Modifying the response labels of an ADHD teacher rating scale: psychometric and epidemiologic implications.

OBJECTIVE: To evaluate the impact of changing the response labels of a teacher rating scale in a population-based study of ADHD. METHOD: For parents, the Diagnostic Interview Schedule for Children, which asks whether each of 18 symptoms occurred "often" in the past year, was used. For teachers, most scales use a 4-point scale, with often and very often as the two highest categories. To make the two instruments more compatible, the authors created a teacher rating scale with often as the highest category. Teachers rated more than 6,000 elementary school students using this instrument. Some teachers completed ratings using both questionnaire formats. RESULTS: The scale's internal consistency, convergent validity, and test-retest reliability are excellent. The factor structure is consistent with established DSM-IV-based instruments. Response category choices influence the proportion of children exceeding symptom and impairment thresholds. CONCLUSION: Altering the response scale does not degrade the psychometric properties of the instrument but makes important differences in the sample.

Prevalence of medication treatment for attention deficit-hyperactivity disorder among elementary school children in Johnston County, North Carolina.

OBJECTIVES: This study estimated the prevalence of medication treatment for attention deficit-hyperactivity disorder (ADHD) among elementary school children in a North Carolina county. METHODS: Parents of 7333 children in grades 1 through 5 in 17 public elementary schools were asked whether their child had ever been given a diagnosis of ADHD by a psychologist or physician and whether their child was currently taking medication to treat ADHD. Parents of 6099 children (83%) responded. RESULTS: By parental report, 607 children (10%) had been given an ADHD diagnosis and 434 (7%) were receiving ADHD medication treatment. Seventy-one % of the diagnosed children were receiving medication. Treatment rates varied by sex, race/ethnicity, and grade. CONCLUSIONS: If treatment patterns observed in this study are representative, the public health impact of ADHD may be underestimated.