Conners' Teacher Rating Scales Revised: Long (CTRS R:L)

Transcription

1 Conners' Teacher Rating Scales Revised: Long (CTRS R:L) By C. Keith Conners, Ph.D. Interpretive Report Copyright 2002, Multi-Health Systems Inc. All rights reserved. P.O. Box 950, North Tonawanda, NY Victoria Park Ave., Toronto, ON M2H 3M6

2 CTRS R:L Interpretive Report for Samantha Sample Page 2 Introduction Conners' Teacher Rating Scales Revised: Long (CTRS R:L) is an assessment tool that prompts the teacher to provide valuable information about the child's behavior in a classroom setting. This instrument is helpful when a diagnosis of ADHD (or related problems) is being considered. The normative sample includes approximately 1,973 teachers. This report provides information about the child's score, how he or she compares to other children, and what subscales are elevated. See the Conners' Rating Scales Revised Technical Manual for more information about this instrument. This computerized report is an interpretive aid and should not be used as the sole basis for clinical diagnosis or intervention. This report works best when combined with other sources of relevant information. CTRS R:L T-Scores The following graph provides Samantha's T-scores for each of the CTRS R:L subscales.

3 CTRS R:L Interpretive Report for Samantha Sample Page 3 Summary of Subscale Scores The following table summarizes the subscale scores of the teacher and gives general data about how Samantha compares to the group norms. More interpretive data are provided later in this report. Subscale Oppositional Cognitive Problems/Inattention Hyperactivity Anxious-Shy Perfectionism Social Problems ADHD Index CGI: Restless-Impulsive CGI: Emotional Lability CGI: Total DSM-IV: Inattentive Symptom Count (max of 9) DSM-IV: Hyperactive-Impulsive Symptom Count (max of 9) DSM-IV: Total Symptom Count (max of 18) Raw Score T- Score Guideline Average (Typical score: Should not Slightly Atypical (Low scores are good: Not a concern) Average (Typical score: Should not Markedly Atypical (Indicates a significant problem) Markedly Atypical (Indicates a significant problem) Markedly Atypical (Indicates a significant problem) Average (Typical score: Should not Average (Typical score: Should not Moderately Atypical (Indicates a significant problem) Slightly Atypical (Borderline: Should Slightly Atypical (Low scores are good: Not a concern) Average (Typical score: Should not Slightly Atypical (Low scores are good: Not a concern) Common Characteristics of High Scorers Break rules, problems with authority, easily annoyed. Learn slowly, organizational problems, difficulty completing tasks, concentration problems. Difficulty sitting still, cannot stay on task, restless, impulsive. Have worries/fears, emotional, sensitive to criticism, shy, withdrawn. Set high goals, fastidious, obsessive. Have few friends, low self-esteem and self-confidence, feel emotionally distant from peers. Identifies children/adolescents 'at risk' for ADHD. Restless, impulsive, inattentive. Emotional, cry a lot, get angry easily. Hyperactive, broad ranged behavior problems. Correspondence with the DSM-IV diagnostic criteria for Inattentive type ADHD. Correspondence with the DSM-IV diagnostic criteria for Hyperactive-Impulsive type ADHD. Correspondence to DSM-IV criteria for combined type ADHD.

4 CTRS R:L Interpretive Report for Samantha Sample Page 4 Item Responses The teacher entered the following response values for the items on the CTRS R:L. The pie graph shows the distribution of responses. Response Key 0 = Not true at all (Never, Seldom) 1 = Just a little true (Occasionally) 2 = Pretty much true (Often, Quite a Bit) 3 = Very much true (Very Often, Very Frequent)

