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Evaluating the Hyperactivity/Inattention Subscale of the National Longitudinal Survey of Children and Youth
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by Alice Charach, Elizabeth Lin and Teresa To
Abstract
Keywords
Findings
Authors
What is already known on this subject?
What does this study add?
Abstract
Background
High scores on the National Longitudinal Survey of Children and Youth Hyperactivity/Inattention Subscale (NLSCY H/I Scale) have been used to indicate severe inattention and overactivity representing Attention Deficit/Hyperactivity Disorder (ADHD) symptoms. However, a threshold on the scale has not been identified for use as an epidemiological marker for clinically significant disorder.
Data and methods
The NLSCY H/I Scale is evaluated in a subsample of the cycle 1 NLSCY population (n=10,498), weighted to represent 2.36 million children aged 6 to 11 in 1994/1995. Logistic regression measured the association of scores on the scale against three potential criteria, adjusting for age, sex and socio-economic status: 1) current methylphenidate use, 2) diagnosed emotional disorder, and 3) functional impairment. Sensitivity analyses identified threshold scores where false positives and false negatives were most nearly equivalent. The preferred criterion provides the greatest area under the Receiver Operating Characteristic (ROC) curve and the highest specificity at the identified threshold.
Results
Current methylphenidate use and diagnosed emotional disorder yielded essentially identical models, with thresholds of 14 or more and nearly overlapping ROC curves. High scores on the NLSCY H/I Scale are associated with current methylphenidate use and diagnosed emotional disorder.
Interpretation
The parent-reported NLSCY H/I Scale can be used in population studies as a highly specific indicator of clinically significant ADHD symptoms.
Keywords
Attention Deficit/Hyperactivity Disorder, epidemiology, hyperactivity, inattention, National Longitudinal Survey of Children and Youth
Findings
The National Longitudinal Survey of Children and Youth (NLSCY) is a federally sponsored, national prospective study designed to measure the well-being, health and development of Canadian children from birth through young adulthood. The survey began in 1994/1995, and data collection has occurred at two-year intervals since then. As part of the interview, the parent (usually the biological mother) was asked to describe the child’s behaviour using the Children’s Behaviour Scale.[Fulltext]
Authors
Alice Charach (1-416-813-6600; alice.charach@sickkids.ca),Teresa To and Elizabeth Lin are with the Faculty of Medicine, University of Toronto, Toronto, Ontario.
What is already known on this subject?
- The parent-reported Hyperactivity/Inattention Subscale in the National Longitudinal Survey of Children and Youth was designed to identify children with severe symptoms of hyperactivity and inattention.
- A threshold score on the scale that identifies children likely to have clinically significant disorder has not been determined.
- Previous studies using the Scale have not been consistent in how children with high levels of hyperactivity were defined.
What does this study add?
- Variables collected by the NLSCY that represent therapeutic concern by parents and health professionals—methylphenidate use and diagnosis of emotional disorder—can be used as criteria to evaluate the Hyperactivity/Inattention Scale and set a threshold that identifies clinical “cases” requiring intervention.
- The threshold where false positives and false negatives are nearly equivalent is a highly specific, but not very sensitive, marker of clinical “caseness.”
