- Email: [email protected]
Rating Scales, Questionnaires, and Behavior Checklists
CHAPTER 1
Rating Scales, Questionnaires, and Behavior Checklists First some comments about using screening tools, rating scales, behavioral checklists, etc. THEY ARE NOT DIAGNOSTIC OF ANY SPECIFIC CONDITION. They are used as preliminary instruments to gather information that may indicate a potential diagnosis or diagnoses that then need to be confirmed by obtaining more information, perhaps by using a more specific tool for a specific condition, by collecting more data, e.g., school information, by conducting a one-on-one interview with the patient, etc. In a clinical setting, e.g., a yearly physical examination (PE) for an adolescent, one might use a behavioral checklist, such as the Guidelines for Adolescent Preventive Services (GAPS), that has a lot of questions regarding safety, high-risk behavior, school and social well-being, etc., which then help the clinician to focus on areas where interventions seem indicated. If mental health concerns are suggested, then one might follow up with another tool mentioned later, the Pediatric Symptom Checklist (PSC). This tool further focuses on emotional and attentional concerns, in the areas of internalizing (anxiety, depression) feelings, externalizing (behavioral) issues, and attention (school progress). The results might then serve as a prompt to further narrow down the concerns by using more specific tools described later: Screen for Child Anxiety Disorders (SCARED, anxiety), Patient Health Questionnaire (PHQ)-9 (depression), and Vanderbilt (academic). These tools take only a few minutes to complete, can be scored easily by the office staff, and can be optimally obtained prior to the appointment, or while in the waiting room prior to being seen by the clinician. They are immense TIMESAVERS in the evaluation process, and although not totally diagnostic in themselves, they contribute greatly to the diagnostic process. Obviously if the stated reason for the appointment is a specific issue, such as rule out (R/O) depression or R/O ADHD, then the clinician might choose to go directly to the specific screening tool, along with appropriate history and physical examination.
PEARL: Rating scales are by and large billable, e.g., Vanderbilt, SCARED, PHQ-9, PSC. Behavior checklists are usually considered to be extensions of the history component of the evaluation and are not billable, e.g., Modified Overt Aggression Scale (MOAS), GAPS. PEARL: Most pediatricians in practice are quite familiar and adept at using the Vanderbilt questionnaires for assessing ADHD. This chapter will describe other screening tools that, although not completely diagnostic of certain mental health conditions such as anxiety and depression, are very important to use in the assessment of such conditions. So if the clinician is going to diagnose and/or treat complex ADHD, which basically means the assessment for all the potential coexistent conditions, such as anxiety, depression, aggression, and possible bipolar disorder, he or she must become knowledgeable about and must be able to use other rating scales in addition to the Vanderbilt or Connor scale (that is what this book is all about.). These tools are described fully in this chapter and are also essentially all available free online, unless noted otherwise.
RATING SCALES AND BEHAVIORAL CHECKLISTS A. Behavioral checklists 1). GAPS • Free, available through the American Medical Association (GAPS-HSR form) • A questionnaire, not a “rating scale” per se • For adolescents, aged 11e21 years • Contains 72 questions for teens regarding risk behaviors such as drinking, smoking, sex, drugs, and car safety (based on the four most frequent causes of death in teensdmotor vehicle accidents, other accidents, suicide, and homicide) • Used by the clinician for the “Identification and Treatment of Risk Behaviors” 1
2
ADHD Complex • Has two forms: younger adolescent and older adolescent • Can be completed easily by an adolescent within a few minutes in the waiting room prior to the appointment • Mnemonics are useful to categorize discussion topics, e.g., SAFE TEENS
S A F E
Sexuality Anxiety Firearms, homicide Suicide, depression
T E E N S
Toxins, tobacco, accidents, abuse Environment (school, home) Exercise Nutrition Shots (immunizations, school)
• Should be used at least annually during annual PE, sports PE, or any other visit 2). PSC-17 • New version (older version had 35 questions) • Parent version (for children/adolescents aged 4e16 years) • Youth version (ages 11e18 years) • Useful for screening for psychosocial issues in primary care • Although it is scored, it is not a definitive diagnostic tool • Rather, it “suggests areas that need more evaluation” • Measures three domains Externalizing Internalizing Attention • Available free online, www.massgeneral. org/psychiatry/services/psc_forms.aspx • Most useful in a general pediatric setting as a preliminary tool if a concern arises regarding mood disorder, behavioral problems, or ADHD issues • If suggestive of concerns in those areas follow up with more specific rating scales (e.g., Vanderbilt, SCARED, PHQ-9) as well as a one-on-one interview (recommended) B. Broadband rating scales Broadband rating scales are lengthy questionnaires (e.g., 100 or more questions) that score responses/information regarding several domains of the child’s life. On the positive side, they screen for many problems/concerns. On the negative side, they obviously screen more superficially and thus should never be used as a definitive diagnostic tool.
