Conners Rating Scales

The majority of CRS-R measures announced to have been developed out of distinctly different particular pools, resulting in sets of scales that may complement rather than duplicate each other.

From: Comprehensive Clinical Psychology , 1998

BEHAVIORAL CHALLENGES AND MENTAL DISORDERS IN CHILDREN AND ADOLESCENTS WITH INTELLECTUAL DISABILITY

Ludwik S. Szymanski , in Developmental-Behavioral Pediatrics (4th Edition), 2009

Rating Instruments and Other Materials

Rating scales, such as Conners Rating Scales (parents' and teachers' versions), Reiss Screen, and the Aberrant Beliefs Checklist, may supplement the clinical observations ( Reiss, 1994). Other instruments with which the clinician is familiar tin be used, and they may be helpful for screening purposes. An important caution is that the rating scales may not accept been normed on individuals with ID, and therefore estimation of the results may be difficult.

If possible, the parents should be asked to bring by and contempo home videos of the kid. They may provide valuable data well-nigh behavioral alter over fourth dimension and the child'south behavior in natural environments.

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Assessment with Brief Behavior Rating Scales

ROBERT J. VOLPE , GEORGE J. DUPAUL , in Handbook of Psychoeducational Assessment, 2001

General Overview and Psychometric Characteristics

The parent and instructor curt forms of the Conners' Rating Scales—Revised (Conners, 1997) were designed for repeated and/or brief cess of symptoms relevant to ADHD and related disorders. These instruments are available in long or short versions for parent, teacher, and boyish completion. The long versions will not exist reviewed here considering they represent wide-band measures. It should be noted that merely the long forms of the revised Conners' scales contain the DSM-Iv symptom subscales that may be preferred for diagnostic purposes. These subscales should non be dislocated with the ADHD Index that is included in the short grade. The 12-item ADHD Index is non factor-derived; rather, it represents the best items for distinguishing ADHD from nonclinical children. Due to space limitations, we will restrict our review to the 27-item parent short form (CPRS-R:S) and the 28-item teacher short form (CTRS-R:South). The parent and instructor short forms incorporate the same subscales/indices (e.chiliad., Oppositional, Cognitive Problems, Hyperactivity, and the ADHD Alphabetize), thus allowing easy comparisons across informants. Respondents are asked to charge per unit behavior that has been problematic over the preceding month using a four-indicate Likert calibration labeled with both levels of appropriateness (e.g., "Not true at all" = 0), and frequency (due east.k., "Very frequent" = 3).

The examination-retest reliability and internal consistency of the CPRS-R:Southward and CTRS-R:S accept both been investigated (Conners, 1997). The internal consistencies of these instruments are good. Coefficient alphas range between .86 to .94 for the parent version and betwixt .88 to .95 for the teacher version. The test-retest reliability (over a vi–8-week period) is somewhat variable across scales and informants, with coefficients of stability ranging betwixt .62 to .85 for parents and between .72 and .92 for teachers. For example, the coefficient of stability for the parent-rated Oppositional subscale is low (.62), whereas the stability for the teacher ratings on the same subscale is adept (.84). Conversely, the stability of the parent-rated Hyperactivity subscale is good (.85), whereas teacher-rated Hyperactivity is moderate (.72).

The Oppositional, Cognitive Problems, and Hyperactivity subscales of the CPRS-R:S and the CTRS-R:Southward were drawn from exploratory factor analyses of the long forms of the Conners' scales (see Conners, Sitarenios, Parker, & Epstein, 1998a, 1998b). Those items with the highest factor loadings were used in the construction of the shortened subscales. These items were and then subjected to a set up of confirmatory maximum likelihood analyses. Goodness of fit for both the parent and teacher versions was adequate as assessed across multiple indices (east.thousand., AGFI, GFI, RMS). Intercorrelations between subscales were highly similar across child gender.

