Rating Scales to Diagnose ADHDby Eileen Bailey Health Writer
Although there is no single, definitive test that will state whether a child has ADHD, there are a number of rating scales that are sometimes used during the diagnostic process.
Some of the most common rating scales are:__
__Child Behavior Checklist (CBLC) There are two versions of the Child Behavior Checklist, one is for ages 6-18 and the other is for ages 1 ½ to 5. The test is designed to assess a child's behavior and social competency, as reported by their parents. The questionnaire includes questions on social issues, such as whether your child has friends, relationships with family members, extracurricular activities and hobbies. In addition, the questionnaire asks the parents to rate their child, on a scale of not true, somewhat true, or true on many different issues, including: academics, inattention, relationships, and behaviors.
It is important for parents to answer all questions and to answer all as honestly as possible. The information gathered from this questionnaire will help doctors to determine the correct diagnosis and help to form a treatment plan specific to the child's needs.
Conners Teacher/Parents Rating Scales (CTRS,CPRS) The Conners Teacher/Parents Rating Scales is completed by the parents (or caregiver) and by the teacher. For adolescents, there is a self-reporting form in order for them to complete the information. The scale was last revised in 1997 and now includes simpler and clearer language as well as items that match the DSM-IV criteria for diagnosing ADHD. The scale measures criteria for children ages 3-17. There is a long and short version of the scale available, where the long should take 15-25 minutes to complete and the short version 5-10 minutes.
In addition to assisting in the diagnostic process, the rating scale can also be used as a follow up to determine if a specific treatment is working by comparing the results from before treatment began to after treatment.
ADD-H Comprehensive Teacher Rating Scale (ACTeRS)
_**_The ADD-H Comprehensive Teacher Rating Scale is divided into two sections. One section is to be completed by the parents and one section is to be completed by the teacher. Each section contains 24 questions and should take 5-10 minutes to complete. This rating scale is used for children between the ages of 5 and 12 years of age, and measures 4 areas of behaviors. It is important to note that the DSM-IV criteria for diagnosis ADHD states that the symptoms must be present in at least two environments. By having both teachers and parents complete the questionnaire, physicians can evaluate behaviors in two separate situations.
Child Attention Problems (CAP) Rating Scale
The Child Attention Problems Rating Scale is a brief rating scale used to monitor the effectiveness of medication or treatment. It is sometimes used on a weekly basis and completed by teachers. This helps the physician adjust treament according to the child's individual needs. This rating scale covers information on over-activity, impulsiveness and inattention. Teachers should be able to complete the questionnaire in 5-10 minutes.
ADHD Rating Scale-IV
This rating scale uses the actual diagnostic criteria as listed in the DSM-IV as the basis for the scale. It is used for both younger children and adolescents. The rating scale has different versions for both parents and teachers to complete. There are a total of 18 items to be completed by both the parents and the teachers. The parents questionnaire asks the parents to rate children's behavior on a scale of "never" to "very often" and includes questions on activity levels, ability to finish work, forgetfulness and inattention. Sample of Parent Questionnaire The teacher version also has 18 items to be evaluated by the teacher, with a scale of "never" to "very often".
Russell Barkley's Home and School Situations Questionnaires
Developed by Dr. Russell Barkley, a renowned expert on ADHD, these questionnaires are designed specifically to gather information from both the parents and the teachers. Since the DSM-IV states that symptoms of ADHD must be present in at least two environments, this is extremely important. The Home Situation Questionnaire evaluates how the symptoms of ADHD disrupt normal home situations such as meal time or completing chores. Parents determine if there were problems in 16 different areas and then rate those problems on a scale of 1-9. The School Situation Questionnaire is completed by teachers and evaluates the child on 12 common school situations. These tests and rating scales are used, along with a complete evaluation to help determine the correct diagnosis for a child. Parents, caregivers and teachers are all asked to complete the rating scales, in order to receive information about the child in different environments. With all of the scales, please keep in mind, they should not be used as the sole diagnostic criteria but should be used as part of a complete evaluation. Your physician will assess the information on the above rating scales and compare the results to the DSM-IV criteria for diagnosis of ADHD. If your physician finds your child to have ADHD, you should sit down together to determine a treatment plan.
Achenbach System of Empirically Based Assessment
Psychological Assessment Resources
Massachusettes General Hospital School Psychiatry Program
Ontario Association of Pediatricians
The Child's Doctor
American Academy of Child and Adolescent Psychiatry
Practical assessment and treatment of attention-deficit/hyperactivity disorder
Journal of Clinical Child and Adolescent Psychology