The Impact of Impairment Criteria on Rates of ADHD Diagnoses in Preschoolers |
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Authors: | Dione M Healey Carlin J Miller Katia L Castelli David J Marks Jeffrey M Halperin |
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Institution: | Department of Psychology, University of Otago, PO Box 56, Dunedin, 9054, New Zealand. dionehealey@psy.otago.ac.nz |
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Abstract: | Behaviors characteristic of ADHD are common among preschool children, and as such, their clinical significance is oftentimes difficult to ascertain. Thus a focus on impairment is essential in determining the clinical significance of these behaviors. In order to explore the impact of impairment criteria on rates of diagnoses in inattentive/hyperactive children aged 36 through 60-months-old, we first developed, and psychometrically evaluated, the Children's Problem Checklist (CPC) which was designed to assess psychosocial impairment associated with ADHD in a community sample of preschoolers (n = 394), and found its reliability and validity to be acceptable. We then examined the impact of the inclusion of various CPC-determined impairment criteria, over and above symptom criteria measured by the ADHD-RS-IV, using various cut points ranging from the 75th to 90th percentile of our community sample. This reduced the number of children meeting criteria for ADHD by 46-77%. These findings are discussed in terms of the importance of using impairment criteria, rather than just severity of inattention, impulsivity and hyperactivity, when diagnosing ADHD in preschool children. |
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Keywords: | ADHD Impairment Preschool Rating scale |
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