RESEARCH UPDATE REVIEW
Ten-Year Review of Rating Scales. V: Scales Assessing Attention-Deficit/Hyperactivity Disorder

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ABSTRACT

Objective

This article summarizes information on scales assessing attention-deficit/hyperactivity disorder (ADHD) in children and adolescents.

Method

The authors sampled articles on ADHD over the past decade. Several popular older ADHD measures have recently been revised, and new ADHD scales have been developed. The authors selected primarily ADHD scales based on the DSM-IV construct of ADHD that also have multiple literature citations. They then reviewed their psychometric properties. Those with adequate psychometric functioning plus considerable literature citations, known wide usage in clinical practice, or a current niche are presented here.

Results

Several rating scales consistent with the DSM-IV conceptualization of ADHD are now available for use in both home and school settings. Many of the instruments demonstrate solid psychometric properties and a strong normative base. However, some popular scales have not been adequately investigated. Some measures are restricted to the comprehensive assessment of ADHD, whereas others also include symptoms of other disorders. The potential applications for these scales with youths diagnosed with ADHD are broad.

Conclusions

Rating scales can reliably, validly, and efficiently measure DSM-IV-based ADHD symptoms in youths. They have great utility in research and clinical work, assist treatment planning, and help to ensure accountability in practice.

Section snippets

General Description.

The Conners Rating Scales-Revised (CRS-R) Conners, 1997) represent a needed update of this popular scale whose long history in the evaluation of ADHD youths has recently been summarized (Gianarris et al., 2001). The Conners scales were developed to assess a wide variety of children's common behavior problems, such as sleep disturbance, eating problems, and peer relationships (Conners, 1970). The scales were later expanded into a 93-item questionnaire, the Conners' Parent Rating Scale-93,

General Comments

These narrow band scales that are based on DSM-IV have good face validity as their items are derived from a clear diagnostic construct for ADHD. Most yield the same core subscales of Inattention and Hyperactivity/Impulsivity, are similar in format, and rely on adults' reports of youths' behavior. Thus it is difficult to glean advantages of one scale over the other, and ā€œhead-to-headā€ comparisons of these scales are not available. Therefore, choosing a scale largely hinges on the need for

General Considerations

The development of ADHD rating scales based on DSM-IV highlights larger issues relevant to the use of all diagnosis-based, or narrow band, rating scales. First, high scores on rating scales do not equate to diagnosis, and rating scales do not substitute for diagnostic evaluation. Second, the trend toward using DSM-IV criteria in a rating scale format is advantageous in that it utilizes a well-established diagnostic construct and overlaps with other procedures that a clinician uses, such as

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