Leviton Alan, Hunter Scott J, Scott Megan N, Hooper Stephen R, Joseph Robert M, O'Shea Thomas Michael, Allred Elizabeth N, Kuban Karl
Boston Children's Hospital, Harvard Medical School, Boston, MA, USA.
The University of Chicago Medicine Comer Children's Hospital, Chicago, IL, USA.
Acta Paediatr. 2017 Aug;106(8):1317-1322. doi: 10.1111/apa.13869. Epub 2017 May 11.
A DSM-5 diagnosis of attention deficit/hyperactive disorder (ADHD) requires that symptoms be present in two settings. We wanted to see how teachers and parents compare on their assessments.
We evaluated how well Child Symptom Inventory-4 (CSI-4) reports from 871 parents and 634 teachers of 10-year-old children born before the 28th week of gestation provided information about indicators of school dysfunction.
Kappa values for parent and teacher agreement of any ADHD were at best fair to poor (<0.41). Nevertheless, ADHD identified by each alone provided a moderate amount of information about such indicators of school dysfunction as grade repetition. Only occasionally did agreement provide more information than provided by only one reporter. Mother's social class and intelligence level did not discriminate between parents who did and did not agree with the teacher.
ADHD identified by a single observer can provide appreciable information about a range of the child's functions needed for success in school and, therefore, should not be discounted when another observer does not consider the child to have ADHD symptoms.
《精神疾病诊断与统计手册》第五版（DSM - 5）中注意力缺陷/多动障碍（ADHD）的诊断要求症状需在两种环境中出现。我们想了解教师和家长在评估方面的比较情况。
我们评估了来自871名10岁儿童（孕28周前出生）的家长和634名教师的儿童症状量表 - 4（CSI - 4）报告，这些报告提供了关于学校功能障碍指标的信息。
家长和教师对任何ADHD的一致性kappa值充其量为中等至较差（<0.41）。然而，单独由家长或教师识别出的ADHD能提供一定量关于学校功能障碍指标（如留级）的信息。只有偶尔情况下，双方一致认可所提供的信息比仅有一方报告者提供的更多。母亲的社会阶层和智力水平并不能区分与教师意见一致和不一致的家长。
单一观察者识别出的ADHD能提供有关孩子在学校取得成功所需的一系列功能的可观信息，因此，当另一位观察者认为孩子没有ADHD症状时，不应忽视这一诊断结果。
