Improving accuracy of ADHD subtype diagnoses with the ADHD symptom rating scale

Child Neuropsychol. 2022 Oct;28(7):962-978. doi: 10.1080/09297049.2022.2044768. Epub 2022 Mar 15.

Abstract

Neuropsychologists evaluate children and adults with ADHD to establish a diagnosis, quantify cognitive deficits associated with ADHD and other common comorbid conditions, and provide recommendations for education and vocational planning. Standardized instruments that align with DSM ADHD symptom criteria are recommended for increasing ADHD diagnostic accuracy. This study examined whether a brief DSM-based symptom rating scale would assist in differentiating subtypes of ADHD. Participants were 253 children diagnosed with ADHD-Inattentive (n = 163) or ADHD-Combined (n = 90). Parents completed the Behavior Assessment System for Children, Second Edition (BASC-2) and DSM-IV ADHD Symptom Rating Scale (SRS) as part of a comprehensive evaluation to establish ADHD diagnoses. The SRS displayed expected convergent and discriminant validity with BASC-2 subscales. The diagnostic accuracy of the SRS subscales to differentiate ADHD was also examined and compared with the BASC-2. Results indicated that SRS Impulsivity, SRS Hyperactivity, and BASC-2 Hyperactivity had significantly better classification accuracy than BASC-2 Attention Problems and SRS Inattention, although they did not differ from each other. The SRS produced symptom profiles consistent with ADHD-Inattentive and Combined subtypes with good classification accuracy when differentiating subtypes. Overall, the SRS is an economical measure that can assist in ADHD presentation differentiation when used as a component of ADHD evaluations.

Keywords: ADHD symptom rating scale; Attention deficit hyperactivity disorder; ROC analysis; behavioral assessment system for children; diagnosis.

MeSH terms

  • Adult
  • Attention Deficit Disorder with Hyperactivity* / diagnosis
  • Attention Deficit Disorder with Hyperactivity* / psychology
  • Child
  • Cognition
  • Data Collection
  • Diagnostic and Statistical Manual of Mental Disorders
  • Humans
  • Impulsive Behavior
  • Psychiatric Status Rating Scales