Identifying ADHD Symptoms Most Associated with Impairment in Early Childhood, Middle Childhood, and Adolescence Using Teacher Report.

The purpose of this study was to examine the relationships between ADHD symptoms and impairment within a sample that includes children in early childhood (n = 250), middle childhood (n = 269) and adolescence (i.e., high school; n = 269). Nested multivariate regression analyses were used to examine the extent to which each ADHD symptom dimension (inattention and hyperactivity/impulsivity) is most associated with impairment in academic, social, and behavioral functioning within and across three developmental levels. Results indicated for academic impairment, inattention is more predictive than hyperactivity/impulsivity at all ages. For social functioning, both with peers and teachers, hyperactivity/impulsivity is more predictive than inattention but only for early childhood students; at the high school level, inattention is a significant predictor of social impairment. For behavioral functioning in the classroom, the pattern is mixed across dimensions and ages with HI decreasing in predictive utility across the three age groups and IA increasing in predictive utility. Forward stepwise regression was used to determine which of the 18 ADHD symptom items are most associated with impairment within and across developmental levels. Findings indicate that the symptoms that were most predictive of impairment varied by age group and by domain of impairment. Implications for assessment are discussed.

Measuring ADHD and ODD symptoms and impairment using high school teachers' ratings.

We analyzed the results of high school teachers' ratings of symptoms of attention deficit hyperactivity disorder (ADHD) and oppositional defiant disorder, as well as school-related impairment of 875 adolescents. One hundred forty-three teachers at 19 high schools across 4 states each rated 6 students from their first-period classes according to selection criteria that led to ratings for 3 male and 3 female students. Factor analyses were conducted on the symptom measure to test hypotheses pertaining to the divergence of impulsivity and hyperactivity dimensions. Normative values for the Disruptive Behavior Disorder-Teacher Rating Scale and Impairment Rating Scale are reported, as well as important differences related to age, race, and gender. Gender and age contrasts revealed that boys were rated as more symptomatic and impaired than girls and younger adolescents were rated as having more problems than older adolescents in most areas. African American adolescents were rated higher on measures of symptoms and impairment than their Caucasian peers. Large differences in normative levels of hyperactivity/impulsivity and inattention are reported that are consistent with a reduced likelihood of a diagnosis of ADHD-C as children get older. Implications for the interpretation of ratings from high school teachers are discussed.