2011 › Trails



ADHD: When Parent and Teacher Ratings Don’t Agree: the TRAILS Study

Authors: Rettew DC, Van Oort FVA, Verhulst FC, Buitelaar JK, Ormel J, Hartman CA, Veenstra R, et al.

Objectives: A commonly encountered situation for evaluating clinicians is a history of significant problems in one setting with little or no difficulties in another. This study aims to describe this phenomenon and to examine its relations with other child and family characteristics. Method: A total of 1730 children (mean age 11.05 years) were studied from the first wave of the TRacking Adolescents Individual Lives Study (TRAILS), a large population-based study of Dutch youth. Parent and teacher ratings of aggression, rule breaking, inattention, and hyperactivity were obtained. Children were assigned to groups according to the presence of clinically relevant problems at home only, at school only, or in both settings. The rate of setting specific problems was calculated and comparisons between groups were made. Results: Setting specific, especially home specific, problems were quite common. Among children whom parents rated as having at least borderline-clinical problems, teachers reported clear or very clear behaviors at school at the following rates: aggression (22%), rule breaking (12.5%), inattention (55%), hyperactivity/impulsivity (33%). Compared to the school specific group, the home specific group contained a significantly higher percentage of girls with regard to inattention or hyperactivity and a significantly lower percentage of girls with regards to rule breaking. Logistic regression analyses revealed that home versus school specific problems were related to sex, child effortful control and parental stress. Conclusion: Externalizing problems are frequently encountered only in one setting between home and school and are related to sex, child effortful control, and parental stress.