Nonetheless, they can be very helpful as an initial screen. Two widely used broadband rating scales are discussed in the following. They are both proprietary and, therefore, not available for free online like other screening tools. 1) Child Behavior Checklist • Also called the “Achenbach” after its developer; proprietary, not free • Contains about 120 questions and covers ages 6e13 years • Has parent, teacher, and child forms • Also has a preschool form, for ages 18 months to 5 years • Covers/screens for symptoms suggesting ADHD, oppositional defiant disorder, conduct disorder, depression, anxiety, phobias, and others • Also develops scores for aggressive behavior and internalizing and externalizing problems • Scores are reported as normal, borderline, or the clinical behavior • Used most often by clinical psychologists and school psychologists, not often by clinicians, but we need to be familiar with it because it will be seen in school reports • Any concerns that are noted should be followed up by more specific screening and interviews to make a definitive diagnosis 2). Behavior Assessment System for Children (Edition 2) • Proprietary, not free • Used commonly by school and clinical psychologists, child psychiatrists • Has teacher [teacher rating scale (TRS)], parent [parent rating scale (PRS)], and child/self [self-rating scale (SRS)] versions • Covers ages from 2 to 25 years • Used commonly prior to a clinical interview to focus on specific areas • Scores conditions such as hyperactivity, aggression, atypicality, withdrawal, and attention • Schools seem to use this instrument, as very often screening is being done for ADHD • Disadvantage: The self-report does not screen for specific emotional disorders, substance abuse, and alcohol abuse
CHAPTER 1
Rating Scales, Questionnaires, and Behavior Checklists
• Any concerns that surface on this screening tool should be followed up by more specific screening tools as well as by a clinical interview • Available at www.BASC-2Summary-basc2.szopkiw.com C. Specific rating scales Following are the specific rating scales designed to screen for and quantitate specific diagnoses or concerns, e.g., ADHD, anxiety, depression, aggression, and mania. However, it should be reiterated that RATING SCALES DO NOT MAKE A DEFINITIVE DIAGNOSIS. They suggest specific diagnoses that must be confirmed by more information, clinical interviews, etc. 1). Vanderbilt ADHD Diagnostic Rating Scales • Free; available online at https:// soonersuccess.ouhsc.edu/ • Measures ADHD cardinal symptoms (inattention, hyperactivity, and impulsivity) • Has parent and teacher versions • Includes questions to measure “functional impairment” as well (at school, home, etc.) • Parent version screens (briefly) for oppositional defiant disorder, conduct disorder, anxiety, and depression • Teacher version also screens for mood disorders and anxiety symptoms, as well as behavioral issues • Follow-up Vanderbilt forms (briefer) are helpful for monitoring the control of ADHD core symptoms as well as impairment, even though they do not screen for coexisting conditions but only for the ADHD symptoms and impairment. For this reason, some clinicians continue to use the larger Vanderbilt questionnaire as a follow-up form as well. PEARL: Based on a study from Cincinnati the Vanderbilt is also a good screening tool for learning disabilities. Langberg JM, Vaughn AJ, Brinkman WB, Froehlich T, and Epstein JN. Learning Disorders: Clinical Utility of the Vanderbilt ADHD Rating Scale for Ruling Out Comorbid Learning Disabilities. Pediatrics 126(5):e1033e8, 2010. 2). PHQ-9 (modified for teens): Depression • Available free online (American Academy of Pediatrics (AAP): www.brightfutures.org) • Useful for the diagnosis of depression as well as for monitoring symptoms over time
3