Correlations between the long and curt versions of the three gene-derived subscales approached i.0. Hence, Conners (1997) performed concurrent and discriminant analyses on the long forms only. The concurrent and discriminant validity of the Conners' scales appear adequate. The Oppositional, Cognitive Problems, and Hyperactivity subscales and the ADHD Index all differed significantly in comparisons of nonclinic and ADHD groups. Correlations between the revised Conners' scales and the subscales of the CPRS-93 and the CTRS-39 indicate meaning overlap across relevant constructs. For example, correlations between pertinent subscales such as CPRS-R Hyperactivity and CPRS-93 Hyperactive Immature range between .63 to .89 for parent-completed instruments, and between .71 and .88 for instructor-completed instruments.

Adequate normative data (Conners, 1997) are available for the CPRS-R:S (Northward = 2426) and CTRS-R:S (N = 1897). It should exist noted that the majority of these data were derived from rescored long forms. Caucasians in these samples appear to be overrepresented (over fourscore%). Males received higher scores on the three subscales and the ADHD Index on both parent and teacher versions, and in general, younger children received higher ratings on Hyperactivity and lower ratings on Cerebral Problems. It appears, however, that the gap between boys and girls on the Hyperactivity subscale narrows as children historic period. Several ethnic differences were also found. Specifically, the Native-American group differed from the African-American, Hispanic, Asian, and Caucasian groups on the Oppositional subscale of the CPRS-R:Southward. Furthermore, teacher ratings of Hyperactivity for the African-American grouping were found to exist significantly higher than those from the Asian and Caucasian groups, and the Asian group was institute to be significantly lower than the Hispanic group. These ethnic differences should be considered in interpreting scores from these instruments due to the lack of divide normative data for various ethnic groups.

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The Assessment of Family, Parenting, and Child Outcomes

Carina Coulacoglou , Donald H. Saklofske , in Psychometrics and Psychological Assessment, 2017

Conners' Scales for Teachers and Parents 3rd Edition

The Conners-3 (Conners, 2008) Parent Rating Calibration (Conners-iii-P) is the virtually recent revision to a widely used beliefs rating scale organization. The Conners-iii-P is designed similarly to the BASC-2 Achenbach systems in that it includes a number of clinically relevant domains for which normative scores are derived. The parent rating scale is designed for children historic period vi–18 years. The Conners-iii-P exists in ii forms: Long Form (110 items) and Brusque Form (45 items). There is besides a 10-item Global Alphabetize Form.

The Conners-3-P includes 5 empirically derived scales: Hyperactivity/Impulsivity, Executive Functioning, Learning Problems, Aggression, and Peer Relations. An Inattention scale is also available, as are 5 DSM- IV-TR Symptom scales for each of the Disruptive Beliefs Disorders (i.e., 3 ADHD subtypes, oppositional defiant disorder, and conduct disorder). The Conners-3-P includes screening items for depression and anxiety to social relationships. Like the BASC, the Conners-3 includes critical items that may signal the demand for farther follow-up. These critical items are specially directed toward severe conduct problems. Consistent with its predecessors, the Conners-iii includes a brief ADHD Index. The Conners-iii has three validity scales: Positive Impression (fake good), Negative Impression (imitation bad), and the Inconsistency Alphabetize.

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Assessment

David Lachar , in Comprehensive Clinical Psychology, 1998

four.13.two.two.iv Commentary

Table 2 displays average T-score grouping estimates derived from hateful raw scores for parent, teacher, and cocky-report scales from three samples: general clinical, ADHD, and matched normative (Conners, 1997, pp. 135–136).

Table two. Boilerplate guess T-scores for ADHD, clinical (CLIN), and normative (NORM) samples.

