Hyperkinetic and Conduct Problem Children in a Primary School Population: Some Epidemiological Considerations

Abstract

SUMMARY An epidemiological survey designed to investigate the possible causal influence of biological and psychological factors on hyperactivity and conduct disturbance among 226 primary school boys is provided. The background variables investigated were: adverse perinatal events, neurodevelopmental abnormalities, minor physical anomalies and a combination of psychosocial disadvantage factors. Hyperactivity and conduct disturbance were measured by parent and teacher questionnaires, the disturbed groups being taken as the top 10 per cent. Teachers and parents largely identified separate children as disturbed. The teacher questionnaires failed to distinguish between the two conditions but disturbance was significantly related to high social disadvantage. The parent questionnaire distinguished the two groups better and disturbance of either kind was markedly associated with maternal mental distress, and this far outweighed the contribution of any other background variable.

Perceived ecological congruence across family/school environments: Impact on the consistency of behavioral patterns and adaptation among children and youth

“…In a review of these studies, Achenbach et al (1987) found that the average correlation between teacher and parent ratings was quite modest (.27). Similarly, when categorical ratings of behavioral adaptation are obtained, parents and teachers rarely classify the same children as severely disturbed (Garrison & Earls, 1985; Rutter, Tizard, & Whitmore, 1970; Sandberg, Wieselberg, & Shaffer, 1980). Marked cross-situational differences in levels of adaptive functioning are also found when children are rated in different settings by trained observers (Bernal, Delfini, North, & Kreutzar, 1976;Lobitz & Johnson, 1975).…”

Attention deficit hyperactivity disorder: The most studied and yet most controversial diagnosis

“…Obtaining information from teachers is further complicated by the fact that frequently there are discrepancies between parent and teacher reports [Fergusson and Horwood, 1993;Sandberg et al, 1980]. Teacher observations, however, demonstrate both reasonable inter-rater reliability [Danforth and Dupaul, 1996] and agreement with direct observations.…”

Specific Cognitive Deficits in ADHD: A Diagnostic Concern in Differential Diagnosis

“…For example, the prevalence of behaviors related to hyperactivity as rated by a teacher can be higher than that rated by a clinician (Lambert et al, 1973). In contrast, the prevalence of behaviors related to hyperactivity can be lower if these behaviors must be judged to be present by more than one source (e.g., parent and teacher) (Sandberg et al, 1980). Because there is no gold standard for diagnosing ADHD, it is important to make a distinction between how ADHD is defined and how it is diagnosed.…”