What Attention Deficit Hyperactivity Disorder (ADHD) and Attention Deficit Disorder (ADD) assessment scales are used for a 14-year-old teenager?

From the Guidelines

For assessing ADHD/ADD in a 14-year-old teenager, the most recommended scales include the Conners Rating Scales, ADHD Rating Scale-5, Vanderbilt ADHD Diagnostic Rating Scales, Behavior Assessment System for Children, Brown Attention-Deficit Disorder Scales for Adolescents, and the Behavior Rating Inventory of Executive Function. These scales are effective because they gather information from multiple perspectives (parents, teachers, and the teen themselves) and evaluate symptoms across different environments, which is crucial since ADHD manifestation can vary by context. The Conners Rating Scales, for instance, evaluate symptoms across multiple settings through parent, teacher, and self-report versions 1. The ADHD Rating Scale-5 directly measures the 18 symptoms outlined in diagnostic criteria, providing a comprehensive assessment of ADHD symptoms 1. The Vanderbilt ADHD Diagnostic Rating Scales offer a comprehensive assessment with both parent and teacher forms, while the Behavior Assessment System for Children evaluates broader behavioral issues alongside ADHD symptoms 1. For adolescents specifically, the Brown Attention-Deficit Disorder Scales for Adolescents and the Behavior Rating Inventory of Executive Function are particularly valuable as they assess executive functioning challenges common in teens with ADHD 1. Comprehensive assessment typically combines several of these scales along with clinical interviews, developmental history, and sometimes neuropsychological testing to ensure accurate diagnosis and appropriate treatment planning for the teenager. It's also important to consider the DSM-5 criteria and to rule out any alternative cause, as well as to assess for comorbid conditions, including emotional or behavioral conditions, developmental conditions, and physical conditions 1. Overall, a comprehensive assessment using a combination of these scales and a thorough clinical evaluation is essential for accurate diagnosis and effective treatment planning for a 14-year-old teenager with ADHD/ADD.

From the FDA Drug Label

Atomoxetine was administered as a divided dose in the early morning and late afternoon (after school) and titrated on a weight-adjusted basis according to clinical response. The maximum recommended atomoxetine dose was 2. 0 mg/kg/day. ADHD symptoms statistically significantly improved more on atomoxetine than on placebo, as measured on the ADHDRS scale. Examination of population subsets based on gender and age (<12 and 12 to 17) did not reveal any differential responsiveness on the basis of these subgroupings Response during the open-label phase was defined as CGI-ADHD-S score ≤2 and a reduction of at least 25% from baseline in ADHDRS-IV-Parent:Inv total score

The ADHDRS scale and ADHDRS-IV-Parent:Inv total score are used to assess ADHD symptoms in a 14-year-old teenager 2.

• The ADHDRS scale is used to measure ADHD symptoms.
• The ADHDRS-IV-Parent:Inv total score is used to assess response to treatment. Key points:
• The scales are used to assess ADHD symptoms in children and adolescents.
• The ADHDRS scale is used in clinical trials to measure the effectiveness of atomoxetine.
• The ADHDRS-IV-Parent:Inv total score is used to assess response to treatment in clinical trials.

From the Research

Assessment Scales for ADHD and ADD in 14-year-old Teenagers

The following assessment scales are used to evaluate Attention Deficit Hyperactivity Disorder (ADHD) and Attention Deficit Disorder (ADD) in teenagers:

• Conners' Rating Scales, which include the Conners 3-P (parent version), Conners 3-T (teacher version), and Conners 3-SR (self-report version) 3, 4
• Vanderbilt ADHD diagnostic parent rating scale, which is used to collect uniform patient data and minimize the time burden of lengthy interviews 5

Psychometric Properties of Assessment Scales

Studies have evaluated the psychometric properties of these assessment scales, including:

• Reliability and validity of the Conners 3 scales in an Italian sample, which supported their use as reliable and valid tools to assess ADHD 3
• Factor structure and internal consistency of the German version of the Conners 3 rating scales, which provided evidence for their non-redundancy and supported their use in international multicenter studies 4
• Psychometric properties of the Vanderbilt ADHD diagnostic parent rating scale, which showed acceptable internal consistency and factor structure, and was found to be a reliable and cost-effective assessment for ADHD in clinical and research settings 5

Limitations and Future Directions

While these assessment scales are widely used, there are limitations and areas for future research, including:

• The need for more studies on the psychometric properties of the Conners 3 scales in different populations and settings 3, 4
• The development of ADHD screening instruments specifically for children with intellectual disabilities 6
• The evaluation of the construct validity of the Conners' Adult ADHD Rating Scales, which raised questions about their use in research and practice 7