ADHD CLIN NORM
CPRS-R
  Oppositional 59 63 47
  Cerebral Issues 67 57 46
  Hyperactivity 69 58 48
  Anxious-Shy 56 58 49
  Perfectionistic 49 57 fifty
  Social Problems 63 68 48
  Psychosomatic 56 57 48
  Global Index 67 64 46
  ADHD Index 66 59 47
DSM-IV Total 69 59 47
CTRS-R
  Oppositional 61 64 47
  Cognitive Issues 56 l 47
  Hyperactivity 69 68 49
  Anxious-Shy 62 62 46
  Perfectionistic 56 62 49
  Social Bug 51 58 53
  Global Index 66 62 46
  ADHD Index 65 58 48
DSM-IV Total 64 58 46
CASS
  Family Issues 53 53 46
  Emotional Problems 56 56 47
  Conduct Problems 57 54 45
  Cognitive Problems 60 56 44
  Anger Command Problems 57 57 47
  Hyperactivity 57 52 45
  ADHD Index 59 53 44

It would exist very useful for the CRS-R Manual to provide for each sample the proportion of scale scores that equaled or exceeded the minimum T-score for the clinical range, whether this is 60T or 65T. Such lack of clinically relevant information is also demonstrated in a journal presentation of the half dozen factor-derived CASS scales (Conners et al., 1997). In comparing 86 adolescents with a sole diagnosis of ADHD combined blazon to matched normative controls, an overall right nomenclature rate of 82.half-dozen% was obtained using all six scales. Although all six scales were statistically meaning in group contrasts (demonstrating comorbidity and need for multidimensional assessment), no indication of the relative importance of each calibration's contribution to this bigotry is given, nor are the proportion of elevated scores per scale provided for ADHD and contrast samples.

Tabular array 2 documents substantial normative/ clinical differences besides as the relative superiority of parent report when information technology is compared to the companion self-report form. Brevity and ease of application would recommend the CRS-R measures in monitoring the treatment of children with ADHD. Versions of DSM-4 scales for parent, teacher, and youth will allow the study of the accuracy of each informant source in diagnosing ADHD every bit well as the report of across-informant understanding.

The majority of CRS-R measures appear to have been adult out of distinctly different particular pools, resulting in sets of scales that may complement rather than indistinguishable each other. It would be useful for the transmission to explain why the CRS norms comprise iii-year intervals. The current profiles suggest in displayed raw-to T-score conversion substantial and variable gender and age effects. The magnitude of this age effect is hands demonstrated by tracking on a profile the T-score equivalents for one scale raw score across the five sets of age norms. For case, a DSM-IV Hyperactive Impulsive raw score of 12 for males resulted in the following five T scores: 3–5, lxT; 6–eight, 63T; nine–xi, 66T; 12–fourteen, 70T; 15–17, 81T. In contrast, the ADHD Index demonstrated far less historic period-related variation.

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Neuropsychological Assessment of Children

KEITH OWEN YEATES , H. GERRY TAYLOR , in Handbook of Psychoeducational Assessment, 2001

Emotional Status, Behavioral Adjustment, and Adaptive Beliefs

Adaptive failures often occur in domains other than academic performance. These failures may be manifest in psychological distress, inappropriate or otherwise undesirable behavior, or deficits in everyday performance, including poor daily living skills or social skills. A wide variety of formal checklists are available to assess emotional status and behavioral adjustment, including the Kid Behavior Checklist (Achenbach, 1991; encounter also Chapter 10), the Behavior Assessment System for Children (Reynolds & Kamphaus, 1992; see also Chapter 9), the Personality Inventory for Children (Wirt, Seat, Broen, & Lachar, 1990), and the Conners' Rating Scales—Revised (Conners, 1997). Rating scales also are bachelor to appraise various aspects of adaptive beliefs, such every bit the Scales of Independent Behavior—Revised (Bruininks, Woodcock, Weatherman, & Hill, 1996), as are detailed semistructured interview procedures, such every bit the Vineland Adaptive Behavior Scales (Sparrow, Balla, & Ciccetti, 1984).

The assessment of emotional and behavioral adjustment and of adaptive functioning is crucial. A careful analysis of deficits in adjustment and adaptive behavior tin assistance to define the mismatch between a kid'southward neuropsychological profile and the ecology demands placed on the child. However, the relationship between neuropsychological skills and adjustment bug or deficits in adaptive behavior is complex. For case, premorbid behavior bug and adaptive deficits may increase the risk of traumatic brain injury. Aligning issues and adaptive difficulties also may be an indirect result of the frustration associated with consistent failures to cope with environmental demands. In other cases, behavioral difficulties or adaptive deficits may exist a more than direct manifestation of neuropsychological deficits (Rourke & Fuerst, 1991).

