Study: Teacher Rating Scales “Valid and Time-Efficient” Measure for Assessing ADHD
A systematic review and meta-analysis evaluating the validity of teacher rating scales found that they accurately assess ADHD in the classroom when compared to semi-structured clinical interviews and structured classroom observations, however they are more likely to accurately detect symptoms of hyperactivity and impulsivity than they are symptoms of inattention.
May 18, 2020
Teacher rating scales accurately and efficiently assess attention deficit hyperactivity disorder (ADHD) in the classroom, though they are a more reliable tool for detecting hyperactive-impulsive behaviors than inattentive behaviors. This is the finding of a new meta-analysis of 22 studies regarding the assessment of ADHD symptoms in 3,947 children, which found that teacher rating scales closely tracked with structured observations of students and clinical interviews — both regarded “gold standard assessments” of ADHD. The new study, published in the Journal of Attention Disorders,1 also suggests that structured observations may aid in the detection of inattentive symptoms in the classroom.
Researchers conducted a systematic review and meta-analysis of convergent and divergent validity of teacher rating scales two “gold standard” methods of assessing ADHD: semi-structured clinical teacher interviews and structured classroom observations. The results supported convergent validity of teacher rating scales when validated against semi-structured clinical interviews, with strong correlations for inattention, hyperactivity-impulsivity, and total ADHD. The review confirmed divergent validity for rating scale measures validated against semi-structured clinical interviews. Against structured observations, convergent validity of these scales was further confirmed. Convergent validity was larger for ratings of hyperactivity and impulsivity than it was for ratings of inattention, independent from the assessment type.
Eighty five percent of clinicians report using teacher rating scales to assess ADHD symptoms at school.2 This study suggests that these scales are helpful, but should not be used as a sole diagnostic tool for assessing ADHD at school, because “ratings may be biased by projection bias or halo effects and they do not take functional impairment into account.” Additionally, teachers aren’t trained in diagnosing psychopathology in children. Semi-structured clinical interviews are less sensitive to bias and accepted as the best assessment method for the evaluation of ADHD symptoms. Likewise, systematic observations are viewed as one of the most objective and direct measurements of a child’s behavior and may be particularly useful in assessing symptoms of inattentive-type ADHD.
1Staff, A. I., Oosterlaan, et al. The Validity of Teacher Rating Scales for the Assessment of ADHD Symptoms in the Classroom: A Systematic Review and Meta-Analysis. Journal of Attention Disorders (May 2020). https://doi.org/10.1177/1087054720916839
2Handler, M. W., DuPaul, G. J. Assessment of ADHD: Differences across psychology specialty areas. Journal of Attention Disorders (2005). https://doi.org/10.1177/1087054705278762