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Development of a Very Brief Measure of ADHD: The CHAOS Scale
Jess D Levy1, William G Kronenberger1, David W Dunn1
11 Indiana University School of Medicine, Indianapolis, IN, USA.
Insights
The CHAOS scale is a brief, reliable tool for assessing Attention-Deficit/Hyperactivity Disorder (ADHD) symptoms in clinical settings. It effectively measures attention problems, hyperactivity-impulsivity, oppositional behavior, and conduct problems.
Area of Science:
- Child and Adolescent Psychiatry
- Behavioral Psychology
- Clinical Psychology
Background:
- ADHD rating scales can be lengthy and difficult to use in busy clinical environments.
- There is a need for brief, user-friendly behavioral checklists for ADHD assessment.
Purpose of the Study:
- To develop a concise and practical behavior checklist for evaluating Attention-Deficit/Hyperactivity Disorder (ADHD) symptoms.
- To create a tool that addresses limitations of existing ADHD rating scales in clinical practice.
Main Methods:
- The Conduct-Hyperactive-Attention Problem-Oppositional Symptom (CHAOS) scale items were derived from DSM-IV criteria by expert clinicians.
- Principal Components Analysis (PCA) was used to create subscales from data of 205 clinically referred children.
- Reliability and validity were assessed in a separate sample of 139 children.
Main Results:
- PCA identified four subscales: Attention Problems, Hyperactivity-Impulsivity, Oppositional Behavior, and Conduct Problems.
- The CHAOS scale demonstrated moderate to high test-retest and interrater reliability.
- Subscale scores showed significant correlations with a DSM-referenced behavior checklist and executive functioning tests.
Conclusions:
- The CHAOS scale is a brief, psychometrically sound instrument.
- It is suitable for the evaluation and monitoring of ADHD symptoms in clinical settings.
Objective:
We sought to develop a brief, easy to use behavior checklist to address common limitations in the use of ADHD rating scales in busy clinical settings.
Method:
Items for the CHAOS ( Conduct- Hyperactive- Attention Problem- Oppositional Symptom) scale were developed based on the ratings of Diagnostic and Statistical Manual of Mental Disorders (4th ed.; DSM-IV) criteria provided by experienced clinicians. The scale was administered to mothers of 205 clinically referred children for the purpose of subscale creation based on principal components analysis (PCA). Reliability and validity were analyzed using a separate sample of 139 children referred for psychological testing.
Results:
PCA resulted in four subscales (Attention Problems, Hyperactivity-Impulsivity, Oppositional Behavior, and Conduct Problems), which demonstrated moderate to high test-retest and interrater reliability. Subscale scores correlated significantly with subscales from a DSM-referenced behavior checklist, along with tests of executive functioning.
Conclusion:
These data suggest that the CHAOS scale is a brief, psychometrically sound tool for evaluation and monitoring of ADHD symptoms.
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