Conners Teacher Rating Scale-Revised Research Articles

Gestational Age at Term and Teacher-Reported Attention-Deficit Hyperactivity Disorder Symptom Patterns

The objective of this study was to estimate associations between gestational age and teacher-reported attention-deficit hyperactivity disorder (ADHD)-related symptom patterns at age 9 years among children born at term (37-41weeks). A secondary data analysis of approximately 1400 children in the Fragile Families and Child Wellbeing study, a US birth cohort study that oversampled nonmarital births, was conducted. At age 9 years, students were evaluated by their teachers using the Conners Teacher Rating Scale-Revised Short Form that included subscales for symptoms of hyperactivity, ADHD, oppositional behavior, and cognitive problems/inattention. Unadjusted and adjusted negative binomial and logistic regression models of associations between gestational age and teacher-reported scores were estimated. Each week of gestational age at term was associated with hyperactivity scores that were 6% lower (adjusted incidence rate ratio [IRR]: 0.94; 95% CI: 0.89-0.99) and ADHD and cognitive problems/inattention scores that were 5% lower (adjusted IRR: 0.95; 95% CI: 0.91-0.98 in both cases). Early-term birth (37-38weeks) was associated with 23% higher hyperactivity scores (adjusted IRR: 1.23; 95% CI:1.07-1.41), 17% higher ADHD scores (adjusted IRR: 1.17; 95% CI: 1.05-1.30), and ∼50% higher odds of scoring 1.5+ SDs above the sample mean for hyperactivity (aOR: 1.51; 95% CI: 1.05-2.18) when compared with birth at 39-41weeks. There were no significant associations between gestational age and oppositional behavior scores. The findings add to growing evidence supporting current recommendations for delaying elective deliveries to at least 39weeks and suggest that regular screenings for ADHD symptoms are important for children born at 37- to 38-weeks gestation.

Effects of Discontinuing Methylphenidate on Strengths and Difficulties, Quality of Life and Parenting Stress

Objectives: To study the effects of discontinuation of long-term methylphenidate use on secondary outcome measures of strengths and difficulties, quality of life (QoL), and parenting stress. Methods: Ninety-four children and adolescents aged 8 to 18 years who had used methylphenidate for over 2 years were randomly assigned to double-blind continuation of treatment for 7 weeks (36 or 54 mg extended release methylphenidate) or to gradual withdrawal over 3 to 4 weeks placebo. We used mixed models for repeated measures to investigate effects on parent, teacher, and child ratings of hyperactivity/inattention and comorbid symptoms with the Strengths and Difficulties Questionnaire (SDQ), investigator- and teacher-rated oppositional symptoms (Conners Teacher Rating Scale-Revised: short form [CTRS-R:S]), and parent-rated aggression with the Retrospective Modified Overt Aggression Scale. QoL was assessed with the Revised Questionnaire for Children and Adolescents to record health-related quality of life and parenting stress with the Nijmegen Parental Stress Index. Results: Hyperactivity/inattention scores from the parent- and teacher-rated SDQ (difference in mean change over time of respectively: -1.1 [95% confidence interval, CI, -2.0 to -0.3]; p = 0.01; -2.9 [95% CI -2.9 to -0.7; p = 0.01]) and oppositional scores of the teacher-rated CTRS-R:S (difference in mean change -1.9 95% CI [-3.1 to -0.6; p < 0.01]) deteriorated to a significantly larger extent in the discontinuation group than in the continuation group. We did not find effects on other symptom domains, aggression, QoL, and parenting stress after discontinuation of methylphenidate. Conclusion: Our study suggests beneficial effects of long-term methylphenidate use beyond 2 years for oppositional behaviors in the school environment. Similarly, beneficial effects were found on hyperactivity-inattention symptoms as rated by parent and teacher scales, confirming our primary study on investigator ratings of attention-deficit/hyperactivity disorder. However, discontinuation of methylphenidate did not appear to have impact on other comorbid problems or aspects of the child's or parental functioning.

Diagnostic Accuracy of Rating Scales for Attention-Deficit/Hyperactivity Disorder: A Meta-analysis.

