Interpretive Report

Copyright 2002, Multi-Health Systems Inc. All rights reserved.P.O. Box 950, North Tonawanda, NY 14120-09503770 Victoria Park Ave., Toronto, ON M2H 3M6

By C. Keith Conners, Ph.D.Conners' Parent Rating ScalesRevised: Long (CPRSR:L)

LesleyText BoxPsychological Assessments AustraliaPO Box 27, Jannali NSW 2226Ph (02) 9589 0011 Fax: (02) 9589 0063E: infopaa@psychassessments.com.auwww.psychassessments.com.au

IntroductionConners' Parent Rating ScalesRevised: Long (CPRSR:L) is an assessment tool that prompts a child'sparent to provide valuable information about the child's behavior. This instrument is helpful when adiagnosis of ADHD (or related problems) is being considered. The normative sample includes 2,482parents. This report provides information about the child's score, how he compares to other children,and what subscales are elevated. See the Conners' Rating ScalesRevised Technical Manual(published by MHS) for more information about the instrument. This computerized report is an interpretive aid and should not be used as the sole basis for clinicaldiagnosis or intervention. This report works best when combined with other sources of relevantinformation.CPRSR:L T-ScoresThe following graph provides John's T-scores for each of the CPRSR:L subscales.

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Summary of Subscale ScoresThe following table summarizes the results of the parent's assessment of John and provides generalinformation about how he compares to the normative group. More interpretive data are provided later inthis report.

Guideline Common Characteristics ofHigh ScorersT-ScoreRawScoreSubscaleMildly Atypical(Possible significantproblem)

Break rules, problems withauthority, easily annoyed.6112Oppositional

Moderately Atypical(Indicates asignificant problem)Learn slowly, organizationalproblems, difficulty completingtasks, concentrationproblems.

6619Cognitive Problems/Inattention

Markedly Atypical(Indicates asignificant problem)Have difficulty sitting still,cannot stay on task, restless,impulsive.

7720Hyperactivity

Average (Typicalscore: Should notraise concern)Have worries and/or fears,emotional, sensitive tocriticism, shy, withdrawn.

473Anxious-Shy

Average (Typicalscore: Should notraise concern)Set high goals, fastidious,obsessive.514Perfectionism

Average (Typicalscore: Should notraise concern)Have few friends, lowself-esteem andself-confidence, feelemotionally distant frompeers.

501Social Problems

Slightly Atypical (Lowscores are good: Nota concern)Report an unusual amount ofaches and pains.440Psychosomatic

Markedly Atypical(Indicates asignificant problem)Identifies children/adolescents'at risk' for ADHD.7327ADHD Index

Markedly Atypical(Indicates asignificant problem)Restless, impulsive,inattentive.7917CGI: Restless-Impulsive

Markedly Atypical(Indicates asignificant problem)Emotional, cry a lot, get angryeasily.777CGI: Emotional Lability

Markedly Atypical(Indicates asignificant problem)Hyperactive, broad rangedbehavior problems.8124CGI: Total

Moderately Atypical(Indicates asignificant problem)Correspondence with theDSM-IV diagnostic criteria forInattentive type ADHD.

6616 2DSM-IV: Inattentive Symptom Count (max of 9)

Markedly Atypical(Indicates asignificant problem)Correspondence with theDSM-IV diagnostic criteria forHyperactive-Impulsive typeADHD.

7419 2DSM-IV: Hyperactive-Impulsive Symptom Count (max of 9)

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Guideline Common Characteristics ofHigh ScorersT-ScoreRawScoreSubscaleMarkedly Atypical(Indicates asignificant problem)

Correspondence to DSM-IVcriteria for combined typeADHD.7435 4

DSM-IV: Total Symptom Count (max of 18)

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Response Key0 = Not true at all (Never, Seldom)1 = Just a little true (Occasionally)2 = Pretty much true (Often, Quite a Bit)3 = Very much true (Very Often, Very Frequent)

Item ResponsesThe following response values were entered for the items on CPRSR:L. The pie graph shows thedistribution of responses.

