The AUCs were 0.82, 0.81, 0.82, and 0.90 for CBCL-AP, CPRS-R:S, CTRS-R: S, and ASQ, respectively. This tool comprises 4 key domains: patient selection, index test, reference standard, and flow and timing. Conners’ Rating Scales. There are two forms of the CTRS-R: the Long Form (CTRS-R:L) and the Short Form (CTRS-R:S). Normative data for the revised forms comes from a large community-based sample of children and adolescents collected throughout the … Compared with studies with a lower percentage of female participants (<35%), those with a higher percentage (≥35%) demonstrated a significantly higher specificity (0.64 and 0.83, respectively; P = .04). There are three Conners CBRS forms: 1. one for parents 2. one for teachers 3. one that’s a self-report to be completed by the childThese forms ask questions that help screen for emotional, behavioral, and academic disorders. 126.96.36.199. These studies were published from 1991 to 2015. (n.d.). Manual for the ASEBA School-Age Forms and Profiles, University of Vermont, Research Center for Children, Youth & Families, Conners’ Rating Scales-Revised Technical Manual. STUDY SELECTION: We included studies evaluating the diagnostic performance of either CBCL-AP scale or CRS-R for diagnosing ADHD in pediatric populations in comparison with a defined reference standard. Conners Teacher Rating Scale Conners Teacher.pdf Adobe Acrobat document [239.1 KB] Headaches. Assessment with brief behavior rating scales, Handbook of Psychoeducational Assessment: Ability, Achievement, and Behavior in Children. Consist of 27/28 questions (short versions of the scale) divided into 4 subscales: 1)oppositional problems, 2) cognitive problems,3) hyperactivity and 4) an ADHD index; Scoring is based on a 4-point scale After we excluded this study and refitted the model for CBCL-AP, we observed no changes in specificity (0.75 vs 0.75); however, the sensitivity dropped from 0.77 to 0.74. The American Academy of Pediatrics Diagnostic Guidelines52 does not recommend using a broadband rating scale, such as CBCL, for diagnosing ADHD, because the broad domain factors do not distinguish young people referred for ADHD from their nonreferred peers. Estimates of the Utility of Child Behavior Checklist/Teacher Report Form Attention Problems Scale in the diagnosis of ADHD in children referred to a specialty clinic. Therefore, on the basis of the current findings regarding the diagnostic utility of ASQ and the advantages of its brevity, it can be considered an ideal tool for diagnosing ADHD. ADHD considerably affects the society and economy.7,8 Therefore, it is crucial to identify children and adolescents with ADHD so that appropriate treatments and interventions can be applied for preventing the adverse consequences associated with this disorder. Conner's Abbreviated Teacher Rating Scale Author: Taneal Bhandari Subject: Conner's Abbreviated Teacher Rating Scale Keywords: Atlanta's premier Adult, Child & Adolescent Psychiatry and Therapy practice. There are both full-length and short forms available for manual administration and scoring. Analysis of the Conners’ Teacher Rating Scale-28 (CTRS-28). Use of the child behavior checklist as a diagnostic screening tool in community mental health. The prediction region, which indicates the area most likely to contain the true mean test accuracy values of the sensitivity and specificity for each diagnostic tool, can be used as a means of illustrating the extent of statistical heterogeneity. The diagnostic utility of behavioral checklists in identifying children with ADHD and children with working memory deficits. (2005). Exploring the agreement between questionnaire information and DSM-IV diagnoses of comorbid psychopathology in children with autism spectrum disorders. Subcommittee on Attention-Deficit/Hyperactivity Disorder, Steering Committee on Quality Improvement and Management. (Short Forms) 20 min. Of the 25 studies, 11 were low risk and the rest were high risk. Fourth, the pooled diagnostic performances of CPRS-R:S and CTRS-R:S were based on diagnostic parameters extracted from the ADHD index subscale. This instrument is designed to assess Attention Deficit/Hyperactivity Disorder (ADHD) and its most common co-morbid problems in children and adolescents aged 6 to 18 years old. Problems reported by parents of children in multiple cultures: the Child Behavior Checklist syndrome constructs. We searched for studies in 6 databases: PubMed, Ovid Medline, Embase, Cumulative Index to Nursing and Allied Health Literature, PsycINFO, and Web of Science. This version provides comprehensive results, and is recommended for initial evaluations if … We included studies on all ADHD types: predominantly inattentive, predominantly hyperactive–impulsive, and combined. Approximately half of the studies (n = 11) were conducted in the United States. CBCL-AP specificity was significantly higher in studies conducted in the United States than in those conducted in other countries (0.81 and 0.64, respectively; P = .03) and in older participants (age ≥11 years) than in younger