PubMed searches were performed in the days leading up to and including May 4, 2011. The objective of this review is to discuss approaches for measuring ADHD treatment outcomes in these 5 core conceptual areas. Although some of these concepts are poorly differentiated in the literature and current measurement approaches, we believe that each should be considered when assessing ADHD outcomes. 16, 17 These overlapping but distinct concepts each contribute to the real-life outcome of the patient. We recognize 5 core conceptual areas that are integral to assessing treatment outcomes in ADHD: (1) DSM-IV-TR ADHD behavioral symptoms (2) functional impairment in familial, social, emotional, academic, and occupational areas (3) quality of life (QOL) or the burden of illness on the daily lives of patients and their families (4) adaptive life skills (the development of strategies and skills to cope with problem behaviors) and (5) executive function (working memory, goal-directed activity, planning, organization, prioritizing, self-monitoring, and self-regulation). 15 There is a strong need to broaden outcome assessments to encompass a multidimensional array of outcomes in patients with ADHD. 14 Although behavioral symptoms show moderate correlation with functional impairments, assessment of symptom improvement alone may not adequately reflect changes in functional status. Because functional impairments are a primary impetus for seeking treatment, they may be the most appropriate targets for assessing treatment response. 13 Children are often referred for diagnosis and treatment because of poor academic performance, difficulty making friends, or low self-esteem (functional impairments) rather than because they cannot remain seated or they lose things or interrupt others (ADHD symptoms). Patients with ADHD are most often referred for treatment because of dysfunction in familial, social, emotional, academic, and occupational roles rather than because of ADHD symptoms.
Brown attention deficit disorder scales for adolescents manual#
7 – 10 However, assessment of treatment response in patients with ADHD has generally been limited to narrowly focused measures of ADHD symptoms as defined by the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision ( DSM-IV-TR), 11 with relatively little attention to other relevant outcome domains. Pharmacologic and behavioral therapy can be effective treatments for ADHD, 3 – 6 as reflected in ADHD treatment guidelines. ▪ Validated rating instruments are available to assess the effects of treatment in all of these domains.Īn estimated 9.5% of children aged 4 to 17 years 1 and 4.4% of adults 2 in the United States meet diagnostic criteria for attention-deficit/hyperactivity disorder (ADHD). ▪ A meaningful assessment of treatment effectiveness requires measures of functionality, quality of life, adaptive life skills, and executive function, as well as reductions of ADHD symptoms. ▪ Attention-deficit/hyperactivity disorder (ADHD) impacts multiple domains, beyond the characteristic symptoms of hyperactivity, impulsivity, and inattention. The authors recommend a potential battery and schedule of measures that could be used to more comprehensively assess treatment response in patients with ADHD.
Validated rating scales exist for assessing these additional domains, but there has been minimal research evaluating the sensitivity of these instruments for detecting treatment response in pediatric and adult samples.Ĭonclusions: Assessment of treatment outcomes in ADHD should move beyond symptom assessment to incorporate measures of functioning, quality of life, adaptive skills, and executive function, especially when assessing long-term treatment response.
Additional domains relevant for assessing treatment response among children and adults with ADHD include functional impairment, quality of life, adaptive life skills, and executive function. Results: The vast majority of studies assessing ADHD treatments have measured treatment response using ADHD symptom measures. Study Selection: Articles found through this search were then selected based on relevance to the topic area no specific quality criteria were applied. Objective: To review measures used to assess treatment response in patients with attention-deficit/hyperactivity disorder (ADHD) across the life span.ĭata Sources: Keyword searches of English-language articles in the PubMed database up to and including the May 4, 2011, index date were performed with the search strings (1) ( attention deficit disorder with hyperactivity OR ADHD) AND ( outcome assessment OR adaptation of life skills OR executive function ) and (2) ( attention deficit disorder with hyperactivity OR ADHD) AND ( function OR functioning OR quality of life ).