Attention-Deficit/Hyperactivity Disorder Tests

The ADD-H: Comprehensive Teacher’s Rating Scale (ACTeRS) is a concise teacher rating scale intended to be a practical tool for diagnosing and monitoring treatment for attention deficit disorder in students in grades K-8. The scale consists of 24 items related to classroom behavior. There are two formats available: paper-and-pencil and microcomputer. The teacher rates the student’s behavior compared to their classmates on a 5-point Likert-type scale. The 24 test items are arranged into four factors: Attention, Hyperactivity, Social Skills, and Oppositional Behavior.

ACTeRS: Interpretation and Use

Raw scores are converted to percentiles with separate profiles for boys and girls. A diagnosis of ADD may be considered legitimate if the student scores at or below the 10th percentile on the Attention subscale, regardless of other scale scores. Scores on the other scales can indicate the presence and severity of other issues, however the Oppositional and Social Skills scales are not recommended for isolated use for diagnostic purposes.

The authors suggest using the Attention and Hyperactivity factors in conjunction to determine the severity of the problem. They caution that the cutoff scores should not be used rigidly, and decisions should be made based on all available data. The authors recommend using ACTeRS over the Conners’ Rating Scales because of its factor purity and relevance of items, and separation of attention from hyperactivity.

The microcomputer version of ACTeRS is user-friendly and allows up to 12 separate observations to be entered, simplifying longitudinal comparisons and evaluation of treatment interventions.

ACTeRS: Psychometric Properties

The ADD-H has high levels of internal consistency. Test-retest reliability coefficients range from .78-.82 for the four subscales. However, this data was based on a small sample size of 80 boys and girls. Interrater reliability coefficients are .61 on the Attention subscale; .73 for the Hyperactivity subscale; .51 for the Social subscale; and .59 for the Oppositional subscale. These coefficients are based on data from 124 children rated by two teachers. The interrater reliability coefficients are quite low to support the use of the instrument as a diagnostic tool, and the sample size is small.

Attention Deficit Disorders Evaluation Scale (ADDES)

The Attention Deficit Disorders Evaluation Scale (ADDES) is designed to evaluate and diagnose Attention Deficit Disorders in children and youth ages 4.5-18, using input from teachers and parents. The ADDES is available in two versions: School and Home. Both versions measure three behavioral constructs of attention deficit disorders, as defined in the DSM-III: inattention, impulsiveness, and hyperactivity.

ADDES: Structure and Scoring

The School Version has 60 items and the Home Version has 46 items, arrayed across the three construct areas. Raw scores are converted to standard scores via conversion tables normed to eight age-sex standardization groups for the School version and nine for the Home version. The standard subscale scores can then be summed for conversion to a percentile score, allowing for comparison to students in the standardization sample.

ADDES: Psychometric Properties

The ADDES demonstrates a high degree of reliability across administrations, raters, and within and among construct subscale areas. Content validity was investigated through reviews of ADD descriptors by diagnosticians, parents, and educators. Item analysis of response distributions and item/total score correlations were also used to refine item pools. The three-subscale construct validity was confirmed through factor analysis and supported by ratings of non-ADD versus identified ADD children and youth. Convergent validity studies showed positive and significant correlations between ADDES scale measures and similar measures from the revised Conners’ Teacher Rating Scale and the Conners’ Parent Rating Scale.

ADDES: Strengths and Limitations

The ADDES meets several criteria for a comprehensive assessment procedure, according to McKinney (1993). The expansive item pool in both versions measures the three primary constructs of inattention, impulsivity, and hyperactivity, as specified in DSM-III. Additionally, differentiation of scale scores by age-sex groups increases the sensitivity of this assessment tool. The ADDES instruments allow for data collection from parents and educators across home and school settings. However, the ADDES does not distinguish itself in efforts toward further diagnosis or assessment in the area of non-hyperactive ADD students.

A significant concern is the ADDES’s apparent inability to address co-occurring conditions. For example, it does not address the co-occurrence of learning disabilities with ADD, which can present particular problems in distinguishing ADD-specific behaviors. Additionally, the content of some items does not allow for measurement across various situations within the home or school.

Attention Test Linking Assessment and Services (ATLAS)

The Attention Test Linking Assessment and Services (ATLAS) is a comprehensive assessment system for diagnosing and remediating ADHD in children and adolescents between 8 and 18 years old. It utilizes ratings from home and school, performance assessments, an interview, and behavioral observations during testing.

ATLAS Components

The ATLAS includes five forms:

• Mental Health Interview Screener (administered to the parent/guardian)
• Parent/Teacher Attention Report (rating scale)
• Attention Performance Assessment
• Examiner’s Observation Report
• Client Profile Summary Report

The manual also includes the Differential Diagnostic Instrument and the Biopsychosocial Treatment Planner. The ATLAS offers two levels of intervention: general classroom strategies and advanced strategies.

