Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH 45229-3039, USA.
Pediatrics. 2010 Nov;126(5):e1033-8. doi: 10.1542/peds.2010-1267. Epub 2010 Oct 11.
The goal was to examine the clinical utility of using the Vanderbilt Attention-Deficit/Hyperactivity Disorder (ADHD) Rating Scale (VARS) to determine when to refer children with ADHD for learning disorder (LD) evaluations.
A total of 128 stimulant-naive children with ADHD, 7 to 11 years of age, were included in the study. The parents and teachers of 128 children with diagnosed ADHD completed the VARS. The reading, numerical operations, and spelling subtests from the Wechsler Individual Achievement Test, Second Edition, were used to identify children with a comorbid LD. We examined the predictive validity and clinical utility of the VARS performance items for ruling in/out the presence of a comorbid LD.
Thirty-eight percent of the samples met the criteria for a comorbid LD. A cutoff score of 7.5 for the sum of the VARS parent and teacher reading items had excellent clinical utility for ruling out both reading and spelling LDs. Cutoff scores of 4 for the VARS teacher reading and writing items had excellent utility for ruling out comorbid reading and spelling LDs, respectively. None of the VARS performance items effectively identified or ruled out math LDs.
The VARS performance items should be used with an interview about school functioning and a review of school records to rule out the presence of a comorbid reading or spelling LD for children with diagnosed ADHD.
旨在考察使用范德比尔特注意力缺陷多动障碍(ADHD)评定量表(VARS)来确定何时转介 ADHD 儿童进行学习障碍(LD)评估的临床实用性。
本研究共纳入 128 名初次接受兴奋剂治疗的 ADHD 儿童,年龄 7 至 11 岁。128 名 ADHD 儿童的家长和教师完成了 VARS。采用韦氏个体成就测验第二版的阅读、数字运算和拼写子测验来识别合并 LD 的儿童。我们检查了 VARS 表现项目的预测效度和临床实用性,以排除/存在合并 LD 的可能性。
38%的样本符合合并 LD 的标准。VARS 父母和教师阅读项目总分 7.5 的截断值对于排除阅读和拼写 LD 具有极好的临床实用性。VARS 教师阅读和写作项目的截断值为 4 对于分别排除阅读和拼写 LD 具有极好的实用性。VARS 表现项目均无法有效识别或排除数学 LD。
对于诊断为 ADHD 的儿童,应结合关于学校功能的访谈和学校记录的审查,使用 VARS 表现项目来排除合并的阅读或拼写 LD 的存在。