Screening Your Preschooler For Attention-Deficit Hyperactivity Disorder (ADHD)

Both the American Academy of Pediatrics and American Psychiatric Association recommend the use of rating scales as diagnostic tools when evaluating a child for ADHD. Like older children diagnosed with ADHD, it's important to assess how preschool children who demonstrate impairments function in the home and preschool settings. Since children as young as 4 years old can be diagnosed with ADHD, a comprehensive evaluation that looks at a child's behavior in multiple environments is essential to the screening process. You can talk with a professional, like Rainbow Pediatrics, to get an idea of what an evaluation entails.  

Early diagnosis leads to early intervention – the focus of which is to improve a child's emotional health and behavior. Here are some common rating scales that look at specific ADHD symptoms:

Vanderbilt ADHD Rating Scales (VADRS)

Parent and teacher versions of the Vanderbilt ADHD Rating Scales test help the evaluator obtain information about a child's behavior with the use of questions to assess symptoms such as inattention, hyperactivity, and impulsivity. The data collected from the questions also helps determine whether a child meets the diagnostic criteria for comorbid conditions (those that occur simultaneously with ADHD) such as:

• Anxiety

• Depression

• Mood disorders

• Oppositional-defiant disorder

• Conduct disorder

Parents and teachers answer questions on the rating scales based on how frequently each behavior listed on the forms occurs (e.g. "never," "very often," etc.). The teacher rating scales include a section for rating a child's academic performance and classroom behavior. These issues are rated on a scale of 1 to 5 with a rating of 1 being problematic and 5 above average.

The assessment questions included on the VADRS, which are based on DSM-5 (Diagnostic and Statistical Manual of Mental Disorders) criteria for diagnosing ADHD, take just a few minutes to answer, yet they help differentiate between children with ADHD and children without ADHD symptoms.

Conners Comprehensive Behavior Rating Scales (CBRS)

The Conners CBRS not only helps to diagnose disorders in children that can lead to emotional, behavioral, social, and academic problems, but also is used to:

• Develop a treatment plan

• Qualify a student for a special education program

• Monitor a child's progress and determine the effectiveness of a treatment or intervention program

Parent, teacher, and clinical index forms are available to help child psychology professionals assess a child for ADHD inattentive, ADHD hyperactive-impulsive, ADHD combined, obsessive-compulsive disorder, autism spectrum disorder, generalized anxiety disorder, and a broad range of other mental disorders that can affect a child's emotional, social, and academic development.

Impairment Rating Scale

The Impairment Rating Scale (IRS) is another diagnostic tool professionals use to assess a child's developmental and functional status. By gathering information about a child's behavior, this screening tool asks both parents and teachers to assign a score to a child's problems.

Scoring responses, which are based on a scale from 0 to 6, helps determine whether a child needs no treatment or has a problem that requires treatment or special services. A child is considered impaired in an area if the answers to any questions receive a score of "3" or greater.

Questions on the IRS are designed to measure how well a child develops interpersonal relationships, including his or her relationships with parents, teachers, siblings, and peers. The IRS also can be used to assess whether a child is making progress as a result of behavior modification and/or pharmacological treatment.