Andrew
10-23-05, 08:50 PM
BY JAMIE TALAN
STAFF WRITER
A popular tool to diagnose attention deficit disorder, or ADD, may fail to identify children in need of treatment, according to a new study.
Dr. Andrew Adesman, chief of developmental and behavioral pediatrics at Schneider Children's Hospital in New Hyde Park, noticed that the popular short version of the Conners' Rating Scales, a psychiatric questionnaire filled out by a child's parents and teachers, misses almost half of the children with symptoms of inattention if they don't also exhibit hyperactivity and impulsivity.
"We were surprised," Adesman said of the results of his study, presented at the recent American Academy of Child and Adolescent Psychiatry meeting in Toronto. "Nobody's ever picked this up. This version is severely flawed."
Keith Conners, a well-known ADD clinician, developed the rating scale in the 1970s. Since then, several versions have been developed, including the one-page form with 10 items.
"Ideally, people should use the long version for the first assessment and the shorter version for tracking changes in behavior. It is not intended to pick up everything in ADHD," said Steven Stein, chief executive officer of Multi-Health Systems, the Toronto publisher of the Connors' Rating Scales, when asked to comment on Adesman's finding.
"This is very important for people who use questionnaires as a main assessment," said Dr. Mary Solanto, associate professor of psychiatry at Mount Sinai School of Medicine and director of the ADHD program at the Manhattan hospital. "It's tempting to use the short form, but you miss a lot of children."
Adesman and Solanto teamed up to test both versions of the Conners' Rating Scales. They recruited 250 families and conducted assessments, which includes a form for parents and teachers. They found that the short version missed 49 percent of the children diagnosed with the longer assessment tool. The children were between 7 and 12 years old. Sixty-one percent were boys.
In school, children with problems related solely to ability to pay attention, but no behavior problems, may get overlooked. On the longer form, there are nine symptoms of inattention -- from distraction to failure to complete tasks -- not on the shorter version, Solanto said.
"Unfortunately, many clinicians use this version because it is quicker and easier to score," said Adesman, who also worked with Dr. Julie Jacob in completing the study.
Lisa Guidice is a Hicksville mother of two sons with attention deficit disorder. "It's very difficult to diagnose," Guidice said.
Her 9-year-old has hyperactivity and her 7-year-old does not. They both have a list of other behavioral conditions that make a single diagnosis impossible. She said that the behavior rating scales would not be sufficient in diagnosing ADD, but that the boys' psychiatrist requests Guidice and the boys' teachers fill out a short rating scale every month to assess behavioral change.
Kenneth Kaufman, a psychologist at the Institute for Behavioral Health in Commack, said that a thorough assessment could take several hours and include many different pen and paper tests, as well as a detailed patient history. "A lot of these rating scales don't address everyday problems," Kaufman said. "You want to know when a child loses attention and why."
Experts estimate that anywhere from 5 to 8 percent of children have attention problems that compromise home and school life.
Copyright 2005 Newsday Inc.
http://www.newsday.com/news/health/ny-hsadd24,0,5649983,print.story?coll=ny-health-big-pix
STAFF WRITER
A popular tool to diagnose attention deficit disorder, or ADD, may fail to identify children in need of treatment, according to a new study.
Dr. Andrew Adesman, chief of developmental and behavioral pediatrics at Schneider Children's Hospital in New Hyde Park, noticed that the popular short version of the Conners' Rating Scales, a psychiatric questionnaire filled out by a child's parents and teachers, misses almost half of the children with symptoms of inattention if they don't also exhibit hyperactivity and impulsivity.
"We were surprised," Adesman said of the results of his study, presented at the recent American Academy of Child and Adolescent Psychiatry meeting in Toronto. "Nobody's ever picked this up. This version is severely flawed."
Keith Conners, a well-known ADD clinician, developed the rating scale in the 1970s. Since then, several versions have been developed, including the one-page form with 10 items.
"Ideally, people should use the long version for the first assessment and the shorter version for tracking changes in behavior. It is not intended to pick up everything in ADHD," said Steven Stein, chief executive officer of Multi-Health Systems, the Toronto publisher of the Connors' Rating Scales, when asked to comment on Adesman's finding.
"This is very important for people who use questionnaires as a main assessment," said Dr. Mary Solanto, associate professor of psychiatry at Mount Sinai School of Medicine and director of the ADHD program at the Manhattan hospital. "It's tempting to use the short form, but you miss a lot of children."
Adesman and Solanto teamed up to test both versions of the Conners' Rating Scales. They recruited 250 families and conducted assessments, which includes a form for parents and teachers. They found that the short version missed 49 percent of the children diagnosed with the longer assessment tool. The children were between 7 and 12 years old. Sixty-one percent were boys.
In school, children with problems related solely to ability to pay attention, but no behavior problems, may get overlooked. On the longer form, there are nine symptoms of inattention -- from distraction to failure to complete tasks -- not on the shorter version, Solanto said.
"Unfortunately, many clinicians use this version because it is quicker and easier to score," said Adesman, who also worked with Dr. Julie Jacob in completing the study.
Lisa Guidice is a Hicksville mother of two sons with attention deficit disorder. "It's very difficult to diagnose," Guidice said.
Her 9-year-old has hyperactivity and her 7-year-old does not. They both have a list of other behavioral conditions that make a single diagnosis impossible. She said that the behavior rating scales would not be sufficient in diagnosing ADD, but that the boys' psychiatrist requests Guidice and the boys' teachers fill out a short rating scale every month to assess behavioral change.
Kenneth Kaufman, a psychologist at the Institute for Behavioral Health in Commack, said that a thorough assessment could take several hours and include many different pen and paper tests, as well as a detailed patient history. "A lot of these rating scales don't address everyday problems," Kaufman said. "You want to know when a child loses attention and why."
Experts estimate that anywhere from 5 to 8 percent of children have attention problems that compromise home and school life.
Copyright 2005 Newsday Inc.
http://www.newsday.com/news/health/ny-hsadd24,0,5649983,print.story?coll=ny-health-big-pix