Incremental Clinical Utility of ADHD Assessment Measures With Latino Families

Abstract

Objective: This study examined the incremental clinical utility of parent and teacher reports of ADHD symptomatology and functional impairment in Latino youth, as well as parent and teacher agreement with the final clinical judgment on a diagnostic structured interview. Method: Participants included 70 Latino youth (47 males, 23 females; M age = 8.13 years, SD = 2.51 years) and their parents and teachers; 60 participants were diagnosed with ADHD. Correlations, percent agreement, kappas, and regressions were utilized. Results: Results demonstrated that teachers agreed with the final clinical judgment more often than did parents. Results additionally demonstrated that functional impairment did not statistically significantly improve diagnostic models already including ADHD symptoms; follow-up analyses were run and are discussed. Finally, results demonstrated that teacher reports statistically significantly improved diagnostic models already including parent reports. Conclusion: The current findings suggest the importance of including both parent and teacher reports of both ADHD symptomatology and functional impairment when assessing ADHD in Latino youth.

Review of Studies on Incremental Validity of Assessment Measures Used in Psychological Assessment of Attention-Deficit Hyperactivity Disorder

“…Measure of Symptoms Over Symptom Report (Multiple Method Same Informant;n = 5) Children. Harvey et al (2009) showed that mother ratings 1 of ADHD in children 3 years of age predicted ADHD diagnosis at age 6 years beyond what is predicted using the diagnostic interview (DISK-IV; 2 Schwab-Stone et al, 1996) alone (χ2 = 11.3, p < .01; (Grace, 2017). A study by Wong (2019) investigated the incremental utility of a specific ADHD assessment (Conners-3-P; 5 Conners, 2008) in diagnosing ADHD in children and adolescents beyond a more general measure (CBCL; 6 Achenbach & Rescorla, 2001).…”

“…Father ratings had no incremental utility over the diagnostic interview. A study on Latino youth showed that a measure of functional impairment 3 had no incremental validity over symptom report (DBD) 4 in diagnosing ADHD, χ 2 (2, 53) = 3.43, p > .05 (Grace, 2017). A study by Wong (2019) investigated the incremental utility of a specific ADHD assessment (Conners-3-P; 5 Conners, 2008) in diagnosing ADHD in children and adolescents beyond a more general measure (CBCL; 6 Achenbach & Rescorla, 2001).…”

“…One of the three studies that investigated the incremental validity of a symptom report over a clinical interview from the same informant (parent and/or teacher) showed some evidence for incremental validity in predicting ADHD diagnosis in children. There is evidence in one of the studies with negative findings (Grace, 2017) for criterion contamination as the same measure (disruptive behavior disorder [DBD]) was used as the predictor and criterion, therefore likely reducing the predictability of the incremental test. Two of the three studies in adults showed evidence for incremental validity of additional measures from the same informant.…”

“…These results indicate that adding teacher report doubles the odds of an ADHD diagnosis and clinically significant impairment. A master’s thesis on Latino youth showed that teacher ratings of ADHD symptoms (DBD) improved specificity (.25 to .75) but not sensitivity (.96 to .98) when added to parent ratings using the same measure (Grace, 2017). Percent correctly classified improved from .85 to .94, ( p < .01).…”