Assessing attention-deficit/hyperactivity disorder in preschool children: A longitudinal study

This longitudinal study investigated the agreement and stability of three teacher rating scales used to assess ADHD in preschool children: the ADHD Rating Scale, the Child Attention Profile (CAP), and the Conners\u27 Teacher Rating Scale-28 (CTRS-28). A sample of suburban children (N = 60) from a private nursery school were observed and rated by their teachers and assistant teachers at preschool level (Time 1) and 4 years later at elementary school level (Time 2). The agreement among the teacher rating scales yielded stronger correlations at Time 2 when the children were in elementary school. Interrater agreement between teacher and assistant teacher on the ADHD Rating Scale, the CAP, and the CTRS-28 resulted in rs =.75,.80,.80, respectively, at Time 2. The agreement between Time 1 and Time 2 was greater for assistant teachers with rs =.50,.51,.52, respectively. Agreement for teachers between Time 1 and Time 2 resulted in rs =.41,.46,.43, respectively. The three teacher rating scales demonstrated high acceptable levels of internal consistency with coefficients ranging from.81 to.96, with a median of.90 with respect to Time 1 and Time 2 for teacher and assistant teacher. Comparisons of the three scales between Time 1 and Time 2 resulted in significant differences on both teacher and assistant teacher ratings on the CAP. The ADHD Rating Scale and the CTRS-28 on total scores for teachers remained stable between Time 1 and Time 2. Stability over the 4-year span existed for the percentages of this population as compared with prevalence rates estimated by DSM-IV at 3%-5%. Teachers and assistant teachers found boys to present symptoms of ADHD more often than girls. Reading achievement at Time 2 correlated with lower scores for children who presented symptoms of ADHD. The results of this study were consistent with previous research demonstrating that ADHD symptoms observed in preschool children can and do persist into elementary school. There were, however, individuals who presented symptoms at preschool level who did not present them at elementary school level. Conversely, there was a child identified at elementary level in this study who was not identified in the entry study. Results suggest that these three teacher rating scales serve to identify children at risk for ADHD at the preschool level