How many fidgets in a pretty much: A critique of behavior rating scales for identifying students with ADHD

The school psychologist's role and responsibilities for meeting the needs of students with Attention-Deficit Hyperactivity Disorder (ADHD) have been expanding in recent years. Students with this disorder present refractory problems that may involve the school psychologist in the assessment and diagnosis of ADHD. Rating scales commonly are used, sometimes in conjunction with other techniques, for assessing and diagnosing ADHD. They often are presented as an objective way to quantify the severity of a child's behavior in comparison with a normative standard. Because rating scales have become such an integral component in the identification of children with ADHD, school psychologists should understand the limitations associated with this methodology. In this article we first describe behavior rating scales and difficulties in the use of cutoff scores to identify students as ADHD. Second, we describe how problems with interobserver agreement hamper the validity of rating scales and the subsequent conclusions that can be drawn about students' behavior. Finally, we present recommendations for obtaining more reliable and valid information from rating scales.