5 CTRS R:L Interpretive Report for Samantha Sample Page 5 DSM-IV Subscales: Elevated Responses The following graph shows the number of items for which the teacher responded Very Much True ("3") or Pretty Much True ("2"). The answers are grouped by DSM-IV subscale. The DSM-IV subscales are interpreted in more detail later in this report. Validity Assessment If the findings presented here conflict with other sources of information, then the reasons for the conflicting information should be considered, and the results described in this report should be interpreted with these reasons in mind. It is possible, however, that behavior and attitudes at home may be quite different than behavior and attitudes away from home (e.g., at school). Analysis of the Index Scores The score on the Conners' Global Index is slightly elevated. This provides limited evidence for the presence of attention or behavior problem. These results may indicate problematic behavior that is only a mild concern or mildly disruptive. The analysis of the other components of the Conners' Rating Scale provided below will help refine the assessment. General Examination of the Profile There are several substantial subscale elevations. The highest elevations relate to different areas of behavior suggesting the possibility of comorbidity. Because the profile is indicative of pervasive problems and the profile shows fairly global elevations, it is often called a Type G (for "Global") Profile. More specific information about the areas that are elevated can be obtained from examining the subscale descriptions given below. Examination of Subscale Scores ADHD Index: T-Score = 47 About average. This index consists of the best set of CTRS R items for identifying children/adolescents "at risk" for ADHD. Samantha's score on this index is about average, and does not suggest a significant attention deficit.

6 CTRS R:L Interpretive Report for Samantha Sample Page 6 Conners' Global Index Total: T-Score = 57 Slightly elevated. Samantha's score on this index is somewhat elevated, indicating some behavior problems. Although elevated scores on the Conners' Global Index may be associated with hyperactivity, often the problems are broader in nature and difficulties exist with a number of different aspects of behavior. The elevation on this scale is minor, however, and probably does not indicate a serious or substantial problem. Conners' Global Index Restless-Impulsive: T-Score = 51 About average. Samantha's score on this subscale is about average, and is unlikely that Samantha has serious problems with restlessness, impulsivity, and inattentiveness. Conners' Global Index Emotional Lability: T-Score = 66 Moderately elevated. Samantha's score on the Emotional Lability subcomponent of the index is moderately elevated, indicating an individual who is prone to emotional responses/behaviors like crying, anger, etc. Oppositional: T-Score = 55 About average. The score on the Oppositional subscale is average, indicating the teacher's perception that Samantha reasonably follows rules and shows adequate respect for persons in authority. Samantha probably is not inclined to temper outbursts and probably doesn't get easily annoyed by little things. Cognitive Problems/Inattention: T-Score = 43 Better than average. The score on the Cognitive Problems subscale is better than average. The teacher doesn't perceive any persistent or severe impairment with learning or memory. Samantha probably has satisfactory organizational skills and is probably able to complete work, tasks or schoolwork as expected most of the time. In addition, Samantha is probably capable of sustained mental effort and can be attentive when required. Hyperactivity: T-Score = 49 About average. The score on the Hyperactivity subscale is average. This means that, from the teacher's perspective, Samantha is able to sit still, and is not overly restless or impulsive. Anxious-Shy: T-Score = 83 Markedly elevated. High scores from the teacher generally indicate that Samantha has more worries and fears than most individuals her age. Samantha is probably prone to be emotional, and is likely to be very sensitive to criticism. Samantha may be particularly anxious in new or unfamiliar situations, and may appear very shy and withdrawn. Perfectionism: T-Score = 86 Markedly elevated. The teacher's responses indicate that Samantha is likely to set high goals for herself. Samantha is probably very fastidious about the way she does things at home and at school, and may be more obsessive about her work or tasks than most individuals her age. Social Problems: T-Score = 105 Markedly Elevated. High scores on this subscale indicate the teacher's perception that Samantha has few friends, low self-esteem, and little self-confidence. In serious cases, the child/adolescent may feel emotionally distant or detached from her peers.

