Psychometric properties of two ADHD rating scales used in children with ADHD and intellectual disability.
M Palmer, Z Fang, V Carter Leno and 1 others
PMID 39243198WHAT IT FOUND
ADHD rating scales remain reliable for children with intellectual disability.
However, parent ratings of hyperactivity are influenced by autism traits and age, potentially leading to misdiagnosis. Teacher ratings were more consistent across these factors. Clinicians should interpret parent-reported activity levels with caution.
Key findings
01Parent ratings of 'difficulty waiting' on the Conners' scale changed depending on the child's IQ and autism symptoms, even when actual ADHD levels were the same.
02Teacher ratings on the Conners' scales were consistent regardless of the child's IQ, autism symptoms or age, unlike parent ratings.
03All scales tested showed acceptable internal reliability for the whole group and when split by mild or severe intellectual disability.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
The study only included children who already had a confirmed diagnosis of ADHD. The results do not tell us how well these scales work for screening or ruling out ADHD in children with intellectual disability who do not have significant symptoms. The sample size was relatively small when split into subgroups for analysis, which limits the strength of the conclusions. Autism diagnoses were not made during the study because it was conducted before DSM-V allowed co-occurrence, so autism symptoms were measured by a questionnaire rather than clinical assessment.
Declared interests
The original trial was funded by The Health Foundation and sponsored by King's College London. Authors received support from the Baily Thomas Charitable Fund, Wellcome Trust and National Institute for Health and Care Research. All authors declared no conflicts of interest.
The easy way to misread this
Do not assume these scales are validated for screening or diagnosing ADHD in children with intellectual disability who do not already have significant symptoms. The study only looked at children with confirmed ADHD, so it does not show how well the tests distinguish ADHD from typical behaviour in this population.