What forms are used to assess for Attention Deficit Hyperactivity Disorder (ADHD)?

ADHD Assessment Forms

The Vanderbilt ADHD Rating Scales (parent and teacher versions) are the primary screening tools recommended by the American Academy of Pediatrics for children ages 6-12 years, while the Conners Rating Scales are validated alternatives across all age groups including preschool, school-age, adolescents, and adults. 1

Primary Recommended Assessment Tools by Age Group

Children Ages 6-12 Years

• The Vanderbilt ADHD Rating Scales are specifically recommended by the American Academy of Pediatrics as part of their comprehensive ADHD toolkit for elementary and middle school children 1
• Both parent and teacher versions must be completed to gather information across home and school settings, as DSM-5 criteria require documentation of impairment in more than one major setting 1
• These forms help clinicians diagnose ADHD and categorize the problem into its various presentations (inattentive, hyperactive-impulsive, or combined) 1

Preschool-Aged Children (4-5 Years)

• The Conners Comprehensive Behavior Rating Scales and the ADHD Rating Scale IV are the only DSM-based scales validated for preschool-aged children 2
• Assessment is particularly challenging in this age group because children may lack separate observers if not attending preschool or childcare 2
• Focused checklists help physicians determine the presence of key symptoms when observation across multiple settings is limited 2

Adolescents (12-18 Years)

• The Vanderbilt scales can be used to screen for ADHD, related behavior disorders, and general academic and behavioral performance 1
• The Pediatric Symptom Checklist and Strengths and Difficulties Questionnaire are well-suited for screening from 48 months through adolescence 1
• The Conners Rating Scale helps gather information from multiple teachers when adolescents have several instructors 1
• Obtaining teacher reports is more challenging because adolescents have multiple teachers, and parents have less opportunity to observe behaviors than when children were younger 2

Adults

• The Conners Adult ADHD Rating Scale (CAARS) is used to evaluate ADHD symptoms in adults 1
• Self-report rating scales and observer report scales quantify ADHD symptoms using Likert scales, making them useful for following the course of the disease 3

Critical Implementation Requirements

Multi-Informant Assessment is Mandatory

• Information must be obtained from multiple sources including parents, teachers, and other observers to verify that DSM-5 criteria are met 1
• Both parent and teacher ratings are needed for clinical purposes, as this is the most efficient assessment method 4
• Rating scales serve to systematically collect symptom information but do not diagnose ADHD by themselves 1

Comprehensive Evaluation Beyond Questionnaires

• Rating scales alone have adequate sensitivity but poor specificity in diagnosing ADHD 5
• A comprehensive evaluation must include clinical interviews with parents, direct examination and observation of the child, and documentation of functional impairment 1
• Alternative causes for symptoms must be ruled out through clinical interview and examination 1

Mandatory Comorbidity Screening

• The American Academy of Pediatrics recommends screening for common comorbid conditions that may alter treatment approach 1
• Essential screening includes emotional/behavioral conditions (anxiety, depression, oppositional defiant disorder, conduct disorders, substance use) 1
• Developmental conditions (learning and language disorders, autism spectrum disorders) and physical conditions (tics, sleep disorders) should also be assessed 1
• The majority of children with ADHD meet criteria for another mental disorder, making this screening essential rather than optional 6

Common Pitfalls to Avoid

• Relying solely on questionnaire scores without clinical interview and multi-informant data is a common pitfall 1
• Failing to gather information from multiple sources and settings leads to incomplete assessment 1
• Not screening for comorbid conditions that may complicate treatment or explain symptoms 1, 6
• Assigning an ADHD diagnosis when symptoms are better explained by trauma, substance use, or other psychiatric conditions 6
• Failing to gather sufficient information from multiple settings before concluding criteria are not met 6

Integration with Treatment Monitoring

• Once diagnosis is established, the same rating scales can be used to monitor treatment response over time 1
• The American Academy of Pediatrics recommends titrating medication doses to achieve maximum benefit with minimum adverse effects, using these scales to track progress 1