Table 3.
Studies Assessing ADHD Symptoms Using Teacher Rating Scales and Structured Classroom Observations.
| Study | Sample size | Age range in years (M) | %Boys | %On ADHD medication | Comorbid psychiatric diagnosis | Sample description | Exclusion criteria | Rating scale | Observational measure | Remarks on methodology |
| Brewis (2002) | 219 | 6–12 (no information) | 50 | 0 | No information | Population sample, no information on %ADHD | Psychotropic medication use | BASC-TRS (19 items): Attention Problems, Hyperactivity | Total duration of Attention states, Hyperactivity–impulsivity states, ADHD total score. κ = not reported | Spearman. OBS: 10 × 2 min on 2 days, CS |
| DuPaul (1991) |
55 | 6–12 (8.9) | 47 | No information | No information | Population sample, no information on %ADHD | No information | ACTRS (10 items): Total score | On-task percentage. κ = .74 | Pearson. OBS: 3 days × 20 min, CA, TS |
| DuPaul et al. (1998b) | 53 | 5–14 (9.8) | 47 | No information | No information | Population sample, no information on %ADHD | Psychotropic medication use <6 months | ADHD-RS-IV (18 items): Inattention, Hyperactivity–impulsivity | ADHD behavior code: Off-task, Fidgets. κ (mean) = .56 | Pearson. OBS: 1 × 15 min, CA, TS |
| DuPaul et al. (2006) | 241 (175 ADHD, 66 MC) | 6–12 (8.58) | 76 | 22 | 38% ODD 15% CD |
Population sample who met criteria for ADHD and MC | ASD, developmental disabilities, brain damage, visual or hearing impairments, MR | CTRS-R:L (59 items): DSM-IV Inattentive, DSM-IV Hyperactive–impulsive, DSM-IV Total symptoms | BOSS: Engagement (Active engaged time + Passive engaged time), Off-task (Off-task motor + Off-task verbal), ADHD total score (Engagement + Off-task). κ = .88–.98 | Spearman. OBS: 2 × 15 min (M, R) on 1 day, TS |
| Epstein et al. (2005) | 528 | 7–9 (8.4) | 81 | 0 | 56% DBD | Participants of the MTA study, all met DSM-IV ADHD-C criteria | No information | CTRS-R (39 items): DSM-IV Inattentive, DSM-IV Hyperactive–impulsive, DSM-IV Total symptoms | COC: Off-task, Hyperactivity–impulsivity (Interference + Interference to teacher + Gross motor standing + Gross motor vigorous), ADHD total score (Off-task + Hyperactivity–impulsivity). φ = .80–1 | Spearman. OBS: 1–2 × 16 min (baseline, on 1 day), CA, TS |
| Imeraj et al. (2016) | 62 | 6–12 (8.94) | 81 | 84 children with ADHD | 8% ODD 3% CD |
Children with formal ADHD-C diagnosis and MC | IQ < 80, PDD, neurological disorder, psychotropic medication use except MPH | DBDRS (18 items): Inattention, Hyperactivity–impulsivity | GUCCI: Off-task, Hyperactivity (Hyperactivity + Noisiness), ADHD total score (Off-task + Hyperactivity). κ = .77–.99 | Spearman. OBS: 4 × 60 min, on 2 days, CA, CS |
| Jiang et al. (2019) | 135 | No information (8.39) | 71 | 0 | No comorbid diagnosis | Children referred for ADHD, who met study criteria for ADHD symptoms and impairment | IQ < 80 | CSI (18 items): Inattention, Hyperactivity–impulsivity | BOSS: Engagement (Active engaged time + Passive engaged time). κ = .83 | Pearson. OBS: 3 days × 48 15-s intervals, TS |
| Johnson et al. (2020) | 42 (21 ADHD 21 MC) | 8–11 (9.7) | 76 | 5 | No comorbid diagnosis | Population sample who met study criteria for ADHD and impairment, and MC | ASD | SWAN (18 items): Inattention, Hyperactivity–impulsivity | DOF: On-task, norm-referenced T score. κ = not reported | Spearman. 4 × 10 min (academic subject) on 3 days, TS |
| Kennerley et al. (2018) | 43 | 6–12 (8.69) | 80 | 27 | 47% ODD | Children with or referred for ADHD, all met formal criteria for ADHD | No information | ADHD-RS-IV (18 items): Inattention, Hyperactivity–Impulsivity, Total | BOSS: Engagement (Active engaged time + Passive engaged time), Off-task (Off-task motor + Off-task verbal), ADHD total score (Engagement + Off-task).κ = .84–.90 | Pearson. OBS: 1 × 30 min (academic subject), TS |
| Lauth et al. (2006) | 106 (53 ADHD, 53 MC) | 7–11 (8.48) | 72 | 0 | No information | Population sample who met criteria for subclinical ADHD and MC | No information | CTRS:S (12 items): Total score | MAI: Expected behavior, Actively disruptive. κ = not reported | Pearson. OBS: 4 days × 3–9 5-s intervals, TS |
| Study | Sample size | Age range in years (M) | %Boys | %On ADHD medication | Comorbid psychiatric diagnosis | Sample description | Exclusion criteria | Rating scale | Observational measure | Remarks on methodology |
| McConaughy et al. (2010) | 310 | 6–12 (8.2) | 69 | 0 | No information | Population sample who met criteria for subclinical ADHD and MC | Parent-reported physical or medical problems, MR, ASD, PDD | ADHD-RS-IV (18 items): Inattention, Hyperactivity–impulsivity | DOF: Rating on problem items of Attention problems, Intrusive, Attention deficit/hyperactivity. IRR = .72–.80 | Pearson. OBS: 3–4 × 10 min on 2 days, TS |
| Minder et al. (2018) | 77 | 8–15 (10.76) | 65 | 31 | 26% ODD 4% AD |
