Abstract
The Swanson, Nolan, and Pelham Rating Scale (SNAP-IV) is a widely used scale that measures the core symptoms of attention deficit hyperactivity disorder (ADHD). However, there are contradictory findings regarding factor structure. Factor structure and measurement equivalence/invariance analysis on parent and teacher SNAP-IV for children referred for an ADHD assessment (N = 250; 6-17 years), revealed a two-factor structure provided the best fit. SNAP-IV scores were also compared with clinician diagnosis of ADHD and research diagnoses of ADHD and hyperkinetic disorder. Parent ratings of inattention and hyperactivity/impulsivity were good predictors of research but not clinician diagnosis. For teacher ratings, only hyperactivity/impulsivity scores were associated with research and clinician diagnosis. SNAP-IV scores showed high sensitivity but low specificity to clinician diagnosis. The SNAP-IV is a valid outcome measure for use in randomized controlled trials and clinical settings, and is best used as a screening rather than a diagnostic tool for ADHD.
Highlights
Attention deficit hyperactivity disorder (ADHD) is one of the most prevalent neuropsychiatric disorders of childhood, affecting 3-5% of children and characterised by symptoms of inattention, hyperactivity and impulsivity (NICE, 2008)
Using data from children who were referred for a clinic assessment of ADHD and who participated in the AQUA-Trial, this study used Exploratory Structural Equation Modelling (ESEM) to explore: 1) the factor structure of the SNAP-IV, 2) the measurement invariance between the two treatment groups and two informants, and 3) the measurement invariance across follow-up time points
SNAP-IV factor structure In order to test for the proposed factor structures in the existing literature and fully demonstrate the incremental value of the proposed models, we explored factor structures ranging from 2-5 factors
Summary
Attention deficit hyperactivity disorder (ADHD) is one of the most prevalent neuropsychiatric disorders of childhood, affecting 3-5% of children and characterised by symptoms of inattention, hyperactivity and impulsivity (NICE, 2008). In support of this, Swanson et al (2012) used Exploratory Factor Analysis (EFA) on only the teacher rated 18-ADHD items of the SNAP-IV and found a two-factor structure (inattention, hyperactivity/impulsivity) in a community sample.
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