Table 1.
Rating Scales Available for Assessing Various Outcome Domains in ADHD
| Rating Scale | Domain | Brief Descriptiona,b | Available Psychometric Assessmentsc |
| Early Childhood Attention Deficit Disorders Evaluation Scale (ECADDES)23 | ADHD (children) | Ages 2–7 y | Test-retest reliability, internal consistency, interrater reliability |
| Inattentive and hyperactive/impulsive subscales | |||
| Parent (50 items) and teacher (56 items) reports | |||
| Available at www.excellenceforchildandyouth.ca/about-learning-organizations/measure-profile?id=109 | |||
| ADHD references: rarely cited | |||
| ADHD Rating Scale–IV (ADHD RS-IV)24,58 | ADHD (children) | 18 items assessing frequency of DSM-IV symptoms | Reliability, validity |
| Inattentive and hyperactive/impulsive subscales | |||
| Parent and teacher reports | |||
| Available at www.healthchoiceaz.com/forms/Child%20ADHD%20Rating%20Screener.pdf | |||
| ADHD references: widely cited | |||
| ADHD Symptoms Rating Scale (ADHD-SRS)25,36 | ADHD (children) | 56 items based on DSM-IV symptoms | Test-retest reliability, internal consistency, interrater reliability, validity |
| Inattentive and hyperactive/impulsive subscales | |||
| Parent and teacher reports | |||
| ADHD references: widely cited | |||
| Conners Rating Scales–Revised (CRS-R)21,22,26 | ADHD (children) | Includes symptoms not specific to ADHD | Test-retest reliability, internal consistency, normative data |
| 7 subscales, including DSM-IV inattentive, hyperactive/impulsive, and total subscales | |||
| Parent, teacher, and adolescent self-reports | |||
| Full-length (parent, 80 items; teacher, 59 items) and abbreviated (27 items; 28 items) formats | |||
| ADHD references: rarely cited | |||
| Swanson, Nolan, and Pelham–IV Teacher and Parent Rating Scale (SNAP-IV)21,27,28,32 | ADHD (children) | Measures DSM-IV and non–DSM-IV ADHD symptoms and items for other DSM-IV disorders | Reliability, internal consistency, validity, normative data |
| Includes inattention and hyperactivity/impulsivity subscales | |||
| 90 items in full-length format | |||
| Parent and teacher reports | |||
| Available at www.adhd.net/snap-iv-form.pdf | |||
| ADHD references: widely cited | |||
| Strengths and Weaknesses of ADHD Symptoms and Normal Behavior Scale (SWAN)28,31,33 | ADHD (children) | Similar to SNAP-IV, but items are reworded and Likert scale is extended to incorporate strengths and weaknesses in each area | Test-retest reliability, internal consistency, validity |
| 30 items | |||
| Parent and teacher reports | |||
| Available at www.adhd.net/SNAP_SWAN.pdf | |||
| ADHD references: commonly cited | |||
| Swanson, Kotkin, Agler, M-Flynn, and Pelham rating scale (SKAMP)22,34,35 | ADHD (children) | Internal consistency, test-retest reliability, validity, normative data | |
| Included in full version of SNAP-IV | |||
| Separate subscale for evaluating classroom impairment related to attention (eg, initiating assignments) and deportment (eg, following school rules) | |||
| 10 items | |||
| Teacher report | |||
| ADHD references: commonly cited | |||
| Vanderbilt ADHD Diagnostic Rating Scales (VARS)21,29,30 | ADHD (children) | Assesses DSM-IV symptoms as well as anxiety and depression and school functioning | Internal consistency, interrater reliability, validity |
| Functional impairment | Parent (VADPRS29: 55 items) and teacher (VADTRS30: 43 items) report | ||
| Comorbid anxiety, depression, tics, oppositional defiant disorder (ADHD-specific) | Includes separate subscale for performance (teacher version includes academic and classroom behavioral performance) | ||
| Includes both initial assessment and follow-up forms that evaluate side effects | |||
| VADPRS available at www.childrenshospital.vanderbilt.org/uploads/documents/DIAGNOSTIC_PARENT_RATING_SCALE(1).pdf | |||
| VADTRS available at www.brightfutures.org/mentalhealth/pdf/professionals/bridges/adhd.pdf | |||
| ADHD references: commonly cited | |||
| Currently incorporated into the American Academy of Pediatrics ADHD Toolkit | |||
