Conners' Parent Rating Scales Revised: Long (CPRS R:L)

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1 Conners' Parent Rating Scales Revised: Long (CPRS 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 CPRS R:L Interpretive Report for John Sample Page 2 Introduction Conners' Parent Rating Scales Revised: Long (CPRS R:L) is an assessment tool that prompts a child's parent to provide valuable information about the child's behavior. This instrument is helpful when a diagnosis of ADHD (or related problems) is being considered. The normative sample includes 2,482 parents. This report provides information about the child's score, how he compares to other children, and what subscales are elevated. See the Conners' Rating Scales Revised Technical Manual (published by MHS) for more information about the 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. CPRS R:L T-Scores The following graph provides John's T-scores for each of the CPRS R:L subscales.

3 CPRS R:L Interpretive Report for John Sample Page 3 Summary of Subscale Scores The following table summarizes the results of the parent's assessment of John and provides general information about how he compares to the normative group. More interpretive data are provided later in this report. Subscale Oppositional Cognitive Problems/Inattention Hyperactivity Anxious-Shy Perfectionism Social Problems Psychosomatic 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) Raw Score T- Score Guideline Mildly Atypical (Possible significant problem) Moderately Atypical Average (Typical score: Should not raise concern) Average (Typical score: Should not raise concern) Average (Typical score: Should not raise concern) Slightly Atypical (Low scores are good: Not a concern) Moderately Atypical Common Characteristics of High Scorers Break rules, problems with authority, easily annoyed. Learn slowly, organizational problems, difficulty completing tasks, concentration problems. Have difficulty sitting still, cannot stay on task, restless, impulsive. Have worries and/or 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. Report an unusual amount of aches and pains. 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.

4 CPRS R:L Interpretive Report for John Sample Page 4 Subscale DSM-IV: Total Symptom Count (max of 18) Raw Score 35 4 T- Score 74 Guideline Common Characteristics of High Scorers Correspondence to DSM-IV criteria for combined type ADHD.

5 CPRS R:L Interpretive Report for John Sample Page 5 Item Responses The following response values were entered for the items on CPRS 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)

6 CPRS R:L Interpretive Report for John Sample Page 6 DSM-IV Subscales: Elevated Responses The following graph shows the number of items for which the parent answered 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 those reasons in mind. It is possible, however, that the parent is either exaggerating or denying problems which may exist. It is also possible that behavior and attitudes at home may be quite different than behavior and attitudes away from home (e.g., at school). An examination of the individual item responses reveals some possible inconsistencies. Quite different responses were given to items with similar content. If possible, discrepancies in the responses to items should be discussed with the parent. Some items may have been misunderstood, or perhaps the parent was unwilling or unable to give a clear picture of the child/adolescent's behavior and attitudes. Analysis of the Index Scores The scores on both the ADHD Index and the Conners' Global Index are notably elevated. The ADHD Index consists of the single best set of items for differentiating children/adolescents with attention problems from those without attention problems. This initial indicator suggests possible ADHD. The fact that the Conners' Global Index is also elevated lends further support for the presence of an attention problem, and also suggests that there may be other problems as well as attention problems, or that the attention problems are affecting other aspects of functioning. General Examination of the Profile There are a substantial number of subscale elevations. These elevations relate to a number of different areas of behavior suggesting 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.

