Abstract
The prevalence of attention-deficit/hyperactivity disorder (ADHD) has been estimated at 3–7% in the population. Children with this disorder are often characterized by symptoms of inattention and/or impulsivity and hyperactivity, which can significantly impact on many aspects of their behaviour and performance. This study investigated the characteristics of the SWAN Rating Scale and its discrimination of ADHD subtypes. This instrument was developed by Swanson and his colleagues and measures attentiveness and hyperactivity on a continuum, from attention problems to positive attention skills, using a seven-point scale of behaviour: “far below average” to “far above average”. The Australian Twin Attention-Deficit/Hyperactivity Disorder Study consists of questionnaire data collected from families in 1990/2007. The Rasch model was used to measure the characteristics of items from the SWAN Rating Scale; how well these items discriminated between those with and without ADHD. The prevalence of each subtype was found to be 5.3% for inattentive ADHD, 4.3% for hyperactive ADHD and 4.6% for combined ADHD. A total of 14.2% of the cohort appeared to have ADHD. While the inattentive items appeared to be consistent with each other in their measurement behaviour and response patterns, the hyperactive items were less consistent. Further, the combined subtype appeared to be an entirely different type, with unique features unlike the other two subtypes. Further work is needed to distinguish the diagnostic features of each subtype of ADHD.
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Acknowledgments
The authors would like to thank Dr Margaret Wu, Research Fellow, Assessment Research Centre, Melbourne Graduate School of Education, and The University of Melbourne. Her input both in terms of her twin daughters and her expertise as a psychometrician was invaluable for this research study. At the Australian Council for Educational Research, Margaret developed the software program ConQuest® for the analysis of item response data. This research was funded by the National Health and Medical Research Council Project Grant, ADHD Grown-up: Genetic and environmental determinants of the adult outcomes of childhood ADHD and comorbid conditions [NHMRC Grant Number 479217]. We would like to acknowledge the support of the Australian Twin Registry [NHMRC Enabling Grant; 2004-2009] and the Western Australian Twin Registry. We would like to thank the families of the twins and their siblings without whom this study could not have taken place.
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This paper is dedicated to Dr Kenneth Rowe, Principal Research Fellow, Australian Council for Educational Research, who encouraged me in my quest to understand the Rasch model. Ken was a selfless researcher who gave much time to teach me about multilevel modelling in 1988 and onwards. Without Ken I would not be the researcher I am today. Sadly, Ken was defending his holiday home in Marysville in Victoria, Australia on Saturday, 7th February 2009 when he was overcome by the fires which claimed the lives of so many from the area. Ken, you were my hero and example. Thank you.
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Young, D.J., Levy, F., Martin, N.C. et al. Attention Deficit Hyperactivity Disorder: A Rasch Analysis of the SWAN Rating Scale. Child Psychiatry Hum Dev 40, 543–559 (2009). https://doi.org/10.1007/s10578-009-0143-z
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DOI: https://doi.org/10.1007/s10578-009-0143-z