| Adult ADHD Self-Report Scale-v1.1 (ASRS)38,39 | ADHD (adult) | Frequency of DSM-IV-TR symptoms | Test-retest reliability, internal consistency, validity |
| 18 items (screener version has 6 items) | |||
| Self-report | |||
| Available at http://webdoc.nyumc.org/nyumc/files/psych/attachments/psych_adhd_checklist.pdf | |||
| ADHD references: widely cited | |||
| Barkley Adult ADHD Rating Scale–IV (BAARS-IV)49 | ADHD (adult) | Current DSM-IV symptoms | Reliability, validity |
| Self- and other report | |||
| Long version and quick screen | |||
| ADHD references: rarely cited | |||
| Conners Adult ADHD Rating Scales (CAARS)40,43–45 | ADHD (adult) | DSM-IV symptom severity | Interrater reliability, internal consistency, test-retest reliability, discriminatory validity |
| Full-length (66 items) and abbreviated (18 items) formats | |||
| Self-report and observer report | |||
| ADHD references: widely cited | |||
| Current Symptoms Scale (CSS)46,47 | ADHD (adult) | Behavior in the past 6 mo, including DSM-IV symptoms and symptom interference with function | Reliability, discriminatory validity |
| 78 items plus employment and social history | |||
| Self-report or observer report | |||
| Self-report form available at www.mnadhd.com/Current_Symptoms_Scale_self.pdf | |||
| ADHD references: rarely cited | |||
| Wender Utah Rating Scale48 | ADHD (adult) | 61 items | Internal reliability, validity |
| Patient report regarding problems at ages 6–10 y | |||
| A subscale of 25 items can be used to identify whether the adult had ADHD as a child | |||
| Available at http://www.venturafamilymed.org/Documents/Wender_Utah%20Rating%20Scale.pdf | |||
| ADHD references: widely cited | |||
| Columbia Impairment Scale67 | Functional impairment (broadband) | 13-item rating of children and adolescents | Test-retest reliability, validity, internal consistency |
| Assesses 4 areas of function: interpersonal relations, psychopathology, function at work or school, use of leisure time | |||
| Items rated on a 4-point Likert scale | |||
| Does not measure specific functional domains | |||
| Available at www.dhs.state.il.us/OneNetLibrary/27896/documents/By_Division/MentalHealth/Columbia/CIS-Y%20-youth%20web%20system%20version%20w%20instructions_1.pdf | |||
| ADHD references: not cited | |||
| Academic Performance Rating Scale (APRS)70,71 | Functional impairment (broadband; child) | 19-item scale for rating academic performance over the past week | Test-retest reliability, internal consistency, divergent validity, normative data |
| Each item scored on a 5-point Likert scale | |||
| Available at www.excellenceforchildandyouth.ca/sites/default/files/meas_attach/Academic_Performance_Rating_Scale_(APRS).pdf | |||
| ADHD references: commonly cited | |||
| Endicott Work Productivity Scale68 | Functional impairment (broadband) | 25-item self-report | Reliability, validity |
| Assesses absenteeism, presenteeism | |||
| ADHD references: rarely cited | |||
| Social Skills Improvement System (SSIS)72 (authors’ revision of Social Skills Rating Scale [SSRS]59,69) | Functional impairment (broadband; child) | 3 domains: social skills (7 subscales), problem behaviors (5 subscales), academic competence (5 subscales) | Interrater reliability, validity (convergent and discriminant), normative data |
| Items scored on 4-point rating scales by teachers and parents and by student | |||
| ADHD references: SSIS (rarely cited); SSRS (commonly cited) | |||
| Impairment Rating Scale (IRS)73 | Functional impairment (ADHD-specific) | Versions for parent (7 domains of impairment) and for teacher (6 domains) | Stability, interrater reliability, validity |
| Ratings on visual analog scale (no problem to extreme problem) but scored by dividing line into segments to form a 7-point Likert scale) | |||
| ADHD references: rarely cited | |||
| Weiss Functional Impairment Rating Scale74–76 | Functional impairment (ADHD-specific; child and adult) | Self-report: 69-item survey in 7 areas (family, work, school, life skills, self-concept, social, risk) | Test-retest reliability, internal consistency, convergent and discriminant validity, factor analysis, domain validation, minimal important difference, receiver operating characteristic cutoff from normal population |