The Child Behavior Checklist-Attention Problem (CBCL-AP) scale and Conners Rating Scale-Revised (CRS-R) are commonly used behavioral rating scales for diagnosing attention-deficit/hyperactivity disorder (ADHD) in children and adolescents. To evaluate and compare the diagnostic performance of CBCL-AP and CRS-R in diagnosing ADHD in children and adolescents. PubMed, Ovid Medline, and other relevant electronic databases were searched for articles published up to May 2015. We included studies evaluating the diagnostic performance of either CBCL-AP scale or CRS-R for diagnosing ADHD in pediatric populations in comparison with a defined reference standard. Bivariate random effects models were used for pooling and comparing diagnostic performance. We identified and evaluated 14 and 11 articles on CBCL-AP and CRS-R, respectively. The results revealed pooled sensitivities of 0.77, 0.75, 0.72, and 0.83 and pooled specificities of 0.73, 0.75, 0.84, and 0.84 for CBCL-AP, Conners Parent Rating Scale-Revised, Conners Teacher Rating Scale-Revised, and Conners Abbreviated Symptom Questionnaire (ASQ), respectively. No difference was observed in the diagnostic performance of the various scales. Study location, age of participants, and percentage of female participants explained the heterogeneity in the specificity of the CBCL-AP. CBCL-AP and CRS-R both yielded moderate sensitivity and specificity in diagnosing ADHD. According to the comparable diagnostic performance of all examined scales, ASQ may be the most effective diagnostic tool in assessing ADHD because of its brevity and high diagnostic accuracy. CBCL is recommended for more comprehensive assessments.

The Effects of Neurofeedback Training on Concentration in Children with Attention Deficit/Hyperactivity Disorder

This study investigated the effects of neurofeedback training on concentration in children with attention deficit/ hyperactivity disorder (ADHD). A single-subject ABA' experimental design was used to determine the effects of neurofeedback training. The participants of the study were three boys with ADHD. In the intervention phase after the baseline assessment, participant 1 and 3 trained neurofeedback for twelve sessions, and participant 2 trained ten times. The EEG was recorded during each session and was analyzed for relative power spectrum by beta/theta ratio. The concentration behaviors were measured on a 10-second interval scale during 15 minutes. The concentration was assessed using Auditory Continuous Performance Test (ACPT), and the ADHD symptoms were assessed by the Conners Teacher Rating Scale-Revised (CTRS-R) in pre and posttest. The data were visually analyzed using graphs and descriptive statistical analysis. The results of the study suggest that, after the neurofeedback training sessions, the participants showed a significant increase in their concentration behaviors. The scores of ACPT and CRTS-R were improved as well. However, no significant EEG change was observed, and no correlation of EEG with concentration behaviors was established.

A Randomized Double-Blind Study of Atomoxetine Versus Placebo for Attention-Deficit/Hyperactivity Disorder Symptoms in Children With Autism Spectrum Disorder

The efficacy of atomoxetine as treatment of symptoms of attention-deficit/hyperactivity disorder (ADHD) in patients with autism spectrum disorder (ASD) has not been established. In this study, 97 patients aged 6 to 17 years with ADHD and ASD were randomly assigned to double-blind treatment with 1.2 mg/kg/day atomoxetine or placebo for 8 weeks. The primary endpoint was the ADHD Rating Scale (ADHD-RS) score; secondary endpoints were the Clinical Global Impression of ADHD-Improvement (CGI-I) and the Conners Teacher Rating Scale-Revised: Short Form (CTRS-R:S) score. Baseline mean ADHD-RS scores for atomoxetine versus placebo were 40.7 and 38.6; after 8 weeks, mixed-effect model repeated-measure means were 31.6 (95% confidence interval 29.2-33.9) and 38.3 (36.0-40.6), respectively, with a difference in least square means of -6.7 (-10.0 to -3.4; p < .001). The CTRS-R:S Hyperactivity subscore also improved significantly for atomoxetine compared with placebo, but not the other CTRS-R:S subscores. However, there were not significantly more patients on atomoxetine (20.9%) who improved much, or very much according to the CGI-I, than on placebo (8.7%; p = 0.14). Adverse events (mostly nausea, decrease in appetite, fatigue, and early morning awakening) were reported in 81.3% of atomoxetine patients and 65.3% of placebo patients (p > .1). There were no serious adverse events. Atomoxetine moderately improved ADHD symptoms in patients with ASD and was generally well tolerated. Adverse events in this study were similar to those in other studies with ADHD patients without ASD. Clinical trial registration information-A Randomized Double-Blind Study of Atomoxetine Versus Placebo for ADHD Symptoms in Children with ASD; www.clinicaltrials.gov; NCT00380692.

