Advancing ADHD diagnosis via standardized observations

描述(由申请者提供)：这项拟议的研究将测试测试阶段和课堂行为的标准化观察对改善注意力缺陷多动障碍(ADHD)评估的贡献。受试者为540名6-11岁的儿童，分为180名ADHD组、180名非ADHD临床转诊组和180名非转诊对照组，男女人数相等。考官将使用测试观察表(TOF)对每个受试者在韦氏儿童智力量表(第三版)和伍德科克·约翰逊-伊利认知能力测试期间的行为进行评分。独立观察员将使用直接观察表(DOF)在四个不同的场合对受试者在学校环境中的行为进行评级。家长将完成结构化诊断面谈(NIMH DISC-IV)、ADHD评定量表-IV(ADHDRS-IV)-家庭版、儿童行为检查表(CBCL)和社会技能评级系统(SSRS)。教师将完成ADHDRS-IV-学校版、教师报告表(TRF)、SSRS和学业表现评定量表(APRS)。本研究的目的是：1)测试测试会话和课堂观察的有效性，以区分ADHD临床转诊儿童和非ADHD临床转诊儿童与匹配的非转诊对照儿童；2)分别和联合测试测试会话和课堂观察区分ADHD注意力不集中亚型和多动/冲动亚型和混合亚型的有效性；3)测试测试会话和课堂观察与家长和教师评分的关联性；4)测试测试会话和课堂观察与认知能力和功能损害测量的相关性；5)确定标准化考试观察和/或课堂观察添加到家长和教师评分中是否显著提高了对ADHD症状所致功能障碍的预测。这项研究的发现将为改进目前诊断ADHD的研究和临床实践提供基础，并将注意力不集中的亚型与其他两个亚型区分开来。

DESCRIPTION (provided by applicant): The proposed study will test the contribution of standardized observations of test session and classroom behavior for improving assessment of Attention Deficit Hyperactivity Disorder (ADHD). Subjects will be 540 children ages 6-11, divided into matched sets of 180 with ADHD, 180 clinically referred without ADHD, and 180 nonreferred controls, with equal numbers of males and females. Examiners will use the Test Observation Form (TOF) to rate each subject's behavior during administration of the Wechsler Intelligence Scale for Children-Third Edition and the Woodcock Johnson-Ill Tests of Cognitive Abilities. Independent observers will use the Direct Observation Form (DOF) to rate the behavior of subjects in the school setting on four separate occasions. Parents will complete a structured diagnostic interview (the NIMH DISC-IV), the ADHD Rating Scale-IV (ADHDRS-IV)-Home version, Child Behavior Checklist (CBCL), and Social Skills Rating System (SSRS). Teachers will complete the ADHDRS-IV-School version, Teacher's Report Form (TRF), SSRS, and Academic Performance Rating Scale (APRS). Aims of the research are: 1) to test the validity of test session and classroom observations for differentiating clinically referred children with ADHD versus clinically referred children without ADHD versus matched nonreferred controls; 2) to test the validity of test session and classroom observations, separately and combined, for differentiating children with ADHD Inattentive subtype from children with the Hyperactive/Impulsive and Combined subtypes; 3) to test associations of test session and classroom observations with parent and teacher ratings; 4) to test associations of test session and classroom observations with measures of cognitive ability and functional impairment; and 5) to determine whether the addition of standardized test session observations and/or classroom observations to parent and teacher ratings significantly improves prediction of functional impairment due to ADHD symptoms. The findings from this study will provide a basis for improving current research and clinical practices for diagnosing ADHD and differentiating the Inattentive subtype from the other two subtypes.