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Running head: TEST REVIEW ON CONNERS RATING SCALES-REVISED

Test Review on Conners Rating Scales- Revised


005054440
CSU Chico State University

TEST REVIEW ON CONNERS RATINGSCALE-REVISED

TEST DESCRIPTION
The author of the revised Conners rating scale (CRS-R), Dr. C. Keith Conners, proposes
that this psychometric test should mainly be used for the assessment of ADHD. However, he
claims that this test is also useful for the assessment of other related problem behaviors, such as,
anxiety or conduct problems. Conners intends for the test to be used in the processes of
researching, screening, diagnosing and monitoring treatment for ADHD and its comorbid
disorders. As such, the intended users of this test include psychologists, social workers, pediatric
nurses, teachers, school officials and pastoral counselors. Conners does qualify that in
accordance with being a diagnostic tool, the CRS-R should be used in conjunction with other
methods of diagnosing (such as clinical observations); those using the test for diagnostic
purposes should have postgraduate training and be familiar with standards for educational and
psychological testing developed by the American Psychological Association, the American
Educational Research Association, and the National Council on Measurement in Education.
Conners states that the instrument is suitable for reporting on youths aged 3 to 17. Self-report
scales are suitable for adolescents with a reading level of at least grade 6, ages 12 through 17.
Although he does not elaborate on the intended ethnicity or income statues of these youths, he
does mention up front that the normative information was gathered only in the United States and
Canada. The test is intended to be administered individually, however, the author explains that
group administration is possible with the CRS-R. Although the CRS-R is intended to report on
youth, the accompanying scales are intended to be administered to the individual childs parents
and teachers who have observed the childs behavior. Self-reports are included, but only
intended for adolescents who have increased rates of aversive behaviors and negative academic
and social outcomes. From the authors description of administering the test, it appears that

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Conners intended for the scales to be read and completed by the parent, teacher or adolescent,
while in the supervision of a trained mental health professional, as he explains, Watch the
respondent answer the first couple of questions to ensure that he or she reads each item carefully
and then makes a rating (pg. 21). However, Conner explains that the test also allows for other
methods when necessary, such as reading the questions to the testee, or communicating the
questions and answers over the phone. The manual for this test is fairly easy to navigate, and
instructions for administering are spelled out fairly thoroughly. As Conners points out in the
manual, The administrator requires little special trainingResearch assistance and teachers
may administer the forms, (pg. 20). While there is more flexibility in who can administer,
Conners points out that the scoring and interpretation of scores requires the training of a
postgraduate professional.
SUMMERY OF TEST DESCRIPTION
As such, it would seem that according to Conners, the CRS-R is primarily a diagnostic
tool for assessing ADHD in children and adolescents from ages 3 through 17. It is a norm
referenced psychometric test. It is most appropriately used when individually administered to
parents, teachers, and adolescents who read and fill out the scales themselves. There is little
restriction for who should administer the test, however, it is advised that only professionals deal
with interpretation of the scores.
NORMATIVE DATA
The CRS-R was printed for initial use in 1997, and many updated versions have since
been produced. Therefore, this version is obviously outdated, and the purpose of this test review
will examine the value of the test at the time it was intended to be used. Different norms were
obtained for each of the different scales. For the Conners Parent Rating scale-revised long form

TEST REVIEW ON CONNERS RATINGSCALE-REVISED

(CPRS-R: L) a sample of 2,482 children and adolescents was utilized. The rating was completed
by a parent or guardian. Of the youth reported on, all were between the ages of 3 to 17 years.
Information was gathered and analyzed in groups of three years. Sample demographics are as
follows: For ages 3 to 5 years old, data was collected on 198 males and 177 females. For ages 6
to 8, data was collected on 326 males and 307 females. For ages 9 to 11, data was collected on
265 males, and 281 females. For ages 12 to 14, data was collected on 278 males and 277
females. Finally, for the age group 15 to 17, data was collected on 168 males and 205 females.
The median annual household income for participating parents was between $40,001 and
$50,000. Chart 1. below represents the breakdown for self-identified ethnicities of the parents
that reported on these youths:

1.10%
2.20%

Ethnicity
4.90%

3.50%
4.80%

83%

Caucasian

Black

Hispanic

Asian American

Native American

Other/omitted

Chart 1.

