Examined agreement among secondary school teachers' behavior ratings for 66 adolescent boys with a history of attention deficit hyperactivity disorder. Behavior ratings consisted of the Teacher Report Form, Iowa/Abbreviated Conners, and the Disruptive Behavior Disorders Rating Scale. Ratings from 2 to 5 teachers were collected for each adolescent. In contrast to previous studies, agreement was examined using statistical indices that corrected for chance agreement and discrepancies in scores (i.e., intraclass correlation [ICC], kappa) in addition to traditional indices (i.e., Pearson correlation and percentage agreement) typically used in the relatively sparse literature on teacher agreement for adolescent behavior ratings. Agreement was poor for dimensional subscale scores (Pearson correlations were in the .40-.50 range, and ICCs were in the .20-.50 range) as well as for categorization of youth as above or below clinical cutoffs (percentage agreement was between 52% and 96%, but ICCs and kappas ranged from .17 to .57). Findings suggest that, regardless of behavior rating scale used, a multiple teacher assessment strategy should be adopted for clinical assessment, treatment design, and evaluation of treatment efficacy.Teacher ratings of child behavior are tremendously useful when a goal of clinical work or research is to assess the disruptive behavior of a child (i.e., overactivity, impulsivity, attentional difficulties, defiance, or severe conduct problems). Not only is determination of treatment efficacy dependent upon teachers' observations, but adequate diagnosis of disruptive behavior disorders depends upon their input. For example, diagnosis of attention deficit hyperactivity disorder (ADHD) requires determination of impaired functioning in Requests for reprints should be sent to Brooke Molina, Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, 3811 O'Hara Street, Pittsburgh, PA 15213. molinab@msx.umpc.edu. Jonathan Blumenthal is now with the National Institute of Mental Health, Bethesda, MD.Portions of this study were presented at the 1996 meeting of the American Psychological Association, Toronto, Ontario, Canada. [DSM-IV]; American Psychiatric Association, 1994). Because children spend so much of their time in school, functioning in the academic domain is of particular importance. Furthermore, academic performance is often severely impaired by difficulties with behaviors such as attentional problems and noncompliance, making teachers especially salient and ecologically valid reporters of child functioning. Research has also shown that teacher ratings are more sensitive than parent ratings to stimulant medication effects (Sprague, Christensen, & Werry, 1974), which makes collection of teacher reports imperative when a goal of treatment is to determine medication efficacy. Clearly, examination of a child's functioning in school should always be included in comprehensive assessments and treatment of childhood disruptive behavior disorders.
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