Preliminary Invention And The Reliability And Validity Analysis Of Symptoms And Functional Impairment Rating Scale For ADHD

Objectives:Based on current clinical needs, to invent a rating scale which preliminarily assess the symptoms and functional impairments in children with ADHD, and to test its psychometric characteristics. Methods:(1)Based on previous studies, to put forward the theory structure of the rating scale for children with ADHD, including two parts—clinical symptoms and functional impairment(Symptoms and Functional Impairment Rating Scale,SFIRS).(2) The preliminary item pool was built by literature review, patient interview and expert verification.(3) A preliminary expert questionnaire was established by investigation and item screening of SFIRS in pilot study.(4) To further modify, merge or delete items by Delphi method and then established the first draft of a 59-item-scale.(5) To test the reliability and validity of the draft scale in 412 ADHD patients and 322 typically development controls. The second draft scale was established by another round of item screening, exploratory factor analysis and confirmatory factor analysis. Forty-four items of the scale has formed a 6-factor structure. We have verified the scale criterion validity by correlation analysis, and also evaluated its internal consistency, test-retest reliability and its quality of response. Results:(1) The author has completed the preliminarily invention of the Symptoms and Functional Impairment Rating Scale for ADHD. This scale is suitable to be used on 6-12 years old school-aged children, it is a carer-rated scale, scored by Likert 5, including 44 items and 6 factors which include hyperactivity-impulsivity factor(8 items), self-control factor(4 items), inattention factor(9 items), self-management factor(7 items), academic performance factor(7 items) and social interaction factor(9 items) and these 6 factors were divided into two subscales:clinical symptom subscale and function impairment subscale.(2) The validity of SFIRS was satisfactory, the 6-factor model fitted well, each factor was significantly correlated with corresponding criterion(r=0.690-0.841).(3) The reliability of SFIRS was also satisfactory, for each factor the Cronbach’s α=0.822-0.937, full scale Cronbach’sα=0.976, the test-retest reliability after 6 weeks was 0.562-0.779 for each factor, total score r=0.816, P<0.01.(4) SFIRS was able to sensitively reflect the symptoms and functional changes of children with ADHD before and after medical treatment. The diagnostic sensitivity was 0.842, and specificity was 0.901 respectively. The scale could distinguish 70.7% of different clinical subtypes from children with ADHD, and demonstrated the the right classification of class rank in 53.8% children with ADHD. Conclusions:The Symptoms and Functional Impairment Rating Scale for ADHD can be used to effectively assess the symptoms and functional impairments for 6-12 years old children with ADHD, it had satisfactory reliability and validity, and was worthy to applicate clinically to further evaluate its ability of screening, diagnosis, treatment monitoring and prognosis prediction.