A novel school-based approach to screening for attention deficit hyperactivity disorder

TY - JOUR

T1 - A novel school-based approach to screening for attention deficit hyperactivity disorder

AU - Coghill, David

AU - Du, Yasong

AU - Jiang, Wenqing

AU - Xian, null

AU - Lu, Dali

AU - Qian, Yun

AU - Mulraney, Melissa

AU - Su, Linyang

N1 - Funding Information: Professor Coghill received funding as part of a research grant from Shire to support travel to China and accommodation whilst there. No other funding was received for study design, the collection, analysis, and interpretation of data, for the writing of the report or the decision to submit the article for publication. All researchers were fully independent from funders and had full access to all of the data. The researchers take responsibility for the integrity of the data and the accuracy of the data analysis. Publisher Copyright: © 2021, Springer-Verlag GmbH, DE part of Springer Nature.

PY - 2022/6

Y1 - 2022/6

N2 - Current approaches to screening for ADHD result in high rates of false positives. A proof of concept study to investigate the added benefits in the school-based detection of ADHD of adding a standardised teacher to teacher interview to traditional parent and teacher report questionnaires. A school-based study of diagnostic accuracy of ADHD using a novel 2-stage screening process. Participants were all 1026 pupils enrolled in grades 1 to 6 (ages 6-12 years) of a school in Hunan Province, China. The primary outcome was a diagnosis of ADHD on the Kiddie Schedule for Affective Disorders and Schizophrenia Present Lifetime version. 230 (22.4%) of the 1026 students screened positive at Stage 1 (parent and teacher questionnaires) (Sensitivity 0.86 [95% CI, 0.75 to 0.96], specificity 0.80 [95% CI, 0.78-0.83], false positive rate 0.20 (95% CI, 0.18 to 0.23), false negative rate was 0.14 (95% CI, 0.12 to 0.16). 65 remained screen-positive at the Stage 2 screen (teacher to teacher SNAP-IV interview). 36/65 (55.4%) of these Stage 2 screen positive participants and 1/144 (0.7%) of the screen negative subjects met DSM-IV criteria for ADHD (sensitivity 0.83 [95% CI, 0.71-0.95]; specificity of 0.97 [95% CI, 0.96-0.98]; false positive rate 0.03 [95% CI, 0.01 to 0.04], false negative rate 0.16 [95% CI, 0.15 to 0.19]. Adding teacher to teacher interviews to traditional questionnaire-based screening has the potential to improve the clinical utility of school-based screening for ADHD reducing the proportion of false positives, without a negative impact on sensitivity.

AB - Current approaches to screening for ADHD result in high rates of false positives. A proof of concept study to investigate the added benefits in the school-based detection of ADHD of adding a standardised teacher to teacher interview to traditional parent and teacher report questionnaires. A school-based study of diagnostic accuracy of ADHD using a novel 2-stage screening process. Participants were all 1026 pupils enrolled in grades 1 to 6 (ages 6-12 years) of a school in Hunan Province, China. The primary outcome was a diagnosis of ADHD on the Kiddie Schedule for Affective Disorders and Schizophrenia Present Lifetime version. 230 (22.4%) of the 1026 students screened positive at Stage 1 (parent and teacher questionnaires) (Sensitivity 0.86 [95% CI, 0.75 to 0.96], specificity 0.80 [95% CI, 0.78-0.83], false positive rate 0.20 (95% CI, 0.18 to 0.23), false negative rate was 0.14 (95% CI, 0.12 to 0.16). 65 remained screen-positive at the Stage 2 screen (teacher to teacher SNAP-IV interview). 36/65 (55.4%) of these Stage 2 screen positive participants and 1/144 (0.7%) of the screen negative subjects met DSM-IV criteria for ADHD (sensitivity 0.83 [95% CI, 0.71-0.95]; specificity of 0.97 [95% CI, 0.96-0.98]; false positive rate 0.03 [95% CI, 0.01 to 0.04], false negative rate 0.16 [95% CI, 0.15 to 0.19]. Adding teacher to teacher interviews to traditional questionnaire-based screening has the potential to improve the clinical utility of school-based screening for ADHD reducing the proportion of false positives, without a negative impact on sensitivity.

KW - ADHD

KW - Diagnosis

KW - Screening

KW - Sensitivity

KW - Specificity

UR - https://www.scopus.com/pages/publications/85099972043

U2 - 10.1007/s00787-021-01721-w

DO - 10.1007/s00787-021-01721-w

M3 - Article

C2 - 33515089

SN - 1018-8827

VL - 31

SP - 909

EP - 917

JO - European Child & Adolescent Psychiatry

JF - European Child & Adolescent Psychiatry

IS - 6

ER -