Attention deficit hyperactivity disorder (ADHD) rating scales use questions about a person’s behavior to evaluate their likelihood of having ADHD.

Rating scales are crucial to the ADHD diagnostic process and are particularly necessary when diagnosing children.

People complete a rating scale form, and doctors use this information to diagnose and recommend treatment. They may also recommend using multiple rating scales.

This article explores ADHD rating scales and their role in ADHD diagnosis in more detail.

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A range of different ADHD rating scales are available.

To get a complete picture of an individual, various people, including the person themselves, their relatives, and teachers, may complete the rating scale forms.

When responding to the rating scale questions, most people can only base their observations on how the individual behaves in one setting, such as at home or school. These individuals are probably unaware of specific behaviors that the person displays in other settings.

ADHD rating scales will often include a selection of questions about how often someone displays ADHD-related behaviors and symptoms of hyperactivity, impulsivity, and inattentiveness.

The ADHD rating scale test may contain questions about typical behaviors, which may include:

  • frequent fidgeting
  • squirming in the chair
  • difficulty focusing on one task
  • trouble with organization
  • making careless mistakes
  • difficulty staying still or remaining seated
  • difficulty paying attention, even when specifically asked to
  • an inability to wait their turn
  • impatient behavior
  • regularly interrupting others, talking over them, or disrupting conversations
  • difficulty completing tasks even when someone gives them direct instructions

Some tests will also ask about classroom performance or performance at work, which may include rating how often someone:

  • has trouble remembering directions, appointments, or direct tasks
  • interrupts others or themselves while talking
  • gets distracted from the task at hand or is unable to keep their mind on one topic
  • avoids homework, class assignments, or projects at work
  • leaves many projects unfinished or has difficulty finishing a project

According to Children and Adults with Attention-Deficit/Hyperactivity Disorder (CHADD), ADHD rating scale test questions often use a scale from either 0 to 3 or 0 to 4. On the scale, 0 means the behavior never happens, while 3 or 4 means it occurs frequently.

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There are different ADHD rating scale tests specifically for children, teenagers, and adults, according to CHADD.

Common rating scales for children include:

  • National Institute for Children’s Health Quality (NICHQ) Vanderbilt Assessment Scale
  • Conners Comprehensive Behavior Rating Scale (CBRS)
  • Child Behavior Checklist (CBCL)
  • Swanson, Nolan, and Pelham-IV Questionnaire (SNAP-IV)
  • Conners-Wells’ Adolescent Self-Report Scale

There may also be some behavioral variations between children of different sexes, so some forms will have separate questions according to a person’s sex assigned at birth.

ADHD behaviors present differently in adults. Tests specifically for measuring signs of ADHD in adults include:

  • Brown Attention-Deficit Disorder Symptom Assessment Scale for Adults (BADDS)
  • Adult ADHD Clinical Diagnostic Scale (ACDS)
  • ADHD Rating Scale-IV With Adult Prompts (ADHD-RS-IV)
  • Adult ADHD Self-Report Scale (ASRS)

How does scoring work?

The scoring for ADHD rating scales varies according to the choice of test and the age of the person under consideration.

Two of the most common tests are the NICHQ Vanderbilt Assessment Scale and the Conners CBRS.

The Vanderbilt ADHD diagnostic rating scale

The Vanderbilt scale is popular with healthcare professionals who are diagnosing children between 5 and 12 years of age. It consists of two different forms for parents or teachers, which vary slightly.

If a child displays at least six behaviors suggesting inattention or hyperactivity with a score of 2 or 3, the healthcare professional will consider diagnosing ADHD.

The Vanderbilt scale also asks questions relating to performance.

The Conners CBRS

The Conners CBRS aims to determine whether or not young students qualify for inclusion in special education. Doctors may also use it to find a treatment plan for symptoms or determine whether a particular treatment for symptoms has been effective.

Separate forms are available for the child, their parent, and a teacher. The shorter version of the test, for following up on progress or symptoms, includes 25 questions and may only take about 5 minutes to complete.

Scores above 60 indicate signs of ADHD, but a doctor will want to break down these scores more thoroughly before making a diagnosis.

The Diagnostic and Statistical Manual of Mental Disorders, 5th edition, text revision (DSM-5-TR) includes criteria for ADHD, including a checklist of symptoms.

The Centers for Disease Control and Prevention (CDC) has compiled the lists to help people understand what extent of behavioral change may lead to an ADHD diagnosis.

An ADHD diagnosis is a possibility for people showing six or more signs of hyperactivity, impulsivity, or inattention.

In addition to a person having multiple symptoms for more than 6 months, the following conditions must also apply:

  • the behaviors must be present in two or more settings
  • the behaviors must be inappropriate for the person’s age
  • the behaviors must interfere with and reduce the quality of a person’s daily life or basic functioning in social settings
  • there should be no other condition that could better explain the symptoms
  • the person must have presented several behaviors before the age of 12

If a person notices six or more signs of ADHD that meet these requirements in themselves or their child, they need to consult a doctor for a more thorough diagnosis.

Anyone can take a test and analyze themselves or their child online, but a thorough diagnosis from a qualified doctor is the only accurate way to diagnose ADHD.

A doctor may request that caregivers ask their child’s teachers to fill out rating scale forms. This will give the doctor several different perspectives on the child’s behavior.

If the scores indicate ADHD, doctors are likely to begin a conversation about various ADHD treatment options.

Following an ADHD diagnosis, a person may receive treatments such as:

Most of the time, ADHD is highly manageable, especially when following a multifaceted treatment plan under the guidance of a mental health professional.

Rating scales are a crucial part of the ADHD diagnostic process and are particularly necessary when it comes to diagnosing a child.

There are different ADHD rating scale tests that health experts have designed for people who may have ADHD and their parents and teachers to fill out. Some examples include the Vanderbilt scale and Conners CBRS.

If a person receives an ADHD diagnosis, a healthcare professional will discuss potential treatment options and management techniques with them. People need to speak with a doctor if they think they may be living with ADHD.