Page 1 of 5 DSM-5 criteria for the diagnosis of ADHD emphasize the importance of gathering behavioral information from multiple settings and multiple informants. To accomplish this, standardized ADHD rating scales are recommended as Best Practice by the American Psychiatric Association and the American Academy of Pediatrics. DefiniPoint provides a variety of standardized ADHD rating scales to gather this behavioral information. Additionally, DefiniPoint allows the results from multiple informants (including disparate rating scales) to be compared and integrated into a single probability score. DefiniPoint facilitates Best Practice ADHD assessments consistent with DSM-5 diagnostic criteria which include the evaluation of other emotional/behavioral, developmental, and physical conditions. As such, the information provided by DefiniPoint is not intended to be the sole source of information but rather is part of a comprehensive evaluation. VANDERBILT ADHD DIAGNOSTIC PARENT RATING SCALE The Vanderbilt Attention-Deficit Hyperactivity Disorder Diagnostic Parent Rating Scale (VADPRS) is a 55-item scale used to evaluate children and adolescents for ADHD. The American Academy of Pediatrics and the National Initiative for Children's Healthcare Quality selected this scale for the ADHD Tool Kit. The VADPRS includes all DSM-5 inattentive and hyperactive-impulsive symptoms. Parents rate each symptoms on a 0 'never' to 3 'very often' scale. Symptoms rated '2' or '3', i.e., 'often' or 'very often' are counted as present. In addition to ADHD symptoms, the VADPRS includes 8 symptoms of oppositional-defiant disorder, 14 symptoms of conduct disorder, and 7 symptoms of anxiety/depression. These symptoms are also counted as present when rated as '2' or '3'. Finally, parents rate their child's performance in 8 academic, e.g., reading, and social, e.g., relationships with peers, domains. Performance items are rated on a 1 'Problematic' to 5 'Excellent' scale; ratings of '1' or '2' are taken to indicate difficulty in that domain. Because information from multiple sources is recommended when evaluating individuals for ADHD, DefiniPoint allows rating scale results from different informants to be compared and integrated into a single probability score. DefiniPoint generates a summary score for each ADHD subtype by converting the number of counted items for each subtype into a score of 0-100. This score increases with higher probability scores reflecting a greater likelihood that ADHD is an appropriate diagnosis. As noted above, this probability score is only one component of a comprehensive evaluation and should not be used in isolation to diagnose any individual.
Page 2 of 5 The graph above summarizes the Parent's observations of the child's ADHD symptoms. The 0-100 score for the inattentive, hyperactive-impulsive, and combined presentations increases as the number of counted items increases. A score >= 50 for any presentation indicates the number of counted items meets/exceeds DSM criteria for that ADHD presentation (>= 6/9 core symptoms). This represents a positive screening result for ADHD but should not be used in isolation to establish a diagnosis. A score < 50 indicates the number of counted items does not meet DSM criteria. Tabular results for this child are shown below. Item counts at or above the clinical threshold represent a positive screen for difficulties in the given domain BUT should not be used in isolation to establish a diagnosis for any child. Instead, the findings should be considered in conjunction with ratings provided by other sources, e.g., teachers, a second parent, along with other data obtained on the child. If ratings have been collected from other sources, you can use DefiniPoint's patented statistical algorithm to integrate these ratings and compute an overall ADHD probability score for this child. Clinical Parent Responses Section Items # Threshold Counted Items Sum of Items Inattentive 1-9 >=6 of 9 7 21 Hyperactivity/Impulsivity 10-18 >=6 of 9 4 13 Oppositional-defiant disorder 19-26 >=4 of 8 1 6 Conduct disorder 27-40 >=3 of 14 2 4 Anxiety or depression 41-47 >=3 of 7 1 7 Performance 48-55 >=1 of 8 3 21
Page 3 of 5 ITEM RESPONSES Ratings on individual items and additional information on the Vanderbilt ADHD Ratings Scales is provided below. Reviewing the individual item ratings will highlight specific areas of difficulty reported by the parent. These counted items are starred. Inattentive Question Answer Score Counted 1 Does not pay attention to details or makes careless mistakes, for example homework Often 2 2 Has difficulty sustaining attention to tasks or activities Occasionally 1 3 Does not seem to listen when spoken to directly Often 2 4 Does not follow through on instructions and fails to finish schoolwork (not due to oppositional behavior or failure to understand) 5 Has difficulty organizing tasks and activities Occasionally 1 6 Avoids, dislikes, or is reluctant to engage in tasks that require sustained mental effort 7 Loses things necessary for tasks or activities (school assignments, pencils or books) 8 Is easily distracted by extraneous stimuli 9 Is forgetful in