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Developmental Disorders and Interventions

Deborah M. Riby , Melanie A. Porter , in Advances in Kid Development and Beliefs, 2010

A Maladaptive behaviors

In a large and thorough report of children with WS (iv–16 years of age), Leyfer et al. (2006) found that but over 64% met the criteria for ADHD. Of this group, the majority met criteria for "ADHD—Inattentive" subtype. Rhodes et al. (in printing) found that parents of children with WS reported (using the Conners Rating Scale) every bit severe problems with inattention and hyperactivity as parents of children with ADHD. Therefore, the severity of these symptoms may be substantial and impact upon daily living. X of the 11 children were rated as being inside the abnormal range for hyperactivity (Rhodes et al., in printing). In like work, Porter et al. (2008) found that 33% of children in their sample met criteria for ADHD in one case their level of full general intellectual ability was taken into business relationship. Therefore, there may be swell variability between individuals in terms of inattention and hyperactivity simply these bug should be considered as a relevant to individuals with the disorder.

Despite a reasonably high likelihood of inattention and hyperactivity in WS, problems of acquit or oppositional behaviors are relatively rarer (Porter et al., 2008). In the same study reported higher up, parents of only 5 of the eleven children involved in research by Rhodes et al. (in press) rated their child as beingness within the abnormal range for oppositional beliefs. Despite this, some interesting patterns seem to exist emerging. For example, Porter et al. (2008) found that parents of younger children with WS were more probable to report difficulties with externalizing behaviors (such as oppositional and conduct problems) than parents of older children and adults with WS. A pattern of greater externalizing difficulties in younger children than older children and adults is consequent with other neurodevelopmental syndromes, such equally ADHD and Asperger syndrome, at least anecdotally (Flom, 2008; Freeman, 2009). Also, females in Porter et al.'due south accomplice tended to exist rated as displaying more externalizing behaviors than males, peculiarly in terms of comport problems. This finding is the contrary design to that seen in typical development and (to the best of the authors' knowledge) is non seen in other neurodevelopmental disorders (e.grand., run across Rucklidge, 2010). It is therefore necessary to explore these problems at an private level (and take the individual needs into consideration in the pattern of interventions).

Other types of maladaptive behavior such as behavioral, emotional, and thought regulation difficulties (e.m., impulsivity, low frustration tolerance, obsessive thoughts, preoccupations) are reasonably mutual and indeed are more than mutual than seen in the typical population. All these bug are likely to be secondary to executive dysfunction (Dodd & Porter, 2009; Gosch & Pankau, 1997; Mobbs et al., 2007; Porter et al., 2008) and therefore interventions targeting executive performance and attentional control may have a "knock on" effect for these aspects of maladaptive behavior.

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Screening and Assessment Tools

GLEN P. AYLWARD , ... LYNN Chiliad. JEFFRIES , in Developmental-Behavioral Pediatrics, 2008

Transformations of Raw Scores

LINEAR TRANSFORMATIONS

Linear transformations provide information regarding a child's continuing in comparing to group means. The z-score is a standard score (standardization beingness the procedure of converting each raw score in a distribution into a z-score: raw score − the mean of the distribution, divided by the standard departure of the distribution) that corresponds to a standard deviation; that is, a z-score of +1 is 1 standard divergence above average and a z-score of −1 is 1 standard difference below average. The mean equals a z-score of 0; therefore scores between z-scores of −1 and +ane are in the average range. Stated differently, if a child receives a z-score of +i, he or she obtained a score college than those of 84% of the population (come across Fig. 7A-1).

The T-score is another linear transformation and can exist considered a z-score × 10 + 50. The mean T-score is fifty, and the standard departure is ten. Therefore a z-score of i equals a T-score of 60. T-scores are often establish in psychopathology-related test instruments such as the Minnesota Multiphasic Personality Inventory—A, the Conners rating scales, or the Kid Behavior Checklist, on which T-scores of seventy or greater are considered to be clinically relevant (approximately the 98th percentile); these cutoffs are depicted in many scoring forms.

