Assessment of Attention‐Deficit/Hyperactivity Disorder (ADHD): A comparative evaluation of five,commonly used,published rating scales

ADHD is one of the most common referrals to school psychologists and child mental health providers. Although a best practice assessment of ADHD requires more than the use of rating scales, rating scales are one of the primary components in the assessment of ADHD. Therefore, the goal of this paper is to provide the reader with a critical and comparative evaluation of the five most commonly used, narrow‐band, published rating scales for the assessment of ADHD. Reviews were conducted in four main areas: content and use, standardization sample and norms, scores and interpretation, and psychometric properties. It was concluded the rating scales with the strongest standardization samples and evidence for reliability and validity are the ADDES, the ADHD‐IV, and the CRS‐R. In determining which of these to use, the prospective users may want to reflect on their goals for the assessment. The ACTeRS and the ADHDT are not recommended for use because they are lacking crucial information in their manuals and have less well‐documented evidence of reliability and validity. Conclusions and recommendations for scale usage are discussed. © 2003 Wiley Periodicals, Inc. Psychol Schs 40: 341–361, 2003.     

Diagnosis and treatment children and adolescents with autism and ADHD

Attention-deficit/hyperactivity disorder (ADHD) and autism are neurodevelopmental disorders that emerge in childhood. There is increasing recognition that ADHD and autism frequently co-occur. Yet, questions remain among clinicians regarding the best ways to evaluate and treat co-occurring autism and ADHD. This review outlines issues relevant to providing evidence-based practice to individuals and families who may be experiencing difficulties associated with co-occurring autism and ADHD. After describing the complexities of the co-occurrence of autism and ADHD, we present practical considerations for best practice assessment and treatment of co-occurring autism and ADHD. Regarding assessment, this includes considerations for interviewing parents/caregivers and youth, using validated parent and teacher rating scales, conducting cognitive assessments, and conducting behavior observations. Regarding treatment, consideration is given to behavioral management, school-based interventions, social skills development, and the use of medications. Throughout, we note the quality of evidence that supports a particular component of assessment or treatment, highlighting when evidence is most relevant to those with co-occurring autism and ADHD across stages of development. In light of the current evidence for assessment and treatment of co-occurring autism and ADHD, we conclude by outlining practical implications for clinical and educational practice.     

DETECTING PARENTAL DECEPTION USING A BEHAVIOR RATING SCALE DURING ASSESSMENT OF ATTENTION‐DEFICIT/HYPERACTIVITY DISORDER: AN EXPERIMENTAL STUDY

It is often assumed that parents completing behavior rating scales during the assessment of attention‐deficit/hyperactivity disorder (ADHD) can deliberately manipulate the outcomes of the assessment. To detect these actions, items designed to detect over‐reporting or under‐reporting of results are sometimes embedded in such rating scales. This study presents the results of an experimental study in which parents (a) read a scenario telling them that their hypothetical son's teacher has suggested their son may have ADHD and (b) considered assigned goals for the assessment. Parents then completed the accompanying Conners 3Parent Short form (Conners 3‐P[S]) in a manner that they believed would achieve their assigned goals. Findings showed that parents are able to engage in deception when completing behavior rating scales. The validity scales embedded in the Conners 3‐P(S), however, demonstrated mixed results for detecting parental deception with the Negative Impression validity scale, accurately detecting attempts to malinger in the majority of cases, whereas the Positive Impression validity scale appears to have little to no diagnostic utility for the detection of defensive responding. Clinicians utilizing behavior rating scales should carefully consider results, and nonresults, obtained from embedded validity scales when interpreting parent responses to behavior rating scales as part of an ADHD assessment.     

Attention‐Deficit/Hyperactivity Disorder (ADHD): A national survey of training and current assessment practices in the schools

The primary purpose of this research was to survey school psychologists to investigate their training and current assessment practices for attention‐deficit/hyperactivity disorder (ADHD) in the schools. The survey consisted of 38 questions regarding participant characteristics and three main areas relevant to ADHD: (a) training, (b) caseloads/referral patterns, and (c) assessment. The respondents reported receiving adequate training in the assessment of ADHD, with doctorate‐level psychologists self‐reporting being better trained than nondoctorate psychologists. Results confirmed a substantial caseload of ADHD referrals. In the assessment of ADHD, the results indicated school psychologists are using multiple informants, methods, and settings for the assessment of ADHD with rating scales, observations, and interviews the most common methods identified. Limitations of current practices will be discussed. © 2003 Wiley Periodicals, Inc. Psychol Schs 40: 583–597, 2003.     

