Can Parent Reports Serve as a Proxy for Teacher Ratings in Medication Management of Attention-Deficit Hyperactivity Disorder?
Can Parent Reports Serve as a Proxy for Teacher Ratings in Medication Management of Attention-Deficit Hyperactivity Disorder?
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DOI：
10.1097/dbp.0b013e31824afea1
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发表时间：
2012-05-01
影响因子：
2.4
通讯作者：
Binns, Helen J.
中科院分区：
文献类型：
--
作者：
Lavigne, John V.;Dulcan, Mina K.;Binns, Helen J.
目的：虽然美国儿科学会的指南建议在治疗注意力缺陷多动障碍（ADHD）儿童时从父母和老师那里获得症状报告，但从父母那里获得的信息更容易获得，医生在管理药物时可能更喜欢只依赖父母的报告。然而，很少有经验数据之间的关系，家长和老师的报告，在药物管理的多动症。本研究探讨了在临床试验期间，父母和教师报告ADHD症状之间的关系。方法：在24个儿科实践中对270名儿童进行了一项旨在改善ADHD药物管理的研究。符合ADHD标准的儿童按实践随机分配到常规治疗组或专门护理组，并将各组的数据合并以检查家长-教师协议。在治疗前、4个月和12个月随访时获得了ADHD评定量表-IV的家长和教师报告。结果如下：在每次评估中，家长和教师评分之间的相关性在统计上是显著的，但相关性的程度很低，占不超过约17%的措施之间的方差。家长和教师评分的变化分数之间的相关性在统计学上显着，但总和注意力不集中的规模低，并不显着的多动-冲动量表。对于极端评分的一致性，9个kappas中有6个具有统计学显著性，但都低得不可接受。结论：家长和教师对ADHD症状的评分之间的一致性太低，临床医生在管理药物时无法依赖家长的报告。仍然需要教师报告，以确保最佳管理。（J Dev Behav Pediatr 33：336-342，2012）
Objective: While American Academy of Pediatrics guidelines recommend obtaining symptom reports from both parents and teachers when treating children with attention-deficit hyperactivity disorder (ADHD), information from parents is easier to obtain and practitioners may prefer to rely solely on parent report when managing medications. There are, however, few empirical data on the relationship between parent and teacher reports during medication management of ADHD. This study examined the relationship between parent and teacher reports of symptoms of ADHD during a clinical trial. Methods: A study to improve medication management of ADHD was conducted in 24 pediatric practices with 270 children. Children meeting criteria for ADHD were randomized by practice to treatment-as-usual or specialized care groups, with data combined from the groups to examine parent-teacher agreement. Parent and teacher reports on the ADHD Rating Scale-IV were obtained at pretreatment, 4 months, and 12 months follow-up. Results: At each assessment, correlations between parent and teacher ratings were statistically significant, but the magnitudes of the correlations were low, accounting for no more than approximately 17% of the variance between measures. Correlations between change scores on parent and teacher ratings were statistically significant but low for Total and Inattentive scales and not significant for the Hyperactive-Impulsive scale. For agreement on extreme scores, 6 of 9 kappas were statistically significant but all were unacceptably low. Conclusions: Agreement between parent and teacher ratings of symptoms of ADHD is too low for clinicians to rely on parent reports while managing medications. Teacher reports are still needed to ensure optimal management. (J Dev Behav Pediatr 33:336-342, 2012)