title: The impact of impairment criteria on rates of ADHD diagnoses in preschoolers.
abstract: Behaviors characteristic of ADHD are common among preschool children, and as such, their clinical significance is oftentimes difficult to ascertain. Thus a focus on impairment is essential in determining the clinical significance of these behaviors. In order to explore the impact of impairment criteria on rates of diagnoses in inattentive/hyperactive children aged 36 through 60-months-old, we first developed, and psychometrically evaluated, the Children's Problem Checklist (CPC) which was designed to assess psychosocial impairment associated with ADHD in a community sample of preschoolers (n = 394), and found its reliability and validity to be acceptable. We then examined the impact of the inclusion of various CPC-determined impairment criteria, over and above symptom criteria measured by the ADHD-RS-IV, using various cut points ranging from the 75th to 90th percentile of our community sample. This reduced the number of children meeting criteria for ADHD by 46-77%. These findings are discussed in terms of the importance of using impairment criteria, rather than just severity of inattention, impulsivity and hyperactivity, when diagnosing ADHD in preschool children.
authors.affiliation: Department of Psychology, University of Otago, PO Box 56, Dunedin, 9054, New Zealand. dionehealey@psy.otago.ac.nz
authors.forename: Dione M
authors.initials: DM
authors.lastname: Healey
authors.forename: Carlin J
authors.initials: CJ
authors.lastname: Miller
authors.forename: Katia L
authors.initials: KL
authors.lastname: Castelli
authors.forename: David J
authors.initials: DJ
authors.lastname: Marks
authors.forename: Jeffrey M
authors.initials: JM
authors.lastname: Halperin
mesh_terms: D001289:Attention Deficit Disorder with Hyperactivity / Q000145:classification / Q000175:diagnosis* / Q000523:psychology; D002648:Child; D002653:Child Behavior Disorders / Q000145:classification / Q000175:diagnosis* / Q000523:psychology; D002675:Child, Preschool; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008403:Mass Screening / Q000706:statistics & numerical data; D010552:Personality Assessment / Q000706:statistics & numerical data*; D011594:Psychometrics / Q000706:statistics & numerical data; D015203:Reproducibility of Results; D012931:Social Environment; D012951:Socialization