Table 6, Description of available tools for ADHD assessment - Attention Deficit Hyperactivity Disorder: Diagnosis and Treatment in Children and Adolescents

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Kemper AR, Maslow GR, Hill S, et al. Attention Deficit Hyperactivity Disorder: Diagnosis and Treatment in Children and Adolescents [Internet]. Rockville (MD): Agency for Healthcare Research and Quality (US); 2018 Jan. (Comparative Effectiveness Reviews, No. 203.)

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Attention Deficit Hyperactivity Disorder: Diagnosis and Treatment in Children and Adolescents [Internet].

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Table 6Description of available tools for ADHD assessment

Category	Tool	Domains Assessed	Method	Scoring	Interpretation
Interviews
	Standard clinical interview	ADHD diagnosis according to DSM-IV or DSM-5 criteria	Parent and/or child interview	NA	Diagnostic interview that determines whether an individual has ADHD.
	K-SADS (Kiddie SADS)	ADHD diagnosis according to DSM-IV or DSM-5 criteria	Semi-structured diagnostic interview with parent and child	Items rated on a 3-point scale for severity (not present, subthreshold, and threshold—which combines both moderate and severe presentations). Parent, child, and summary ratings are made.	A diagnostic algorithm that includes all DSM criteria for ADHD. Results of the semi-structured interview indicate whether the individual has ADHD.
	DISC/DISC IV (Diagnostic Interview Schedule for Children)	ADHD diagnosis according to DSM-IV criteria	Structured diagnostic interview with parent and/or child	Items rated as yes, no, somewhat or sometimes	A diagnostic algorithm that includes the DSM criteria for ADHD. Results of the diagnostic interview indicate whether the individual has ADHD.
Rating Scales
	NICHQ (National Institute for Children’s Health Quality) Vanderbilt Assessment Scale	ADHD Predominantly Inattentive ADHD Predominantly Hyperactive/Impulsive ADHD Combined Oppositional Defiant Disorder Conduct Disorder Anxiety/Depression	Parent questionnaire Teacher questionnaire	Symptom Questions Rated based on frequency 0–3 scale (never, occasionally, often, very often) Number of symptoms endorsed at a 2 (often) or 3 (very often) is summed for each domain Performance Questions Rated based on problem severity 0–5 scale (excellent, above average, average, somewhat of a problem, problematic)	A positive screen indicates the need for further evaluation The screening measure is positive if both of the following are met for a given domain: - Specific number of Symptom Questions are rated 2 or 3 - At least one Performance Question is rated 4 or 5
	Conners Rating Scales CPRS CTRS CRS Conners 3	Note: Subscale names vary slightly between versions of the Conners Rating Scales, but include: ADHD-related scales Inattention Hyperactivity/Impulsivity Learning Problems Executive Functioning DSM Symptoms Scales ADHD Index Conners Global Index Behavioral/emotional scales Defiance/Aggression Peer Relations/Social Problems Family Relations Oppositional Defiant Disorder Conduct Disorder Cognitive Problems Anxious-Shy Perfectionism Psychosomatic	Parent questionnaire Teacher questionnaire Adolescent questionnaire	Rated based on how true the question is for the child 0–3 (not true at all, just a little true, pretty much true, very much true).	Raw scores for each scale are converted to T scores (mean=50, SD=10) based on a normative sample Higher scores indicated increased clinical concern Interpretation guidelines indicate that scores ≥ 60 are above average
	SNAP-IV (Swanson, Nolan and Pelham Revision)	ADHD Predominantly Inattentive ADHD Predominantly Hyperactive/Impulsive ADHD Combined	Parent questionnaire Teacher questionnaire	Rated based on frequency 0–3 scale (not at all, just a little, quite a bit, very much)	Scores can be interpreted in two different ways: Sum of items for each of the three subscales, with high score indicating more symptoms. Average rating per item for each of the three subscales. This rating is compared to the parent/teacher 5% cut off and a higher score indicates more symptoms.
	DBDRS (Disruptive Behavior Disorder Rating Scale )	ADHD Predominantly Inattentive ADHD Predominantly Hyperactive/Impulsive ADHD Combined Oppositional Defiant Disorder Conduct Disorder	Parent questionnaire Teacher questionnaire	Rated based on frequency 4 point scale (not at all, just a little, pretty much, and very much)	Scales scores are computed by summing the items in each domain. Scores were considered to be in the clinical range for ADHD if they are between the 95th to 100th percentile.
