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ADHD rating scale

The ADHD Rating Scale (ADHD-RS) is a parent-report or teacher-report inventory created by DuPaul and colleagues consisting of 18 questions regarding a child’s behavior over the past 6 months. It is used to aid in the diagnosis of attention deficit hyperactivity disorder (ADHD) in children ranging from ages 5–17.

The ADHD-RS is currently in its fifth version in correlation with DSM-V.

The ADHD-RS, a 18-question self-report assessment, takes about five minutes to complete. Each question measures the frequency of the behavior, in which the respondent is asked to indicate whether the behavior occurs “always or very often”, “often”, “somewhat”, or “rarely or never”. The questionnaire is intended to be filled out by parents and teachers of the child or adolescent. The first nine items ask questions about behavior related to inattention (e.g., "has difficulty organizing task and activities"). The second set of nine items ask questions about behavior related to symptoms of hyperactivity and impulsivity (e.g., "talks excessively"). The last question asks if the behaviors were present before age seven. The ADHD Rating scale has impacted the world of clinical psychology by providing an accurate and valid measure that is able to identify the presence of ADHD in children. It is also helpful in identifying the subtype (inattention or hyperactive) of the disorder.

Attention Deficit/ Hyperactivity Disorder (ADHD) is one of the most prevalent behavior disorders found in children. Children with ADHD are at an increased risk for poor scholastic performance, problems with personal conduct, and maintaining social relationships.

The ADHD-RS was created to address the need for an effective evaluation for children and adolescents that are suspected of having ADHD, especially given the disorder's prevalence. The assessment also serves an additional purpose of matching parent and teacher observations of ADHD symptoms to DSM-IV criteria of ADHD.

DSM-IV outlines three subtypes of ADHD: ADHD combined type, ADHD predominantly inattentive, and ADHD predominantly hyperactive-impulsive. The ADHD-RS separates domain scores of “Inattention” and “Hyperactivity-Impulsivity” which ultimately results in three scores for “Inattention,” Hyperactivity-Impulsivity,” and “Total”. DSM-IV also organizes diagnostic criteria into two categories of Inattention and Hyperactivity-Impulsivity, each of which includes nine symptoms. The eighteen questions of the ADHD-RS were written to reflect each symptom of both categories.

Rubric for evaluating norms and reliability for the ADHD Rating Scale*
Criterion Rating (adequate, good, excellent, too good*) Explanation with references
Norms Adequate
Internal consistency (Cronbach’s alpha, split half, etc.) Excellent Alphas were > .90 for the School and Home versions.
Inter-rater reliability Less than adequate reliability between parents and teachers was =.41
Test-retest reliability (stability) Adequate Total score =.85 over a 4 week period
Repeatability Not published No published studies formally checking repeatability
Evaluation of validity and utility for the ADHD Rating Scale*
Criterion Rating (adequate, good, excellent, too good*) Explanation with references
Content validity Adequate Covers DSM diagnostic symptoms for both hyperactivity and impulsivity subtypes and combined type.
Construct validity (e.g., predictive, concurrent, convergent, and discriminant validity) Excellent In the clinical setting the predictive validity for the combined subscale for parents and teachers were 60% and 65% accuracy, respectively. This indicates that the assessment has statistically significant accuracy at identifthe nying the diagnosis.
Discriminative validity Adequate Statistically significant discrimination in mean rating between three groups of participants that identified as ADHD Combined, ADHD Inattentive and no ADHD.
Validity generalization Good Used as other-report from both teachers and parents; used in school settings as well as clinical setting; assessment was normed on a random sample of the population that included many different ethnic and demographic backgrounds.
Treatment sensitivity Adequate Can be used in order to access progression of ADHD symptoms throughout treatment.
Clinical utility Good Easily accessible through the purchase of the handbook that includes the assessment and scoring information with permission to photocopy, strong psychometrics. Completion and scoring are quick and easy.



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