AREA TRANSFORMATIONS

A percentile (the technical slang is "centile") tells the practitioner how an individual child'south performance compares to a specified norm group. If a percentile score is 50, half of the children tested volition score above this, and half will score beneath. A score that is i standard departure beneath average is at approximately the 16th percentile; a score 1 standard deviation above average is at the 84th percentile. Clinicians must exist aware that small differences in scores in the middle of the distribution produce substantial differences in percentile ranks, whereas greater raw score differences in outliers do not have as much of an outcome on percentile scores. Often, the tertiary percentile is considered to be a clinical cutoff (due east.g., in the case of the babe born small for gestational age). Deciles are bands of percentiles that are 10 percentile ranks in width (each decile contains 10% of the normative group). Quartiles are percentile bands that are 25 percentile ranks in width; each quartile contains 25% of the normative group. Percentiles require the fewest assumptions for accurate interpretation and can be applied to about whatever shape of distribution. This metric is about readily understood by parents and professionals and is recommended every bit the preferred manner to describe how a child'due south score compares within a group of scores. For case, a Wechsler Intelligence Calibration for Children—Fourth Edition (WISC-Iv) Full Scale IQ score of 70 indicates that fewer than iii% of children of a like age score lower on that measure of intelligence; conversely, more than than 97% of children taking the test take a higher score.

The stanine is short for standard 9, and this metric divides a distribution into 9 parts. The mean = 5, and the SD = two, with the 3rd to seventh stanine being considered the boilerplate range. Approximately 20% of children score in the fifth stanine, 17% each in the fourth and sixth stanines, and 12% each in the third and seventh stanines (78% in total). Stanines are frequently encountered with group administered tests such as the Iowa Tests of Basic Skills, the Metropolitan Achievement Tests, or the Stanford Accomplishment Tests. The interrelatedness of these scores is depicted in Figure 7A-1.

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Attention Deficit Hyperactivity Disorder: Bear witness-Based Assessment and Handling for Children and Adolescents

Julie Sarno Owens , ... Samantha G. Margherio , in Reference Module in Neuroscience and Biobehavioral Psychology, 2020

Rating Scales

There are three primary types of rating scales to include in a diagnostic cess for ADHD: broadband rating scales, ADHD symptom scales, and impairment scales. Broadband rating scales provide an efficient method for screening for ADHD and possible comorbid weather, and ruling out other potential causes of the symptoms. Broadband measures are best thought of every bit screening tools due to their high sensitivity and depression specificity which can lead to over-identification. Results tin guide the selection of more specific symptom measures to follow. Specific to ADHD, subscales assessing hyperactivity, impulsivity, and inattention are of particular interest at the screening level.

Iii of the well-nigh commonly used and scientifically supported broadband measures are the Child Behavior Checklist (CBCL) and Teacher'due south Report Course (TRF; Achenbach and Rescorla, 2001) of the Achenbach System of Empirically Based Assessment (ASEBA); the Behavior Assessment System for Children, Tertiary Edition (BASC-three; Reynolds et al., 2015); and the Strengths and Difficulties Questionnaire (SDQ; Goodman, 2001). Each of these broadband scales discriminates well between children with and without ADHD (Goodman et al., 2003; Raiker et al., 2017; Rimvall et al., 2014; Zhou et al., 2018). Each measure out is available in parent-written report, teacher-written report, and self-written report for adolescents to assess youth across multiple ages (pre-school through adolescence). For data on the psychometric properties of broadband rating scales visit the Wikiversity page on Evidence-based Assessment of ADHD at https://w.wiki/LHD.