| Parent report: 50-item survey in 6 areas (family, school, life skills, child’s self-concept, social activities, risky activities) | |||
| Items scored on 4-point Likert scale | |||
| Certified translation into 16 languages | |||
| Available at www.caddra.ca/cms4/pdfs/caddraGuidelines2011WFIRS_S.pdf ; www.caddra.ca/cms4/pdfs/caddraGuidelines2011WFIRS_P.pdf | |||
| ADHD references: rarely cited | |||
| Strengths and Difficulties Questionnaire37,77 | Functional impairment (ADHD-specific; child) | 25-item survey for parents or teachers of children age 4–16, or self-report in children age 11–16 | Interrater reliability, internal consistency, test-retest stability |
| 5 areas (emotional symptoms, conduct problems, hyperactivity/inattention, peer relationship problems, prosocial behavior) | |||
| Includes an impact factor (rates the impact of symptoms on the patient) | |||
| Available at www.sdqinfo.com | |||
| ADHD references: commonly cited | |||
| Child Health and Illness Profile (CHIP)91–93 | QOL (broadband) | Versions for self- and parent report cited | Stability, internal consistency, validity |
| For children (CHIP-CE91,92: ages 6–11), domains are satisfaction, comfort, resilience, risk avoidance | |||
| For adolescents (CHIP-AE93: ages 11–18), domains are satisfaction, discomfort, risk avoidance, resilience, achievement | |||
| Items scored on 5-point Likert scale | |||
| Normal mean = 50, normal range 44–56 (≤ 43, poor health; ≥57, excellent health) | |||
| Availability www.childhealthprofile.org | |||
| ADHD references: commonly | |||
| Child Health Questionnaire90,95,96 | QOL (broadband) | 28- and 50-item versions for parents of children ages 5–18; 87-item self-report version for children ≥ 10 | Internal consistency, validity |
| Measures 14 physical and psychosocial concepts | |||
| Scoring on 4- to 6-point scales | |||
| ADHD references: commonly cited | |||
| Pediatric Quality-of-Life Inventory (PedsQL)97,98 | QOL (broadband) | 15 core items and 8 add-on modules for specific symptoms and treatment domains reflecting physical, emotional, social, and school functioning | Internal consistency, validity |
| Items scored on 5-point Likert scale | |||
| Available at www.pedsql.org | |||
| ADHD references: rarely cited | |||
| Short-Form-3699,100 | QOL (broadband) | 36-item survey of physical and mental health and function (4 subscales each) | Reliability, validity |
| Items scored on 5-point response scales | |||
| Normal mean = 50, SD = 10 | |||
| ADHD references: rarely cited | |||
| ADHD Impact Module (AIM)102–105 | QOL (ADHD-specific) | 8-item child scale (eg, schoolwork), 10-item home scale (eg, effect of ADHD on home); 9 descriptive items on treatment status (AIM-C102,103) | Reliability, validity |
| Adult self (AIM-A104,105) | |||
| Items scored on 5-point Likert scale | |||
| AIM-C available at www.healthact.com/pdf/surveys/aim-c.pdf | |||
| AIM-A available at www.healthact.com/pdf/surveys/aim-a.pdf | |||
| ADHD references: rarely cited | |||
| Adult ADHD QOL Scale (AAQOL)106 | QOL (ADHD-specific) | 29-item survey in 4 domains (life productivity, psychological health, relationships, and life outlook) | Reliability, validity, internal consistency |
| Items scored on a 5-point Likert scale | |||
| ADHD references: rarely cited | |||
| Vineland Adaptive Behavior Scales (VABS)118,119 | Adaptive life skills | Semistructured interview of parents or caregivers to nonhandicapped children (0–19 years) | Reliability, validity |
| Assesses communication, daily living skills, socialization, and motor function | |||
| For adaptive behavior composite score, mean = 100, SD = 15 | |||
| ADHD references: rarely cited | |||
| Kidcope121 | Adaptive life skills | Questionnaire for children and adolescents | Reliability, validity, test-retest reliability |
| Assesses 10 coping strategies in terms of frequency of use and efficacy of use | |||