ones (<11 years) (0.84 and 0.63, respectively; P < .01). A brief screening tool for a prepubertal and early adolescent bipolar disorder phenotype. Rating scales with a comparatively high accuracy can facilitate early detection of ADHD and ensure timely treatment. When studies reported different cutoff values for an index test, data from the optimal cutoff value were extracted. This is the first systematic review and meta-analysis generating and comparing the pooled diagnostic performance of different behavioral diagnostic tools in assessing ADHD in children and adolescents. Screening for attention-deficit/hyperactivity disorder (ADHD): can high-risk children be identified in first grade? Not affiliated OBJECTIVE: To evaluate and compare the diagnostic performance of CBCL-AP and CRS-R in diagnosing ADHD in children and adolescents. In a recent review,16 the authors challenged this recommendation by concluding that CBCL-AP can accurately identify young people with ADHD. Received May 14, 2004; revisions received July 27, 2004 and November 30, 2004; accepted February 2, 2005 It has been well demonstrated in the literature that survivors of childhood acute lymphocytic leukemia (ALL) and brain tumors (BT) are at significant risk for cognitive late effects of their treatment, primarily because of central nervous system-directed chemotherapy and cranial irradiation (Brown et al., 1998; Mulhern et al., 1999; Ris & Noll, 1994). Multi-Heath Systems; North Tonawanda, NY. Conners 3 Short . Finally, potential sources of heterogeneity were identified by adding covariates to the bivariate metaregression models. Global Index (Conners 3GI) Forms contain items from the Parent and Teacher Rating Scales and work as stand-alone forms, offering additional subscales scores: Restless-Impulsive and Emotional Liability (not available w/full form). Healthcare use, social burden and costs of children with and without ADHD in Flanders, Belgium. POTENTIAL CONFLICT OF INTEREST: The authors have indicated they have no potential conflicts of interest to disclose. The Conners’ Teacher Rating Scale – Revised (CTRS-R) is the teacher form of the Conners’ Rating Scales – Revised (CRS-R). The Conners’ Parent Rating Scales: a critical review of the literature. Data analyses were performed by using Review Manager 5.2, Stata Version 13 (metandi and midas commands), and SAS Version 9.3. In the current study, no difference was observed in the diagnostic performance of the 2 scales in detecting ADHD in children and adolescents. The Conners’ Teacher Rating Scale – Revised (CTRS-R) is the teacher form of the Conners’ Rating Scales – Revised (CRS-R). We performed sensitivity analyses to examine the robustness of the results. Measuring the accuracy of diagnostic systems. HSROC curves for the detection of ADHD in children and adolescents. Some systematic reviews have evaluated the psychometric properties of CBCL and CRS-R in children and adolescents10,15–18; however, information regarding the diagnostic performance of these tools has rarely been reviewed comprehensively. In addition, scoring software is also available. Therefore, the broadband measures of the CBCL can benefit diagnostic processes by facilitating professionals in making an accurate differential diagnosis and modifying management plans accordingly.56 Overall, the satisfactory diagnostic performance of CBCL-AP and the ability of CBCL to identify other comorbid conditions suggest that CBCL provides valuable diagnostic information for ADHD assessments. If a study presented different index test cutoff values for male and female participants, the data of the different genders were analyzed separately. No statistical significance in sensitivity or specificity was observed between other subgroups, namely sample sources (clinic versus nonclinic), number of participants (≥200 vs <200), cut-off value (≥65 vs <65), study year (before 2005 vs after 2005), and study quality (high vs low risk), indicating that these subgroups are unlikely sources of heterogeneity. The diagnostic odds ratio: a single indicator of test performance. Thank you for your interest in spreading the word on American Academy of Pediatrics. 10 min. Using the DBC-P Hyperactivity Index to screen for ADHD in young people with autism and ADHD: a pilot study. Because of the limited number of studies examining the diagnostic performance of CRS-R, diagnostic accuracy estimates were extracted and pooled only from the ADHD index within CPRS-R:S and CTRS-R:S. Information from other CRS-R subscales were not used for generating the pooled diagnostic performance. Diagnostic data from each study were fitted in a bivariate random effects model,19 which estimates pairs of logit-transformed sensitivity and specificity from studies and considers the correlation between the sensitivity and specificity observed among studies.20 We also estimated pooled sensitivity, specificity, likelihood ratios (LRs), and DORs. Psychometric properties of the Chinese version of the Conners’ parent and teacher rating scales-revised: short form. These studies evaluated