# Evidence-based assessment/Instruments/ADHD Rating Scale

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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.

## Psychometrics
### Reliability

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) | Excellent | Alpha > .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 |

### Validity

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 | Excellent | the predictive validity for the combined subscale for parents and teachers were 60% and 65% accuracy, respectively. |
| Discriminative validity | Adequate | Statistically significant discrimination in mean ratings between three groups of participants that were identified as ADHD Combined, ADHD Inattentive and no ADHD. |
| Validity generalization | Good | Used by teachers and parents; used in school and clinical settings; assessment was normed on a random sample that included different ethnic and demographic backgrounds. |
| Treatment sensitivity | Adequate | Able to reflect progression of ADHD symptoms throughout treatment. |
| Clinical utility | Good | Easily accessible by purchasing the handbook. Strong psychometrics. Quick and easy completion and scoring. |

## Scoring and Interpretation
### Scoring

The 18 item ADHD Rating Scale is a questionnaire measured on a likert-type scale from "always or very often" to "rarely or never." It ends with one demographic question regarding age. All questions are intended to be answered regarding the child's behavior in the last 6 months.
* Items 1-9 are regarding inattention.
* Items 10-18 are regarding impulsivity and hyperactivity.
* item 19 asks if some of the behaviors were present in the child before the age of 7

### Interpretation

Scoring is based on the DSM-IV-TR criteria for Attention-Deficit/Hyperactivity Disorder. For all subtypes, the DSM-IV requires that some symptoms be present in the child before the age of 7. The information required to meet criteria is as follows:
* ADHD inattentive sub-type: 6 or more of the 9 responses in the “Inattention” section must be either “often” or “always or very often”.
* ADHD hyperactive sub-type: 6 or more of the 9 responses in the “Impulsivity and Hyperactivity” section must be either “often or “always or very often”.
* ADHD combined subtype: 6 of the 9 responses must be marked as either “often” or “always or very often” in both the “Inattention” and “Impulsivity and Hyperactivity” sections.
In order to meet the DSM-IV criteria for ADHD, symptoms must be present in two or more settings. It is recommended and common for a parent and a teacher to both complete the ADHD Rating Scale.

## Development and History

The ADHD Rating Scale was developed by George J. DuPaul, Thomas J. Power, Arthur D. Anastopoulos, and Robert Reid in 1998 based on the diagnostic criteria for ADHD as described in DSM-4. It contains two subscales respectively measuring inattention and hyperactivity-impulsivity.
The newest edition, ADHD Rating Scale 5, was published in 2016 with updates for DSM-5. This edition has separate adolescent versions of both home and school rating scales.

## See Also

* ADHD rating scale wikipedia page

## External Links

* Society of Clinical Child and Adolescent Psychology
* EffectiveChildTherapy.Org information on ADHD