Deb S, Dhaliwal A-J, Roy M
University of Birmingham Medical School, Birmingham, UK.
J Intellect Disabil Res. 2008 Nov;52(11):950-65. doi: 10.1111/j.1365-2788.2007.01035.x. Epub 2008 Jan 2.
Symptoms of Attention Deficit Hyperactivity Disorder (ADHD) are believed to be common in children with intellectual disabilities (ID). Conners' Rating Scales are widely used for screening ADHD among children who do not have ID, but little is known about their usefulness among children with ID.
To find cut-off scores for the Conners' Parent Rating Scales-Revised (CPRS-R) and the Conners' Teacher Rating Scale-Revised (CTRS-R) that will give optimum levels of sensitivity and specificity for screening for ADHD among children with ID and borderline intelligence.
Receiver operating characteristic analysis was used to compare a clinical diagnosis of ADHD according to the Diagnostic and Statistical Manual 4th revision-Text Review criteria with scores according to the CPRS-R and the CTRS-R.
Among children with ID, a CPRS-R total score of 42 provided a sensitivity of 0.9 and a specificity of 0.67 with an area under the curve of 0.84. Similarly, a CTRS-R total score of 40 provided a sensitivity of 0.69 and a specificity of 0.67 with an area under the curve of 0.71. There was poor concordance between the CPRS-R and the CTRS-R total scores (Intraclass Correlation; ICC = 0.17). There were statistically significant differences in the total score of the CPRS-R and most of its sub-scores between children with ID with and without ADHD. The CTRS-R total score and its sub-scores did not show any statistically significant difference between two groups. Factor analysis showed three clinically distinct factors for both the CPRS-R and the CTRS-R items, although the CPRS-R factors were better and had less item overlap than the CTRS-R factors.
The CPRS-R scores may distinguish between children with ID with and without ADHD but not the CTRS-R scores. Many items in the CPRS-R and the CTRS-R are not applicable to children with severe and profound ID who do not have speech. The CPRS-R and the CTRS-R scores did not correlate with each other. There is a need to develop an ADHD screening instrument specifically for children with ID.
注意力缺陷多动障碍（ADHD）症状在智力障碍（ID）儿童中普遍存在。康纳斯评定量表广泛用于筛查非智力障碍儿童中的ADHD，但对于其在智力障碍儿童中的效用知之甚少。
寻找康纳斯父母评定量表修订版（CPRS-R）和康纳斯教师评定量表修订版（CTRS-R）的临界分数，以便为筛查智力障碍和边缘智力儿童中的ADHD提供最佳水平的敏感性和特异性。
采用接受者操作特征分析，将根据《精神疾病诊断与统计手册》第4版文本修订标准得出的ADHD临床诊断与CPRS-R和CTRS-R的分数进行比较。
在智力障碍儿童中，CPRS-R总分42时，敏感性为0.9，特异性为0.67，曲线下面积为0.84。同样，CTRS-R总分40时，敏感性为0.69，特异性为0.67，曲线下面积为0.71。CPRS-R和CTRS-R总分之间的一致性较差（组内相关系数；ICC = 0.17）。有ADHD和无ADHD的智力障碍儿童在CPRS-R总分及其大部分子分数上存在统计学显著差异。CTRS-R总分及其子分数在两组之间未显示出任何统计学显著差异。因子分析表明，CPRS-R和CTRS-R项目均有三个临床上不同的因子，尽管CPRS-R的因子更好，项目重叠比CTRS-R的因子少。
CPRS-R分数可区分有和无ADHD的智力障碍儿童，但CTRS-R分数不能。CPRS-R和CTRS-R中的许多项目不适用于无言语能力的重度和极重度智力障碍儿童。CPRS-R和CTRS-R分数彼此不相关。需要专门为智力障碍儿童开发一种ADHD筛查工具。