Additionally, the Conners Parent Rating Scale- Revised Short form (CPRS-R: L) had
similar norming data. A sample of 2,426 children and adolescents was used, and rating was
completed by a parent or guardian. Of the youth reported on, all were between the ages of 3 to 17

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years. Information was gathered and analyzed in groups of three years. For ages 3 to 5 years old,
data was collected on 163 males and 140 females for the sample. For the sample of children ages
6 to 8, data was collected on 332 males and 309 females. For ages 9 to 11, data was collected on
266 males and 282 females for the sample. For ages 12 to 14, data was collected on 291 males
and 265 females. Finally, for the age group 15 to 17, data was collected on 168 males and 210
females. Chart 2. represents the ethnicity of the parents that reported on the youth for this short
form:

Ethnicity
4.70%
2.10% 1%
3.80%
4.30%

84%

Caucasian

Black

Hispanic

Asian American

Native American

Other/omitted

Chart 2.

The Conners Teacher Rating Scale- Revised Long form (CTRS-R: L), had a sample of
1,973 children and adolescents and was rated by one of their teachers. Of the youth reported on,
all were between the ages of 3 to 17 years. Information was gathered and analyzed in groups of
three years. For the sample of children ages 3 to 5 years old, data was collected on 102 males and
96 females for ages 6 to 8, data was collected on 274 males and 266 females. For ages 9 to 11,
data was collected on 230 males and 256 females. For ages 12 to 14, data was collected on 246

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males and 262 females. Finally, for the age group 15 to 17, data was collected on 113 males and
128 females. For this group, the youths were identified by the teachers. The reported ethnicity is
represented in chart 3. below:

Ethnicity
1.60%

2%

2.80%

5.80%

10.20%

78%

Caucasian

Black

Hispanic

Asian American

Native American

Other/omitted

Chart 3.

The Conners Teacher Rating Scale- Revised short form, (CTRS-R: S) had a sample of
1,897 children and adolescents, as rated by one of their teachers. Of the youth reported on, all
were between the ages of 3 to 17 years. Information was gathered and analyzed in groups of
three years. For ages 3 to 5 years old, data was collected on 62 males and 47 females for the
sample. For ages 6 to 8, data was collected on 284 males and 261 females for the sample. For
ages 9 to 11, data was collected on 240 males and 256 females for the sample. For ages 12 to 14,
data was collected on 247 males and 262 females for the sample. Finally, for the age group 15 to
17, data was collected on 112 males and 126 females. Once again, for this sample the youths
were identified by the teachers. The reported ethnicities are represented in Chart 4. below:

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1%
1.40%

Ethnicity
2.80%

5.70%

7.20%

81%

Caucasian

Black

Hispanic

Asian American

Native American

Other/omitted

Chart 4

The Conners-Wells Adolescent Self Scale long form (CASS: L), had a normative sample
of 3,394 adolescents, rated by each individual. Of the adolescents who submitted self-reports, all
were between the ages of 12 to 17 years. Information was gathered and analyzed in groups of
three years. For ages 12 to 14, data was collected on 469 males and 510 females for the sample.
For the age group 15 to 17, data was collected on 1089 males and 1326 females. This sample
reported on their own ethnicity as represented below in chart 5:

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Ethnicity
1.60%

1%

3.10%

2.30%

29.90%
62%

Caucasian

Black

Hispanic

Asian American

Native American

Other/omitted

Chart 5.

The Conners-Wells Adolescent Self Scale short form (CASS: S), had similar norming
data. The sample consisted of 3,486 adolescents, rated by each individual. Of the adolescents
who submitted self-reports, all were between the ages of 12 to 17 years. Information was
gathered and analyzed in groups of three years. For ages 12 to 14, data was collected on 477
males and 511 females for the sample. For the age group 15 to 17, data was collected on 1,146
males and 1,352 females. The same ethnic percentages were identified for the CASS: S sample
as was for the CASS: L sample.
NORMATIVE INTURPRATAION
The sample size for almost all of the gender/age groups is sufficient to assume a normal
distribution. A representative image of the population will be obtained with this data, as a
minimum sample size of 100 is needed to begin to see the normal distribution reflective of the
population (N. Schwartz, personal communication, Feb/04/14). However, the CTRS-R: S has too
small of a sample for the age group 3 to 5. Interpreting results obtained from teachers for this age