If data from the broadband measures reflect risk for ADHD, narrowband symptom rating scales should be used to evaluate symptom severity. The most commonly used narrowband rating scales for ADHD symptoms include the Conners Rating Scales ( Conners, 2008); Disruptive Behavior Disorder (DBD) rating scale (Pelham et al., 1992); the Vanderbilt Assessment Scales (Wolraich et al., 2003); the ADHD Rating Scale-five Dwelling and School Version (ARS-five; DuPaul et al., 2016a); and the Swanson, Nolan, and Pelham Rating Scale (SNAP; Swanson, 1992). Items on the ARS-5, DBD, and SNAP closely align with the eighteen DSM symptoms of ADHD assuasive assessors to direct evaluate diagnostic criteria; yet, the ARS-5 aligns with the most recent diagnostic criteria found in the DSM-5 and has the most current normative data. The Conners-3 and Vanderbilt include items related to both specific DSM symptoms and commonly associated deficits, such equally learning bug and executive performance concerns.

In because which measure to utilize, assessors should consider the specific goals of the assessment, likewise equally the efficiency of the measure out for that goal. These measures vary in their toll, the number of items and completion time, age ranges supported, and specific domains assessed. For example, although both the SNAP and VDARS are free and hands attainable, their psychometric properties have not been assessed for older adolescents and thus they would not exist the best choice for assessing high-school students. The ARS-v is ideal in many situations given its revised language to closely parallel DSM-5 symptoms, the inclusion of impairment items, and recent normative data for children in grades Thou through 12. Additionally, the ARS-five has a lower toll than the Conners-3, making it more accessible for some providers.

Given the necessity of symptom-related harm to meet diagnostic criteria, the assessment of ADHD should include an impairment rating scale. Global assessments (due east.g., Children'southward Global Assessment Scale; Shaffer et al., 1983) provide an overall estimate of functioning and harm, which offers efficiency in diagnostic conclusion making (Jensen et al., 2007). Still, they may not reveal specific domains of damage that warrant treatment (due east.g., social, academic). In contrast, multi-dimensional impairment rating calibration can reveal the extent to which symptoms interfere with academic operation, relationships with peers, parents, or teachers, or self-esteem to inform both diagnosis and treatment planning. Examples of multi-dimensional measures are the Competence and Adaptive subscales on the CBCL and TRF, the impairment related subscales on the BASC (e.one thousand., aggression and learning problems), and the supplemental touch on questions on the SDQ. Multi-dimensional measures focused specifically on ADHD-related damage include the Child and Adolescent Functional Assessment Scale (CAFAS; Hodges and Wong, 1996), the Impairment Rating Scale (IRS; Fabiano et al., 2006), the Weiss Functional Impairment Rating Scale (WFIRS; Weiss, 2000), the Barkley Functional Damage Scale: Children and Adolescents (BFIS-CA; Barkley, 2012), the impairment items on the ARS-five, and the Student Functioning Scale (SFS; DuPaul et al., 2019). In deciding which impairment measure to select, the assessor should consider their specific resources availability, prioritized impairment domains, and developmental level. For example, the SFS is a brief teacher-rated measure designed to overcome challenges to the assessment of schoolhouse functioning in high school students. Likewise, the WFIRS may be pertinent for utilize with adolescents considering information technology includes items specifically examining the presence of risky behaviors common in this age group.

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Developmental Disorders and Interventions

Joni Holmes , ... Darren L. Dunning , in Advances in Child Development and Behavior, 2010

Three Social and Behavioral Contour

Poor working memory is associated with relatively normal social integration, self-esteem, and emotional control. However, high levels of inattentive and distractible behavior accompany working retentivity problems and individuals with poor working memory have difficulties maintaining focused behavior in practical situations.

It is now widely recognized that the majority of problems in individuals with poor working retention are related to inattentive and distractible behaviors. Both children and adults with low retention experience difficulties in applied situations that require maintained and focused attention. Kane, Brown, McVay, Silvia, Myin-Germeys, & Kwapil, (2007) establish that typically developed adults with depression working memory spans were more likely to "zone out" when engaged in demanding ongoing activities than individuals with higher working retention spans. They asked individuals to rate their beliefs on several dimensions at eight random points during the mean solar day. Those with higher working memory spans were less probable to report instances of mind wandering and were able to maintain on chore thoughts better during challenging cerebral tasks than those with poor working memory.

