The Validities and Efficiencies of Korean ADHD Rating Scale and Korean Child Behavior Checklist for Screening Children with ADHD in the Community

Abstract

ObjectiveThe purpose of this study is to examine the validity of primary screening tools for attention deficit hyperactivity disorder (ADHD) in a community-based sample of children using the Korean version of the Child Behavior Checklist (K-CBCL) and the Korean version of the ADHD Rating Scale (K-ARS).MethodsA large-scale community-based study for ADHD screening was conducted in the Jeollabuk province in the Republic of Korea. In 2010-2011, we surveyed a total of 49,088 first- and fourth-grade elementary school students. All of the participants in this study were assessed by the K-ARS-Parent version (K-ARS-P) and the K-ARS-Teacher version (K-ARS-T) as the primary screening instruments. The Diagnostic Interview Schedule for Children Version IV (DISC-IV) was used for confirming the diagnosis of ADHD. DISC-IV was administered to subjects who received top 10% scores in the K-ARS-P or K-ARS-T tests.ResultsOf the 3,085 subjects who completed the DISC-IV, 1,215 were diagnosed as having ADHD. A reasonable level of sensitivity, specificity, and negative predictive value were obtained when the total K-ARS-P scores were ≥90th percentile. The positive predictive value and specificity increased significantly when the total K-ARS-P scores were ≥90th percentile, T scores were ≥60 in the attention problems of K-CBCL, and T scores were ≥63 in the total problems of K-CBCL.ConclusionThese results suggested that the K-ARS-P could effectively serve as a primary screening tool to identify elementary school children with ADHD in the community. Also, there might be some increment in the effectiveness of K-ARS-P when combined with K-CBCL-A and K-CBCL-T as a secondary screening tool.

Parent-based diagnosis of ADHD is as accurate as a teacher-based diagnosis of ADHD

“…Figure 2b plots the results for each study. We see clear differences among studies with the best results being obtained by Fabiano et al [30] and Pineda et al [32] and the worst results being reported by Tripp et al [33] and Park et al [36]. …”

“…Inspection of Figure 2b shows three samples with fairly large differences in accuracy favoring parents over teachers [34–36] and one favoring teachers over parents [31]. Those studies showing the highest levels of accuracy [30 32] show very similar results for parents and teachers.…”

“…They used a modified DISC as the predictor for parents and the DBD for teachers. Park et al [36] used the DISC as a gold standard. The predictor was the ARS.…”

“…Four studies provided an AND rule, one by considering a symptom positive only if endorsed by both informants [34] and the others by considering a diagnosis only if the score was reported to be abnormal by both informants [33 35 36 38]. The OR rule was provided in two of the studies, one by deeming a symptom positive if endorsed by either informant [34], and the other by considering a diagnosis if the score of either informant report was abnormal [38].…”

ADHD: Pathophysiology, Management, and Assessment Scales

“…They are helpful in research and clinical work. Rating scales also help in the treatment planning and ensure accountability in practice 33,34 .…”