Assessment & Research

The ADHD rating scale-IV preschool version: Factor structure, reliability, validity, and standardisation in a Danish community sample.

Alexandre et al. (2018) · Research in developmental disabilities 2018
★ The Verdict

The Danish ADHD RS-IV-P is psychometrically sound for preschool screening, but treat the three subscales as highly overlapping at this age.

✓ Read this if BCBAs who screen or consult on ADHD in Danish preschools or early-intervention teams using rating scales.
✗ Skip if Clinicians only serving school-age or non-Danish populations where local norms already exist.

01Research in Context

01

What this study did

Alexandre et al. (2018) checked if the ADHD Rating Scale-IV Preschool version works in Danish 3- to 5-year-olds. They gave the checklist to parents and teachers in a large community sample.

The team ran factor analysis to see if the scale still splits into three groups: inattention, hyperactivity, and impulsivity. They also tested reliability and set local norms.

02

What they found

The scale stayed reliable and a three-factor structure fit the data. Yet the three factors were almost glued together—scores moved in lock step.

Danish norms were created, so a teacher or clinician can now compare a preschooler's scores with same-age peers in Denmark.

03

How this fits with other research

Arildskov et al. (2022) later tested the same scale in older Danish kids. They found one big general ADHD factor plus tiny specific factors, not three clear ones. The shift suggests the hyperactivity/impulsivity split firms up after preschool.

Gomez et al. (2021) saw a similar blur with adults—hyperactivity items fell apart while inattention held strong. Together the studies warn that hyperactivity is the shakiest factor across ages.

A et al. (2019, 2020) ran parallel work on the CBCL/1½-5 ASD scale. Like Lysdal, they showed preschool rating scales travel well across cultures, but item-level stability stays modest.

04

Why it matters

If you screen Danish preschoolers, you can trust the ADHD RS-IV-P total score. Use the three subscales as rough guides, not hard labels, because they overlap heavily at this age. When kids enter school, switch your lens: start weighing inattention and hyperactivity/impulsivity scores more separately, as Wigh et al. found the structure sharpens later.

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Use the total raw score first; if you must share subscale numbers, add a note that hyperactivity and impulsivity are still entangled at age 4.

02At a glance

Intervention
not applicable
Design
other
Sample size
916
Population
neurotypical
Finding
positive

03Original abstract

BACKGROUND: ADHD is a debilitating disorder with symptoms often appearing in early childhood. To facilitate early identification, developmentally appropriate and validated assessment tools for the preschool-age are needed. AIMS: The current study aims to examine the psychometric properties of the ADHD Rating Scale (RS)-IV Preschool Version (-P) in a Danish community sample and provide national standardisation data. METHODS AND PROCEDURES: Parents (n = 916) and kindergarten teachers (n = 275) of preschool children, aged 3-5 years, completed the ADHD RS-IV-P. OUTCOMES AND RESULTS: Confirmatory factor analysis indicated that a three-factor model (inattention, hyperactivity, and impulsivity) best fit the data regardless of rater. Scales generally showed acceptable internal consistency, test-retest reliability, inter-rater reliability, and criterion validity. Boys received higher ratings on the ADHD RS-IV-P than girls and younger preschool children were rated as more inattentive than older preschool children. CONCLUSIONS AND IMPLICATIONS: Our findings support the reliability and validity of the ADHD RS-IV-P and a three-factor model of ADHD. However, high factor correlations and similarity in model fit suggest that more research is needed to clarify the organisation of ADHD symptoms in preschool children. Furthermore, the external validity of separate ADHD dimensions at this age should be examined.

Research in developmental disabilities, 2018 · doi:10.1016/j.ridd.2018.05.006