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Reliable Ratings or Reading Tea Leaves: Can Parent, Teacher, and Clinician Behavioral Ratings of Preschoolers Predict ADHD at Age Six?

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Abstract

To assess the relative ability of parent, teacher, and clinician behavioral ratings of preschoolers to predict ADHD severity and diagnosis at 6 years of age. Hyperactive/inattentive preschoolers [N = 104, 75 % boys, Mean (SD) age = 4.37 (0.47) years] were followed over 2 years (mean = 26.44 months, SD = 5.66). At baseline (BL), parents and teachers completed the ADHD-RS-IV and clinicians completed the Behavioral Rating Inventory for Children following a psychological testing session. At age 6, [Mean (SD) age = 6.62 (0.35) years], parents were interviewed with the K-SADS-PL; teachers completed the ADHD-RS-IV; and laboratory measures of hyperactivity, impulsivity, and inattention were obtained from children. Hierarchical logistic and linear regression analyses examined which combination of BL ratings best predicted 6-year-old ADHD diagnosis and severity, respectively. At age 6, 56 (53.8 %) children met DSM-IV criteria for a diagnosis of ADHD. BL ratings from parent/teacher/clinician, parent/teacher and parent/clinician combinations significantly predicted children who had an ADHD diagnosis at age 6. Parent and clinician, but not teacher, behavior ratings were significant independent predictors of ADHD diagnosis and severity at 6-years-old. However, only clinician reports of preschoolers’ behaviors predicted laboratory measures of over-activity and inattention at follow-up. Cross-situationality is important for a diagnosis of ADHD during the preschool years. Among parents, teachers and clinicians, positive endorsements from all three informants, parent/teacher or parent/clinician appear to have prognostic value. Clinicians’ ratings of preschoolers’ inattention, impulsivity and hyperactivity are valid sources of information for predicting ADHD diagnosis and severity over time.

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Acknowledgements

This work was supported by grant #R01 MH68286 from the National Institute of Mental Health to Jeffrey Halperin. The content is solely the responsibility of the authors and does not necessarily represent the official view of the National Institute of Mental Health.

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Authors and Affiliations

  1. Department of Psychology, The City College of the City University of New York, 160 Convent Avenue, New York, NY, 10031, USA

    Sarah O’Neill

  2. Ferkauf Graduate School of Psychology, Yeshiva University, New York, USA

    Robyn L. Schneiderman

  3. Department of Social Work, Ohio University Zanesville, 1425 Newark Road, Zanesville, OH, 43701, USA

    Khushmand Rajendran

  4. Department of Psychology, Queens College of the City University of New York, 65-30 Kissena Boulevard, Flushing, NY, 11367, USA

    David J. Marks & Jeffrey M. Halperin

  5. Department of Child and Adolescent Psychiatry, NYU Langone Medical Center, New York, USA

    David J. Marks

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  1. Sarah O’Neill
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  2. Robyn L. Schneiderman
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  4. David J. Marks
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  5. Jeffrey M. Halperin
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Correspondence to Jeffrey M. Halperin.

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O’Neill, S., Schneiderman, R.L., Rajendran, K. et al. Reliable Ratings or Reading Tea Leaves: Can Parent, Teacher, and Clinician Behavioral Ratings of Preschoolers Predict ADHD at Age Six?. J Abnorm Child Psychol 42, 623–634 (2014). https://doi.org/10.1007/s10802-013-9802-4

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  • DOI: https://doi.org/10.1007/s10802-013-9802-4

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