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range should thus take that into consideration. There are separate norms obtained for gender and
this will aid in the interpreting of scores. It was found that across the groups used to establish a
norm, males tended to score significantly higher than females in all areas with the exception of
emotional problems. Thus, having separate norms will avoid the possibility of obtaining too
high of a number of false positives for males, or false negatives for females if compared only to
youth as a whole, with disregard to gender differences.
The manual includes, but does not describe to any depth, figures with visual
representations of Canadian and U.S maps, and the locations the information was sampled from.
Canadas provinces appear to be equally sampled from. There seems to be a higher concentration
of sampling from the east coast then from the middle most states. Around the time, there were
generally lower populations in the middle states, and therefore this sampling concentration seems
reasonable. Although there is some variance between the ethnicities represented between
subscales, all scales have a high concentration of Caucasian youth, from 83% to 62% of the total
sample. Data reported in 2000 (three years after this test came out,) express that about 75% of
the U.S population, and about 90% of the Canadian population was Caucasian. When sampled
together, the Caucasian population in the sample reflects the populations for both the U.S and
Canada during the time when the test would be expected to be used. Hispanics appear as a
minority in the sample, ranging from 5.8% to 2.3% across scales. According to census data in
2000, the U.S had a population consisting of about 14% Hispanic, while Canada only had 1%.
Knowing that the sample was randomly selected from both Canada and the United States (U.S),
thus blending these percentages, this seems to be an accurate representation of the Hispanic
population for that time. The sample had an even lower percentage of Asians, ranging from 2.2%
to 1.4%. The census data around this time reports about 4% percent of Asians in the U.S.

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population, and about 7% in the Canadian population. This percentage is slightly higher than
what is observed in the sample. Therefore, results should be interpreted carefully when
administering the test to Asian youth. The Native Americans in the sample appear to be the
lowest, with a range of 1.5% to 1% across scales. Census data around this time revealed that
there was about 1% Native Americans in the U.S population, while Canadian Census data does
not report on this population. Therefore, the sample would seem to reflect the population around
the appropriate time. The sample lists a range of other or omitted from 2.8% to 4.9%. These
data are not helpful, because the ethnicity of one person who omitted an answer will not
resemble another persons ethnicity who decides to omit an answer. Data from the sample on
black youth has an incredible range of variance between scales, from 4.3% to 29.9%. The
Census data reflected something in-between those scores, with 12% in the U.S population, and
about 3% in Canadian populations. Because the data across scales are intended to factor into an
overall score, this variance is concerning. The CRS-R attempts to rectify this by providing a
separate set of score interpretation, based on a separate set of norms for black youth. Yet, the
separate normed data is only based on the self-report scales for ages 12 to 17, meaning that the
test is inappropriate for assessing black youth under 12 years of age. Furthermore, very little if
any information is reported for this separate norming group, making this measure questionable at
best for all self-identified black youth.
Other problems with the normative data include the inconsistencies with ethnic
identification. The CPRS-R: L and CPRS-R: S scales have parents report their own ethnicity, not
the ethnicity of the child. The ethnicity of the childs parent or guardian does not necessarily
reflect the ethnicity the youth may consider themselves. The CTRS-R: L and CTRS-R: S scales
have teachers label the ethnicity of the youth they are reporting on. The methods the teachers

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used to know this information is not clarified. Therefore, this information and the break-down
of ethnic percentages represented in the sample is questionable.
The norming data lists the median annual income for participating parents as between
40,001 to 50,000. The census data around this time reports a median annual income of 41,994.
Although the sample seems to reflect the population, the problem with only reporting the
median, is that we cannot tell how close to the maximum and minimum incomes the sample
covered. It could be that all income levels were represented, or it could be that a chunk of the
lowest and highest brackets are not reported.
Other pertinent information that was not reported include the marital status of the parents
as well as the size of the family or household. These are factors that may add to a childs stress
and tendency towards aversive behaviors. If the sample only gathered information on two parent
homes with one or two children households, the normative data would not reflect the distribution
of stress attributable to family life, and may yield too many false positives during score
interpretation. Finally, it is questionable whether uniformly grouping ages in sets of three is
relevant to the cognitive and socio-emotional development through childhood.
SCORING
The Raw scores are transformed into T-Scores (with a mean of 50 and a standard
deviation of 10) and/or percentile scores. T-scores are normally a linear transformed score,
which will allow for the comparison of scores between scales, subscales and between
individuals. However, the manual describes the way to achieve transformation as Raw scores
are converted to T-scores by plotting them on the appropriate CRS-R profile form (pg. 43). This
is a method intended to create ease of scoring, as scoring profiles are set up in such a way that
the raw scores are graphed and fall on a line adjacent to their T-score. This allows for automatic

