Customer Reviews

ADHD Rating Scale--IV: Checklists, Norms, and Clinical Interpretation

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Description: The ADHD IV Manual enables one to discover if a school-aged child or teen has ADHD. The manual includes parent and teacher rating forms for ADHD, and norms for boys and girls at different ages.

Background: ADHD is usually diagnosed using the standard for psychiatric diagnoses, the "Diagnostic and Statistical Manual, Forth Edition" (DSM-IV). These criteria are based on and revised to reflect the most recent research. By norming the DSM-IV criteria for ADHD, Professor DuPaul made the diagnosis of ADHD far easier and more reliable.

Expert Recommendation: I first bought the ADHD-IV manual when a well-known investigator on the treatment of ADHD, Russ Barkley of Harvard University, recommended the ADHD-IV checklist at the Sandestin, Florida ADHD conference in 2000.

This test costs less: Dr. DuPaul's test protocol cannot be copyrighted because he used the DSM-IV criteria as the text of this test. So, there's no additional expense for using the test beyond the purchase price of the manual. One doesn't have to pay more for extra test protocols. The SNAP and the Connors Rating Scales are good tests of ADHD, but they add a cost for protocols. The Connors Rating Scales starter kit cost from five to ten times the price of the ADHD-IV manual and requires that one pay approximately $2 for each additional form.


Drawback- the ADHD-IV has no medication scale.

Importance of medication: In the late 1990s, the Multimodal Treatment studies compared the effectiveness of every known promising treatment for ADHD, pooling subjects from many medical schools across the US. The Multimodal studies found that titrating stimulant medication was, by far, the most effective treatment for ADHD. Psychological treatments can add by further improving both treatment effectiveness and long-term results.

Limits of Medication: According to Bill Pelham of the University of Buffalo, stimulant medications appear to "normalize" ADHD children, but doesn't treat all symptoms. Carolyn Webster-Stratton of the University of Washington showed that helping these children learn to recognize emotions and to respond well to problem situations can produce an impressively better long-term outcome.

Cautions about medication: Bill Pelham (called `Mr. Ritalin' on the television-newsmagazine 20-20) said that overmedication of stimulants should be suspected if the child loses his or her sparkle. If a child diagnosed as ADHD gets worse when given stimulant medication, more easily angered or hyper, one might be wise to have the child evaluated to rule out a possible bipolar disorder. If stimulant medication increases tics or cursing, rule out Tourette's Syndrome. If medication doesn't help and the child is obsessed with specific topics, has severe interpersonal problems and tremendous difficulty recognizing the emotions of others, rule out Asperberger's Syndrome. Asperberger's is like ADHD on steroids. It has symptoms similar to that of ADHD, but to an extreme. It is quite rare, but early intervention can help.

Connors included a medication scale: The Connors Rating Scales have a subscale that measures the effect of medication on ADHD. That scale may make the Connors more useful for titrating medication. However, as noted before, the Connors Scales are much more expensive.

In summary, the ADHD-IV scale is the most cost-effective instrument available for screening for ADHD. It's derivation from the DSM-IV makes it valid and reliable. The cost of using it is limited to the price of the manual.

More information: Those who wish to learn more about ADHD rating scales might be interested in a succinct article on the topic by Dr. Jay A. Salpekar in the Summer 2006 edition of Children's National News: an electronic newsletter for pediatricians. Some other sources of reliable information on ADHD are ChADD (Children and Adults with ADHD) and the National Institute of Mental Health.

A very useful book for pediatricians and other health care professionals taking care of children. If you buy the book, you can use the forms in your practice.