The utility of a DSM-IV-referenced screening instrument for attention-deficit/hyperactivity disorder

In this study, we examined the clinical utility of the ADHD Symptom Checklist-4 (ADHD-SC4), a screening measure for attention-deficit/hyperactivity disorder (ADHD). The objectives were to assess the scale's concurrent, differential, and criterion validity. Participants were 103 children between 5 and 17 years old referred to a child psychiatry outpatient service and diagnosed as having a variety of emotional and behavioral disorders. Children were assessed with a battery of standardized assessment instruments and clinical interviews. Clinical diagnoses were verified with an operationalized diagnostic criteria procedure. Parents and teachers completed several rating scales for each child, including the ADHD-SC4, the Child Behavior Checklist (CBCL), the Teacher Report Form (TRF), and the IOWA Conners Teacher's Rating Scale. Findings support the internal consistency and validity of the ADHD-SC4 as a screening instrument for ADHD, oppositional defiant disorder, and aggressive behavior. Sensitivity for ADHD was relatively high, especially when information from both parent and teacher ratings was used to determine the presence of symptoms. Eighty-five percent of the children with diagnosed ADHD received high (T > 70) ADHD-SC4 Symptom Severity scores. As expected, parent-teacher agreement was modest. ADHD-SC4 scale scores were highly correlated with corresponding CBCL, TRF, and IOWA Conners scale scores. The ADHD-SC4 appears to be a clinically useful screening instrument for ADHD.