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conversion from raw score to T-score. However, there is no mention of how this graph was
systematically set up and created. Furthermore, the mean and standard deviations are not given
for raw scores. Therefore there is no way for the test interpreter to appropriately make a true
linear transformation by, for example, converting the raw score to a Z-score with the formula:
Individual score minus the mean score, divided by the standard deviation, and then use the
formula to convert to a T-score: 10 times the Z-score plus 50 (Kaplan & Saccuzzo, 2013).
Without this information about the raw scores, there is no reasonable way to tell if the
CRS-R used the T-score appropriately. We are left to assume linear transformation on the basis
that T-scores are linearly transformable, and the manual speaks about the T-score in a logical
manner. However, this assumption raises concerns.
Percentile scores are linearly transformed, as used in the manual. Once T-Scores have
been obtained, there is a table in appendix A to reference for quick transformation from T-score
to percentile. The percentiles are described as being based on the theoretical distribution (of a
normal distribution). Given the mean and standard deviation of the T-score, and knowing the
properties of normal distributions, the table can be easily confirmed. It does indeed match correct
scores. For example, the mean score, 50, is transformed into the 50th percentile, which is half of
the distribution. Therefore, as far as scoring is concerned, the test offers a process that is simple
and appears to be appropriate, at least on the surface.
RELIABILITY
The internal reliability of the CRS-R was assessed with Cronbachs alpha coefficient.
Separate reliabilities were found for each scale, subscale, gender and each age group, with the
exception of three DSM-IV symptom subscales on the CASS, where males and females had to be
combined to form an adequate sample size. Within the manual, it is not specified which youth

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the reliability data was gathered on. It is not made clear whether the scores from the group used
to collect norming data also contributed to reliability data, or if it is another group. For each scale
(CPRS-R: L, CPRS-R: S, CTRS-R: L, etc.), the age sets received different reliabilities for
different subscales (anxiety, ADHD, hyperactivity, etc.). All reliabilities ranged from .667 to
.958. Although this is generally high (especially since Cronbachs alpha finds the lowest bracket
of reliability), the purpose of the test must be taken into consideration.
The test claims to be useful as a diagnostic tool, however, diagnostic decisions require a
reliability at the .90 level. That means that not all scores for age sets and subscales should be
considered in a diagnostic decision. For example, on the CPR-R:L scale, the only scores that
should be considered in a diagnostic decision are hyperactivity ADHD, and DSM-IV inattentive
for males ages 3-5 (with a reliability of .9, .925, and .913 respectively), oppositional problems,
cognitive problems, hyperactivity, ADHD, DSM-IV inattentive, and DSMI-IV hyperactiveimpulsive for males ages 6-8 (with a reliability of .917, .927, .917, .943, .930, and .911
respectively), oppositional problems, cognitive problems, hyperactivity, ADHD, DSM-IV
inattentive, and DSMI-IV hyperactive-impulsive for females ages 6-8 (with a reliability of .903,
.930, .920, .940, .929, and .918 respectively), oppositional problems, cognitive problems,
hyperactivity, ADHD, Conners global index-restless-impulsive, DSM-IV inattentive, and
DSMI-IV hyperactive-impulsive for males ages 9-11 (with a reliability of .914, .939, .902, .942,
.905, .942, and.905 respectively), oppositional problems, cognitive problems, ADHD, and DSMIV inattentive for females ages 9-11 (with a reliability of .917, .928, .919, and .917 respectively),
oppositional problems, cognitive problems, ADHD , and DSM-IV inattentive for males ages 1214 (with a reliability of .926, .943, .943, and .947 respectively), oppositional problems, cognitive
problems, ADHD, and DSM-IV inattentive, for females ages 12-14 (with a reliability of .902,