Poor working memory part is also closely associated with inattentive behavior in children. In a nonclinical sample, Aronen and colleagues found children with low working memory performance were reported by teachers to have more bookish and attentional difficulties at schoolhouse than children with good working memory performance (Aronen, Vuontela, Steenari, Salmi, & Carlson, 2005). Similarly, children identified solely on the footing of poor working memory skills take high levels of inattentive and distractible behavior. Teachers frequently draw them as having short attention spans and rarely say that they take retention bug (Gathercole, Alloway, et al., 2006). Furthermore, when asked to rate behavior on ordinarily used checklists such as the Conner's Teacher Rating Scales (Conners, 1997), teachers typically estimate children with poor working memory to be highly inattentive with loftier levels of distractibility. Over 70% of children aged 5 or six years with low working retentiveness have markedly singular scores on the cognitive bug/inattention subscale of the Conner's checklist (75% reported in Alloway et al., 2009a, 2009b studies of 53 children; 79% reported in Gathercole, Alloway, et al.'s (2008) and Gathercole, Durling, et al.'south (2008) studies of 29 children). Figures for older children range from 58% (Alloway et al., 2009a, 2009b) to seventy% (Gathercole, Alloway, et al., 2008). Gathercole, Alloway, et al. (2008) found that the majority of elevated scores were largely due to high ratings on problem behaviors that relate to inattention and short attention spans. In stark contrast, they found that none of the children in a comparison grouping of twenty children with typical working memory had atypically loftier levels of inattentive behavior.

ADHD in babyhood is besides characterized by both working memory deficits and inattentiveness (Holmes, Gathercole, Alloway, et al., 2010; Klingberg et al., 2005; Martinussen & Tannock, 2006; McInnes et al., 2003; Willcutt, Doyle, et al., 2005; Willcutt, Pennington, et al., 2005). The co-occurrence of working retention and attentional problems in poor working memory and ADHD groups suggests at that place may be substantial overlap in the behavioral characteristics of the two groups. In a recent study, nosotros directly compared teacher beliefs ratings for 59 children with a diagnosis of ADHD and 27 children of the same age with low working memory (see Alloway, Gathercole, Holmes, Place, & Elliott, 2009). Teachers were asked to rate the extent to which a kid has shown problem behaviors in school over the by calendar month on the Conners' Teacher Rating Scale Revised Brusque-Form (Conners, 1997). Overall, teacher ratings of oppositional and hyperactive behaviors were significantly elevated in the ADHD group, while ratings of cognitive bug/inattention were elevated in both the ADHD and low working memory groups. As a consequence of high ratings on individual subscales, scores for both groups were also elevated on the ADHD index of the Conners' scale (Conners; see Effigy four). The inattentive symptoms observed in children with working memory deficits, which are also commonly associated with ADHD, about likely occur when overloaded working retention systems enable interference from irrelevant information to disrupt goal-directed behavior.

Fig. four. Behavioral profiles of children with ADHD and children with poor working memory, from Holmes et al. (2010).

Beyond attentional problems, children with low working memory are typically reserved in group discussions in the classroom, but integrate well with friends and peers in less formal situations outside of the classroom (Gathercole, Alloway, et al., 2008). Approachable and humorous children with poor working memory rarely volunteer information in the classroom or raise their hand to answer questions, mayhap because their poor memory skills make information technology hard for them to participate—teachers typically ask questions about contempo activities which they may be unable to reply because they have forgotten the relevant information (Gathercole, Alloway, et al., 2008).

Related to this, poor working memory part is not strongly associated with low self-esteem. Of 113 children with low memory ability, Alloway et al., 2009a, 2009b found that overall levels of self-esteem were either at the good or vulnerable levels (43% and 39% of the sample, respectively). Only 12% scored at the very depression stop of the scale, which is characterized by those who may exist depressed and need constant support and encouragement (Morris, 2002). This demonstrates that very few children with poor working retentiveness, who typically take poor bookish success, have depression self-esteem and is consistent with literature showing little clan between global self-esteem and academic functioning both in the general population (Baumeister, Campbell, Krueger, & Vohs, 2003; Marsh & Craven, 2006) and in those with learning difficulties (east.g., Snowling, Muter, & Carroll, 2007).

