Parent versus teacher ratings of attention-deficit/hyperactivity disorder symptoms in the preschoolers with attention-deficit/hyperactivity disorder treatment study (PATS)

Objective. To assess parent-teacher concordance on ratings of DSM-IV symptoms of attention-deficit/ hyperactivity disorder (ADHD) in a sample of preschool children referred for an ADHD treatment study. Methods. Parent and teacher symptom ratings were compared for 452 children aged 3-5 years. Agreement was calculated using Pearson correlations, Cohen's kappa, and conditional probabilities. Results. The correlations between parent and teacher ratings were low for both Inattentive (r = .24) and Hyperactive-Impulsive (r = .26) symptom domains, with individual symptoms ranging from .01-.28. Kappa values for specific symptoms were even lower. Conditional probabilities suggest that teachers are only moderately likely to agree with parents on the presence or abscence of symptoms. Parents were quite likely to agree with teachers' endorsement of symptoms, but much less likely to agree when teachers indicated that a symptom was not present. Conclusions. Results provide important data regarding base rates and concordance rates in this age group and support the hypothesis that preschool-aged children at risk for ADHD exhibit significant differences in behavior patterns across settings. Obtaining ratings from multiple informants is therefore considered critical for obtaining a full picture of young children's functioning.