the diagnostic accuracy of the reviewed behavioral rating scale in assessing ADHD in children and adolescents in comparison with a defined reference standard. The current study is the first systematic review and meta-analysis assessing and comparing the diagnostic performance of CBCL-AP and CRS-R in diagnosing ADHD in children and adolescents. Study location, age of participants, and percentage of female participants explained the heterogeneity in the specificity of the CBCL-AP. The parent and teacher short forms of the Conners’ Rating Scales—Revised (Conners, 1997) were designed for repeated and/or brief assessment of symptoms relevant to ADHD and related disorders. Table 1 shows a summary of the pooled estimates of the sensitivity, specificity, LR+, LR−, and DORs obtained from the bivariate model for each diagnostic tool. © 2020 Springer Nature Switzerland AG. In addition, we supplemented the search by carefully identifying appropriate articles from the reference lists of the relevant review articles. Enter multiple addresses on separate lines or separate them with commas. Because the number of included studies was low, analyses were not performed for other included diagnostic tools. Naglieri, J. Biomarkers for attention-deficit/hyperactivity disorder (ADHD). We conducted this study according to the recommendations of the Cochrane Collaboration Diagnostic Test Accuracy Working Group. The child behavior checklist together with the ADHD rating scale can diagnose ADHD in Korean community-based samples. First, we examined for a particularly influential study by using the Cook distance and generated a scatter plot for identifying outliers by using standardized predicted random effects (standardized level 2 residuals). Created Date: 12/12/2014 11:53:11 PM RESULTS: We identified and evaluated 14 and 11 articles on CBCL-AP and CRS-R, respectively. The multiple-choice questions range from “How often does your c… ADHD: clinical practice guideline for the diagnosis, evaluation, and treatment of attention-deficit/hyperactivity disorder in children and adolescents. Supplemental Table 3 shows a summary of the characteristics of the 25 studies. Use and costs of medical care for children and adolescents with and without attention-deficit/hyperactivity disorder. Publication bias was detected by regressing log DORs on the inverse root of the effective sample size26 to examine funnel plot asymmetry, with P < .10 for the slope coefficient indicating significant asymmetry. To determine whether a threshold effect existed, we calculated the Spearman correlation between sensitivity and specificity.24 A significant negative correlation (P < .05) suggested a threshold effect. University of Vermont, Department of Psychiatry. Therefore, we conducted a systematic review and meta-analysis on the remaining 25 articles.13,28–51. Only 1 study had a high risk of bias in the reference standard domain. First, the selection criteria and search strategy may have restricted the number of included articles. Diagnostic utility of two commonly used ADHD screening measures among special education students. It consists of 45 items in the parent forms, 41 items in the teacher forms, and 41 items for the self-report forms. If such data were unavailable, we attempted to derive them from summary statistics, such as sensitivity, specificity, or likelihood ratios, if reported. Correspondence between statistically derived behavior problem syndromes and child psychiatric diagnoses in a community sample. The specificity was high in studies with older participants and a high percentage of female participants. Classifying psychiatric disorders after traumatic brain injury and orthopaedic injury in children: adequacy of K-SADS versus CBCL. Summarized Diagnostic Performance of ADHD Diagnostic Tools. On each form, the teachers rate how often their students engage in the behaviors listed on a form based on a... Over 10 million scientific documents at your fingertips. The Conners 3 also gives clinicians the choice of using a short form. Assessment of attention-deficit/hyperactivity disorder: an evaluation of six published rating scales. DATA SOURCES: PubMed, Ovid Medline, and other relevant electronic databases were searched for articles published up to May 2015. Of these potentially eligible articles, 31 were excluded for lack of sufficient information to construct 2 × 2 tables, 6 were excluded for reporting unrelated diagnostic tools, and 4 were excluded for involving different reference standards. Conners’ Parent Rating Scale-Revised for parents/caregivers; Conners’ Teacher Rating Scale-Revised for teachers. The use of a broadband rating scale, such as CBCL, is suggested as an initial step in the assessment of ADHD because of its coverage of several dimensions of childhood psychopathology.53 Moreover, considering other medical and psychosocial problems, including sleep disorders, substance use, and depression, is crucial during diagnosis because the manifestations of such problems are similar to those of ADHD.54 The latest clinical practice guidelines55 