• Not diagnostic in itselfdneeds to be confirmed with clinical symptoms and interviews • Questions are all self-reported, and hence the need to be verified by clinical interviews and observation • Has excellent validity Sensitivity, 88% Specificity, 88% • The scores below indicate the likelihood of a diagnosis of Major Depression 0e4, No evidence 5e9, Minimal evidence 10e14, Minor depression 15e19, Moderately severe depression >20, Severe depression 3). SCARED • Available free online, www.pediatricbipolar. pitt.edu or www.dbp2doc.org • Has child and parent versions • Has good reliability and validity • Sensitive to treatment response (therefore excellent for serial monitoring) • Used for children aged 8e18 years • Can be scored by hand or automatically • Also measures subtypes of anxiety, e.g., separation, social phobia, panic, school phobia • Most experts feel the subtypes overlap too much in children, or merge with time, so that discrimination of subtypes is not that valid or helpful 4). MOAS • Available free online, www.cappcny.org/ home/documents • Rates four types of aggressive behavior: verbal, property, autoaggression (to self), and physical • Used by clinicians to assess degree/type of aggressive behavior • Also used by clinicians to track/monitor aggressive behavior, e.g., monitor response to treatment • Has good reliability and validity 5). The Young Mania Rating Scale (Dr. Young was the developer) • Has parent and teacher forms • 11-Item, multiple-choice questionnaire • Helpful in diagnosis of bipolar disorder in children/adolescents but has high falsepositive rate • High scores suggest “risk” of bipolar disorder
4
ADHD Complex Scores 0e60 >13 suggests “potential mania” >21 suggests “probable mania” • Can also be used to monitor “response to management” • Available free online 6). The Modified Nisonger Child Behavior Rating Form (NCBRF) • Originally designed for assessing behavior in children with intellectual disability, autism, etc. • Now, new edition, NCBRFeTIQ is available for assessing behavior in children/ adolescents with “typical development” • Assesses for conduct problems, oppositional, hyperactive, inattentive, withdrawn, dysphoric, and overly sensitive • Has teacher and parent versions • For ages 3e16 years • More suitable to follow behavior serially, e.g., response to interventions, rather than as a diagnostic tool • Available free Contact: The Nisonger Center Dr. Aman Ohio State University Columbus, OH 43210-1296, United States [email protected] 7). CRAFFT (substance abuse) • For adolescents aged <21 years • Often used along with the GAPS questionnaire • Has six questions; screens for high-risk drug and alcohol usage/abuse • Short and effective tool • Questions are asked by clinician using exact wording in the questionnaire C. Have you ever ridden in a CAR driven by someone, including yourself, who was “high” or had been using alcohol or drugs? R. Do you ever use alcohol or drugs to RELAX, feel better about yourself, or fit in? A. Do you ever use alcohol/drugs while you are by yourself ALONE? F. Do you ever FORGET things you did while using alcohol or drugs? F. Do your family or FRIENDS ever tell you that you should cut down on your drinking or drug use?
T. Have you gotten into TROUBLE while you were using alcohol or drugs? • Free; available at AAP www.brightfutures. org and [email protected] 8). Adult ADHD Self-Report Scale • 18-Question self-report • Has two parts A. Inattentive traits B. Hyperactive/impulsive traits • Score 0e16, ADHD unlikely 17e23, ADHD likely 24 or more, ADHD highly likely • Also assesses presence of functional impairment (e.g., home life, job, social) • Needs to be correlated with patient’s history, PE, and evidence of other mental health issues (e.g., anxiety, depression) that may “mimic” ADHD or be a coexisting problem PEARL: This questionnaire can be used to explore possible ADHD in a parent of the child/adolescent patient with ADHD (statistically w50% of parents of children with ADHD had/have ADHD). It would be very helpful to diagnose and treat him/her, if needed. PEARL: The ADHD remaining symptom traits may be subthreshold, but impairment and fallout from earlier ADHD might be major (anxiety/depression, substance abuse, etc.) • Available free at https://med.nyu.edu/ psych/adhd-self-assessment-tools-andinformation 9). Adolescent ADHD self-report (Ages 12e 18 Years): Available online (not free), www. drthomasebrown.com/assessment-tools. 10). Edinburgh Postnatal Depression Scale: Use this tool to screen for postnatal depression. Available free online at www.brightfutures. org. Reference for website screening tool and rating scale: http://www.heardalliance.org/wp-content/uploads/2011/ 04/Mental-Health-Assessment.pdf Following is a questionnaire for parents with academic and/or behavioral concerns about their child. Used by permission from Allegro Pediatrics, Bellevue, WA, United States. (May be reprinted for personal clinical use as long as the name of the clinic [Allegro Pediatrics, Bellevue, WA, United States] and the name of the author [Harlan R. Gephart, MD] are acknowledged.)