DSM-IV Subscales: Elevated ResponsesThe following graph shows the number of items for which the parent answered Very Much True ("3") orPretty Much True ("2"). The answers are grouped by DSM-IV subscale. The DSM-IV subscales areinterpreted in more detail later in this report.

If the findings presented here conflict with other sources of information, then the reasons for theconflicting information should be considered, and the results described in this report should beinterpreted with those reasons in mind. It is possible, however, that the parent is either exaggerating ordenying problems which may exist. It is also possible that behavior and attitudes at home may be quitedifferent than behavior and attitudes away from home (e.g., at school). An examination of the individual item responses reveals some possible inconsistencies. Quite differentresponses were given to items with similar content. If possible, discrepancies in the responses to itemsshould be discussed with the parent. Some items may have been misunderstood, or perhaps the parentwas unwilling or unable to give a clear picture of the child/adolescent's behavior and attitudes.

Validity Assessment

The scores on both the ADHD Index and the Conners' Global Index are notably elevated. The ADHDIndex consists of the single best set of items for differentiating children/adolescents with attentionproblems from those without attention problems. This initial indicator suggests possible ADHD. The factthat the Conners' Global Index is also elevated lends further support for the presence of an attentionproblem, and also suggests that there may be other problems as well as attention problems, or that theattention problems are affecting other aspects of functioning.

Analysis of the Index Scores

There are a substantial number of subscale elevations. These elevations relate to a number of differentareas of behavior suggesting comorbidity. Because the profile is indicative of pervasive problems andthe profile shows fairly global elevations, it is often called a Type G (for "Global") Profile. More specificinformation about the areas that are elevated can be obtained from examining the subscale descriptionsgiven below.

General Examination of the Profile

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Markedly elevated. This index consists of the best set of CPRSR items for identifyingchildren/adolescents "at risk" for ADHD. John's score on this index is markedly elevated indicatingpossible ADHD. This finding should be combined with other information to corroborate theappropriateness of a diagnosis of ADHD.

ADHD Index: T-Score = 73Examination of Subscale Scores

Markedly elevated. John's score on this index is markedly elevated, indicating general problematicbehavior. Although high scores may be associated with hyperactivity, often the problems are broader innature and difficulties exist with a number of different aspects of behavior.

Conners' Global Index Total: T-Score = 81

Markedly elevated. John's score on the Restless-Impulsive subcomponent of the index is considerablyelevated, indicating potentially serious problems with restlessness, impulsivity, and inattentiveness.Conners' Global Index Restless-Impulsive: T-Score = 79

Markedly elevated. John's score on the Emotional Lability subcomponent of the index is notably high,indicating an individual who is very prone to emotional responses/behaviors like crying, anger, etc.Conners' Global Index Emotional Lability: T-Score = 77

Mildly elevated. Elevated scores on this subscale indicate an individual with a tendency to break rules,and to have problems with persons in authority. This individual may be more easily annoyed andangered than others his age.

Oppositional: T-Score = 61

Moderately elevated. High scorers on this subscale tend to learn more slowly than most individuals theirage. John may have problems organizing his work, completing tasks on schoolwork, or concentratingon tasks that require sustained mental effort. A number of items on this subscale relate toinattentiveness.

Cognitive Problems/Inattention: T-Score = 66

Markedly elevated. Based on the parent's responses, this subscale score indicates that John hasdifficulty sitting still or remaining at the same task for very long. John is probably more restless andimpulsive than most individuals his age, and he probably has the need to be always "on the go".

Hyperactivity: T-Score = 77

About average. The score on the Anxious-Shy subscale is about average. According to the parent'sresponses, John is fairly typical in terms of worries and fears, and is not overly shy or withdrawn.Anxious-Shy: T-Score = 47

About average. The score on the Perfectionism subscale is about average. According to the parent'sresponses, John probably sets and keeps fairly realistic goals. He can strive to achieve and accomplishthings without becoming overly obsessive.

