title: ADD-H-Comprehensive Teacher's Rating Scale (ACTeRS): a measure for attention deficit hyperactivity disorder among children with intellectual disability in India.
abstract: OBJECTIVE
  There is no validated measure for assessing Attention Deficit Hyperactivity Disorder (ADHD) in India, and therefore, the authors validated the ADD-H Comprehensive Teacher's Rating Scale (ACTeRS).
  
  
  METHODS
  Teachers/parents/clinicians of 110 children with ADHD completed the ACTeRS. The diagnosis of ADHD was confirmed by an independent multi-disciplinary team using ICD-10 diagnosis for diagnostic accuracy and criterion validity. The convergent and divergent validity were assessed by another rater. The data was analyzed for diagnostic accuracy, reliability and validity appropriately.
  
  
  RESULTS
  An ACTeRS score of ≥61 [Sensitivity (Sn) =85.51%; Specificity (Sp) = 90.24%; Area under the curve (AUC) = 0.94] is appropriate for the diagnosis of ADHD. The test-re-test reliability [Intra-class correlation coefficient (ICC) = 0.87], internal consistency (Cronbach's α = 0.80; range of 0.89-0.93), section-total correlation, face and content validity for the ACTeRS were good. Convergent validity of attention deficit, hyperactivity and oppositional subscales of ACTeRS with the corresponding subscales of Swanson, Nolan & Pelham Rating Scale-Revised (SNAP-IV) was moderate (r = 0.60, P = 0.005; r = 0.49, P = 0.02; r = 0.58, P = 0.008 respectively), and negative correlation with the Childhood Autism Rating Scale (r = -0.36; P =0.1) for divergent validity was found. The criterion validity analysis showed a high concordance rate of 82.52% between ACTeRS and International Classification of Diseases, Edition10 (ICD-10) diagnosis of ADHD. A 4-factor structure was replicated.
  
  
  CONCLUSIONS
  The ACTeRS has adequate psychometric properties for use in the Indian population for identifying ADHD.
authors.affiliation: Child and Adolescent Psychiatry Unit, Department of Psychiatry, Christian Medical College, Vellore, 632 002, Tamil Nadu, India.
authors.forename: Sherab
authors.initials: S
authors.lastname: Tsheringla
authors.forename: Aby
authors.initials: A
authors.lastname: Simon
authors.forename: Paul Swamidhas Sudhakar
authors.initials: PS
authors.lastname: Russell
authors.forename: SatyaRaj
authors.initials: S
authors.lastname: Shankar
authors.forename: Sushila
authors.initials: S
authors.lastname: Russell
authors.forename: Priya
authors.initials: P
authors.lastname: Mammen
authors.forename: M K C
authors.initials: MK
authors.lastname: Nair
mesh_terms: D001289:Attention Deficit Disorder with Hyperactivity / Q000175:diagnosis*; D000067290:Behavior Rating Scale; D002648:Child; D002675:Child, Preschool; D006801:Humans; D007194:India; D008607:Intellectual Disability / Q000150:complications*; D000070777:School Teachers