CHAPTER 1
Rating Scales, Questionnaires, and Behavior Checklists
5
6
ADHD Complex
CHAPTER 1
Rating Scales, Questionnaires, and Behavior Checklists
7
Rating Scales, Questionnaires, and Behavior Checklists First some comments about using screening tools, rating scales, behavioral checklists, etc. THEY ARE NOT DIAGNOSTIC OF ANY SPECIFIC CONDITION. They are used as preliminary instruments to gather information that may indicate a potential diagnosis or diagnoses that then need to be confirmed by obtaining more information, perhaps by using a more specific tool for a specific condition, by collecting more data, e.g., school information, by conducting a one-on-one interview with the patient, etc. In a clinical setting, e.g., a yearly physical examination (PE) for an adolescent, one might use a behavioral checklist, such as the Guidelines for Adolescent Preventive Services (GAPS), that has a lot of questions regarding safety, high-risk behavior, school and social well-being, etc., which then help the clinician to focus on areas where interventions seem indicated. If mental health concerns are suggested, then one might follow up with another tool mentioned later, the Pediatric Symptom Checklist (PSC). This tool further focuses on emotional and attentional concerns, in the areas of internalizing (anxiety, depression) feelings, externalizing (behavioral) issues, and attention (school progress). The results might then serve as a prompt to further narrow down the concerns by using more specific tools described later: Screen for Child Anxiety Disorders (SCARED, anxiety), Patient Health Questionnaire (PHQ)-9 (depression), and Vanderbilt (academic). These tools take only a few minutes to complete, can be scored easily by the office staff, and can be optimally obtained prior to the appointment, or while in the waiting room prior to being seen by the clinician. They are immense TIMESAVERS in the evaluation process, and although not totally diagnostic in themselves, they contribute greatly to the diagnostic process. Obviously if the stated reason for the appointment is a specific issue, such as rule out (R/O) depression or R/O ADHD, then the clinician might choose to go directly to the specific screening tool, along with appropriate history and physical examination.
PEARL: Rating scales are by and large billable, e.g., Vanderbilt, SCARED, PHQ-9, PSC. Behavior checklists are usually considered to be extensions of the history component of the evaluation and are not billable, e.g., Modified Overt Aggression Scale (MOAS), GAPS. PEARL: Most pediatricians in practice are quite familiar and adept at using the Vanderbilt questionnaires for assessing ADHD. This chapter will describe other screening tools that, although not completely diagnostic of certain mental health conditions such as anxiety and depression, are very important to use in the assessment of such conditions. So if the clinician is going to diagnose and/or treat complex ADHD, which basically means the assessment for all the potential coexistent conditions, such as anxiety, depression, aggression, and possible bipolar disorder, he or she must become knowledgeable about and must be able to use other rating scales in addition to the Vanderbilt or Connor scale (that is what this book is all about.). These tools are described fully in this chapter and are also essentially all available free online, unless noted otherwise.
RATING SCALES AND BEHAVIORAL CHECKLISTS A. Behavioral checklists 1). GAPS • Free, available through the American Medical Association (GAPS-HSR form) • A questionnaire, not a “rating scale” per se • For adolescents, aged 11e21 years • Contains 72 questions for teens regarding risk behaviors such as drinking, smoking, sex, drugs, and car safety (based on the four most frequent causes of death in teensdmotor vehicle accidents, other accidents, suicide, and homicide) • Used by the clinician for the “Identification and Treatment of Risk Behaviors” 1
2
ADHD Complex • Has two forms: younger adolescent and older adolescent • Can be completed easily by an adolescent within a few minutes in the waiting room prior to the appointment • Mnemonics are useful to categorize discussion topics, e.g., SAFE TEENS
S A F E
Sexuality Anxiety Firearms, homicide Suicide, depression
T E E N S
Toxins, tobacco, accidents, abuse Environment (school, home) Exercise Nutrition Shots (immunizations, school)
• Should be used at least annually during annual PE, sports PE, or any other visit 2). PSC-17 • New version (older version had 35 questions) • Parent version (for children/adolescents aged 4e16 years) • Youth version (ages 11e18 years) • Useful for screening for psychosocial issues in primary care • Although it is scored, it is not a definitive diagnostic tool • Rather, it “suggests areas that need more evaluation” • Measures three domains Externalizing Internalizing Attention • Available free online, www.massgeneral. org/psychiatry/services/psc_forms.aspx • Most useful in a general pediatric setting as a preliminary tool if a concern arises regarding mood disorder, behavioral problems, or ADHD issues • If suggestive of concerns in those areas follow up with more specific rating scales (e.g., Vanderbilt, SCARED, PHQ-9) as well as a one-on-one interview (recommended) B. Broadband rating scales Broadband rating scales are lengthy questionnaires (e.g., 100 or more questions) that score responses/information regarding several domains of the child’s life. On the positive side, they screen for many problems/concerns. On the negative side, they obviously screen more superficially and thus should never be used as a definitive diagnostic tool.
