The validities and efficiencies of korean ADHD rating scale and korean child behavior checklist for screening children with ADHD in the community

Abstract

Objective: The purpose of this study is to examine the validity of primary screening tools for attention deficit hyperactivity disorder (ADHD) in a community-based sample of children using the Korean version of the Child Behavior Checklist (K-CBCL) and the Korean version of the ADHD Rating Scale (K-ARS).

Methods: A large-scale community-based study for ADHD screening was conducted in the Jeollabuk province in the Republic of Korea. In 2010-2011, we surveyed a total of 49,088 first- and fourth-grade elementary school students. All of the participants in this study were assessed by the K-ARS-Parent version (K-ARS-P) and the K-ARS-Teacher version (K-ARS-T) as the primary screening instruments. The Diagnostic Interview Schedule for Children Version IV (DISC-IV) was used for confirming the diagnosis of ADHD. DISC-IV was administered to subjects who received top 10% scores in the K-ARS-P or K-ARS-T tests.

Results: Of the 3,085 subjects who completed the DISC-IV, 1,215 were diagnosed as having ADHD. A reasonable level of sensitivity, specificity, and negative predictive value were obtained when the total K-ARS-P scores were ≥90th percentile. The positive predictive value and specificity increased significantly when the total K-ARS-P scores were ≥90th percentile, T scores were ≥60 in the attention problems of K-CBCL, and T scores were ≥63 in the total problems of K-CBCL.

Conclusion: These results suggested that the K-ARS-P could effectively serve as a primary screening tool to identify elementary school children with ADHD in the community. Also, there might be some increment in the effectiveness of K-ARS-P when combined with K-CBCL-A and K-CBCL-T as a secondary screening tool.

Keywords: ADHD rating scale; Attention deficit hyperactivity disorder; Child Behavior Checklist; DISC-IV; Diagnostic Interview Schedule for Children Version IV.

Figure 1

ROC curves of K-ARS-T, K-ARS-P, K-CBCL-A, K-CBCL-E, K-CBCL-T. 1st group: first graders surveyed during 2010, 2nd group: first graders surveyed during 2011, 3rd group: fourth graders surveyed during 2011. K-ARS-T: Korean ADHD Rating Scale Teacher version, K-ARS-P: Korean ADHD Rating Scale Parent version, K-CBCL-A: Korean Child Behavior Checklist attention problems, K-CBCL-E: Korean Child Behavior Checklist externalizing problems, K-CBCL-T: Korean Child Behavior Checklist total problems.