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According to the Agency for Healthcare Research and Quality (AHRQ), formerly the Agency for Health Care Policy and Research, ADHD-specific rating scales are more accurate in distinguishing between children with and without the diagnosis of ADHD, than global, nonspecific questionnaires and rating scales that assess a variety of behavioral conditions.
Clinicians evaluating a child for ADHD use a variety of assessment tools to gather information. They will ask parents and educators to complete various forms, including checklists, behavior questionnaires, or rating scales. These tools are an essential component of a comprehensive evaluation for ADHD.
If you suspect you or your child might have attention deficit hyperactivity disorder (ADHD), your doctor has several ways to make a diagnosis. One is an ADHD rating scale, which measures symptoms like inattention and lack of impulse control. Doctors have many such scales to choose from. They often use one called the Conners rating scale.
The Conners rating scale is a questionnaire that asks about things like behavior, work or schoolwork, and social life. The answers show your doctor which ADHD symptoms you might have and how serious they are. They can show how these symptoms affect things like grades, job, home life, and relationships.
Parents and teachers usually fill out scales for children. Older children complete their own rating scale. Adults answer a questionnaire about themselves and may ask a spouse, co-worker, or close friend to do one as well.
Depending on which version your doctor uses, the Conners ADHD rating scale might ask a lot of questions or just a few. Whether aimed at children or adults, the Conners scale assesses symptoms such as:
When answering questions on the Conners rating scale, you enter a number from 0 to 3 to indicate how often you notice a symptom or behavior. A "0" means never, while a "3" means it happens very often.
For almost 50 years, ADHD rating scales have been used to help screen, evaluate, and monitor the symptoms of attention deficit hyperactivity disorder (ADHD) in children and adults. Rating scales are considered essential for ADHD diagnosis in children. Many different types of scales are available. Ideally, you or one of the following people will complete the forms:
A typical rating scale will have 18 to 90 questions about the frequency of ADHD-related behaviors. Questions are based on the definition of ADHD provided by the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). Some examples of these behaviors include:
ADHD rating scales are available for children, teenagers, and adults. Questionnaires can take anywhere from 5 to 20 minutes to complete. You can find them online for free or sold for up to $140. While anyone can fill out a rating scale, only your doctor can provide an accurate diagnosis of ADHD.
A question may probe the extent of excessive talking or fidgeting to gauge hyperactivity. Questions regarding impulsivity may ask about interrupting. Rating these behaviors can help measure inattention, hyperactivity, and impulsiveness. Some rating scales like the SNAP-IV will also ask about classroom performance. Overall, the tests are designed to look for strong evidence of ADHD behaviors.
Many healthcare professionals use the NICHQ Vanderbilt Assessment Scale Diagnostic Rating Scale to help diagnose ADHD. The scale is meant for children ages 6 to 12, but people in other age groups can use it, if applicable. Different forms are available for parents and teachers. Both forms screen for symptoms of ADHD and inattention. The parent assessment scale has a separate section for conduct disorder, or antisocial behavior while the teacher assessment scale has an extra section on learning disabilities.
The SNAP-IV rating scale contains nine questions regarding inattention and nine regarding hyperactivity and impulsivity. For each item, or behavior, you note the frequency from not at all to very much. These responses are ranked on a scale of 0 to 3. Once you add up the scores for each section, you divide the number by 9 to determine an average.
On the Snap-IV scale, teachers can rate a child who scores above 2.56 as inattentive. For parents, the figure is 1.78. A score on the hyperactive and impulsive questions of 1.78 for teachers and 1.44 for parents indicates a need for further investigation for ADHD.
Over 7,000 assessments were collected in the development of the Conners CBRS and Conners CI, including ratings of children and youth for the normative sample, clinical cases, and for the validity studies. In the normative study, 3,400 Conners CBRS assessments were collected. The large normative data sample is representative of the general U.S. population in terms of ethnicity/race, gender, and parental education level (U.S. Bureau of the Census, 2000). The normative sample is also diverse in terms of parental education level and geographic region.
Concurrent validity has been established through comparing parent rating with teacher ratings and those independently diagnosed with ADHD (Mark et al., 2003). Confirmatory factor analysis confirmed four factors that fitted with the theoretical formulation of inattention, hyperactivity/impulsivity, ODD-CD, and anxiety-depression subscales.
Becker et al. (2011) validated the subscales but reformulated the scoring method for the comorbid sub-scales by using the total sum of scores. In this scoring system the total sum of the subscales (rather than when a parents rates either 2 or 3 on the Likert scale), ODD is ruled out at
Becker, S. P., Langberg, J. M., Vaughn, A. J., & Epstein, J. N. (2012). Clinical utility of the Vanderbilt ADHD diagnostic parent rating scale comorbidity screening scales. Journal of Developmental and Behavioral Pediatrics, 33(3), 221. 2b1af7f3a8