daily activities Hyperactivity/Impulsivity 10 Fidgets with hands or feet or squirms in seat Occasionally 1 11 Leaves seat when remaining seated is expected Occasionally 1 12 Runs about or climbs excessively in situations when remaining seated is expected Often 2 13 Has difficulty playing or engaging in leisure/play activities quietly Often 2 14 Is "on the go" or often acts as if "drive by a motor" Occasionally 1 15 Talks too much Often 2 16 Blurts out answers before questions have been completed Often 2 17 Has difficulty waiting his/her turn Occasionally 1 18 Interrupts or intrudes on others (e.g., butts into conversations or games) Occasionally 1 Oppositional-defiant disorder 19 Argues with adults Never 0 20 Loses temper Occasionally 1 21 Actively defies or refuses to comply with adults' requests or rules Occasionally 1 22 Deliberately annoys people Occasionally 1 23 Blames others for his or her mistakes or misbehaviors Never 0 24 Is touchy or easily annoyed by others Often 2 25 Is angry or resentful Occasionally 1
Page 4 of 5 Question Answer Score Counted 26 Is spiteful and vindictive Never 0 Conduct disorder 27 Bullies, threatens, or intimidates others Never 0 28 Initiates physical fights Never 0 29 Lies to obtain goods for favors or to avoid obligations (i.e., "cons" others) Often 2 30 Is truant from school (skips school) without permission Often 2 31 Is physically cruel to people Never 0 32 Has stolen items of nontrivial value Never 0 33 Deliberately destroys others' property Never 0 34 Has used a weapon that can cause serious harm (bat, knife, brick, gun) Never 0 35 Is physically cruel to animals Never 0 36 Has deliberately set fires to cause damage Never 0 37 Has broken into someone else's home, business, or car Never 0 38 Has stayed out at night without permission Never 0 39 Has run away from home overnight Never 0 40 Has forced someone into sexual activity Never 0 Anxiety or depression 41 Is fearful, anxious, or worried Occasionally 1 42 Is afraid to try new things for fear of making mistakes Occasionally 1 43 Feels worthless or inferior Occasionally 1 44 Blames self for problems, feels guilty Occasionally 1 45 Feels lonely, unwanted, or unloved: complains that "no one loves him/her" Often 2 46 Is sad, unhappy, or depressed Occasionally 1 47 Is self-conscious or easily embarrassed Never 0 Performance 48 Overall Academic Performance: Reading Somewhat Problematic 49 Overall Academic Performance: Mathematics Somewhat Above Average 2 4 50 Overall Academic Performance: Written Expression Very Problematic 1 51 Overall Classroom Behavior: Relationship with peers Average 3 52 Overall Classroom Behavior: Following Directions/Rules Somewhat Problematic 2 53 Overall Classroom Behavior: Disrupting Class Average 3 54 Overall Classroom Behavior: Assignment Completion Average 3 55 Overall Classroom Behavior: Organizational Skills Average 3 56 Additional Comments She occasionally has trouble with other students. Downloaded: 12/19/2013 15:26:10
Powered by TCPDF (www.tcpdf.org) Sam English Page 5 of 5 References Question for the Vanderbilt ADHD Rating Scales: Answer Score Counted Wolraich ML, Feurer ID, Hannah JN, Baumgaertel A, Pinnock TY. Obtaining systematic teacher reports of disruptive behavior disorders utilizing DSM-IV. J Abnorm Child Psychol. 1998 Apr;26(2):141-52. Wolraich ML, Lambert W, Doffing MA, Bickman L, Simmons T, Worley K. Psychometric properties of the Vanderbilt ADHD diagnostic parent rating scale in a referred population. J Pediatr Psychol. 2003 Dec;28(8):559-67. Bard DE, Wolraich ML, Neas B, Doffing M, Beck L. The psychometric properties of the Vanderbilt attention-deficit hyperactivity disorder diagnostic parent rating scale in a community population. J Dev Behav Pediatr. 2013 Feb;34(2):72-82. Wolraich ML, Bard DE, Neas B, Doffing M, Beck L. The psychometric properties of the Vanderbilt attention-deficit hyperactivity disorder diagnostic teacher rating scale in a community population. J Dev Behav Pediatr. 2013 Feb;34(2):83-93. Becker SP, Langberg JM, Vaughn AJ, Epstein JN. Clinical utility of the Vanderbilt ADHD diagnostic parent rating scale comorbidity screening scales. J Dev Behav Pediatr. 2012 Apr;33(3):221-8. References for the DefiniPoint probability score: Robeva R, Penberthy JK, Loboschefski T, Cox D, Kovatchev B. Sequential Psychophysiological Assessment of ADHD: A Pilot Study of Bayesian Probability Approach Illustrated by Appraisal of ADHD in Female College Students. Applied Psychophysiology and Biofeedback, 29 (1), 1-18, 2004 Kovatchev BP, Penberthy JK, Robeva RS, Breton M, Cox DJ. Computational Strategies in the Evaluation of Attention Deficit/Hyperactivity Disorder (ADHD). In: Attention Deficit/Hyperactivity Disorder Research, Michelle P. Larimer (Ed.). Nova Science Publishers, Inc., NY. 2005 Penberthy JK, Cox, DJ, Breton M, Robeva R, Loboschefski T, Kovatchev BP. Calibrated Bio-Behavioral Assessment of ADHD: A Prospective Study of a Meta-Analysis Method. Applied Psychophysiology and Biofeedback, 30 (1): 31-51. 2005 Robeva R, Penberthy JK. Bayesian probability approach to ADHD appraisal. Methods Enzymol. 2009;467:357-80 Downloaded: 12/19/2013 15:26:10