Using the Conners' Teacher Rating Scale—Revised in School Children Referred for Assessment

Predictive validity of the Conners' Teacher Rating Scale-Revised (CTRS-R) was evaluated against a semi-structured clinical teacher interview in school children referred for diagnostic assessment of attention-deficit hyperactivity disorder (ADHD). We hypothesized that extreme scale values would increase diagnostic certainty and that classification errors would be associated with comorbid conditions. Children (n = 1038), aged 6 to 12 years, were screened using the CTRS-R and their teachers were interviewed. Three levels of T scores on the 3 Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) subscales of the CTRS-R were compared with DSM-IV symptom thresholds by interview. Where subscale scores and interviews showed highest agreement, presence of comorbid disruptive behavioural disorders, reading disability, language impairment, and low IQ were investigated for children classified correctly, compared with incorrectly. T scores of 60 and above on all CTRS-R DSM-IV subscales offered high sensitivity, from 91% to 94%. Only on subscales M (hyperactive-impulsive) and N (total) did T scores of less than 60 offer posttest probabilities of less than 10%, confirming that a child does not reach diagnostic threshold by interview. T scores of 80 and more offered high specificity, from 88% to 93%, but did not provide high posttest probabilities that children reach diagnostic criteria. Classification errors were associated with more language impairment among false positives than true positives on the M (18.9%, compared with 11.3%, P = 0.04) and N (19.0%, compared with 9.5%, P = 0.023) subscales, and more reading disabilities among false positives than among true positives on the N subscale (35.2%, compared with 21.6%, P = 0.009). The ability of the CTRS-R to predict whether clinically referred children reach DSM-IV criteria for ADHD at school is limited.

The usefulness of Conners' Rating Scales‐Revised in screening for Attention Deficit Hyperactivity Disorder in children with intellectual disabilities and borderline intelligence

Symptoms of Attention Deficit Hyperactivity Disorder (ADHD) are believed to be common in children with intellectual disabilities (ID). Conners' Rating Scales are widely used for screening ADHD among children who do not have ID, but little is known about their usefulness among children with ID. To find cut-off scores for the Conners' Parent Rating Scales-Revised (CPRS-R) and the Conners' Teacher Rating Scale-Revised (CTRS-R) that will give optimum levels of sensitivity and specificity for screening for ADHD among children with ID and borderline intelligence. Receiver operating characteristic analysis was used to compare a clinical diagnosis of ADHD according to the Diagnostic and Statistical Manual 4th revision-Text Review criteria with scores according to the CPRS-R and the CTRS-R. Among children with ID, a CPRS-R total score of 42 provided a sensitivity of 0.9 and a specificity of 0.67 with an area under the curve of 0.84. Similarly, a CTRS-R total score of 40 provided a sensitivity of 0.69 and a specificity of 0.67 with an area under the curve of 0.71. There was poor concordance between the CPRS-R and the CTRS-R total scores (Intraclass Correlation; ICC = 0.17). There were statistically significant differences in the total score of the CPRS-R and most of its sub-scores between children with ID with and without ADHD. The CTRS-R total score and its sub-scores did not show any statistically significant difference between two groups. Factor analysis showed three clinically distinct factors for both the CPRS-R and the CTRS-R items, although the CPRS-R factors were better and had less item overlap than the CTRS-R factors. The CPRS-R scores may distinguish between children with ID with and without ADHD but not the CTRS-R scores. Many items in the CPRS-R and the CTRS-R are not applicable to children with severe and profound ID who do not have speech. The CPRS-R and the CTRS-R scores did not correlate with each other. There is a need to develop an ADHD screening instrument specifically for children with ID.

Assessment and Etiology of Attention Deficit Hyperactivity Disorder and Oppositional Defiant Disorder in Boys and Girls

Attention deficit hyperactivity disorder (ADHD) and oppositional defiant disorder (ODD) are more common in boys than girls. In this paper, we investigated whether the prevalence differences are attributable to measurement bias. In addition, we examined sex differences in the genetic and environmental influences on variation in these behaviors. Teachers completed the Conners Teacher Rating Scale-Revised:Short version (CTRS-R:S) in a sample of 800 male and 851 female 7-year-old Dutch twins. No sex differences in the factor structure of the CTRS-R:S were found, implying the absence of measurement bias. The heritabilities for both ADHD and ODD were high and were the same in boys and girls. However, partly different genes are expressed in boys and girls.