| Frequency and efficacy scored, respectively, on 4-point and 5-point Likert scales | |||
| ADHD references: not cited | |||
| Life Participation Scale—Child version122 | QOL (ADHD-specific) | 24-item survey analyzed as 2 factors (17-item Self-control and 7-item Agreeable subscales) | Internal consistency, validity |
| Items scored on a 4-point Likert scale | |||
| Available with publication122 | |||
| ADHD references: rarely cited | |||
| Adaptive Behavior Assessment System, second edition (ABAS-II)123,124 | Adaptive life skills | Assessment of 10 adaptive skills (as given in DSM-IV) in 3 domains asking what the child does rather than what they can do | Reliability, validity |
| Available in 5 forms for different age ranges and respondents (193–241 items across these forms) | |||
| For norm-referenced skill scores, mean = 10, SD = 3; for general adaptive composite score, mean = 100, SD = 15 (also given with 95% CI and percentile ranking) | |||
| ADHD references: not cited | |||
| Instrumental Activities of Daily Living (IADL) Scale125 | Adaptive life skills | Assesses 8 items, with 3–4 behaviors included in each item; only 5 items assessed in men who cannot perform housework | Interrater reliability, validity |
| Behaviors are scored with either a 0 or 1 | |||
| Scored by individual administering the questionnaire | |||
| Most often used in geriatric populations | |||
| Available at www.abramsoncenter.org/pri/documents/iadl.pdf | |||
| ADHD references: not cited | |||
| Behavior Rating Inventory of Executive Function (BRIEF)135,137 | Executive function | 86-item questionnaire for parents and teachers of children ages 5–18 (adult version also available) | Test-retest reliability, interrater reliability, validity, normative data |
| Evaluates 8 domains of executive functioning to derive a Behavioral Regulation Index and Metacognition Index | |||
| Items scored on 3-point Likert scale | |||
| Global Executive Composite T score is the sum of the 2 Index scores | |||
| ADHD references: commonly cited | |||
| Brown Attention-Deficit Disorder Scales (BADDS)139–141 | Executive function | 40 items in 5 domains of ADHD-related effects on executive function (subscale scores in activation, attention, effort, affect, memory) | Test-retest reliability, internal consistency, validity |
| Includes aspects of executive function and emotional self-regulation beyond DSM-IV criteria | |||
| Items scored on 4-point Likert scale | |||
| Total score with T scores available for each domain | |||
| 4 versions by age ranges and respondent | |||
| ADHD references: commonly cited | |||
| Barkley Deficits in Executive Functioning Scale142 | Executive function | For adults, available in self-report and other report forms, long and short versions | Test-retest reliability, internal consistency, interrater reliability, validity |
| Items scored on 4-point Likert scale | |||
| ADHD references: not cited | |||
| Children’s Organizational Skills Scales (COSS)143,144 | Executive function | Assesses organization of time, materials, and actions at home and school | Test-retest reliability, internal consistency, discriminant validity |
| Includes responses from parents (66 items), teachers (42 items), and a self-report (63 items) | |||
| Includes 3 scales: task planning, organized actions, and memory and materials management | |||
| Uses a 4-point Likert scale | |||
| ADHD references: rarely cited |
a
Widely cited (> 50 publications); commonly cited (10–50 publications); rarely cited (< 10 publications); based on PubMed search of published titles and abstracts using the scale name AND (attention-deficit/hyperactivity disorder OR ADHD) as search terms.
b
If publicly available at no cost, the Web site is provided.
c
Listing of tests performed; not intended as endorsement of the quality of the scale’s properties.
Abbreviations: ADHD = attention-deficit/hyperactivity disorder; CI = confidence interval, DSM-IV = Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition; DSM-IV-TR = Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision, QOL = quality of life.