Standardized ADHD rating scales can streamline diagnosis

With input from a variety of populations, diagnosis can be made rapidly and accurately.


Clinical Rating Scale

Clinical rating scales can enhance ADHD assessments

With firsthand observation becoming more limited, standardized ADHD rating scales and self-report checklists can help streamline diagnosis and treatment. Several rating scales also encourage input from teachers and caregivers—supporting the multimodal approach endorsed in current ADHD guidelines.1



Rating Scale

ADHD Rating Scale-5 (ADHD-RS-5)4

An 18-item scale for use by parents and teachers, which takes approximately 5 minutes to complete. The ADHD-RS-5 was recently modified to include more information on 6 important functional domains. Three symptom scores (Inattention, Hyperactivity/Impulsivity, and Total) are derived from each version.

Domains/subscales measured

  • Relationships with significant others—family members for the home version and teachers for the school version
  • Peer relationships
  • Academic functioning
  • Behavioral functioning (eg, impairment due to disruptive behavior)
  • Homework functioning
  • Self-esteem

Rating Scale

Conners Rating Scales2,5

A group of short scales (<30 questions) for use by parents, teachers, and adolescents (self-reporting).

Domains/subscales measured

  • Oppositional problems
  • Cognitive problems
  • Hyperactivity

Rating Scale

Weiss Functional Impairment Rating Scale—Parent Form (WFIRS-P)6

A 50-item scale completed by parents or caregivers, who rate impairment across a number of domains clinically relevant to ADHD.

Domains/subscales measured

  • Family
  • School and learning
  • Child’s self-concept
  • Social activities

Key Takeaways

  • Clinical scales promote standardized assessment, enhancing efficacy
  • The use of scales encourages participation by patients as well as caregivers
  • ADHD rating scales can provide a rapid view across multiple functional domains

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  1. Subcommittee on Attention-Deficit/Hyperactivity Disorder, Steering Committee on Quality Improvement Management, Wolraich M, et al. Clinical practice guideline for the diagnosis, evaluation, and treatment of attention-deficit/hyperactivity disorder in children and adolescents. Pediatrics. 2019;144(4):e20192528.
  2. Children and Adults with Attention-Deficit/Hyperactivity Disorder (CHADD). Which ADHD rating scales should primary care physicians use? CHADD website. Accessed March 31, 2020.
  3. Children and Adults with Attention-Deficit/Hyperactivity Disorder (CHADD). Clinical practice tools. CHADD website. Accessed March 31, 2020.
  4. Faries D, Yalcin D, Harder, HeiligensteinJ. Validation of the ADHD Rating Scale as a clinician administered and scored instrument. J Attention Discord. 2001;(5):107-115.
  5. Conners K. Conners Comprehensive Behavior Rating Scales. Accessed February 28, 2018.
  6. Thompson T, Lloyd A, Joseph A, Weiss M. The Weiss Functional Impairment Rating Scale-Parent Form for assessing ADHD: evaluating diagnostic accuracy and determining optimal thresholds using ROC analysis. Qual Life Res. 2017;26(7):1879-1885.