Emotional problems are non a hallmark characteristic of children with poor working memory, although studies that take examined instructor ratings written report that approximately 50% of children identified every bit having poor working memory are also perceived to have bug with emotional control and regulation. Alloway et al. reported that 38% of their sample of 113 children had levels of emotional command bug that reached clinical significance (Alloway et al., 2009a, 2009b). Likewise, Gathercole, Alloway, et al. (2008) reported that 45% of children aged five/half-dozen years with depression working memory and 48% of children aged 9/10 years with depression working memory obtained high ratings of trouble behaviors relating to emotional command. It is possible that the incidence of emotional problems associated with poor working retentiveness is a issue of the number of children with poor working retentivity who have other comorbid disorders, such as ADHD or oppositional defiance disorder, which are more ordinarily associated with emotional and behavioral difficulties. Consistent with this view, children with depression working memory have mildly elevated levels of oppositional and hyperactive behaviors in comparison to normative samples (Alloway et al. ), and there is substantial overlap betwixt the behavioral characteristics of children with low working memory and ADHD (due east.g., Alloway et al., 2009; Aronen et al., 2005; Lui & Tannock, 2007).

Teachers of children with poor working retentivity rate them as having problem behaviors relating to a range of executive functions. In detail, they experience problems in monitoring the quality of their work, in generating new solutions to bug, planning/organizing written piece of work, and big amounts of information, and in being proactive initiating new tasks (Alloway et al., 2009, 2009a, 2009b; Gathercole, Alloway, et al., 2008). As discussed earlier in this chapter, poor working memory may underpin this range of difficulties.

In summary, the primal behavioral difficulties observed in children with poor working memory relate to inattention. Teachers view them as highly inattentive and distractible and guess them to have problem behaviors related to poor executive functioning. These behaviors are near likely the consequence of memory overload during complex and challenging mental activities, although further research is needed to test the direction of causality between poor attention, executive function issues, and working memory difficulties. In terms of social profiles, children with poor working memory are typically socially integrated, although they can be reserved in large group situations.

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Attending deficit/hyperactivity disorder and methylphenidate

Marker D Rapport , Catherine Moffitt , in Clinical Psychology Review, 2002

ACRS=Abbreviated Conners Rating Scale; ACTRS=Abbreviated Conners Teacher Rating Calibration; ARS=ADHD Rating Scale; bid=twice daily; BL=baseline; CBCL=Child Behavior Checklist; CBCL TRF=Child Behavior Checklist Teacher Report Form; CMI=clomipramine; CPRS=Conners Parent Rating Scale; CPT=Continuous Performance Test; CTRS=Conners' Teachers' Rating Scale; DBP=diastolic BP; d/c=discontinued; DEX=dextroamphetamine; DICA-P=Diagnostic Interview for Children and Adolescents—Parent Version; DMI=desipramine; HR=heart rate; HSQ=Home Situations Questionnaire; K-SADS=Schedule for Affective Disorders and Schizophrenia for School-Age Children—Epidemiologic version; LD=learning disabled; MBD=minimal brain damage; MPH=methylphenidate; NFDC=no formal diagnostic criteria; NR=not reported; NS=not significant; O=other; P=parent report; PEM=pemoline; Ph=physical or physiological measurement; PICS=Parent Interview for Child Symptoms; PL=placebo; PPVT=Peabody Picture Vocabulary Test; RCMAS=Revised Children's Manifest Anxiety Calibration; RT=reaction time; SEs=side effects; SBP=systolic BP; SE/BMS=Side Effects Behavior Monitoring Scale; SEQ=Side Effects Questionnaire; SNAP=Swanson, Nolan, and Pelham Checklist; SR=self-report; SPPC=Cocky-Perception Profile for Children; Ss=subjects; T=teacher written report; UC-CCBS=University of California—Conners Child Behavior Scale; WRAT-R=Wide Range Achievement Exam—Revised; WWP=Werry–Weiss–Peters Activeness Rating Scale.

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