Usefulness of parent-child observation in assessment for attention deficit/hyperactivity disorder among children

Research indicates that the most effective means to assess for Attention Deficit Hyperactivity Disorder (ADHD) in children is a multi-method, multi-rater system. Classroom observations and behavior rating scales are routinely used in the assessment for ADHD. Research has demonstrated frequent discrepancies between parent and teacher ratings of a child's behavior. It is unclear if these differences are due to rater bias and/or situational differences. School observations can be used as a source of information on child behavior in the classroom and compared to teacher ratings. However, standard ADHD assessment batteries generally do not include a second source of information to compare against parent ratings.; The present study examined the usefulness of parent-child observation in assessment for ADHD. Clinic-referred children were observed during a 25-minute structured parent-child observation in a lab setting designed to simulate typical situations in the home. Child behavior during the analog home situation observation (AHSO) was compared to parent and teacher ratings on a behavior rating scale and child behavior during a school observation.; Convergent validity for the AHSO was found with parent and teacher ratings of conduct problems and aggression. Minimal correspondence was found between parent and teacher ratings of problems with hyperactivity and attention and AHSO composite scores. However, teacher ratings of inattention and hyperactivity were significantly associated with child behavior during the school observation. Overall, teacher ratings tended to correlate more strongly with child behavior in the school setting versus parent ratings compared with child behavior during the AHSO. Group differences were found for school observation total and AHSO adaptive composite score such that ADHD children displayed less adaptive/cooperative behaviors as compared to a no-ADHD group. Results provide minimal support for parent-child observation in assessment for ADHD, but suggest that this type of observation may be helpful in assessing for Oppositional Defiant Disorder.