Multi-method ADHD diagnostics in children: CBCL and TRF lead the way

Luisa Himmelmeier^1,2*Robert Waltereit^2,3Katja Werheid¹

• ¹Clinical Neuropsychology and Psychotherapy, Faculty of Psychology ad Sports Science, Bielefeld University, Bielefeld, Germany
• ²Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, LWL-Hospital Marsberg, LWL-Klinik Marsberg, Marsberg, Germany
• ³Department of Psychiatry, Psychotherapy and Preventive Medicine, Ruhr-Universitat Bochum, Bochum, Germany

Objective: Diagnosing ADHD in children requires multi-method examinations, yet the effi-cacy of this approach remains inconsistent. Our case control study investigated which stand-ardized assessment methods most accurately predict an ICD-10 ADHD diagnosis in mixed settings (inpatient, outpatient, school). Methods: We examined 125 children aged 6-13 years, thereof 56 with an ADHD diagnosis (M = 9.7, SD = 2.09) and 69 without (M = 9.04, SD = 2.05). Our assessment included a chil-dren’s self-report questionnaire (Youth Self Report 11-18R, YSR), which was exploratorily used for younger children, and two objective tests, a Gameboy-administered Go/No-Go-task (QIKtest, EEGInfo, 2011) and a PC-administered continuous performance test (CPT, Knye et al., 2003). Parents were asked to complete some questions on the child’s possible diagno-ses and medication, and a parent questionnaire (Child Behavior Checklist 6-18R, CBCL). Teachers received the same questionnaire in adapted form (Teacher’s Report Form 6-18R, TRF). Classification accuracy was determined using receiver operating characteristic (ROC) analyses (Sensitivity, Specificity, Area under the Curve and Diagnostic Odds Ratio). A stepwise combination of indices was used to explore a multi-method procedure and its diag-nostic accuracy. Results: CBCL and TRF achieved the highest classification accuracy focusing on inatten-tion, followed by the YSR. Omission errors of CPT and QIKtest showed moderate classifica-tion performance while commission errors achieved the lowest. Combining CBCL, TRF and YSR showed superior diagnostic accuracy. Conclusions: Our results emphasize the relevance of multi-perspective questionnaire proce-dures for ADHD diagnosis despite potential acquisition challenges in clinical practice. Fu-ture research should develop more accurate objective test procedures and norm-based scales for children’s self-reports.