DIAGNOSTIC UTILITY OF 2 COMMONLY USED ADHD SCREENING MEASURES AMONG SPECIAL-EDUCATION STUDENTS

Objective: To examine the diagnostic utility of two commonly used atte ntion-deficit hyperactivity disorder (ADHD) screening measures in a po pulation of special education students and address whether screener pe rformance is affected by demographic characteristics. Method: A school district population of special education students was screened for AD HD risk using two parent questionnaires, the 46-item Attention Deficit Disorders Evaluation Scale (ADDES) and the 10-item Conners Abbreviate d Symptom Questionnaire (ASQ). All high-risk children and a random sam ple of low-risk children subsequently underwent DSM-IV-based diagnosti c assessment through parental diagnostic interviews (Diagnostic Interv iew Schedule for Children Version 3.0). Diagnostic utility was summari zed by sensitivity, specificity, predictive utilities of positive and negative tests, and efficiency, all of which were estimated using an a pproach that accounted for the sampling design. Results: Overall effic iency scores ranged between 70% and 74%. Sensitivity estimates were be low 70% even at low screener cutoff scores. The ADDES did not perform significantly better than the ASQ. Significant gender and ethnicity ef fects emerged. Conclusions: Overall, both the ASQ and the ADDES yielde d substantial numbers of false positives and false negatives among thi s population of children, indicating that alternative approaches will be required to accurately and efficiently identify children in need of services for ADHD, Child psychiatrists can play a valuable consulting role as school districts and primary care settings struggle to implem ent appropriate identification procedures for ADHD.