Vocational Students Experiences with Assessment in Workplace Learning

Vocational education, as part of the Norwegian upper secondary education, includes both school-based learning and workplace learning. While school-based learning is characterized by formal structures and guided by aims in the curricula, workplace learning is often informal, incidental and directed by the daily work-tasks. Assessment in workplace learning is mainly formative and different stakeholders are involved in the assessment; namely students, teachers and workplace instructors. However, the guidelines for assessment are vague and call for a close cooperation between the stakeholders. This is demanding and has resulted in a variety of assessment practices. The study presented in this article is a qualitative study of students’ experiences with assessment in workplace learning periods in their first year in vocational education. The aim of the study is to give voice to students` experiences with assessment and illuminate how assessment supports their learning processes. Data was collected through focus group interviews with two groups of students in the Programme for Health and Social Care. The main findings indicate different assessment cultures in school and workplaces. This is expressed through the students’ perceptions of assessment, assessment criteria, tools for assessment and vocational knowledge. It is recommended that an open dialogue about the discontinuity in assessment between schools and workplaces is one of several measures necessary to bridge the gap between the stakeholders.     

Factor structures of Taiwanese teachers' ratings of ADHD: a comparison with U.S. studies

The purpose of this study was to compare factor structures from Taiwanese teachers' ratings with diagnostic definitions of attention-deficit/hyperactivity disorder (ADHD) as described in the DSM-III-R, DSM-IV, and ICD-10; to examine how factor structures of Taiwanese teachers' ratings of ADHD symptoms compare with factor structures reported in research using school-based American participants; and to examine gender differences. One hundred and twenty-one homeroom teachers from six public elementary schools in Taipei County, Taiwan, rated two boys and two girls randomly selected from their homerooms using the ADHD checklist. Findings from this study support the concurrent validity of the DSM-IV ADHD factor structures of hyperactivity-impulsivity and inattention. Comparability of these findings with school-based U.S. studies suggests the cross-cultural congruency of behaviors associated with ADHD.     

儿童注意缺陷多动障碍的学校干预研究回顾

回顾了国内外关于学校开展儿童注意缺陷多动障碍(简称ADHD)干预的研究,对ADHD的治疗和干预研究现状以及学校开展干预的措施进行了总结,其中包括单项干预措施和综合干预措施。最后作出结论,相对其他ADHD干预,学校干预对于改善ADHD学生的人际交往以及提高其学业成绩更具有优势。     

A contemporary review of the assessment,diagnosis and treatment of ADHD

Attention-deficit/hyperactivity disorder (ADHD) is a neuro-behavioural disorder that presents frequently in paediatric and mental health settings. Children with ADHD present with symptoms of hyperactivity, inattention, distractibility and impulsivity. The purpose of this paper is to provide clinicians with a summary of contemporary issues relevant to their clinical understanding, assessment, diagnosis and treatment of the disorder. Issues discussed include the primary and secondary symptoms of the disorder, developmental course, underlying causes, recognition in a clinical setting, diagnosis and treatment.     

Multi-Method Assessment of ADHD Characteristics in Preschool Children: Relations between Measures

Several forms of assessment tools, including behavioral rating scales and objective tests such as the Continuous Performance Test (CPT), can be used to measure inattentive and hyperactive/impulsive behaviors associated with Attention-Deficit/Hyperactivity Disorder (ADHD). However, research with school-age children has shown that the correlations between parent ratings, teacher ratings, and scores on objective measures of ADHD-characteristic behaviors are modest at best. In this study, we examined the relations between parent and teacher ratings of ADHD and CPT scores in a sample of 65 preschoolers ranging from 50 to 72 months of age. No significant associations between teacher and parent ratings of ADHD were found. Parent-ratings of both inattention and hyperactivity/impulsivity accounted for variance in CPT omission errors but not CPT commission errors. Teacher ratings showed evidence of convergent and discriminant validity when entered simultaneously in a hierarchical regression. These tools may be measuring different aspects of inattention and hyperactivity/impulsivity.     

Executive impairment determines ADHD medication response: implications for academic achievement

Methylphenidate (MPH) often ameliorates attention-deficit/hyperactivity disorder (ADHD) behavioral dysfunction according to indirect informant reports and rating scales. The standard of care behavioral MPH titration approach seldom includes direct neuropsychological or academic assessment data to determine treatment efficacy. Documenting "cool" executive-working memory (EWM) and "hot" self-regulation (SR) neuropsychological impairments could aid in differential diagnosis of ADHD subtypes and determining cognitive and academic MPH response. In this study, children aged 6 to 16 with ADHD inattentive type (IT; n = 19) and combined type (n = 33)/hyperactive-impulsive type (n = 4) (CT) participated in double-blind placebo-controlled MPH trials with baseline and randomized placebo, low MPH dose, and high MPH dose conditions. EWM/ SR measures and behavior ratings/classroom observations were rank ordered separately across conditions, with nonparametric randomization tests conducted to determine individual MPH response. Participants were subsequently grouped according to their level of cool EWM and hot SR circuit dysfunction. Robust cognitive and behavioral MPH response was achieved for children with significant baseline EWM/SR impairment, yet response was poor for those with adequate EWM/ SR baseline performance. Even for strong MPH responders, the best dose for neuropsychological functioning was typically lower than the best dose for behavior. Findings offer one possible explanation for why long-term academic MPH treatment gains in ADHD have not been realized. Implications for academic achievement and medication titration practices for children with behaviorally diagnosed ADHD will be discussed.     

