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Correspondence of parent and teacher reports in medication trials

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Abstract

Although much has been written about the agreement of parents and teachers regarding the diagnosis of attention-deficit/hyperactivity disorder (ADHD), some uncertainty remains about their agreement when assessing change during drug treatment. To address this issue, we analyzed data from a placebo-controlled short-term study and an open-label long-term study of ADHD children treated with OROS® methylphenidate (MPH). Both reporters agreed that OROS® MPH was efficacious for symptoms of inattention/overactivity and oppositionality/defiance and that the effect was greater for inattention/overactivity than oppositionality/defiance. Thus, in clinical trials, having two reports may not be absolutely essential for assessing the efficacy of ADHD medications. We also computed diagnostic efficiency statistics and found a high probability that parents would confirm teacher reports of therapeutic improvement and a somewhat lower probability that teachers would confirm parent reports of therapeutic improvement. In contrast, neither reporter was likely to confirm the other reporter’s report of no improvement or worsening. Thus, when given a report of no improvement from one setting, clinicians cannot be certain about clinical status in the other setting. For symptoms of oppositionality and defiance, we also saw that parent- teacher agreement about improvement was better than agreement about lack of improvement. However, for these symptoms, teacher reports were somewhat better predictors of parent reports than vice-versa.

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Author notes

  1. Stephen V. Faraone Ph.D.

    Present address: Dept. of Psychiatry and Behavioral Sciences, SUNY Upstate Medical University, 750 East Adams Street, Syracuse (NY), 13210, USA

Authors and Affiliations

  1. Department of Psychiatry and Harvard Medical School, Massachusetts General Hospital, Boston (MA), USA

    Stephen V. Faraone Ph.D. & Joseph Biederman M.D.

  2. Department of Epidemiology, Harvard School of Public Health, Harvard Medical School Pediatric Psychopharmacology Research, Massachusetts General Hospital, Boston (MA), USA

    Stephen V. Faraone Ph.D.

  3. McNeil Consumer & Specialty Pharmaceuticals, Fort Washington (PA), USA

    Brenda Zimmerman M.S.

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  1. Stephen V. Faraone Ph.D.
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  2. Joseph Biederman M.D.
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  3. Brenda Zimmerman M.S.
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Correspondence to Stephen V. Faraone Ph.D..

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Faraone, S.V., Biederman, J. & Zimmerman, B. Correspondence of parent and teacher reports in medication trials. Europ.Child & Adolescent Psych 14, 20–27 (2005). https://doi.org/10.1007/s00787-005-0415-5

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