7 CPRS R:L Interpretive Report for John Sample Page 7 Examination of Subscale Scores ADHD Index: T-Score = 73 Markedly elevated. This index consists of the best set of CPRS R items for identifying children/adolescents "at risk" for ADHD. John's score on this index is markedly elevated indicating possible ADHD. This finding should be combined with other information to corroborate the appropriateness of a diagnosis of ADHD. Conners' Global Index Total: T-Score = 81 Markedly elevated. John's score on this index is markedly elevated, indicating general problematic behavior. Although high scores may be associated with hyperactivity, often the problems are broader in nature and difficulties exist with a number of different aspects of behavior. Conners' Global Index Restless-Impulsive: T-Score = 79 Markedly elevated. John's score on the Restless-Impulsive subcomponent of the index is considerably elevated, indicating potentially serious problems with restlessness, impulsivity, and inattentiveness. Conners' Global Index Emotional Lability: T-Score = 77 Markedly elevated. John's score on the Emotional Lability subcomponent of the index is notably high, indicating an individual who is very prone to emotional responses/behaviors like crying, anger, etc. Oppositional: T-Score = 61 Mildly elevated. Elevated scores on this subscale indicate an individual with a tendency to break rules, and to have problems with persons in authority. This individual may be more easily annoyed and angered than others his age. Cognitive Problems/Inattention: T-Score = 66 Moderately elevated. High scorers on this subscale tend to learn more slowly than most individuals their age. John may have problems organizing his work, completing tasks on schoolwork, or concentrating on tasks that require sustained mental effort. A number of items on this subscale relate to inattentiveness. Hyperactivity: T-Score = 77 Markedly elevated. Based on the parent's responses, this subscale score indicates that John has difficulty sitting still or remaining at the same task for very long. John is probably more restless and impulsive than most individuals his age, and he probably has the need to be always "on the go". Anxious-Shy: T-Score = 47 About average. The score on the Anxious-Shy subscale is about average. According to the parent's responses, John is fairly typical in terms of worries and fears, and is not overly shy or withdrawn. Perfectionism: T-Score = 51 About average. The score on the Perfectionism subscale is about average. According to the parent's responses, John probably sets and keeps fairly realistic goals. He can strive to achieve and accomplish things without becoming overly obsessive.

8 CPRS R:L Interpretive Report for John Sample Page 8 Social Problems: T-Score = 50 About average. The score on the Social Problems subscale is about average. The parent feels that John's ability to make and keep friends is about typical compared to other individuals his age. John probably has adequate self-confidence and probably fits in well with his peers. Psychosomatic: T-Score = 44 Better than average. The Psychosomatic score indicates that John does not report physical symptoms (e.g., aches and pains) unless they have an identifiable physical cause. Psychosomatic behavior is not an issue for this individual. DSM-IV: Inattentive: T-Score = 66 The parent's responses indicate that six or more symptoms of the Inattentive subtype of ADHD may be present. The stringent requirement is that at least 6 items be rated "Very Much True" before suggesting a possible DSM-IV diagnosis. However, if you combine the fact that 2 of 9 items are rated "Very Much True" with the observation that 4 of 9 items are rated "Pretty Much True", there does seem to be sufficient reason to explore the possibility that this youth meets the DSM-IV criteria for the Inattentive subtype of ADHD. DSM-IV: Hyperactive-Impulsive: T-Score = 74 The parent's responses indicate that six or more symptoms of the Hyperactive-Impulsive subtype of ADHD may be present. The stringent requirement is that at least 6 items be rated "Very Much True" before suggesting a possible DSM-IV diagnosis. However, if you combine the fact that 2 of 9 items are rated "Very Much True" with the observation that 6 of 9 items are rated "Pretty Much True", there does seem to be sufficient reason to explore the possibility that this individual meets the DSM-IV criteria for the Hyperactive-Impulsive subtype of ADHD. DSM-IV: Total (Combined Type ADHD): T-Score = 74 Based on the parent's responses there is moderate, although not substantial, evidence for a diagnosis of both the Hyperactive-Impulsive subtype ADHD and Inattentive subtype ADHD. In addition, the possibility of Combined type ADHD should be considered. Integrating Results with Other Information The following subscale scores are elevated and could be cause for concern. Oppositional Cognitive Problems/Inattention Hyperactivity ADHD Index CGI: Restless-Impulsive CGI: Emotional Lability CGI: Total DSM-IV: Inattentive DSM-IV: Hyperactive-Impulsive DSM-IV: Total 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

9 CPRS R:L Interpretive Report for John Sample Page 9 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. CPRS-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 that they can reduce negative behavior in their children and promote adaptive functioning. School-Based Intervention This can involve both academic and behavioral intervention. Child-Based Intervention The child is taught to monitor, evaluate, and reinforce himself 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: Thursday, December 30, 2004 End of Report

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