Quantifying Potential Bias Resulting From Child Age on Screening for Hyperactive/Impulsive Presentations of ADHD

Area of Science:

• Pediatric Psychology
• Child Psychiatry
• Neurodevelopmental Disorders

Background:

• Attention Deficit-Hyperactivity Disorder (ADHD) is a common neurodevelopmental disorder in children.
• Screening tools for ADHD often use age-based percentiles to account for developmental changes.
• Potential age bias in screening requires careful evaluation to ensure accurate diagnosis.

Purpose of the Study:

• To investigate whether age-based percentiles enhance the screening accuracy for hyperactive/impulsive ADHD presentations in children aged 5 to 12.
• To compare the effectiveness of age-based versus overall percentiles in ADHD screening models.

Main Methods:

• A clinical sample of 307 children (ages 5-12) with behavioral concerns was assessed.
• The Vanderbilt Attention Deficit-Hyperactivity Disorder Diagnostic Parent Rating Scale (VADPRS) was administered.
• Logistic regression and receiver operating characteristic (ROC) curves were used to compare percentile methods.

Main Results:

• Age-based percentiles did not improve ADHD screening models for hyperactive presentations compared to overall percentiles.
• This lack of improvement was consistent across the entire sample and in a subgroup of 5- to 6-year-old children.
• No significant difference in screening performance was observed when incorporating age-specific data.

Conclusions:

• Age-based percentiles do not enhance the screening of hyperactive/impulsive ADHD in children aged 5 to 12.
• Current screening models using overall percentiles appear as effective as age-adjusted models for this population.
• Further research may explore other factors influencing ADHD screening accuracy in pediatric populations.