GARCIA- ROSALES,
A., Vitoratou, S., Faraone, S.V., Rudaizky, D., Banaschewski,
T., Asherson, P., Sonuga-Barke, E., Buitelaar, J., Oades,
R. D., Rothenberger, A., Steinhausen, H- C., Taylor, E.,
Chen, W.,
Differential utility of teacher and parent–teacher
combined information in the assessment of Attention Deficit/Hyperactivity
Disorder symptoms. European Child & Adolescent
Psychiatry, 2020 https://doi.org/10.1007/s00787-020-01509-4.
Abstract
Consistent research findings indicate that parents and teachers observe
genuinely different Attention Deficit / Hyperactivity Disorder (ADHD)
behaviours in their respective settings.
-- Objective -- To evaluate the utility of information provided by
teacher informant assessments (INFAs) of
ADHD symptoms, & the implications of aggregation algorithms in combing
parents’ information, i.e. using ‘or-rule’
(endorsement by either one informant) vs. ‘and-rule’
(endorsement by both informants).
0/ Teacher ratings on Conners scales
and clinical data from parental accounts on 1383 probands and
their siblings from the IMAGE study were analysed. The psychometric
properties of teacher and combined ratings using the
item response theory model (IRT) are presented. Kappa coefficients,
intraclass correlations and linear regression were employed.
1/ First, teacher endorsement of symptoms
is located in a narrow part of the trait continuum close to the average
levels. Symptoms exhibit comparable perception in the measurement of
the trait(s) with similar discrimination ability and information (reliability).
2/ Second, the IRT properties of the
‘or-rule’ ratings are predominantly influenced by parent-INFAs;
and the ‘and-rule’ ratings predominantly
by teacher-INFAs ratings.
3/ Third, parent-teacher
INFAs agreement was low, both for individual items (p = 0.01–0.15)
and for dimensional scores (r = 0.12–0.16). The
‘or-rule’ captured milder expressions of ADHD symptoms,
whereas the ‘and-rule’ indexed greater severity of ADHD.
These findings have important implications for psychiatric nosology,
drug development and risk prediction.
Conclusions
Parent & teacher-INFAs provide different kinds of information,
while both are useful.
Teacher-INFA & the ‘and-rule’
provide a more accurate index of severity
than an additive symptom count. Parent-INFA
and the ‘or-rule’ are more sensitive for detecting cases
with milder ADHD.
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