When it comes to diagnosing attention deficit hyperactivity disorder (ADHD) in young children, who can make the best judgment? While parents play a critical role in identifying ADHD in their children, a study from City College of New York (CUNY), Queens College by Sarah O’Neill and her research team has shown that clinicians and teachers are also important. The results of the research emphasized the need to have multiple informants when diagnosing children with ADHD.

The researchers designed a study to determine how effective parents, teachers, and clinicians are at identifying ADHD in preschool children and how well those early reports correlate with a diagnosis at age six. As such, the research team conducted a two-year study with data from 104 hyperactive and inattentive three- and four-year-old children. Parents and teachers both were asked to rate the children’s behavior. The children were also evaluated by clinicians in a psychological testing session. The clinicians were blind to the other parties’ reports.

When the children reached age six, over 50% were diagnosed with ADHD. The likelihood of an ADHD diagnosis was increased when all three informants had rated the child with strong symptoms back at age three or four. The parental reports were the most predictive, especially when taken with a report from a teacher or clinician.

Teachers’ reports were the least useful at predicting ADHD over time. This could be due to a number of factors including that at age three and four, preschoolers are still new to what it means to be in school and that the teachers may have skewed definitions of “difficult” behavior.

The researchers explained that these results highlight the need to have multiple informants who interact with the children in different settings for ADHD diagnosis. While parent reports are crucial, they should not be the only information taken into account during the diagnostic process. The researchers also suggest that this may help with early identification of children with severe symptoms, which could help in planning appropriate interventions.

“Consider a preschool child’s behavior in different contexts. Although parents’ reports of preschoolers’ inattention, hyperactivity, or impulsivity are very important, ideally we would not rely solely on them. At least for young children, the clinician’s behavioral observations appear to hold prognostic utility,” stated O’Neill.

This study is published in the Journal of Abnormal Child Psychology.

For examples of how iLs works with ADHD, please visit our case studies page.

Previous news in ADHD: