Jm. Byrne et al., Preschoolers classified as having attention-deficit hyperactivity disorder(ADHD): DSM-IV symptom endorsement pattern, J CHILD NEU, 15(8), 2000, pp. 533-538
In the present study, 50 preschoolers were formally and independently class
ified using both the Diagnostic and Statistical Manual of Mental Disorders,
fourth edition (DSM-IV) and third edition-revised (DSM-III-R) criteria for
attention-deficit hyperactivity disorder (ADHD). The sample consisted of 2
5 preschoolers classified as having ADHD and 25 typically developing presch
oolers for comparison; the sample was matched on gender, age, and socioecon
omic status. All 50 preschoolers were without neurologic or neurodevelopmen
tal disorders, oppositional defiant disorder, or language delay. There were
four key findings: first, of the 25 preschoolers with ADHD, DSM-IV classif
ication was as follows: hyperactive-impulsivity type (68%), combined type (
28%), and inattentive type (4%). Second, the DSM-IV profiles showed that se
veral symptoms were either infrequently endorsed by parents, reflecting Lim
ited applicability to preschoolers with ADHD, or frequently endorsed by par
ents of typically developing preschoolers, thus reducing their diagnostic v
alue. Third, of the 25 preschoolers classified as having ADHD using DSM-IV
criteria, 16% would not have been classified as having ADHD using the DSM-I
II-R criteria. The DSM-IV criteria therefore appear to be more lenient than
the DSM-III-R criteria for this age group. Fourth, two symptoms that were
not included in the DSM-IV, but were part of the DSM-III-R, were found to h
ave clinical value for differentiating preschoolers with ADHD from their ty
pically developing peers.