When a child is suspected of having ADHD, parents often turn to their family doctor who may refer them to a behavioral health expert, such as a psychologist.
The psychologist may then use an ADHD rating scale, such as the Conners Comprehensive Behavior Rating Scale, or Conners CBRS, to better understand the child's symptoms and their severity.
The Conners CBRS aids diagnosis by helping to discover where the child's issues lie, as well as in what settings these issues are most troublesome.
What does the scale measure?
The Conners rating scale assesses a range of behaviours.
Scoring for the Conners rating scale is designed to be comprehensive, and measures many behavioral markers, including signs of:
- aggressive behavior
- potential for violence
- compulsive behaviors
- difficulty in class
- extra trouble with math
- difficulty with language
- social issues
- emotional distress
- separation anxiety
How is the rating done?
Parents may be asked to complete a Conners CBRS after an initial visit to a psychologist.
The scale will help determine if their child has ADHD symptoms and give a general idea of their severity.
If the psychologist agrees that the symptoms resemble typical ADHD behaviors, they will often ask the parents to fill out a parent version of the Conners CBRS form.
The Conners CBRS can help give the psychologist a better understanding of the child's behaviors and habits on multiple levels.
The benefits of using the Conners CBRS include:
- Giving a perspective on the child's behavioral patterns as experienced by people close to them.
- Comparing this information with standardized clinical information to help support a diagnosis.
- Finding a baseline of typical behaviors to guide treatment and medication recommendations.
- Helping mental health professionals create a treatment plan for the child.
- Helping decide if a child qualifies for special education at school or inclusion in new studies.
The test also helps psychologists check for other signs of emotional distress, behavioral problems, or academic disorders. These may include:
After the test has been completed, the psychologist interprets the forms and their report is reviewed with the parents. Finally, the two parties will discuss the recommendations for treatment.
Long and short versions
The Conners CBRS assessment is intended for children and teenagers.
There are short and long versions of the Conners CBRS assessments. Both versions are designed to test children from ages 6 to 18 years old, but experts use each for a different purpose.
The long version of the Conners CBRS is used for the initial evaluation of a child. The short version is used to follow up on a child's behavioral patterns.
The long version will ask questions to check for:
- types of behavioral issues
- emotional disorders
- difficulties with academics
There are also three different forms within each version of the Conners CBRS assessment. One is designed for parents to fill out, another for teachers, and one for the child to give their assessment of their symptoms.
Each form is worded differently, depending on what it is being used for. By combining the answers from all three forms, doctors can begin to paint a picture of a child's behaviors. They are then able to decide if the child has ADHD, and start to help them understand their symptoms.
The long version of the Conners CBRS assessment may take up to 90 minutes to complete correctly and is designed to give a comprehensive evaluation of a child's behaviors.
The short version of the test is called the Conners Clinical Index, or Conners CI, and may take as little as 5 minutes to complete.
The Conners CI covers 25 questions. It is designed to assess symptoms or progress over time. It is often used to follow up on a child's behaviors, or see how they are responding to a medication or treatment routine.
What do the results mean?
The psychologist will add up the scores from all the areas of the assessment and compare them to the scores of others in the child's age group to get their standardized scores.
These scores, called T-scores, can help people see how the child's symptoms and their severity compare to other children's. The scores will often be displayed in a visual format in the report for better understanding.
T-scores should be discussed directly with a doctor or mental health professional, and no one should try to self-diagnose or diagnose a child on their own.
It is usually considered normal when T-scores are less than 60, while scores above 60 are signs of academic, behavioral, or social issues. There are several different classes as well:
- A T-score of more than 60 can indicate that the child may have an issue such as ADHD.
- A T-score greater than 60 but under 70 may indicate moderately severe issues.
- A T-score above 70 may be a sign that the behavioral, academic, or emotional problems are severe.
These results will help the psychologist diagnose a child's ADHD or other issues, and they will recommend treatment based on how atypical the scores are, as well as the most severe issues.
Limitations of the Conners rating scale
Using multiple evaluation approaches will aid an accurate diagnosis.
As with all ADHD rating scales, the Conners rating scale is subjective and has limitations.
According to the medical assessment publisher MHS Assessments, validity analyses are used to ensure the accuracy of Conners CBRS scores. Furthermore, the mean overall classification accuracy rate is said to be 78 percent across all Conners CBRS forms.
As much as these tests aim to be objective, assessing a child's behavior will always have a subjective element to it.
Because of this subjectivity, individuals are often recommended to use the Conners CBRS alongside other evaluation approaches.
- attention span tests
- the Conners 3 for continuing assessment
- an ADHD symptom checklist
Further analysis of an individual's behaviour can help to give a more rounded view of symptoms. It may also help avoid a misdiagnosis.
Self-diagnosis of ADHD is not an intended outcome of any ADHD test.
Anyone who suspects they or their child has symptoms of ADHD should make an appointment with their doctor and a mental health specialist for diagnosis. Even if the person has self-analyzed their behaviors prior to the visit, the psychologist will often recommend retesting under their guidance.
The Conners rating scale is not perfect, nor is any other ADHD rating scale. But when used correctly, and under the guidance of a medical health professional, it may offer people a way to understand better their child's behaviors and possible ADHD symptoms.