7 CTRS R:L Interpretive Report for Samantha Sample Page 7 DSM-IV: Inattentive: T-Score = 43 The teacher's responses to the DSM-IV items suggest that the criteria for the Inattentive subtype of ADHD would not be met. Six or more symptoms of ADHD are required, but only 0 of 9 items are rated "Very Much True" and 0 of 9 items are rated "Pretty Much True". DSM-IV: Hyperactive-Impulsive: T-Score = 47 The teacher's responses to the DSM-IV items suggest that the criteria for the Hyperactive-Impulsive subtype of ADHD would not be met. Six or more symptoms of ADHD are required, but only 0 of 9 items are rated "Very Much True" and 0 of 9 items rated "Pretty Much True". DSM-IV: Total (Combined Type ADHD): T-Score = 44 Based on the teacher's responses, one or both sets of criteria have not been met for the Hyperactive-Impulsive subtype ADHD or Inattentive subtype ADHD. It is unlikely, then, that the youth would qualify for Combined type ADHD. Examination of Individual Item Responses The following items elicited a response of "Very Much True" from the teacher. Note: Items will be listed more than once if they pertain to more than one subscale. Oppositional Cognitive Problems/Inattention Hyperactivity Anxious-Shy Sensitive to criticism Perfectionism Is a perfectionist Everything must be just so Likes everything neat and clean Social Problems Is one of the last to be picked for teams or games Has poor social skills ADHD Index CGI: Restless-Impulsive

8 CTRS R:L Interpretive Report for Samantha Sample Page 8 CGI: Emotional Lability CGI: Total DSM-IV: Inattentive DSM-IV: Hyperactive-Impulsive DSM-IV: Total Examination of Individual Item Responses The following items elicited a response of "Pretty Much True" from the teacher. Note: Items will be listed more than once if they pertain to more than one subscale. Oppositional Cognitive Problems/Inattention Hyperactivity Anxious-Shy Feelings easily hurt Is an emotional child Shy, withdrawn Perfectionism Keeps checking things over and over Seems over-focused on details Things must be done the same way every time Social Problems Appears to be unaccepted by group Has no friends Does not know how to make friends ADHD Index

9 CTRS R:L Interpretive Report for Samantha Sample Page 9 CGI: Restless-Impulsive CGI: Emotional Lability CGI: Total DSM-IV: Inattentive DSM-IV: Hyperactive-Impulsive DSM-IV: Total Integrating Results with Other Information The following subscale scores are elevated and could be cause for concern. Anxious-Shy Perfectionism Social Problems CGI: Emotional Lability These results must be incorporated with other information before drawing any conclusions. It is recommended that a comprehensive evaluation include A history of the pregnancy, delivery, and developmental milestones from infancy; A family history of psychiatric disorders; Assessment of specific symptoms, including severity, frequency, situational specificity, and duration; An educational assessment that covers both academic functioning and classroom behavior; An overview of the individual's intrapsychic processes, including self-image and sense of efficacy with family, peers, and school; Child and family interaction patterns and family structure; An assessment of neurological status, when related problems are indicated by other evidence. CTRS-R:L results interpreted without considering these other factors may have limited validity. Considering Intervention There are a large number of possible treatment approaches, and the choice of which treatment is most appropriate can vary from case to case. The intervention should be individualized, and the goals/targets of each intervention should be clearly specified. All of the following types of intervention should be considered. Parent-Based Intervention Involves educating parents about the disorder or concern (e.g., ADHD), and teaching parents behavior management skills so the they can reduce negative behavior in their children and promote adaptive functioning.

10 CTRS R:L Interpretive Report for Samantha Sample Page 10 School-Based Intervention Can involve both academic and behavioral intervention Child-Based Intervention The child is taught to monitor, evaluate, and reinforce herself with respect to target behaviors. Pharmacologic Intervention Medication is often effective (with ADHD) but should only be used after careful consideration of the child's particular symptomatology. The choice of drug, dosage and potential side effects must be considered. In many cases, these and other intervention approaches can be used in combination with each other to produce the optimal results. Date Printed: Wednesday, December 24, 2003 End of Report