	ADHD-RS (ADHD Rating Scale)	ADHD Predominantly Inattentive ADHD Predominantly Hyperactive/Impulsive ADHD Combined	Parent questionnaire Teacher questionnaire	Rated based on frequency 0–3 (does not experience the symptom at all … symptom very often)	Scores are calculated by summing the items in each domain and the total items.
	SDQ (Strengths and Difficulties Questionnaire)	Emotional symptoms Conduct problems Hyperactivity/inattention Peer relationship problems Prosocial behavior Total difficulties	Parent questionnaire Teacher questionnaire	Rated based on how true the question is for the child 0–2 (not true, somewhat true, certainly true) Some items are reverse coded.	Higher scores indicate more concerns in a given area. Raw scores can be compared to cut-points derived from a typical population.
	BRIEF (Behavior Rating Inventory of Executive Function)	Behavioral Regulation Index (three scales) Metacognition Index (five scales) Global Executive Composite	Parent questionnaire Teacher questionnaire	Rated based on frequency 3-point scale (never, sometimes often)	Raw scores are converted to T scores (mean=50; SD=10) and percentiles based on a normative sample. Higher scores indicate more problems relative age-matched peers.
	CHEXI (Childhood Executive Functioning Inventory)	Inhibition (inhibition and regulation Working Memory (working memory and planning)	Parent questionnaire Teacher questionnaire	Rated based on how true the question is for the child 0–5 point (definitely not true, not true, partially true, true, definitely true)	Subscale scores are calculated by computing the mean score for items in each scale. Higher scores are indicative of more severe symptoms.
	ATTEX (Attention and Executive Function Rating Inventory)	Distractibility Impulsivity Motor hyperactivity Directing attention Sustaining attention Shifting attention Initiative Planning Execution of action Evaluation Total score	Teacher questionnaire	Rated based on severity 3-point scale (not a problem, sometimes a problem, often a problem)	Subscale scores are calculated by computing the mean score for items in each scale. A Total Score is calculated by summing all of the scale scores. Higher scores indicate greater severity (i.e., the behavior is more often a problems).
Continuous Performance Tests
	Conners CPT (Continuous Performance Test)	Attention Impulsivity Sustained Attention Vigilance	Computerized test	Responses to a target and nontarget	Raw and standardized scores are calculated using an algorithm for each domain. T scores and percentiles are provided, with higher scores indicating more problems in a given area.
	IVA CPT (Integrated Visual and Auditory Continuous Performance Test)	Auditory Response Control Visual Response Control Auditory Attention Visual Attention Auditory Sustained Attention Visual sustained Attention	Computerized test	Responses to the target (visual or auditory) and to the nontarget (visual or auditory)	Visual and Auditory domain scores are calculated for a total of 12 quotients. Omission and commission scores are generated, with more omission errors indicating greater distraction and more commission errors indicating greater impulsivity. Hyperactivity-impulsiveness and attention deficit scales are calculated from the omission and commission errors, each comprising 3 visual and 3 auditory quotients.
	TOVA (Test of Variables of Attention)	Attention Inhibitory control	Computerized test	Responses to the target (correct) and responses to the nontarget (incorrect)	Errors of omission (not responding to the target) yield a measure of inattention. Errors of commission (responding to a nontarget) yield a measure of impulsivity.
	CANTAB (Cambridge Neuro-psychological Test Automated Battery)^a	General memory and learning, with subtests including: - Working memory - Executive functioning - Visual memory - Attention - Reaction time - Decision making - Response control	Computerized test	Scoring varies by domain and includes scores such as percent correct, number of errors, time to complete, response latency	Interpretation varies depending on the outcome measures (e.g., higher number of errors indicates more impairment; lower response latency indicates less impairment).

a: CANTAB description from personal communication with Cambridge Cognition Ltd. (January 2017).
: Abbreviations: ADHD=attention deficit hyperactivity disorder; CPRS=Conners Parent Rating Scale; CTRS=Conners Teacher Rating Scale; DSM=Diagnostic and Statistical Manual of Mental Disorders

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Kemper AR, Maslow GR, Hill S, et al. Attention Deficit Hyperactivity Disorder: Diagnosis and Treatment in Children and Adolescents [Internet]. Rockville (MD): Agency for Healthcare Research and Quality (US); 2018 Jan. (Comparative Effectiveness Reviews, No. 203.) Table 6, Description of available tools for ADHD assessment.
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