Do parental reports of child hyperkinetic disorder symptoms at school predict teacher ratings?

Clinical practice guidelines for the evaluation of children with suspected hyperkinetic disorder or ADHD recommend that information is collected from teachers. Using the development and well-being assessment, parents of 5-16 year olds participating in the 1999 and 2004 British Child and Adolescent Mental Health Surveys were asked about symptoms relating to hyperkinetic disorder and reports of teacher complaints about these symptoms. We examined whether parental reports about symptoms at school reflect teacher ratings and can be relied upon by clinicians. Parent reports about symptoms at school were moderately correlated with teacher ratings. If children potentially met criteria for hyperkinetic disorder based on parental ratings only, the positive predictive value (PPV) for a research diagnosis of hyperkinetic disorder was 47%. When parents reported high levels of symptoms at school in addition to sufficient parent-rated symptoms and impairment, the PPV for a diagnosis of hyperkinetic disorder increased to 59%. In a community sample, we found that parental reports about symptoms at school have limited utility in predicting teacher ratings. Our findings highlight that it is desirable and worthwhile for clinicians to obtain direct information from the teacher. If this is unavailable, clinicians and researchers should be aware that "second-hand" information about symptoms at school is second best.