-ADHD; <jats:italic>M<\/jats:italic> age = 9.36 years), along with their teachers. Factor analyses confirmed the AFSQ\u2019s robust five-factor structure, and convergent validity was supported by strong correlations with executive function (|<jats:italic>r|<\/jats:italic> =.62\u2013.71) and social skills (|<jats:italic>r|<\/jats:italic> =.58\u2013.66). Students with ADHD exhibited greater adaptive challenges across all domains compared to neurotypical peers, with large effect sizes (<jats:italic>d<\/jats:italic> =.82\u20131.34). While inattention predicted adaptive functioning broadly, Oppositional Defiant Disorder\/symptoms (ODD) uniquely exacerbated social-behavioral and emotional challenges in students with ADHD, highlighting the need for tailored interventions in comorbid cases. The AFSQ demonstrates strong reliability (<jats:italic>\u03b1<\/jats:italic> =.83\u2013.96) and validity, offering educators and clinicians a school-specific tool to identify individualized support needs and guide targeted support strategies beyond symptom profiles.<\/jats:p>","DOI":"10.1007\/s10578-025-01867-7","type":"journal-article","created":{"date-parts":[[2025,6,17]],"date-time":"2025-06-17T06:39:07Z","timestamp":1750142347000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Adaptive Functioning in School: A Multidimensional Questionnaire for Assessing Functional Challenges Beyond Symptoms in Students with ADHD"],"prefix":"10.1007","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4975-4631","authenticated-orcid":false,"given":"Que","family":"Zheng","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-0975-1997","authenticated-orcid":false,"given":"Bryan Kwok Hin","family":"Hui","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8697-4049","authenticated-orcid":false,"given":"Jiaxi","family":"Li","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4340-3160","authenticated-orcid":false,"given":"Kathy Kar-man","family":"Shum","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2025,6,17]]},"reference":[{"issue":"2","key":"1867_CR1","doi-asserted-by":"publisher","first-page":"434","DOI":"10.1093\/ije\/dyt261","volume":"43","author":"GV Polanczyk","year":"2014","unstructured":"Polanczyk GV, Willcutt EG, Salum GA, Kieling C, Rohde LA (2014) ADHD prevalence estimates across three decades: an updated systematic review and meta-regression analysis. 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Zheng, B. K. H. Hui, J. Li, and K. K. M. Shum declare that they have no conflict of interest.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"The study is approved by the Human Research Ethics Committee (HREC) at the authors\u2019 affiliated university (Reference Number: EA210226).","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval statement"}},{"value":"The original Chinese version of the Adaptive Functioning in School Questionnaire for Students with ADHD (AFSQ) and its translated English version can be provided to researchers and clinicians upon request.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Additional information"}}]}}