The Greek ADHD Rating Scale IV

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The Greek ADHD Rating Scale-IV /- IV

Tanya Maria GeritsidouThe American College of GreeceThe Greek ADHD Rating Scale-IV /- IV

The Basics of ADHDWhat is Attention Deficit Hyperactivity Disorder?

There have been no changes for ADHD from the DSM-IV to the DSM-5, except for the age of onset (APA,2013, Weis, 2014).According to the DSM-5 it is: A persistent pattern of inattention and/or hyperactivity-impulsivity that interferes with functioning or development (APA, 2013)

The Basics of ADHDInattention (at least 6 for 6 months): Fails to pay attention to detail at work/schoolFails to pay attention in play activities/tasksDoesnt listen when spoken to Doesnt follow through with instruction/fails to finish schoolworkDifficulty organizing tasksLoses things necessary for schoolworkDifficulty/reluctance to engage in mentally demanding tasksForgetful in daily activities Hyperactivity/Impulsivity (at least 6 for 6 months):Often fidgets or taps hands/feet or squirms in seatOften inappropriately leaves seatOften inappropriately runs about/climbs, feels restlessUnable to play or engage in leisure quietlyOften is constantly on the goOften talks excessivelyOften blurts out an answer before question is completed/ speaks out of turnDifficulty waiting for his/her turnOften interrupts or intrudes on others

The Basics of ADHD

The symptoms have to be present prior to age 12 years

Several of the symptoms are present in more than two settings (e.g. both at home and at school)

There is clear evidence that the symptoms interfere with or reduce the quality of social, academic or occupational functioning

The Basics of ADHDPresentation can be:

COMBINED (both Inattention AND Hyperactivity/Impulsivity present for more than 6 months)

PREDOMINANTLY INATTENTIVE (The criterion for Hyperactivity/Impulsivity is not met)

PREDOMINANTLY HYPERACTIVE/IMPULSIVE (The criterion for Inattention is not met)

The Test: ADHD Rating Scale - IVThe standardized Greek version (qualification level B)

Test Description

It is a test based on self-reportOne questionnaire is filled out by the parent, one by the teacherAll answers are on the childs behavior during the past 6 monthsAll items in the questionnaire have to be completed (scale is problematic if more than three items are unanswered)It is for children and adolescents from ages 5 to 19 years

Test StructureEach questionnaire has 18 items:

Items with odd numbers are testing for Inattention

Items with even numbers are testing for Hyperactivity/Impulsivity

The items consist of questions answered with Likert type scales of 4 points (0 = almost never to 4 = often)

Parent Questionnaire

Teacher Questionnaire

Test Administration

As the test is self-report, the only instruction is for the parent or teacher to fill in all the items, with emphasis on not omitting anything.

The forms are given to the teachers and parents to complete on their own time.

Scoring the TestThe odd numbers of the questionnaire all test for Inattention, and are referred to as the Inattention Subscale: Raw scores for the Inattention Scale are yielded by adding together all the ratings from the Likert scales of the odd numbers

The even numbers of the questionnaire all test of Hyperactivity/Impulsivity and are referred to as the Hyperactivity/Impulsivity Subscale: Raw scores for the Inattention Scale are yielded by adding together all the ratings from the Likert scales of the odd numbers

Scoring the TestScore Conversion Table for BoysScore Conversion Table for Girls

Scoring the Test

Scoring the TestOn the parent formOn the teacher formA child can be diagnosed with ADHD if his score is: For inattention, equal or above the 90th percentileFor Hyperactivity/ Impulsivity, equal or above the 85th percentileFor both, equal or above the 85th percentile

A child can be diagnosed with ADHD if his score is: For inattention, equal or above the 98th percentileFor Hyperactivity/ Impulsivity, equal or above the 93rd percentileFor both, equal or above the 93rd percentile

Scoring the TestOn the parent formOn the teacher formA child can be eliminated for ADHD if his score is: For inattention, equal or below the 90th percentileFor Hyperactivity/ Impulsivity, equal or below the 75th percentileFor both, equal or below the 80th percentile

A child can be eliminated for ADHD if his score is: For inattention, equal or below the 70th percentileFor Hyperactivity/ Impulsivity, equal or below the 70th percentileFor both, equal or below the 70th percentile

An Example

StandardizationThe Greek version of the ADHD-RS-IV was translated from English and then went through reverse translation as well. Some elements in the wording were changed to reflect the same meaning, according to the findings from the pilot study

The Main Study: 2,994 children and adolescents with Greek nationality in the majority, ages 4-21 from all sectors of Greece

ADHD sample: 775 children

PsychometricsThe Greek ADHD RS-IV has good validity and reliability, as was proven statistically after the relevant clinical study conductedThe test is good for screening proceduresThe test is good for diagnosis if in context and in conjunction with a full diagnostic procedure where data is gathered from other sources as wellThe same has been found for the ADHD RS-IV in studies conducted for both the USA and Europe (Zhang, Faries, Vowles, Michelson, 2005)

ReferencesAmerican Psychological Association. (2013). Attention Deficit/ Hyperactivity Disorder. Retrieved from: http://www.dsm5.org/documents/adhd%20fact%20sheet.pdfKalantzi-Azizi, A., Aggeli, K. & Efstathiou, G. (2012). /-IV. Athens, Greece: Weis, R. (2014). Abnormal child and adolescent psychology. Thousand Oaks, CA: SAGE.Zhang, S., Faries, D.E., Vowles,M. & Michelson, D. (2005). ADHD Rating Scale-IV: psychometric properties from a multinational study as a clinician-administered instrument. International Journal of Methods in Psychiatric Research.14(4).186-201. doi: 10.1002/mpr.7