ATLAS: Development and Approach

The ATLAS was developed to provide a comprehensive ADHD battery that would also assist in differential diagnosis and treatment planning. The test authors approach ADHD from a biopsychosocial perspective, emphasizing deficits in the prefrontal cortex area of the brain. Their approach reveals an adherence to a medical model, a within-child approach that has been largely discarded within the educational community. This is inconsistent with their emphasis on environmental cues and conditions that influence the child’s behavioral functioning.

ATLAS: Limitations

The ATLAS has several limitations:

• Standardization Sample: The standardization sample is small (318) and includes minimal representation from the northeastern and southern regions of the U.S..
• Reliability: There is not enough information on reliability provided.
• Response Format: The response format on the Parent/Teacher Attention Report and the Mental Health Screener is problematic.
• Examiner’s Observation Report: Lacks specific, operational definitions of the behaviors to be observed.
• Performance-Based Assessment: Unable to differentiate between ADHD and other disorders based on performance-based assessment alone.

References

Switzky, H. N., & Greenspan, S. (in press). Adaptive behavior, everyday intelligence, and the constitutive definition of mental retardation. In A. Rutatori (Ed.), Advances in special education (vol. 2). Greenwich,

CT: JAi Press. Miller, R. J. (1995). ADD-H: Comprehensive Teacher’s Rating Scale, Second Edition. In J. C. Conoley & J. C. Impara (Eds.), The twelfth mental measurements yearbook (pp. 15-17). Lincoln, NE: Buros Institute of Mental Measurements.

Miller, R. J. (1995). Review of the ADD-H: Comprehensive Teacher’s Rating Scale, Second Edition. In J. C. Conoley & J. C. Impara (Eds.), The twelfth mental measurements yearbook (pp. 15-17). Lincoln, NE: Buros Institute of Mental Measurements.

Oehler-Stinnett, J. (1995). Review of the ADD-H: Comprehensive Teacher’s Rating Scale. In J. C. Conoley & J. C. Impara (Eds.), The twelfth mental measurements yearbook (pp. 17-20). Lincoln, NE: Buros Institute of Mental Measurements.

Oehler-Stinnett, J. (1995). Review of the ADD-H: Comprehensive Teacher’s Rating Scale. In J. C. Conoley & J. C. Impara (Eds.), The twelfth mental measurements yearbook (pp. 17-20). Lincoln, NE: Buros Institute of Mental Measurements.

Oehler-Stinnett, J. (1995). Review of the ADD-H: Comprehensive Teacher’s Rating Scale. In J. C. Conoley & J. C. Impara (Eds.), The twelfth mental measurements yearbook (pp. 17-20). Lincoln, NE: Buros Institute of Mental Measurements.

Collins, D. (1995). Attention Deficit Disorders Evaluation Scale: Home and School Version Rating Forms. In J. C. Conoley & J. C. Impara (Eds.), The twelfth mental measurements yearbook (pp. 38-41). Lincoln, NE: Buros Institute of Mental Measurements.

Collins, D. (1995). Review of the Attention Deficit Disorders Evaluation Scale. In J. C. Conoley & J. C. Impara (Eds.), The twelfth mental measurements yearbook (pp. 38-41). Lincoln, NE: Buros Institute of Mental Measurements.

Collins, D. (1995). Review of the Attention Deficit Disorders Evaluation Scale. In J. C. Conoley & J. C. Impara (Eds.), The twelfth mental measurements yearbook (pp. 38-41). Lincoln, NE: Buros Institute of Mental Measurements.

Olejnik, S. (1995). Review of the Attention Deficit Disorders Evaluation Scale. In J. C. Conoley & J. C. Impara (Eds.), The twelfth mental measurements yearbook (pp. 41-43). Lincoln, NE: Buros Institute of Mental Measurements.

Chittooran, M. M. (2009). Attention Test Linking Assessment and Services. In R. A. Spies, B. S. Plake, & K. F. Geisinger (Eds.), The sixteenth mental measurements yearbook (pp. 8-11). Lincoln, NE: Buros Institute of Mental Measurements.

Chittooran, M. M. (2009). Review of the Attention Test Linking Assessment and Services. In R. A. Spies, B. S. Plake, & K. F. Geisinger (Eds.), The sixteenth mental measurements yearbook (pp. 8-11). Lincoln, NE: Buros Institute of Mental Measurements.

Chittooran, M. M. (2009). Review of the Attention Test Linking Assessment and Services. In R. A. Spies, B. S. Plake, & K. F. Geisinger (Eds.), The sixteenth mental measurements yearbook (pp. 8-11). Lincoln, NE: Buros Institute of Mental Measurements.

Meadows, T. J., & Grady, E. (2009). Review of the Attention Test Linking Assessment and Services. In R. A. Spies, B. S. Plake, & K. F. Geisinger (Eds.), The sixteenth mental measurements yearbook (pp. 11-14). Lincoln, NE: Buros Institute of Mental Measurements.

Meadows, T. J., & Grady, E. (2009). Review of the Attention Test Linking Assessment and Services. In R. A. Spies, B. S. Plake, & K. F. Geisinger (Eds.), The sixteenth mental measurements yearbook (pp. 11-14). Lincoln, NE: Buros Institute of Mental Measurements.