What knowledge and conceptions do Irish primary schoolteachers hold on attention deficit hyperactivity disorder?

Attention deficit hyperactivity disorder (ADHD) diagnosis rates have increased significantly in recent times. A teacher's role is crucial in determining if a child will be referred for an ADHD assessment. Teachers' opinions and observations are also required for and play a huge role in the actual assessment process. For this reason, their knowledge of ADHD is also an important part of this process. This research has measured, on a small scale, Irish primary schoolteacher's knowledge and conceptions about ADHD using the Knowledge of Attention Deficit Disorders Scale (KADDS) questionnaire. Ninety teachers participated in the research from 11 primary schools in County Clare. A quantitative method was utilised enabling the research to be comparable with other pieces of research using the same questionnaire. Data in relation to the teachers' professional background were also gathered in order to analyse significant differences based on a variety of factors. The results were analysed as prescribed in KADDS test manual using the statistical software package SPSS. This research shows that Irish primary schoolteachers are more knowledgeable in regards to ADHD symptoms and diagnosis than they are in the areas of associated features or treatments. It also shows that knowledge levels of Irish primary schoolteachers are higher than teachers in earlier research using the same questionnaire.     

Assessing ADHD Symptoms in Preschool Children: Use of the ADHD Symptoms Rating Scale

Attention-Deficit Hyperactivity Disorder (ADHD) is a common childhood disorder that is typically diagnosed during the school years, although features of the disorder can be identified in early childhood. As more children enter into preschool programs, there are increasing opportunities for professionals to identify and treat ADHD prior to school entry. This may increase the likelihood that children will have successful academic and social experiences. Unfortunately, diagnosing ADHD in preschoolers is difficult, in part because few assessment instruments are designed and validated for this age group. The purpose of this study was to examine the psychometric and normative properties of the ADHD-Symptoms Rating Scale (ADHD-SRS) in preschool children. Results shed light on normative levels of ADHD behaviors in preschool children and suggest that preschoolers may present with a somewhat different symptom pattern than school-age children. Further, findings reveal that parents are more likely to endorse ADHD symptoms in their children than are teachers. Given this disparity, the current data emphasize the need for cross-informant assessment in the preschool population.     

The development of children with ADHD in day treatment centres after school hours

The behavioural and emotional development of children with ADHD visiting day treatment centres after school hours is described and the childrearing factors that govern positive development explored. Test scores on the Child behaviour checklist (CBCL) and ADHD behavioural symptoms rating scale were obtained over a period of nine months, in a sample of 86 children with ADHD, and related to the activities of the professional care‐givers. Behavioural control mixed with affectionate and emotional support reduced the ADHD symptoms at the follow‐up. According to the CBCL measures, the overall emotional and behavioural problems of the children did not improve. This suggests that prolongation of the day treatment is still required after nine months.     

Stimulant medication and parent training therapies for attention deficit-hyperactivity disorder

The present article provides a brief overview of the clinical use of two of the most commonly used and effective therapies for Attention Deficit-Hyperactivity Disorder (ADHD) in children: stimulant medication treatment and training parents in child behavior management skills. The clinical issues involved in the use of each treatment, as well as their limitations, are reviewed, along with evidence for their efficacy. It is concluded that ADHD is a developmental disorder of attention, impulse control, and regulation of activity level that requires multiple treatment methods, which must be applied over long time intervals if they are to produce an impact on the outcome of children with ADHD.     

Development and testing of a direct observation code training protocol for elementary aged students with attention deficit/hyperactivity disorder

Observational measures can add objective data to both research and clinical evaluations of children’s behavior in the classroom. However, they pose challenges for training and attaining high levels of interrater reliability between observers. The Behavioral Observation of Students in Schools (BOSS) is a commonly used school-based observation instrument that is well adapted to measure symptoms of attention deficit/hyperactivity disorder (ADHD) in the classroom setting. Reliable use of the BOSS for clinical or research purposes requires training to reach reliable standards (kappa?≥?0.80). The current study conducted training observations in one suburban and one urban elementary school in the Greater Boston area. To enhance interrater reliability and reduce training time, supplemental guidelines, including 30 additional rules to follow, were developed over two consecutive school years. The complete protocol was then used for training in the third school year. To reach sufficient interrater reliability (kappa?≥?0.80) during training, 45 training observations were required in the first year while, in the third year, only 17 observations were required. High interrater reliability was sustained after training across all three school years, accumulating a total of 1,001 post-training observations. It is estimated that clinicians or researchers following this proposed protocol, who are naive to the BOSS, will require approximately 30 training observations to reach proficient reliability. We believe this protocol will make the BOSS more accessible for clinical and research usage, and the procedures used to obtain high interrater reliability using the BOSS are broadly applicable to a variety of observational measures.     

