DSM-Based ADHD Rating Scales

DSM-based ADHD Rating Scales

DSM-based rating scales are designed to focus on ADHD symptoms (inattentive, hyperactive-impulsive) to help determine the possible presence of core symptoms of ADHD as defined by DSM-5 criteria for ADHD.* The AAP recommends the use of DSM-based ADHD rating scales when evaluating ADHD:

For the initial diagnosis of a child with ADHD
For the assessment of conditions that mimic or are comorbid with ADHD
For monitoring the treatment strategy that has been put in place

DSM-based rating scales should be completed for 2 or more major settings. The rating scales may be completed by the parent or other family members, teachers, clinicians, or other professional observers who have opportunities to observe the child’s behavior to help determine which ADHD symptoms and co-occurring conditions are present in the patient, in which environments (home, school, work, social), and over what time period.
NOTE: Be aware that screening tools and rating scales are not diagnostic; they are instruments used to help clinicians identify the possible presence of a condition. Additional information/tests are required to confirm or rule out a diagnosis.

For purposes of this EQIPP course, some recommended age-specific rating scales/scoring interpretations include, but are not limited to, the following:

Age	Recommended Rating Scales	Scoring Interpretation
Pre-school children, ages 4-5	ADHD Rating Scale IV – Preschool Version^* Note: Currently validated for DSM-4. There are some wording variations to make the DSM criteria more applicable to preschool children, but symptom criteria are the same as on the other rating scales. Also see the Vanderbilt Assessment Scales below, which can be applicable to preschoolers.	Proprietary. Rating Scales and scoring information as described in McGoey KE, DuPaul GJ, Haley E, Shelton TL. Parent and teacher ratings of attention-deficit/hyperactivity disorder in preschool: the ADHD rating scale-IV preschool version. J Psychopathol Behav Assess. 2007;29(4):269-276
School age children and adolescents, ages 6-18	Vanderbilt Assessment Scale: ADHD Toolkit Parent-Informant Form Vanderbilt Assessment Scale, Follow-up: ADHD Toolkit Parent-Informant Form Vanderbilt Assessment Scale: ADHD Toolkit Teacher-Informant Form Vanderbilt Assessment Scale, Follow-up: ADHD Toolkit Teacher-Informant Form Note: Vanderbilt Scales are updated to DSM-5 but only validated for DSM-4. Originally designed for the 6- to 12-year-old age group, they are applicable to other age groups, including preschoolers and adolescents.	Use the gray boxes to tally positive scores in the right margin at the end of each section. The Vanderbilt Assessment Scales Scoring Instructions provides scoring information for diagnostic purposes and for monitoring symptom and performance improvement. The instructions help correlate totals to DSM-5 criteria.
	ADHD Rating Scale–5, (ADHD RS-5) Home Version ADHD Rating Scale–5, (ADHD RS-5) School Version Note: Available in Child Form (ages 5–10) and Adolescent Form (ages 11–17); both updated and validated for DSM-5.	Proprietary. Rating scales and scoring sheets may be purchased from Guilford Press.
	Conner Rating Scales (Conners 3) 6-18 years. Parent and Teacher Scales 8-18 years. Self-Report Scale Note: All scales updated to DSM-5 but validated only for DSM-4.	Proprietary. Forms and scoring sheets purchased through MHS Assessments.

^*Note: The fifth edition of the DSM-5 does not include significant changes to ADHD-related recommendations from the DSM-4 publication. Therefore, rating scales based on DSM-4 criteria are sufficient for purposes of this EQIPP quality improvement activity. Notable changes from DSM-4 to DSM-5 include: 1) Permission now granted to diagnose ADHD and autistic spectrum disorder as coexisting diagnoses; 2) ADHD symptoms must be seen before age 12; and 3) adolescents age 17 may qualify for an ADHD diagnosis if 5 of 9 symptoms of inattention and/or hyperactivity/impulsivity are noted.