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What to Know About ADHD Rating Scales

Medically Reviewed by Smitha Bhandari, MD on July 02, 2020

There is no single test that can diagnose ADHD in children or adults. So doctors use lots of tests and tools to figure out whether you have ADHD or something else.

One of these tools is called an ADHD rating scale. Used for more than 50 years, rating scales are usually checklists or questionnaires. They measure symptoms of ADHD, like problems with attention or impulse control.

If you or your child have already been diagnosed with ADHD, ratings scales can help doctors figure out the right treatments. And they can help doctors track whether treatments are working.

Many experts think rating scales are the most important tool to diagnose ADHD.

How They Work

Rating scales are often filled out by people who know someone being tested for ADHD. For a child, this might be their parents, teachers, and doctor. An adult being tested for ADHD can answer the questions themselves or have a family member or co-worker do it. Often, they do both.

These people can see your or your child's behavior in different situations, like at home, school, and work. Symptoms must show up in more than one area of your life for you to be diagnosed with ADHD.

Types of ADHD Rating Scales

Doctors have many types of ADHD rating scales to choose from. Some examples are:

For children:

  • Vanderbilt Assessment Scale. This reviews symptoms of ADHD. It also looks for other conditions such as conduct disorder, oppositional-defiant disorder, anxiety, and depression. Parents or teachers answer questions about how well the child does with schoolwork and gets along with others.
  • Behavior Assessment System for Children (BASC). This looks for things like hyperactivity, aggression, and conduct problems as well as anxiety, depression, attention, and learning problems.
  • Child Behavior Checklist/Teacher Report Form (CBCL). Among other things, this scale looks at problem behavior in children.
  • Conners Rating Scales. The questions are different for parents and teachers. They look for things like hyperactive or defiant behavior and problems with thinking.

For adults:

  • Adult ADHD Clinical Diagnostic Scale (ACDS). A doctor, therapist, or other health care worker asks you 18 questions about your symptoms during an interview.
  • Brown Attention-Deficit Disorder Symptom Assessment Scale (BADDS) for Adults: You answer 40 questions, either on a questionnaire or during an interview with a health care worker. It looks for problems with things like attention, memory, and mood.

Types of Questions

ADHD rating scales might include only a few questions or more than 100. Some only ask about symptoms that point to ADHD. Others branch out by asking about other symptoms.

You might be asked, for example, if you or your child:

  • Are unable to stay on task
  • Often lose items
  • Easily get distracted
  • Are forgetful
  • Often want to get even
  • Can be physically cruel
  • Are fearful, anxious, or worried
  • Are unhappy
  • Don't listen closely when spoken to
  • Often get angry
  • Blurt out answers before questions are completed
  • Talk too much
  • Fidget or squirm when sitting
  • Interrupt others
  • Bully or threaten others

How Doctors Use Rating Scales

Rating scales are usually scored on a 3- or 4-point basis. Doctors, parents, and others might rate each ADHD symptom as happening never, occasionally, often, or very often.

Along with rating scales, doctors use other methods to make an ADHD diagnosis. One reason is that sometimes, different people who fill out a rating scale don’t agree on the answers. Other tests for ADHD include things like physical exams, observations of behavior, interviews with family members, and tests of attention and thinking skills.

WebMD Medical Reference

Sources

SOURCES:

CHADD: “Diagnosing ADHD,” “Clinical Practice Tools,” “Which ADHD Rating Scales Should Primary Care Physicians Use?”

Psychiatry: “ADHD: Is Objective Diagnosis Possible?”

RAND Corporation: “Behavior Assessment System for Children (BASC).”

National Institute for Children’s Health Quality: “NICHQ Vanderbilt Assessment Scales.”

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