Multiple Informant Average Integration Of Adhd Symptom Ratings Predictive Of Concurrent And Longitudinal Impairment

To date, there remains no consensus about the best evidence-based method for integrating multiple informant data in the diagnosis of Attention-Deficit/Hyperactivity Disorder (ADHD). Several approaches exist, including the psychometrically sound approach of averaging scores, as well as the use of "OR" and "AND" algorithms, which are still commonly used in research. The current study tested these major integration methods in their concurrent and longitudinal prediction of clinician-rated impairment, teacher-rated academic, and parent- and self-rated social skill ratings in children overrecruited for ADHD across a 6-year span from childhood to adolescence. The sample included a total of 800 children, 480 with ADHD, ages 6 to 13, who completed a "gold standard" assessment of ADHD and associated impairment. Overall, the "OR," "AND," and average integration approaches showed significantly high interrelations with one another (r range from .78 to .96) and were all significantly and strongly related to impairment measures concurrently and longitudinally. Multivariate regressions demonstrated that the average integration approach concurrently and longitudinally out predicted the other two approaches. Results demonstrated that the average approach slightly outperformed the other two in its prediction of concurrent and longitudinal clinician-rated impairment, teacher-rated academic skills, and parent- and self-rated child social skills across childhood and adolescence. Evidence-based assessment integration of parent and teacher ratings of ADHD in childhood might best utilize an averaging approach, as it is most related to later impairment ratings, particularly if such findings are replicated by other groups.