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.939, .912, and .924 respectively), cognitive problems, ADHD, and DSM-IV inattentive for
males ages 15-17 (with a reliability of .922, .918, and .921, respectively) and finally,
oppositional problems, cognitive problems, ADHD, and DSM-IV inattentive, for females ages
15-17 (with a reliability of .912, .922, .911, and .920 respectively).
Furthermore, since reliability at the .8 level is needed simply for the test to appropriately
serve as a screening tool, there are some subscales, for some ages that should not even be used
for screening. One such example is the hyperactivity subscale, for ages 15-17, on the CPRS-R: L
scale (which obtained a reliability of .743 for males and .724 for females).
The standard error of measurement and a standard error of prediction were found for each
scale, sex, and age group. According to the tables, these standard errors range from .601 to 3.84.
This means that with some subscales and for some age groups, scores will tend to be more
certain (and more useful for diagnosing) than others. The subscales that yield SEMs in the 3.0
are more or less useless and the scores will not mean much. Moreover, the SEMs were derived
by the Cronbachs alpha, an internal consistency. This will tend to yield a lower SEM. Since
ADHD is a trait that remains constant throughout life (Turgay, et al., 2012), it would be more
appropriate to obtain SEMs from a test-retest reliability, that deals with the tests ability to find
this trait over time.
Test-retest reliability data was gathered separately for most scales and all separate
subscales. The CPRS-R: L and CPRS-R: S forms were administered to the parent(s) of 49
children and adolescents (25 females and 24 males). The mean age was 11.8 years with a
standard deviation of 3.68. The test-retest interval was between six and eight weeks. For the
CTRS-R: L and CTRS-R: S forms, a sample of 50 children and adolescents (25 females and 25
males) was reported on. The mean age was 11.24 years and the standard deviation was 3.45.

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Again, the test-retest interval was between six and eight weeks. The CASS: L and CASS: S
forms were administered to a sample of 50 children and adolescents (21 females and 29 males).
The mean age of this group was 14.84 with a standard deviation of 1.53. Once again, the testretest interval was between six and eight weeks.
It is to the test authors credit that all subscales were derived separately. The reliabilities
range from .47 to .87, with most at the .87 level. This would seem high, however there are two
major issues that make those scores less credible, and less meaningful. It would appear that for
the parent and teacher reporting scales, the lower age bracket is underrepresented. Therefore,
there is doubt to be casted on the test-retest reliability for the youngest children. Additionally, as
mentioned earlier, ADHD is a trait that has been known to follow individuals throughout their
lives (Turgay, et al., 2012). If this test was used solely for the purpose of assessing the
effectiveness of treatment and intervention, than 8 weeks might be sufficient. However, because
the test author claims that the test should be used for diagnostic purposes, a test-retest interval of
eight weeks is insufficient.
Finally, as it concerns the reliability scores, parallel forms reliability should have been
included and discussed in the manual. The author claims that the short versions of each scale
include only the most important questions from its long version, but that both versions are
equally efficient at obtaining a score (pg. 15). This would suggest that shorts and longs for each
form are intended to be alternate forms of the same test. Conners does correlate the short and
long forms, (although it is unclear if the correlation was a Pearson product moment correlation,
as is usually done in alternate forms) however, this information is oddly included in a discussion
of convergent validity, instead of reliability. There is also a lack of mention as to why the long
version should even be used if the short versions are less time consuming, yet yield the same

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scores. This does not invalidate the correlation; it does however, make the manual less userfriendly.
VALIDITY
In the CRS-R, subscales were created and items were chosen from a larger pool of items.
This was done by running all items through a factor analysis. The scores on items came from
those scores in the norming group, which had a relatively representative sample with the
exception of black youths. According to the data tables, all grouping was significant (p < .05).
This empirical method of choosing items for the scale allows the user to assume they are in fact
obtaining scores from individuals with a consistent scale that is measuring the same thing every
time. However, this method allows for some arbitrary assignment of meaning or titles for each
grouping. That is to say, even though we can say we are measuring a real thing, we do not know
if this thing we are measuring is the ADHD that has been conceptually created.
The CPRS-R: L/S and the CTRS-R: L/S was correlated. The CPRS-R: L/S and the
CASS: L/S was correlated. The CTRS-R: L/S and the CASS: L/S was also correlated. The scores
were all obtained from the normative sample. There was a lot of variability between the parent
and teacher scales, with subscales ranging from a correlation of .01 to .49. The author explains
this as expected, in consideration of the trend that parents and teachers will view the same child
very differently. There was low, if any correlation between parent and self-report scales, with
subscales ranging from a correlation of .01 to .54. The author explains this by citing research that
explains how perceptions of problem behavior can vary greatly between parents and adolescents.
Similarly, low or non-significant correlations appeared between the teacher and self-report
scales, with subscales ranging from a correlation of .01 to .40. The author also explains this by
citing research that explains how teachers and adolescences differ in their perceptions of problem