Factor Analysis and Validity of the Conners Parent and Teacher Rating Scales in Childhood Cancer Survivors

To examine the factor structure of the Conners Parent Rating Scale-Revised: Short Form (CPRS-R:S) and the Conners Teacher Rating Scale-Revised: Short Form (CTRS-R:S) in children who are long-term survivors of acute lymphocytic leukemia (ALL) or brain tumors (BT)and who have received central nervous system directed treatment. Parents and teachers of 150 long-term survivors completed the CPRS-R:S or CTRS-R:S as part of a screening battery. The data were submitted to a maximum likelihood confirmatory factor analysis to test the construct validity of the scales and the forms were compared. The CPRS-R:S was also compared to selected subscales of the Achenbach Child Behavior Checklist (CBCL) for further validation. The analyses demonstrated an adequate fit of the original three-factor structure of the CTRS-R:S [oppositional, cognitive problems/inattention, hyperactivity]. The analyses of the CPRS-R:S suggested a less adequate fit of the original three-factor structure but principal components factor analysis yielded a three-factor solution with factors similar to those of Conners' original factor structure. Significant correlations were found between the CPRS-R:S and the selected subscales of the CBCL. These findings support the similar construct validity of the original CTRS-R:S and CPRS-R:S. Although significantly correlated, the CPRS-R:S and CTRS-R:S are not interchangeable in the assessment of survivors of childhood cancer.

Behavioral Inhibition, Self-Regulation of Motivation, and Working Memory in Children With Attention Deficit Hyperactivity Disorder

We examined 3 aspects of Barkley's (1997) recent model of Attention Deficit Hyperactivity Disorder (ADHD)-behavioral inhibition, self-regulation of motivation, and working memory utilizing 152 elementary school children ages 7 to 12. Seventy-six children with ADHD and 76 children without a psychiatric diagnosis completed the stop-signal task, a computerized Digit Span Task requiring concurrent storage and processing, and the Kaufman Brief Intelligence Test during a 1-hr testing session. Parent and teacher ratings were also obtained on the Conners Parent Rating Scale-Revised: Long Version (Conners, 1997), and the Conners Teacher Rating Scale-Revised: Long Version (Conners, 1997), respectively. Results indicated that children with ADHD had deficits in inhibitory control, working memory, and short-term memory relative to children without the disorder. Contrary to our prediction, the groups did not differ in their responsiveness to external reinforcement. In addition, children with and without ADHD had similar self-perceptions of their performances during the experimental session. Future directions for specifying childhood difficulties in inhibitory control and memory processes are discussed.

Schedules for detection, diagnosis and assessment of psychiatric disorders

Developmental Medicine & Child NeurologyVolume 43, Issue s90 p. 29-30 Free Access Schedules for detection, diagnosis and assessment of psychiatric disorders Conners Teacher Rating Scale - Revised (CTRS-R) First published: 12 November 2008 https://doi.org/10.1111/j.1469-8749.2001.tb12451.xAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat No abstract is available for this article. Volume43, Issues90December 2001Pages 29-30 ReferencesRelatedInformation

A Generalizability Study of the Conners' Teacher Rating Scale-Revised

The hyperactivity scale of the Conners' Teacher Rating Scale-Revised (CTRS-R) was investigated to compare teachers' use of this instrument to its use by independent classroom observers. Results of this study indicate that teacher ratings of children are highly stable over time. Independent observers agree with one another within an occasion both within a classroom and across classrooms; however, observations based on a one-hour period are not stable over time, but a composite score based on three occasions can be expected to be as stable as teacher ratings. Teachers and observers agree only slightly within a classroom, and teacher and observer classroom means are virtually independent of one another. The implications of these results for continued use of teachers' ratings are that the referents for teacher ratings should be determined, ratings should be made more objective, standardization across teachers should be demonstrated before norms are preferred, and the rating scale should be validated via observations or other objective hyperactivity measures.