ADHD (Attention Deficit Hyperactivity Disorder)
ADHD Rating Scale: What It Is and How to Understand It
Questions That Shed Light
Rating scales allow parents or teachers to determine if an individual has attention deficit hyperactivity disorder (ADHD).
Typical scales range from 18 to 90 questions. The questions refer to typical ADHD behavior including inattention, hyperactivity, and impulsiveness. You can choose from at least eight different scales that typically take 5 to 20 minutes to complete.
Click through the slideshow to learn about the ADHD rating scales and how to interpret the findings.
Options for Youth
The rating scales can be found online for free or sold for up to $140. Youth options include:
- the SNAP-IV Rating Scale, ages 6 to 18
- the Vanderbilt ADHD Diagnostic Parent Rating Scale, and an allied rating scale for teachers, for children ages 6 to 12
- the Attention Deficit Disorders Evaluation Scale (ADDES-3), ages 4 to 18
- the ADHD Rating Scale and the ADHD Rating Scale-UV, ages 5 to 17 and 6 to 12, respectively
- ADD-H: Comprehensive Teacher’s Rating Scale: Parent Form (ACTeRS), for ages 6 to 14; also available in a parent version
Types of Ratings
The scales consist of observational behavioral questions that reflect ADHD symptoms. Parents or teachers indicate the frequency they observe the behavior exhibited in a child, ranging from never, rarely, sometimes, often, very often or always.
The observer may otherwise be asked to rate the child’s behavior on a scale from 1 to 5, with a score of 1 indicating that the child never exhibits the behavior and 5 indicating that the behavior occurs up to several times an hour.
A typical ADHD questionnaire will ask whether the child avoids assignments that require sustained mental effort, such as homework. This question provides a measure of a child’s attention. Other questions may ask if the child listens when directly spoken to or if the child has difficulty organizing activities.
To gauge hyperactivity, a question may probe the extent of excessive talking, fidgeting or a child’s tendency to squirm in his or her seat. Questions regarding impulsivity may ask about interrupting or having difficulty waiting for a turn.
ADHD for Adults
An adult scale helps diagnose ADHD for adult individuals. The Adult ADHD Self-Report Scale contains 18 questions with answers ranging from “never” to “very often.”
With respect to the child questionnaire, the questions for adults can contain more detailed-specific questions, such as if one has difficulty remembering appointments or obligations. Other questions, however, are similar to those asked of children, such as, “Do you feel like a motor drives you? Do you make careless mistakes when you have a difficult or boring project to work on?”
Scoring the Vanderbilt
Each test may have a different way of totting up the score. Overall, test designers look for strong evidence of ADHD behaviors.
For example, the Vanderbilt ADHD Diagnostic Teacher Rating Scale counts any behavior if it scores as either a 2 (often), or 3 (very often). A child needs to have six counted behaviors of the nine questions dealing with inattention to indicate inattentive ADHD.
Scoring the SNAP-IV
The Snap-IV rating scale contains nine questions regarding inattention and nine regarding hyperactivity and impulsivity. For each section, you similarly score items as 3 if it is very much the case that the child can’t pay attention or doesn’t listen. You score a question as a 2 if it is quite a bit the case that a child makes careless mistakes or fails to finish work.
Once you add up the scores for each section, you divide the number by 9 to determine an average.
The Snap IV Cutoffs
On the Snap IV scale, teachers can rate a child who scores above 2.56 as inattentive. For parents, the figure is 1.78. A score on the hyperactive/impulsive questions of 1.78 for teachers and 1.44 for parents indicate a need for further investigation for ADHD.
A combined score above 2.00 for teachers and 1.67 for parents indicates a need for further investigation of possible ADHD complex.
What Scales Don’t Tell You
The rating scales don’t produce a diagnosis. They may indicate that your child has a behavioral difficulty that warrants a visit to a clinician.
The score doesn’t conclusively determine if a child has ADHD. A professional can only make the diagnosis after a complete evaluation. The clinician will observe the child in person and ask additional questions.
What Rating Scales Do Tell You
Rating scales can serve as one component of an evaluation. They can help determine if your child is making progress if your child begins medication or behavioral therapy. This serves as a valuable tool to help find the best method of treatment.
- ADHD Rating Scale. (2008, February 1). The Foundation for Medical Practice Education. Retrieved December 9, 2013, from http://www.fmpe.org/en/documents/appendix/Appendix%201%20-%20ADHD%20Rating%20Scale.pdf
- Adult ADHD Self-Report Scale (ASRS-v1.1) Symptom Checklist. (2012, June 1). Canadian ADHD Resource Alliance. Retrieved December 9, 2013, from http://caddra.ca/cms4/pdfs/caddraGuidelines2011ASRS.pdf
- Bussing, R., Fernandez, M., Harwood, M., Hou, W., Garvan, C. W., Eyberg, S. M., et al. (2008). Parent And Teacher SNAP-IV Ratings Of Attention Deficit Hyperactivity Disorder Symptoms: Psychometric Properties And Normative Ratings From A School District Sample. Assessment, 15(3), 317-328. Retrieved December 9, 2013, from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3623293/
- Peacock, G., & Holland, M. L. (2003). Emotional and behavioral problems of young children: Effective interventions in the preschool and kindergarten years. New York: Guilford Press. http://books.google.com/books?id=usQAb3Y5V2EC&pg=PA40&dq=ADHD+Rating+Scale&hl=en&sa=X&ei=GP6kUuGlJsmUkQeKrYHAAQ&ved=0CFEQ6AEwAg#v=onepage&q=ADHD%20Rating%20Scale&f=false
- Scoring Instructions for the SNAP-IV-C Rating Scale. ADHD.net. Retrieved December 9, 2013, from http://www.adhd.net/snap-iv-instructions.pdf
- Table of All Screening Tools & Rating Scales. (2010, January 1). Massachusetts General Hospital School Psychiatry Program. Retrieved December 9, 2013, from http://www2.massgeneral.org/schoolpsychiatry/screeningtools_table.asp
- Vanderbilt ADHD Diagnostic Teacher Rating Scale. Bright Futures at Georgetown University. Retrieved December 9, 2013, from http://www.brightfutures.org/mentalhealth/pdf/professionals/bridges/adhd.pdf
- SNAP-IV 26 Teacher and Parent Rating scale. (2013, May 1). Canadian ADHD Resource Alliance. Retrieved December 8, 2013, from http://caddra.ca/cms4/pdfs/caddraGuidelines2011SNAP.pdf