Interviews with children and their parents form the
core of the clinical evaluation. It is essential that the interviewer directly
en-quire about all symptoms of ADHD and common comorbidities, and therefore
some structured questioning is usually required.
A number of structured and semistructured
diagnostic in-terviews are currently available for use with children, including
the Diagnostic Interview Schedule for Children (DISC-II), the Diagnostic
Interview for Children and Adolescents (DICA), the Schedule for Affective
Disorders and Schizophrenia for School Aged Children (K-SADS), the Child and
Adolescent Psychiatric Assessment (CAPA), the Child Assessment Schedule (CAS)
and the Diagnostic Interview Schedule for Children (DISC). Among the AD-DBDs,
it has been found that CD often has better reli-ability and validity
coefficients than ADHD.
Psychological and cognitive test performance is
generally not required to determine the presence of an AD-DBD. Neverthe-less,
because the AD-DBDs are frequently associated with learn-ing problems,
neuropsychological testing may be indicated particularly when assessment of
cognitive functioning is required. Information from a neuropsychological and/or
educational evalu-ation can often be used to supplement the clinical evaluation
by providing an understanding of the individual child’s level of cog-nitive and
attentional functioning, as well as screening for sus-pected mental retardation
and various learning disabilities.
Other psychometric measures include computerized
con-tinuous performance tests (CPTs), of which there are many va-rieties.
Recent interest in creating developmentally appropriate measures of AD-DBDs
symptom domains for preschoolers has led to the development of CPTs for use in
this population (Harper and Ottinger, 1992). While CPTs have been found to
differentiate children with ADHD from normals, their ability to differentiate
ADHD from other clinical groups is less clear, and there is little evidence
that they are able to identify individuals with enough precision to be useful
as diagnostic instruments.
Objective measures of activity level, such as
stabilomet-ric chairs, wrist actometers and solid state actigraphs, have also
been used in the assessment of ADHD. Although these devices provide a
judgment-free assessment of activity level, their valid-ity, as assessed by
correlations with ratings of behavior, has been inconsistent. At the present
time, it is suggested that these mea-sures not be used to diagnose clinical