Accuracy of Achenbach Scales in the Screening of Attention-Deficit/Hyperactivity Disorder in a Community Mental Health Clinic

Joseph S. Raiker, Andrew J. Freeman, Guillermo Perez-Algorta, Thomas W. Frazier, Robert L. Findling, Eric A. Youngstrom

Research output: Contribution to journalArticlepeer-review


Objective To use receiver-operating characteristics analysis to identify multilevel diagnostic likelihood ratios and provide a framework for the diagnosis of attention-deficit/hyperactivity disorder (ADHD) in children (5–10 years old) and adolescents (11–18 years old) in an outpatient setting. Method Caregiver, teacher, and youth reports from the Achenbach System of Empirically Based Assessment (ASEBA) were obtained for 299 children and 321 adolescents with multiple imputation of missing data. The reference standard was diagnosis of ADHD based on case history and a semistructured diagnostic interview masked to the ASEBA measurements. Results In children, caregiver-reported Attention Problems (area under the curve [AUC] = 0.74) outperformed all other subscales of the caregiver and teacher measures (AUCs ≤ 0.72). In the older sample, caregiver- and teacher-reported Attention Problems (caregiver AUC = 0.73; teacher AUC = 0.61) were best at identifying ADHD. Inclusion of caregiver and teacher reports significantly (p < .001 for all comparisons) increased prediction of ADHD diagnosis, whereas youth self-report did not. Conclusion Caregiver-reported Attention Problems were more useful than teacher-reports and self-report in identifying ADHD. Combining caregiver and teacher reports improved identification. Multilevel likelihood ratios are provided to facilitate routine clinical use.

Original languageEnglish (US)
Pages (from-to)401-409
Number of pages9
JournalJournal of the American Academy of Child and Adolescent Psychiatry
Issue number5
StatePublished - May 2017


  • attention-deficit/hyperactivity disorder
  • likelihood ratios
  • receiver-operating characteristics curve
  • sensitivity and specificity

ASJC Scopus subject areas

  • Developmental and Educational Psychology
  • Psychiatry and Mental health

Fingerprint Dive into the research topics of 'Accuracy of Achenbach Scales in the Screening of Attention-Deficit/Hyperactivity Disorder in a Community Mental Health Clinic'. Together they form a unique fingerprint.

Cite this