Population sample who met study criteria for clinically relevant symptoms of ADHD | ASD, TD, other psychiatric disorders, neurological diseases, psychotropic medication except MPH, IQ < 80 | Conners-3 (111 items): Inattention, Hyperactivity–impulsivity, Total score | aBOSS: Engagement (Active engaged time + Passive engaged time), Off-task (Off-task motor + Off-task verbal), ADHD total score (Engagement + Off-task). κ = .64–.73 | Spearman. OBS: No information on length (baseline), TS |
| Nolan & Gadow (1994) | 34 | 5–13 (9.1) | 91 | 0 | 53% tics 8% MR |
Participants diagnosed with ADHD using criteria of DSM-III or DSM-III-R | Psychosis, seizure disorder, major organic brain dysfunction, major medical illness, PDD | ATRS (10 items): Total score | COC: Off-task, Hyperactivity–impulsivity (Mean motor movement, Interference). κ = .77–.94 | Pearson. OBS: 3–4 days × 20 min (placebo), CA, TS |
| Pelham et al. (1993) | 31 | 5–9 (8.23) | 100 | 0 | 32% ODD 48% CD |
Participants diagnosed with ADHD using DSM-III-R | No information | IOWA (five items): Inattention–overactivity | COCADD: On-task. κ = .75 | Pearson. OBS: 38 × 15-s intervals (adaptation period) on 10 days, CA, TS |
| Pelham et al. (1999) | 25 | 5–12 (9.6) | 84 | 0 | 52% ODD 32% CD |
Participants diagnosed with ADHD using DSM-IV | No information | IOWA (five items): Inattention–overactivity | COCADD: On-task. κ = .80 | Pearson. OBS: 38 × 15-s intervals (placebo) on 5 days, TS |
| Pfiffner et al. (2013) | 57 | 5–12 (8.1) | 70 | 7 | No comorbid diagnosis | Population sample who met study criteria for ADHD | PDD, full-day special education, visual or hearing impairments, LD, psychosis | CSI (18 items): Inattention, Hyperactivity–impulsivity, Total | BOSS: Engagement (Active engaged time + Passive engaged time), Off-task (mean Off-task motor, Off-task verbal), ADHD total score (Engagement + Off-task). κ ADHD Composite score = .86 | Pearson. OBS: 3 days × 15 min (baseline), TS |
| Stevenson et al. (2010) | 144 | 8–9 (8.85) | 52 | 0 | No information | Population sample, none had ADHD diagnosis | No information | ADHD-RS (10 items): Total score | COC: ADHD total score. IRR > .87 | Pearson. OBS: 3 days × 8 min (baseline), CA, TS |
| Veenman et al. (2017) | 114 | 6–13 (8.94) | 76 | 0 | 1% PDD 1% CD |
Population sample screened for ADHD, 10% had DSM-IV-TR diagnosis and 53% met criteria based on TTI | ADHD treatment (<6 months), neurological or severe physical condition, IQ < 80 | SWAN (18 items): Inattention, Hyperactivity–impulsivity, Total score | COC: Off-task, Hyperactivity–impulsivity (Interference + Interference to teacher + Gross motor standing + Gross motor vigorous), ADHD total score (Off-task + Hyperactivity–impulsivity). κ = not reported | Spearman. OBS: 2 × 8 min (baseline) on 1 day, CA, TS |
Note. BASC-TRS = Behavior Assessment for Children—Teacher Rating Scale; OBS = observation; CS = continuous sampling; ACTRS = Abbreviated Conners’ Teacher Rating Scale; CA = concurrent assessment of the rating scale and observational measure; TS = time sampling; ADHD-RS-IV = ADHD Rating Scale-IV: School Version; MC = matched controls; ODD = oppositional deviant disorder; CD = conduct disorder; ASD = autism spectrum disorder; MR = mental retardation; CTRS-R:L = Conners’ Teacher Rating Scale—Revised: Long Form; DSM-IV = Diagnostic and Statistical Manual of Mental Disorders (4th ed.); BOSS = Behavioral Observation of Students in Schools; DBD = disruptive behavior disorder; MTA = Multimodal Treatment of Attention Deficit Hyperactivity Disorder; ADHD-C = attention-deficit/hyperactivity disorder, combined; CTRS-R = Conners’ Teacher Rating Scale—Revised; COC = Classroom Observation Code; IQ = Intelligence Quotient; PDD = pervasive developmental disorder; MPH = methylphenidate; DBDRS = Disruptive Behavior Disorders Rating Scale; GUCCI = Ghent University Classroom Coding Inventory; CSI = Child Symptom Inventory; SWAN = Strengths and Weaknesses of ADHD-Symptoms and Normal-Behaviors; DOF = Direct Observation Form; T = teacher; CTRS:S = Conners’ Teacher Rating Scale—Short Form; Conners-3 = Conners 3rd Edition; MAI = Munich Observation of Attention Inventory; IRR = incidence rate ratio; AD = anxiety disorder; TD = tic disorder; DSM-III = Diagnostic and Statistical Manual of Mental Disorders (3rd ed.); DSM-III-R = Diagnostic and Statistical Manual of Mental Disorders (3rd ed., rev.); ATRS = Abbreviated Teacher Rating Scale; COCADD = Classroom Observations for Conduct and Attention Deficit Disorder; LD = language delay; ADHD-RS = Abbreviated ADHD Rating Scale; DSM-IV-TR = Diagnostic and Statistical Manual of Mental Disorders (4th ed., text rev.); TTI = Teacher Telephone Interview.
Correlations reported in this article were standardized associations of the observations as compared with peer measures. For our meta-analysis, we used raw scores of target children.