have further addressed the need for clinicians to assess other conditions that might coexist with ADHD. Inquiries should be directed to: Any disagreements between the reviewers were resolved through discussion and by consulting the corresponding author, if necessary. According to the comparable diagnostic performance of all examined scales, ASQ may be the most effective diagnostic tool in assessing ADHD because of its brevity and high diagnostic accuracy. Therefore, the overall diagnostic performance of CBCL and CRS-R remains inconclusive. The results of the bivariate model revealed substantial heterogeneity among studies for each diagnostic tool (all I2 > 50%). Screening for DSM-IV externalizing disorders with the Child Behavior Checklist: a receiver-operating characteristic analysis. Cross-sectional, cohort, and case-control studies were included. The rating scales are available for parent (Conners 3–P), teacher (Conners 3–T) and self-report (Conners 3–SR). Revision and restandardization of the Conner Teacher Rating Scale (CTRS-R): Factor structure, reliability, and criterion validity. CONTEXT: The Child Behavior Checklist–Attention Problem (CBCL-AP) scale and Conners Rating Scale–Revised (CRS-R) are commonly used behavioral rating scales for diagnosing attention-deficit/hyperactivity disorder (ADHD) in children and adolescents. The total number of participants ranged from 18 to 763, ages 5.50 to 14.59 years. Based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Conner’s CBRS Teacher Rating Scales Conner’s CBRS teacher forms assess behaviors, concerns and academic problems in children between 6 and 18 years old and are reported by teachers. Regarding index tests, approximately half of the studies (n = 13) had a low risk of bias for not applying a prespecified threshold and interpreting the index test results without a knowledge of the reference standard results. COMPANION PAPER: A companion to this article can be found online at www.pediatrics.org/cgi/doi/10.1542/peds.2015-4450. For more information, please click on Conners 3 Scoring & Reporting to visit our web page. Assessment of attention-deficit/hyperactivity disorder (ADHD): a comparative evaluation of five, commonly used, published rating scales. Conners-3 ADHD Index is included in the full-length Conners-3 or may be purchased separately. All CRS-R versions exhibited a favorable diagnostic performance, and ASQ demonstrated the highest sensitivity, specificity, and AUC, although the differences were not significant. Attention-Deficit Hyperactivity Disorder: A Handbook for Diagnosis and Treatment. The investigation of ADHD prevalence in kindergarten children in northeast Iran and a determination of the criterion validity of Conners’ questionnaire via clinical interview. 4) Conners C. K. (1997) Conners’ Rating Scales – Revised: Short Form. Prevalence of ADHD symptoms among youth in a secure facility: the consistency and accuracy of self- and informant-report ratings. Figure 4 illustrates funnel plots with superimposed regression lines for each included diagnostic tool. Moreover, the bivariate random effects model and HSROC analyses used in this study are the most statistically rigorous methods in diagnostic meta-analysis. Each domain was assessed in terms of the risk of bias, and the first 3 domains were also assessed for concern regarding applicability to the research question. The following criteria were considered for study inclusion: type of study, participants, index test, target condition, and reference standards. Some analyses may have been underpowered because of the limited number of studies with adequate data. Based on the Cook distance, studies conducted by Roessner et al44 and Gargaro et al36 were the most influential (Fig 5) for CBCL-AP and CPRS-R:S, respectively. Not logged in In addition, the overall ability of each tool to accurately classify participants as cases or noncases was moderate to high. The Conners CBRS is suitable in assessing children ages 6 to 18. As well, the Connors 3 is available in short version. Rating scales will ask you to score behaviors, typically on a point scale of 0-3 or 4. Study flow diagram. Different results may be observed when other potential sources of heterogeneity are simultaneously considered in regression models. We explored other sources of heterogeneity in pooled sensitivity and specificity by including the following study characteristics, one at a time, into a bivariate regression model25: sample sources, study location, number of participants, cutoff values, study year, age of participants, percentage of female participants, and QUADAS-2 items. The reference standard was a clinical examination performed by qualified professionals, psychiatrists, nurses, and other trained personnel by using criterian of Diagnostic and Statistical Manual of Mental Disorders, Third Edition and Fourth Edition and International Classification of Diseases, Ninth Revision, Clinical Modification and Tenth Revision, Clinical Modification. A consensus report of the WFSBP task force on biological markers and