Rating scales in attention-deficit/hyperactivity disorder: use in assessment and treatment monitoring.

Rating scales are valuable tools in both assessment and treatment monitoring. However, caution in their use is indicated because of several types of rater errors. Recent large-scale normative studies provide a set of instruments that cover child, adolescent, and adult ages, with separate gender norms and large representative samples. By including DSM-IV symptoms for ADHD in a proposed nationwide standardization of parent, teacher, and self-report scales, it is apparent that the proposed subtypes of ADHD are reasonable; however, item content in this standardization is somewhat broader than that proposed by DSM-IV. Empirical indexes were created and cross-validated, providing powerful discrimination between ADHD and non-ADHD samples. Separate scoring for the traditional DSM subtypes of ADHD allows both categorical and dimensional measures to be used in assessment and treatment monitoring.