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behavior. This seems appropriate, yet, it implies that obtaining an overall score by looking at the
opinions of multiple separate perspectives will yield more true results than to only take the
reports from one perspective.
The CRS-R was correlated with the original CRS. The parents of a group of children and
adolescents (15 boys and 10 girls) were administered both the CPRS and the CPRS-R: L. the
mean age of the children reported on was 11.68 with a standard deviation of 3.97. A second
group of youths (29 boys and 19 girls) were rated by the teachers on both the CTRS and the
CTRS-R: L. The mean age of this group was 12.85 with a standard deviation of 3.67. All
groups of youth had been referred for assessment for ADD to a large medical center. The
majority of correlations were significant across subscales, with the exception of the perfectionist
scale from the revised version. The correlations ranged from .31 to .95. This seems to suggest
that the revised version still holds relatively the same meaning as the original version, at least for
older children. This is due to the fact that younger children were scarcely included in the sample,
and therefore not much can be stated with them in mind. The meaning of both CRS and the
revised version still needs to be addressed.
The CRS-R was correlated with the Childrens depression inventory, (CDI). This
psychometric test is a self-report scale for children ages 7 to 17. It was developed to asses a
variety of depressive symptoms. The author, Conners proposed that this scale should correlate
highly with the hyperactivity and negative dysphoria subscales. This association would be
consistent with well-established descriptions in the developmental literature of the hyperactiveimpulsive-emotionally labile child (pg. 130). A group of nonclinical children and adolescents
(18 boys and 15 girls) completed the CDI while one of each youths parents completed the
CPRS-R: L. The mean age of this group was 10.39, with a standard deviation of 2.46. A separate

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group of nonclinical children and adolescents (13 boys and 14 girls) completed the CDI while
one of their teachers was administered the CTRS-R: L. The mean age of this second group was
10.41 with a standard deviation 2.47. A third nonclinical group of adolescents (12 boys and 17
girls) was administered both the CDI and CASS: L. the mean age was 12.66 with a standard
deviation of 1.56.
Some of the subscales showed non-significant results, such as the perfectionist subscale
from the CPRS-R: L and the CTRS-R: L, in correlation with most subscales on the CDI, or the
negative self-esteem subscale from the CDI in correlation with any of the scales from the CASS:
L. Of those that correlated significantly, the range was from .41 to .82. There are many
significant correlations between subscales.
The CPRS-R: L and CTRS-R: L was correlated with the Continues Performance Test,
(CPT). This test was also created by Conners and is intended to screen for attention problems.
One group of nonclinical children and adolescents (25 boys and 25 girls) was administered the
CPT and each of their parent(s) were administered the CPRS-R: L. The mean age of the youths
was 9.40 with a standard deviation of 1.98. A second group of nonclinical youths (25 boys and
31 girls) were administered the CPT, while one of each childs teachers was administered the
CTRS-R: L. The mean age for this group was 8.96 with a standard deviation of 1.68. The CPRSR subscale, DSM-IV Inattentive, correlated significantly at r = .33. The subscale, cognitive
problems correlated significantly for both the CPRS (.44), and the CTRS, (.35). The subscale on
the CPRS-R: L, psychosomatic, correlated significantly at r = .37. Finally, the last subscale that
produced a significant correlation was perfectionism (-0.35).
These correlations would only indicate that the CRS-R shared similar meaning with the
CPT and CDI. This in and of itself is irrelevant, unless the CPT and CDI have meaning

