A preview of this full-text is provided by SAGE Publications Inc.
Content available from Journal of Attention Disorders
This content is subject to copyright.
10.1177/1087054705278762Journal of Attention Disorders / November 2005Handler, DuPaul / Assessment of ADHD
Assessment of ADHD: Differences Across
Psychology Specialty Areas
Marcie W. Handler
The May Institute
George J. DuPaul
Lehigh University
Child psychologists are frequently involved in the assessment of ADHD symptoms among school-aged youth. There is limited
information regarding the extent to which psychologists adhere to recommended assessment practices and whether differ-
ences exist in assessment strategies among psychologists from different specialty areas (clinical, counseling, and school) and/
or who practice in different settings (university, school, or outpatient clinic). A 3 (specialty area) ×3 (employment setting)
between-groups design is used wherein 230 child psychologists completed surveys regarding diagnostic practice. Psycholo-
gists differ in adherence with Diagnostic and Statistical Manual of Mental Disorders (4th ed., text revision) diagnostic criteria,
use of clinical interviews, and type of behavior observation.Only 15% of psychologists report using multiple methods consis-
tent with recommended standards of best practice. Differences between groups of psychologists indicate that the diagnosis of
ADHD in children is influenced by the type of psychologist conducting the evaluation and the setting in which the evaluation is
conducted. (J. of Att. Dis. 2005;9(2), 402-412)
Keywords: assessment of ADHD; diagnosis of ADHD; psychology specialty area
ADHD entails persistent problems with inattention,
impulsivity, and hyperactivity that are inconsistent
with one’s developmental level and result in clinically
significant impairment across at least two settings (Amer-
ican Psychiatric Association, 2000). Given that ADHD is
a relatively common behavior disorder, children may be
referred to many different types of psychologists (e.g.,
clinical, counseling, or school psychologists) and physi-
cians (e.g., pediatricians, family practitioners, or psychia-
trists). To diagnose a child with ADHD, Diagnostic and
Statistical Manual of Mental Disorders (4th ed., text revi-
sion; DSM-IV-TR; American Psychiatric Association,
2000) criteria requires that a clinician determine not only
the presence of symptoms but also their severity relative
to same-aged peers, chronicity, pervasiveness, age of
onset, and the degree of impairment that results from the
symptoms.
Psychologists, psychiatrists, and pediatricians agree
that “best practice” when assessing ADHD symptoms in
children occurs when a clinician uses a multimethod
approach across multiple sources and settings to obtain
information about symptom presence, pervasiveness,
chronicity, and impairment as outlined by standardized
diagnostic criteria (i.e., DSM-IV-TR; American Academy
of Pediatrics, 2000; Dulcan & Benson, 1997; Goldman,
Genel, Bezman, & Slanetz, 1998; Hoff, Doepke, & Lan-
dau, 2002). Typically, recommended assessment methods
include clinical interviews with the parent, teacher, and
child; standardized behavior rating scales completed by
the parent and teacher; review of school information; and
clinical observations of the child’s behavior (when possi-
ble, in the classroom and in less structured situations;
Barkley, 1998; Dulcan & Benson, 1997; DuPaul &
Stoner, 2003; Hoff et al., 2002; Zentall & Javorsky, 1996).
Despite ongoing discussions about best practice, the
National Institutes of Health (NIH) Consensus Develop-
ment Panel concluded that “there is a wide variation
among types of practitioners with respect to frequency of
diagnosis of AD/HD” (NIH, 1998, p. 9). Thus, given the
growing number of children being diagnosed with
ADHD, researchers have become interested in examining
402
Journal of Attention Disorders
Volume 9 Number 2
November 2005 402-412
© 2005 Sage Publications
10.1177/1087054705278762
http://jad.sagepub.com
hosted at
http://online.sagepub.com
Address correspondence to George J. DuPaul, Lehigh University, 111
Research Drive, Bethlehem, PA 18015; gjd3@lehigh.edu