Diagnosing ADHD; how helpful is the symptoms scale report?

The prevalence of ADHD among children has been growing steadfastly over the past few years; due to our growing interest in psychiatric disorders. The diagnosing process constitutes interviews, rating scales and observations and here I would like to focus on the rating scales that are filled out by the youth, parents and teachers.

First of all, rating scales that are used to diagnose children with ADHD are rarely given to youths themselves to fill out; they tend to score their inattentiveness or hyperactivity, if they have one, lower compared to their adults and teachers.

Second, parents’ reports on their child’s problem can be overstated especially if the child is their first one; many parents aren’t aware that some of the behaviours described on the rating scales are normative. Hence, if a clinician uses only the rating scale to diagnose a child with ADHD then the number of those diagnosed may be higher than expected. This is why clinicians also use interviews and observations which are conducted by themselves to determine whether a child has ADHD or not; clinicians are definitely more trained than the parents and teachers in detecting problems in behaviours.

Another question we have to ask is whether the internal validity of the reports are high or low. Because people with ADHD are distinguished between those who are ADHD inattentive and ADHD hyperactive, or both, the behaviours that are measured in the two categories are genuinely different. In the ADHD inattentive test, subjects are asked questions concerning sustaining attention and mental effort during activities. On the other hand, in the ADHD hyperactivity test, those who are tested are asked on behaviours such as being always “on the go,” interrupting others and etc. Considering the symptoms that are described on the scaling report to diagnose those with ADHD inattentiveness or ADHD hyperactivity, I personally believe that the internal validity of such reporting scales is high.

Moreover, while there may be biases and over-diagnosing of ADHD when using the scale report tests, studies indicate that the presumption we make; conducting interviews are more beneficial to diagnose ADHD compared to scales reporting, is not entirely true. Therefore, instead of throwing the rating scale out of the picture, using interviews, rating scales and observations to diagnose someone with ADHD seems to be the best way to do so.

References

“Attention Deficit Hyperactivity Disorder (ADHD) Evaluation Form: Parent and Teacher Version (Assessment).” TeenMentalHealthorg RSS. N.p., n.d. Web. 12 Feb. 2015.

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