Nonetheless, they can be very helpful as an initial screen. Two widely used broadband rating scales are discussed in the following. They are both proprietary and, therefore, not available for free online like other screening tools. 1) Child Behavior Checklist • Also called the “Achenbach” after its developer; proprietary, not free • Contains about 120 questions and covers ages 6e13 years • Has parent, teacher, and child forms • Also has a preschool form, for ages 18 months to 5 years • Covers/screens for symptoms suggesting ADHD, oppositional defiant disorder, conduct disorder, depression, anxiety, phobias, and others • Also develops scores for aggressive behavior and internalizing and externalizing problems • Scores are reported as normal, borderline, or the clinical behavior • Used most often by clinical psychologists and school psychologists, not often by clinicians, but we need to be familiar with it because it will be seen in school reports • Any concerns that are noted should be followed up by more specific screening and interviews to make a definitive diagnosis 2). Behavior Assessment System for Children (Edition 2) • Proprietary, not free • Used commonly by school and clinical psychologists, child psychiatrists • Has teacher [teacher rating scale (TRS)], parent [parent rating scale (PRS)], and child/self [self-rating scale (SRS)] versions • Covers ages from 2 to 25 years • Used commonly prior to a clinical interview to focus on specific areas • Scores conditions such as hyperactivity, aggression, atypicality, withdrawal, and attention • Schools seem to use this instrument, as very often screening is being done for ADHD • Disadvantage: The self-report does not screen for specific emotional disorders, substance abuse, and alcohol abuse
CHAPTER 1
Rating Scales, Questionnaires, and Behavior Checklists
• Any concerns that surface on this screening tool should be followed up by more specific screening tools as well as by a clinical interview • Available at www.BASC-2Summary-basc2.szopkiw.com C. Specific rating scales Following are the specific rating scales designed to screen for and quantitate specific diagnoses or concerns, e.g., ADHD, anxiety, depression, aggression, and mania. However, it should be reiterated that RATING SCALES DO NOT MAKE A DEFINITIVE DIAGNOSIS. They suggest specific diagnoses that must be confirmed by more information, clinical interviews, etc. 1). Vanderbilt ADHD Diagnostic Rating Scales • Free; available online at https:// soonersuccess.ouhsc.edu/ • Measures ADHD cardinal symptoms (inattention, hyperactivity, and impulsivity) • Has parent and teacher versions • Includes questions to measure “functional impairment” as well (at school, home, etc.) • Parent version screens (briefly) for oppositional defiant disorder, conduct disorder, anxiety, and depression • Teacher version also screens for mood disorders and anxiety symptoms, as well as behavioral issues • Follow-up Vanderbilt forms (briefer) are helpful for monitoring the control of ADHD core symptoms as well as impairment, even though they do not screen for coexisting conditions but only for the ADHD symptoms and impairment. For this reason, some clinicians continue to use the larger Vanderbilt questionnaire as a follow-up form as well. PEARL: Based on a study from Cincinnati the Vanderbilt is also a good screening tool for learning disabilities. Langberg JM, Vaughn AJ, Brinkman WB, Froehlich T, and Epstein JN. Learning Disorders: Clinical Utility of the Vanderbilt ADHD Rating Scale for Ruling Out Comorbid Learning Disabilities. Pediatrics 126(5):e1033e8, 2010. 2). PHQ-9 (modified for teens): Depression • Available free online (American Academy of Pediatrics (AAP): www.brightfutures.org) • Useful for the diagnosis of depression as well as for monitoring symptoms over time
3
• Not diagnostic in itselfdneeds to be confirmed with clinical symptoms and interviews • Questions are all self-reported, and hence the need to be verified by clinical interviews and observation • Has excellent validity Sensitivity, 88% Specificity, 88% • The scores below indicate the likelihood of a diagnosis of Major Depression 0e4, No evidence 5e9, Minimal evidence 10e14, Minor depression 15e19, Moderately severe depression >20, Severe depression 3). SCARED • Available free online, www.pediatricbipolar. pitt.edu or www.dbp2doc.org • Has child and parent versions • Has good reliability and validity • Sensitive to treatment response (therefore excellent for serial monitoring) • Used for children aged 8e18 years • Can