Conners' Rating Scales-Revised
Developed by C. Keith Conners, Ph.D., the Conners' Rating Scales-Revised (CRS-R) are paper and pencil screening questionnaires designed to be completed by parents and teachers to assist in evaluating children for attention-deficit/hyperactivity disorder (ADHD).
The CSR-R is used as part of a comprehensive examination and are designed to be easily administered and scored. Both the long and short versions are tools to assist in determining whether children between the ages of three and 17 years might suffer from ADHD.
Those who administer the CRS-R should have a good understanding of psychological testing and its limitations. Although the CRS-R can be readily administered and scored by a nonprofessional, the ultimate responsibility for interpretation lies with a seasoned professional. As with all psychological evaluation instruments, the CRS-R is not perfect. One runs the risk of obtaining false positives (incorrectly diagnosing the disorder) or false negatives (failing to identify the disorder). Therefore, the information obtained from completed forms should not be used in isolation. It should be one piece of a complex evaluation that includes a clinical interview with the child, other diagnostic measures such as a computerized continuous performance test, and patient self-report—for those old enough and with sufficient reading ability to do so.
Previous versions of the Conners' scales were criticized by those claiming disparity between results obtained in different ethnic groups. The most recent version should dispel this concern, since they were "normed" using data from more than 8,000 subjects crossing all cultural and ethnic boundaries. The technical manual for CRS-R even contains separate normative information for specific ethnic groups. However, when age and sex are taken into account there were either no differences or insignificant differences. Statistically, a difference of two or three T-score points would be insignificant.
The CRS-Rs are available in long and short versions for both parents and teachers. The long version for parents contains 80 items while the long version for teachers contains 59 items. The parents' short version contains 27 items and the teachers' short version has 28. The forms are multi-paged, and numbers circled on the front or back page are automatically transferred to a middle section for use by the clinician. The clinician transfers the circled scores into appropriate scales on the middle form and totals each scale at the bottom of the page. The parent version contains scales A through N. The teacher version is similar but lacks scale G (psychosomatic) contained on the parent version.
After transferring the raw scores to the various scales and totaling them, the total of each scale (A–N) is transferred to another form designed to portray the results graphically. The clinician must be careful to transpose the raw scores to the correct age group column within each major scale. For example, column 1 is used for ages three to five, column 2 for ages six to eight, column 3 for ages nine to 11, etc. Each of these column scores can then be converted to a T-score. T-scores are standardized scores with a mean of 50 and a standard deviation of 10. These can be further converted to percentile scores as needed.
As a rule, T-scores above 60 are cause for concern and have interpretive value. Interpretable scores range from a low T-score of 61 (mildly atypical) to above 70 (markedly atypical). However, again, this information should not be used in isolation to make a diagnosis .
Conners' Rating Scales-Revised Technical Manual. North Tonawanda, New York: Multi Health Systems, 2000.
Center for Mental Health Services. Office of Consumer, Family, and Public Information, 5600 Fishers Lane, Room 15-105 Rockville, MD 20857. (301) 443-2792.
Children and Adults with Attention Deficit Disorders (CH.A.D.D.). 499 NW 70th Avenue, Suite 109, Plantation, FL 33317. (305) 587-3700. (800) 233-4050 <www.chadd.org> .
Jack H. Booth, Psy.D.