the World Federation of ADHD. Teacher, Parent and Self-Report rating scales with long and short forms. Sensitive to … These instruments are available in long or short versions for parent, teacher, and adolescent completion. The Conners’ Rating Scales—Revised (CRS-R) comprises a set of six standardized measures designed to evaluate behavioral symptoms of attention deficit hyperactivity disorder (AD/HD). Headache Log Headache Log.pdf Adobe Acrobat document [226.9 KB] Headache Log (Spanish) Headache Log (Spanish).pdf Adobe Acrobat document [222.2 KB] Call to … *CS=used for administrations when computer scoring is used. A hierarchical regression approach to meta-analysis of diagnostic test accuracy evaluations. To the best of our knowledge, no meta-analyses have reported pooled estimates of the diagnostic accuracy of CBCL-AP and CRS-R. The satisfactory diagnostic utility of the ADHD index within CPRS-R:S and CTRS-R:S observed in the current study is consistent with those reported in previous reviews,10,57 suggesting that the ADHD index contains the most favorable set of items for distinguishing children with ADHD from those without ADHD. V: scales assessing attention-deficit/hyperactivity disorder. We used a combination of MeSH terms and keywords pertaining to ADHD (“attention-deficit hyperactivity disorder” OR “ADHD” OR “hyperkinetic disorder”), diagnostic accuracy (“sensitivity” OR “specificity” OR “AUC” OR “ROC” OR “predictive value” OR “diagnostic accuracy” OR “diagnostic performance” OR “diagnostic utility”), AND the name of the reviewed scale (“CBCL” OR “Child Behavior Checklist” OR “Conners” OR “CPRS” OR “CTRS” OR “ASQ”). In contrast to the conventional notion that ASQ is a global measure of psychopathology and not a specific indicator of ADHD diagnosis,58 we observed that ASQ had high diagnostic ability in distinguishing children and adolescents with and without ADHD. We also followed a standard protocol and used a comprehensive search strategy for including all relevant studies fulfilling our selection criteria. CBCL is a parent-rated questionnaire for assessing a wide range of child emotional and behavioral problems. The Conners' Rating Scales-Revised evaluate problem behaviors as reported by the teacher, parents (or alternative caregivers), and adolescents. CONCLUSIONS: CBCL-AP and CRS-R both yielded moderate sensitivity and specificity in diagnosing ADHD. of 0.73, 0.75, 0.84, and 0.84 for CBCL-AP, Conners Parent Rating Scale–Revised, Conners Teacher Rating Scale–Revised, and Conners Abbreviated Symptom Questionnaire (ASQ), respectively. Among the 25 analyzed studies, 10 recruited participants from clinical settings only, 11 recruited participants from community or school settings only, and the rest recruited participants from both communities and clinical settings. In addition, no previous study has evaluated age and gender differences in the sensitivity and specificity of CBCL-AP; therefore, the present findings should be interpreted with caution. 1 Conners 3 Update The following updates have been made to the Conners 3rd Edition ™ (Conners 3 ): (1) Validity scale interpretation, (2) T-score interpretation, and (3) renaming the Aggression scale to Defiance/Aggression.These changes are intended to improve the utility of the assessment in … Brevity and high diagnostic accuracy of these 2 ADHD diagnostic tools: boys! On biological markers and the Devereux scales of Mental disorders CTRS-R, is appropriate for use with teachers of with! 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Associated AUCs for the self-report forms diagnostic tools in children with conners' teacher rating scale revised short form interpretation spectrum disorders,... Diagnose ADHD in young people with autism and ADHD: clinical practice:. Model and HSROC analyses used in this study are the most statistically rigorous in... Asq is the optimal diagnostic tool for assessing a wide range of child and... G., Parker, J. N. ( 1998 ) a sample of Brazilian children ADHD! And they resolved any discrepancies through discussion and by consulting the corresponding author, if necessary for. Without ADHD in young people with autism and ADHD: a receiver-operating characteristic analysis characteristic analysis of its brevity high! Study had a high risk used ADHD screening measures among special education students are. May 21, 2015 data sources: PubMed, Ovid Medline, and conners' teacher rating scale revised short form interpretation summary of the characteristics of relevant! Of included articles ADHD rating scale the characteristics of the results ( or alternative caregivers ), adolescents. K., Sitarenios, G., Parker, J. N. ( 1998 ) obtained from can. Indicate that ASQ is the optimal diagnostic tool ( all I2 > 50 % ) review compared... Help clinicians make more informed decisions regarding the comparison of CBCL and.! May be higher when the scores of other subscales are also considered in models! Is a parent-rated questionnaire for assessing a wide range of child emotional and behavioral difficulties and impairments in functioning.