Heartland Area Education AgencyBehavior rating scales are a primary method for screening and identifying children with attention deficit hyperactivity disorder (ADHD). The factorial structure and normative data of a teacher rating scale containing the 18 symptoms of ADHD were examined in this study. Factor analyses and assessment of differences in ADHD ratings across sex, age, and ethnic group were conducted with 4,009 children and adolescents who attended kindergarten through 12th grade in 31 U.S. school districts. Two factors (inattention and hyperactivity-impulsivity) were derived, and normative data for a nationally representative sample were presented. Boys, younger children, and African Americans received higher ratings of ADHD symptoms. Limitations of this investigation and potential uses of this scale in clinical practice and research are discussed.Attention deficit hyperactivity disorder (ADHD) involves the display of developmentally inappropriate levels of inattention, impulsivity, and overactivity resulting in functional impairment across two or more settings (American Psychiatric Association[APA], 1994). Approximately 4% of school-aged children and adolescents in the United States have this disorder. Children with this disorder are at higher than average risk for academic underachievement, conduct problems, and social relationship difficulties, as a function of the core symptoms of ADHD (Barkley, 1990). The disorder is chronic for most individuals with ADHD and requires long-term treatment (Weiss & Hechtman, 1993). Given the chronic nature of ADHD and associated prob-

Abstract:The reliability and criterion-related validity of the Home and School versions of the AD/HD Rating Scale-IV were evaluated in a nonreferred sample of 71 students. Parent and teacher ratings were obtained 4 weeks apart at a time contemporaneous with observations of classroom behavior and academic productivity. Results indicated adequate levels of internal consistency, test-retest reliability, and cross-informant agreement for both parent and teacher ratings. Teacher ratings were significantly correlated with classroom observational data, and parent ratings were primarily related to behavior ratings. The discriminant validity of these scales also was examined in a sample of 92 clinic-referred children.

In a sample of students referred to a school-based Pupil Assistance Committee, the Inattention and Hyperactivity-Impulsivity factors of the Attention Deficit Hyperactivity Disorder (ADHD) Rating Scale-IV were used to predict diagnostic status, determined by a parent-reported diagnostic interview and teacher rating scale. Results of logistic regression and receiver operating curve analyses indicated that the Inattention and Hyperactivity-Impulsivity factors differentiated students with ADHD from controls and distinguished children with different ADHD subtypes. Symptom utility estimates demonstrated that a single informant approach was best suited for ruling out ADHD, whereas a combined informant method was optimal for positively diagnosing this disorder. Methods for determining the incremental utility of combining teacher with parent reports were demonstrated.Because students with attention deficit hyperactivity disorder (ADHD) usually display significant levels of impairment in school, the provision of school-based services for these children is essential (DuPaul & Stoner, 1994). The importance of schoolbased programming for students with ADHD was affirmed dramatically in 1991 when a memorandum issued by the U.S. Department of Education outlined the responsibilities of school officials in meeting the needs of students suspected of having ADHD (see Fowler, 1992). The need to establish school-based assessment and intervention programs for students with, or suspected of having, ADHD has been further highlighted by the recognition of the limitations of clinic-based models of care. Clinic-based professionals often cannot obtain naturalistic data about a child's functioning, whereas school personnel can readily collect a wealth of information about a child's functioning in diverse settings, including classroom, playground, and lunchroom (Atkins & Pelham, 1991). In addition, coordination of educational, health, and mental health services may be lacking in clinical settings that are not naturally linked to the community and can be achieved more readily in school-based mental health programs (Power, Atkins, Osborne, & Blum, 1994).

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Two case studies were conducted to investigate the utility of curriculum-based measurement of math and reading for evaluating the effects of methylphenidate on the academic performance of 2 students diagnosed with attention deficit hyperactivity disorder. Following baseline measurement, double-blind placebo-controlled procedures were employed to evaluate each student's response to three levels (5 mg, 10 mg, and 15 mg) of the medication. Results of the first study suggest that the curriculum-based measures were sensitive indicators of the student's response to medication. This finding was replicated in the second study. In the second study, when the student's follow-up dose of medication was based on trial-phase data, follow-up performance was improved compared to baseline performance. These case studies suggest that further research is warranted on the utility of curriculum-based measurements for monitoring and evaluating stimulant medication interventions with children with this disorder.