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. 2021 Jan;30(1):143-153.
doi: 10.1007/s00787-020-01509-4. Epub 2020 Apr 3.

Differential utility of teacher and parent-teacher combined information in the assessment of Attention Deficit/Hyperactivity Disorder symptoms

Alexandra Garcia-Rosales #  1   2   3 , Silia Vitoratou #  4 , Stephen V Faraone  5 , Daniel Rudaizky  6 , Tobias Banaschewski  7 , Philip Asherson  8 , Edmund Sonuga-Barke  8 , Jan Buitelaar  9 , Robert D Oades  10 , Aribert Rothenberger  11 , Hans-Christoph Steinhausen  12   13   14   15 , Eric Taylor  8 , Wai Chen  16   17   18
Affiliations

Differential utility of teacher and parent-teacher combined information in the assessment of Attention Deficit/Hyperactivity Disorder symptoms

Alexandra Garcia-Rosales et al. Eur Child Adolesc Psychiatry. 2021 Jan.

Abstract

Background: Consistent research findings indicate that parents and teachers observe genuinely different Attention Deficit/Hyperactivity Disorder (ADHD) behaviours in their respective settings.

Objective: To evaluate the utility of information provided by teacher informant assessments (INFAs) of ADHD symptoms, and the implications of aggregation algorithms in combing parents' information, i.e. using 'or-rule' (endorsement by either one informant) versus 'and-rule' (endorsement by both informants).

Method: Teacher ratings on Conners scales and clinical data from parental accounts on 1383 probands and their siblings from the IMAGE study were analysed. The psychometric properties of teacher and combined ratings using the item response theory model (IRT) are presented. Kappa coefficients, intraclass correlations and linear regression were employed.

Results: First, teacher endorsement of symptoms is located in a narrow part of the trait continuum close to the average levels. Symptoms exhibit comparable perception in the measurement of the trait(s) with similar discrimination ability and information (reliability). Second, the IRT properties of the 'or-rule' ratings are predominantly influenced by parent-INFAs; and the 'and-rule' ratings predominantly by teacher-INFAs ratings. Third, parent-teacher INFAs agreement was low, both for individual items (κ = 0.01-0.15) and for dimensional scores (r = 0.12-0.16). The 'or-rule' captured milder expressions of ADHD symptoms, whereas the 'and-rule' indexed greater severity of ADHD.

Conclusions: Parent and teacher-INFAs provide different kinds of information, while both are useful. Teacher-INFA and the 'and-rule' provide a more accurate index of severity than an additive symptom count. Parent-INFA and the 'or-rule' are more sensitive for detecting cases with milder ADHD.

Keywords: ADHD DSM-IV criteria; Caseness; Diagnostic overshadowing; IRT; Parent/teacher.

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Conflict of interest statement

ESB: Speaker fees, consultancy, research funding and conference support from Shire Pharma and Janssen Cilag. Consultancy from Neurotech Solns, Aarhus University, Copenhagen University and Berhanderling, Skolerne, Copenhagen, and KU Leuven. Book royalties from OUP and Jessica Kinglsey. Royalties from the New Forest Parenting Package. TB served in an advisory or consultancy role for Actelion, Hexal Pharma, Lilly, Lundbeck, Medice, Novartis, Shire, received conference support or speaker’s fee by Lilly, Medice, Novartis and Shire, has been involved in clinical trials conducted by Shire & Viforpharma and received royalties from Hogrefe, Kohlhammer, CIP Medien, Oxford University Press.

Figures

Fig. 1
Fig. 1
Item characteristic curves per informant assessment—IA and HI
Fig. 2
Fig. 2
Item information curves per informant assessment—IA and HI
Fig. 3
Fig. 3
Total information curves per informant assessment—IA and HI
See this image and copyright information in PMC

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