ADHD Rating Scale: What It Is and How to Understand It

Written by Jeannette Belliveau | Published on January 22, 2014
Medically Reviewed by George T. Krucik, MD, MBA on January 22, 2014

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.

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.

Typical Questions

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.

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.

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.

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