be scored by hand or automatically • Also measures subtypes of anxiety, e.g., separation, social phobia, panic, school phobia • Most experts feel the subtypes overlap too much in children, or merge with time, so that discrimination of subtypes is not that valid or helpful 4). MOAS • Available free online, www.cappcny.org/ home/documents • Rates four types of aggressive behavior: verbal, property, autoaggression (to self), and physical • Used by clinicians to assess degree/type of aggressive behavior • Also used by clinicians to track/monitor aggressive behavior, e.g., monitor response to treatment • Has good reliability and validity 5). The Young Mania Rating Scale (Dr. Young was the developer) • Has parent and teacher forms • 11-Item, multiple-choice questionnaire • Helpful in diagnosis of bipolar disorder in children/adolescents but has high falsepositive rate • High scores suggest “risk” of bipolar disorder
4
ADHD Complex Scores 0e60 >13 suggests “potential mania” >21 suggests “probable mania” • Can also be used to monitor “response to management” • Available free online 6). The Modified Nisonger Child Behavior Rating Form (NCBRF) • Originally designed for assessing behavior in children with intellectual disability, autism, etc. • Now, new edition, NCBRFeTIQ is available for assessing behavior in children/ adolescents with “typical development” • Assesses for conduct problems, oppositional, hyperactive, inattentive, withdrawn, dysphoric, and overly sensitive • Has teacher and parent versions • For ages 3e16 years • More suitable to follow behavior serially, e.g., response to interventions, rather than as a diagnostic tool • Available free Contact: The Nisonger Center Dr. Aman Ohio State University Columbus, OH 43210-1296, United States [email protected] 7). CRAFFT (substance abuse) • For adolescents aged <21 years • Often used along with the GAPS questionnaire • Has six questions; screens for high-risk drug and alcohol usage/abuse • Short and effective tool • Questions are asked by clinician using exact wording in the questionnaire C. Have you ever ridden in a CAR driven by someone, including yourself, who was “high” or had been using alcohol or drugs? R. Do you ever use alcohol or drugs to RELAX, feel better about yourself, or fit in? A. Do you ever use alcohol/drugs while you are by yourself ALONE? F. Do you ever FORGET things you did while using alcohol or drugs? F. Do your family or FRIENDS ever tell you that you should cut down on your drinking or drug use?
T. Have you gotten into TROUBLE while you were using alcohol or drugs? • Free; available at AAP www.brightfutures. org and [email protected] 8). Adult ADHD Self-Report Scale • 18-Question self-report • Has two parts A. Inattentive traits B. Hyperactive/impulsive traits • Score 0e16, ADHD unlikely 17e23, ADHD likely 24 or more, ADHD highly likely • Also assesses presence of functional impairment (e.g., home life, job, social) • Needs to be correlated with patient’s history, PE, and evidence of other mental health issues (e.g., anxiety, depression) that may “mimic” ADHD or be a coexisting problem PEARL: This questionnaire can be used to explore possible ADHD in a parent of the child/adolescent patient with ADHD (statistically w50% of parents of children with ADHD had/have ADHD). It would be very helpful to diagnose and treat him/her, if needed. PEARL: The ADHD remaining symptom traits may be subthreshold, but impairment and fallout from earlier ADHD might be major (anxiety/depression, substance abuse, etc.) • Available free at https://med.nyu.edu/ psych/adhd-self-assessment-tools-andinformation 9). Adolescent ADHD self-report (Ages 12e 18 Years): Available online (not free), www. drthomasebrown.com/assessment-tools. 10). Edinburgh Postnatal Depression Scale: Use this tool to screen for postnatal depression. Available free online at www.brightfutures. org. Reference for website screening tool and rating scale: http://www.heardalliance.org/wp-content/uploads/2011/ 04/Mental-Health-Assessment.pdf Following is a questionnaire for parents with academic and/or behavioral concerns about their child. Used by permission from Allegro Pediatrics, Bellevue, WA, United States. (May be reprinted for personal clinical use as long as the name of the clinic [Allegro Pediatrics, Bellevue, WA, United States] and the name of the author [Harlan R. Gephart, MD] are acknowledged.)
CHAPTER 1
Rating Scales, Questionnaires, and Behavior Checklists
5
6
ADHD Complex
CHAPTER 1
Rating Scales, Questionnaires, and Behavior Checklists
7