黔东南中小学体育教师校本课程开发能力研究

采用文献资料法和实地调查法对黔东南中小学体育教师校本课程开发能力进行研究,提出了体育教师校本课程开发应具备的技能和能力,对照教师应具备的技能和能力发现黔东南中小学体育教师在校本课程开发能力方面存在的不足,针对性地提出解决问题的策略与途径.     

The experiences of and attitudes toward non-pharmacological interventions for attention-deficit/hyperactivity disorder used in school settings: a systematic review and synthesis of qualitative research

School-based non-pharmacological interventions are an important part of the treatment of attention-deficit/hyperactivity disorder (ADHD). We aimed to systematically review qualitative literature relating to the experience of and attitudes towards school-based non-pharmacological interventions for ADHD. Systematic searches of 20 electronic databases were undertaken. Reviewers screened titles, abstracts and full reports of studies, before extracting data and critically appraising 33 included papers. Studies were synthesised using meta-ethnographic methods. Four-key interrelated themes were identified: (1) individualising interventions, (2) structure of interventions, (3) barriers to effectiveness, (4) perceived moderators and impact of interventions. The perceived effectiveness of interventions used in school settings is reported to vary. Therefore, flexible, tailored interventions ought to hold potential. However, highly individualised interventions may negatively affect children with ADHD. Findings point to the need for school-based interventions to take into account the wider school context, as well as core symptoms of ADHD.     

Learning disabilities and risk-taking behavior in adolescents: a comparison of those with and without comorbid attention-deficit/hyperactivity disorder

Risk-taking behavior includes alcohol and drug use, delinquency, acts of aggression, sexual activity, and so on. Many studies have explored the relationship between adolescents and risk-taking behavior; however, only a few studies have examined this link in adolescents with learning disabilities (LD) or attention-deficit/hyperactivity disorder (ADHD). The purpose of the present study was to address that limitation by comparing the risk-taking behavior of adolescents with LD (n=230), with comorbid LD/ADHD (n=92), and without LD or ADHD (n=322) on their substance use, engagement in major and minor delinquency, acts of aggression, sexual activity, and gambling activities. The study also investigated whether psychosocial variables (e.g., well-being) may act as mediating variables that help explain between-group differences. Results suggest that it is a combination of the LD and the secondary psychosocial characteristics that explains why adolescents with LD and comorbid LD/ADHD more frequently engage in some risk-taking behavior.     

Between education and psychology: school staff perspectives

When discussing contributions from psychology in/to educational practices like school-based mental health promotion, it is peculiar that psychologists (of an educational or clinical kind) or education-oriented sociologists, both not often based in schools or classrooms, dominate the topic. It has been acknowledged that school staff have been over looked and underutilised in contributing to the discussion, particularly as this pertains to sharing perspectives on how they experience their role in relationship to education policy and practice. The study presented here looked to address this situation by seeking the perspectives of school staff on a range of concerns situated at the nexus between education and psychology. Contrary to the type of displaced assessment intimated above, this group of school staff generally accepts they perform a crucial task in supporting students, their main concern being to incisively question how they might negotiate existing role-related pressures to better current school-based practice.     

Does peer assessment promote student learning? A meta-analysis

Abstract

In recent years, there has been an increasing use of peer assessment in classrooms and other learning settings. Despite the prevailing view that peer assessment has a positive effect on learning across empirical studies, the results reported are mixed. In this meta-analysis, we synthesised findings based on 134 effect sizes from 58 studies. Compared to students who do not participate in peer assessment, those who participate in peer assessment show a .291 standard deviation unit increase in their performance. Further, we performed a meta-regression analysis to examine the factors that are likely to influence the peer assessment effect. The most critical factor is rater training. When students receive rater training, the effect size of peer assessment is substantially larger than when students do not receive such training. Computer-mediated peer assessment is also associated with greater learning gains than the paper-based peer assessment. A few other variables (such as rating format, rating criteria and frequency of peer assessment) also show noticeable, although not statistically significant, effects. The results of the meta-analysis can be considered by researchers and teachers as a basis for determining how to make effective use of peer assessment as a learning tool.