title: Observer variability identifying attention deficit/hyperactivity disorder in 10-year-old children born extremely preterm.
abstract: OBJECTIVE
  A DSM-5 diagnosis of attention deficit/hyperactive disorder (ADHD) requires that symptoms be present in two settings. We wanted to see how teachers and parents compare on their assessments.
  
  
  METHODS
  We evaluated how well Child Symptom Inventory-4 (CSI-4) reports from 871 parents and 634 teachers of 10-year-old children born before the 28th week of gestation provided information about indicators of school dysfunction.
  
  
  RESULTS
  Kappa values for parent and teacher agreement of any ADHD were at best fair to poor (<0.41). Nevertheless, ADHD identified by each alone provided a moderate amount of information about such indicators of school dysfunction as grade repetition. Only occasionally did agreement provide more information than provided by only one reporter. Mother's social class and intelligence level did not discriminate between parents who did and did not agree with the teacher.
  
  
  CONCLUSIONS
  ADHD identified by a single observer can provide appreciable information about a range of the child's functions needed for success in school and, therefore, should not be discounted when another observer does not consider the child to have ADHD symptoms.
authors.affiliation: Boston Children's Hospital, Harvard Medical School, Boston, MA, USA.
authors.forename: Alan
authors.initials: A
authors.lastname: Leviton
authors.affiliation: The University of Chicago Medicine Comer Children's Hospital, Chicago, IL, USA.
authors.forename: Scott J
authors.initials: SJ
authors.lastname: Hunter
authors.affiliation: The University of Chicago Medicine Comer Children's Hospital, Chicago, IL, USA.
authors.forename: Megan N
authors.initials: MN
authors.lastname: Scott
authors.affiliation: University of North Carolina School of Medicine, Chapel Hill, NC, USA.
authors.forename: Stephen R
authors.initials: SR
authors.lastname: Hooper
authors.affiliation: Boston University School of Medicine, Boston, MA, USA.
authors.forename: Robert M
authors.initials: RM
authors.lastname: Joseph
authors.affiliation: University of North Carolina School of Medicine, Chapel Hill, NC, USA.
authors.forename: Thomas Michael
authors.initials: TM
authors.lastname: O'Shea
authors.affiliation: Boston Children's Hospital, Harvard Medical School, Boston, MA, USA.
authors.forename: Elizabeth N
authors.initials: EN
authors.lastname: Allred
authors.affiliation: Boston Medical Center, Boston University School of Medicine, Boston, MA, USA.
authors.forename: Karl
authors.initials: K
authors.lastname: Kuban
mesh_terms: D001289:Attention Deficit Disorder with Hyperactivity / Q000175:diagnosis* / Q000453:epidemiology; D002648:Child; D005260:Female; D006801:Humans; D062071:Infant, Extremely Premature; D007231:Infant, Newborn; D008297:Male; D015588:Observer Variation; D010290:Parents / Q000523:psychology; D011446:Prospective Studies; D000070777:School Teachers / Q000523:psychology; D014481:United States / Q000453:epidemiology
keywords: Attention deficit disorder with hyperactivity/diagnosis; Attention deficit disorder with hyperactivity/epidemiology; Extremely premature; Follow-up studies; Infant; Surveys and questionnaires