Ratings of hyperactivity and developmental indices: should clinicians correct for developmental level?
Use chronological age norms when rating hyperactivity in kids with cognitive delays; mental age adds no value.
01Research in Context
What this study did
The team asked 52 parents and teachers to rate hyperactivity in kids with delays. All children had IQs below 70 and mixed diagnoses like autism or Down syndrome.
They recorded each child's real age and mental age. Then they ran stats to see which age predicted the hyperactivity scores better.
What they found
Real age alone explained the ratings. Once you know the child's birthday, mental age adds zero extra information.
In plain words, a young learners with a young learners mind still looks hyperactive for a young learners, not for a young learners.
How this fits with other research
Smith et al. (1994) and Hastings et al. (2001) also built or checked rating scales for kids with ID. All three studies agree: standard scores work if the sample has delays.
Efstratopoulou et al. (2012) seems to clash. Their Motor Behavior Checklist separated ADHD from ASD using teacher ratings without age tweaks. The difference is setting: Maria's kids were in regular PE classes, so age was already matched. A et al.'s kids had large delay ranges, so age mattered.
Oliver et al. (2002) later refined the DBC into five factors. Their work extends A et al.'s point: once you control for age, the checklist structure stays solid across ID levels.
Why it matters
When you score a hyperactivity checklist for a child with cognitive delays, use chronological age norms. Do not subtract mental age points. This keeps your data in line with the test manual and prevents under-referral. One minute of correct scoring saves months of wrong treatment plans.
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02At a glance
03Original abstract
This study assessed the relationship between parent and teacher ratings of hyperactivity and developmental indices (chronological age, IQ, and mental age) in two groups of children. Subjects were drawn separately from two psychiatric clinics: (a) a general clinical sample, largely of normal ability, seen for a multitude of psychiatric and behavioral problems, and (b) a developmental clinic sample, comprising children with cognitive delays and seen for ADHD or the absence of ADHD. The results showed consistent negative correlations between chronological age and severity of hyperactivity symptoms; however, these occurred mainly within the developmental clinic sample. Only 4 of 27 comparisons (15%) between mental age and hyperactivity ratings (all confined to the developmentally delayed sample) showed a significant correlation. When chronological age was first partialled out, the correlations between ratings of hyperactivity and mental age ceased to be significant. Findings suggest that chronological age should be taken into consideration when behavior ratings are used to assess cognitively delayed children for ADHD. However, the results do not support guidelines stating that mental age must be used to determine which norms should be applied when such children are evaluated clinically.
Journal of autism and developmental disorders, 1994 · doi:10.1007/BF02172125