Perfectionism: T-Score = 51

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About average. The score on the Social Problems subscale is about average. The parent feels thatJohn's ability to make and keep friends is about typical compared to other individuals his age. Johnprobably has adequate self-confidence and probably fits in well with his peers.

Social Problems: T-Score = 50

Better than average. The Psychosomatic score indicates that John does not report physical symptoms(e.g., aches and pains) unless they have an identifiable physical cause. Psychosomatic behavior is notan issue for this individual.

Psychosomatic: T-Score = 44

The parent's responses indicate that six or more symptoms of the Inattentive subtype of ADHD may bepresent. The stringent requirement is that at least 6 items be rated "Very Much True" before suggestinga possible DSM-IV diagnosis. However, if you combine the fact that 2 of 9 items are rated "Very MuchTrue" with the observation that 4 of 9 items are rated "Pretty Much True", there does seem to besufficient reason to explore the possibility that this youth meets the DSM-IV criteria for the Inattentivesubtype of ADHD.

DSM-IV: Inattentive: T-Score = 66

The parent's responses indicate that six or more symptoms of the Hyperactive-Impulsive subtype ofADHD may be present. The stringent requirement is that at least 6 items be rated "Very Much True"before suggesting a possible DSM-IV diagnosis. However, if you combine the fact that 2 of 9 items arerated "Very Much True" with the observation that 6 of 9 items are rated "Pretty Much True", there doesseem to be sufficient reason to explore the possibility that this individual meets the DSM-IV criteria forthe Hyperactive-Impulsive subtype of ADHD.

DSM-IV: Hyperactive-Impulsive: T-Score = 74

Based on the parent's responses there is moderate, although not substantial, evidence for a diagnosisof both the Hyperactive-Impulsive subtype ADHD and Inattentive subtype ADHD. In addition, thepossibility of Combined type ADHD should be considered.

DSM-IV: Total (Combined Type ADHD): T-Score = 74

Integrating Results with Other InformationThe following subscale scores are elevated and could be cause for concern. Oppositional Cognitive Problems/Inattention Hyperactivity ADHD Index CGI: Restless-Impulsive CGI: Emotional Lability CGI: Total DSM-IV: Inattentive DSM-IV: Hyperactive-Impulsive DSM-IV: Total These results must be incorporated with other information before drawing any conclusions. It is recommended that a comprehensive evaluation include A history of the pregnancy, delivery, and developmental milestones from infancy; A family history of psychiatric disorders; Assessment of specific symptoms, including severity, frequency, situational specificity, and duration; An educational assessment that covers both academic functioning and classroom behavior; An overview of the individual's intrapsychic processes, including self-image and sense of efficacy

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with family, peers, and school; Child and family interaction patterns and family structure; An assessment of neurological status, when related problems are indicated by other evidence. CPRS-R:L results interpreted without considering these other factors may have limited validity. Considering InterventionThere are a large number of possible treatment approaches, and the choice of which treatment is most appropriate can vary from case to case. The intervention should be individualized, and the goals/targets of each intervention should be clearly specified. All of the following types of intervention should be considered. Parent-Based InterventionInvolves educating parents about the disorder or concern (e.g., ADHD), and teaching parents behavior management skills so that they can reduce negative behavior in their children and promote adaptive functioning. School-Based InterventionThis can involve both academic and behavioral intervention. Child-Based InterventionThe child is taught to monitor, evaluate, and reinforce himself with respect to target behaviors. Pharmacologic InterventionMedication is often effective (with ADHD) but should only be used after careful consideration of the child's particular symptomatology. The choice of drug, dosage, and potential side effects must be considered. In many cases, these and other intervention approaches can be used in combination with each other to produce the optimal results.

End of ReportDate Printed: Thursday, December 30, 2004

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