Reliability and validity of the assessment of neurological soft-signs in children with and without attention-deficit-hyperactivity disorder.
OBJECTIVE
To study the value and reliability of an examination of neurological soft-signs, often used in Sweden, in the assessment of children with attention-deficit-hyperactivity disorder (ADHD), by examining children with and without ADHD, as diagnosed by an experienced clinician using the DSM-III-R.


METHODS
We have examined interrater reliability (26 males, nine females; age range 5y 6mo-11y), internal consistency (94 males, 43 females; age range 5y 6mo-11y), test-retest reliability (12 males, eight females; age range 6-9y), and validity (79 males, 33 females; age range 5y 6mo-9y).


RESULTS
The sum of the scores for the items on the examination had good interrater reliability (intraclass correlation [ICC] 0.95) and acceptable internal consistency (Cronbach's alpha 0.76). The test-retest study also showed good reliability (ICC 0.91). There were modest associations between the examination and the assessment of motor function made by the physical education teacher (ICC 0.37) as well as from the parents' description (ICC 0.39). The examination of neurological soft-signs had a sensitivity of 0.80 and a specificity of 0.76 in predicting motor problems as evaluated by the physical education teacher.


CONCLUSIONS
The reliability and validity of this examination seem to be good and can be recommended for clinical practice and research.
Gustafsson
Peik
P
Department of Child and Adolescent Psychiatry, Department of Clinical Sciences, Lund University, Sweden. Peik.Gustafsson@med.lu.se <Peik.Gustafsson@med.lu.se>
Svedin
Carl Göran
CG
Ericsson
Ingegerd
I
Lindén
Christian
C
Karlsson
Magnus K
MK
Thernlund
Gunilla
G
D000203:Activities of Daily Living / Q000523:psychology; D001289:Attention Deficit Disorder with Hyperactivity / Q000150:complications* / Q000523:psychology; D057189:Checklist / Q000379:methods; D002648:Child; D002652:Child Behavior / Q000502:physiology; D002658:Developmental Disabilities / Q000175:diagnosis / Q000209:etiology / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D009048:Motor Skills / Q000502:physiology; D009422:Nervous System Diseases / Q000175:diagnosis* / Q000209:etiology*; D009483:Neuropsychological Tests; D010372:Pediatrics / Q000379:methods; D010552:Personality Assessment; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales; D015203:Reproducibility of Results; D011795:Surveys and Questionnaires; D013548:Sweden