Evaluating attention deficit hyperactivity disorder using multiple informants: The incremental utility of combining teacher with parent reports.

Abstract

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).

Speed of Inhibition Predicts Teacher‐rated Medication Response in Boys with Attention Deficit Hyperactivity Disorder

“…Riccio, Hynd, Cohen, and Gonzalez (1993) found that teacher ratings of ADHD and other behavioural problems predicted performance on a measure of set-shifting, whereas parent ratings failed to do so. Together with these earlier studies, the present study fits with the finding that teachers, as opposed to children and parents, are the optimal informants for ADHD symptoms (Loeber, Green, & Lahey, 1990;Loeber, Green, Lahey, & Stouthamer-Loeber, 1989, 1991Power et al, 1998).…”

Aceitação e rejeição: percepção de escolares desatentos no ambiente escolar

“…Assim sendo, tanto a aprendizagem quanto a socialização de escolares desatentos revelam prejuízos capazes de se configurarem como reais problemas na vida acadêmica e social (Power, 1998;Bagwell, 2001;Hoza & cols., 2001). Considerando-se que a auto-regulação do comportamento mostra-se deficitária para a criança desatenta, a implementação de atividades empregadas pelo professor, salientando os comportamentos adequados e inadequados e suas conseqüências, provavelmente, possam contribuir para a melhoria dos relacionamentos em sala de aula (Barkley, 1990).…”

“…Na literatura especializada, é possível encontrar a descrição desses problemas, manifestados como dificuldades, distúrbios, síndromes ou transtornos. Atualmente, a referência mais utilizada e de aceitação mundial para a classificação dos problemas de atenção é a da American Psychiatric Association (1994), no Diagnostic and Statistical Manual of Mental Disorders (DSM-IV), que define critérios específicos e rigorosos, permitindo a identificação dos problemas mais graves denominados Transtornos da Falta de Atenção (TDA), que podem ser classificados como tipo predominantemente desatento, predominantemente hiperativo-impulsivo ou tipo combinado (Barabasz & Barabasz, 1996;Biederman & cols.,1997;Gaub & Carlson,1997;Power, 1998;Mitsis & cols., 2000;Tonelotto, 2000).…”

“…A variabilidade de metodologia utilizada para diagnóstico deve ser considerada e o DSM-IV aparece freqüentemente como instrumento auxiliar (Biederman & cols., 1997;DuPaul & cols., 1997;Power, 1998;Mitsis, 2000).…”

“…Estudos a respeito da rejeição foram conclusivos ao afirmar que ela predispõe não apenas ao baixo desempenho escolar, mas também a transtornos de conduta na escola, na família e no ambiente social, capazes de prever problemas a longo prazo, tais como envolvimento em roubos (Mussen, 1995;Power, 1998;Newcombe, 1999).…”