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themselves. There have been validity studies for these measures. The CDI has been used in a
study to cross validate youth that have been clinically diagnosed with major depressive disorder.
The group was compared to control groups which included youth diagnosed with generalized
anxiety disorder (GAD), conduct/oppositional defiant disorder (CD/ODD), and attention deficit
hyperactivity disorder (ADHD); all matched for sex, age, and race/ethnicity characteristics. The
group previously diagnosed with Major depressive disorder scored significantly higher on the
CDI then did the other groups (Bae, 2012). The CPT was used in a study to cross validate
patients who had been previously clinically diagnosed with schizophrenia. Neurocognitive
impairment is a core component of schizophrenia and one of its most debilitating features.
Attentional dysfunction is a key element of neurocognitive impairment, and is found in patients
with schizophrenia when they are actively psychotic or in remission. These patients scored
significantly different on the CPT then did individuals in the control (Kahn, et al., 2012).
Therefore, in accordance with the above correlations the manual provides under the heading,
Convergent validity.., (pg. 125) test users can only assume that the CRS-R is a valid test for
detecting level of attention and level of depression in youth around the ages of 7 to 12. Because
there was a restricted age range the validity studies were performed on, not much can be
concluded about ages at the lower or higher ends.
A further validity study is listed, yet, it is under the heading discriminative validity.
The convergent study listed here, examined DSM-IV symptom subscales to see if the CRS-R test
items cross validated with the measures on the DSM-IV. The DSM-IV only diagnosis 3% to 5%
of school aged children with significant levels of ADHD. The overall rates for ADHD found
with the CRS-R are consistent with this statement (at 3.85% found with the teachers rating scale,
and 2.30% found with the parent rating scale).

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Discriminant studies were performed separately for each of the scales. For the CPRS-R:
L, a group of 91 children (70 males and 21 females) with diagnosis of ADHD according to
DSM-IV criteria was compared to a control group of 91 nonclinical children (70 males and 21
females). The first control group was randomly selected from normative data, but matched with
the clinical group for age, sex, and ethnicity. The mean age for both groups was about 10.2 with
a standard deviation of 3.4. the second control group consisted of 55 youth (42 males and 13
females) rated by a psychologist or psychiatrist as having emotional problems. The mean age
for this group was 11.64 with a standard deviation of 2.84. Difference in age was controlled for
by a series of one-way ANOVAs. The results indicated that the ADHD group scored
significantly higher on the CPRS-R: L than the nonclinical group on all scales (with the
exception of perfectionism). The ADHD group scored significantly higher than the emotional
problem group on the subscales cognitive problems, hyperactivity, restless-impulsive, and the
ADHD index.
The same study was performed for the CTRS-R: L. Differences include 154 children (122
males and 32 females) in the ADHD group, 154 children in the nonclinical group, and 131
children (105 males, and 26 females) in the emotional problems group. For the teacher ratings,
the ADHD scored significantly higher than the nonclinical group in all subscales with the
exception of the social problems subscale. The same study was also performed for the CASS:
L form. Differences in this study include an ADHD group of only 85 (62 males and 23 females)
as well as a nonclinical group of 85. The mean age for these two groups was 14.02 with a
standard deviation of 1.62. The emotional problems group had 84 children (64 males and 20
females). There were no differences in the comparison between the nonclinical group and the
ADHD group for this form.

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These discriminative studies indicate that the CRS-R does not measure emotional
problems. Rather, the CRS-R only detects emotional disturbances specific to ADHD. The
discriminative studies also reveal that some of the subscales do not discriminate. For example,
this is seen with the social problem subscale, or the perfectionism subscale.
COMMENTARY
In accordance with the information reviewed, the CRS-R had its place, but it is not the
glorified culmination of psychometric tests as the manual describes. Assuming that we still lived
in the early 2000s, this test would be useful for researching, screening, or monitoring treatment
for none-black youth (between the ages of 7 to 12) for ADHD, as well as major depressive
disorder, attention problems, cognitive problems, hyperactivity, and restless-impulsivity which
may be related to ADHD. Meaningful inferences would not be justifiable with a broader age
range because the reliability and validity studies did not look at information for a broader age
range. The test could feasibly be used as a diagnostic tool for some age groups and for some
subscales. However, much effort would have to be executed by the test user to keep track of
which of these age ranges and subscales have reliabilities at the .9 level. This would make
comparing scores across scales, as well as making inferences between subscales extremely
difficult, and it might be advisable to simply find a better tool for diagnostic purposes.
Furthermore, there are simply too many questionable factors, in the way the information was
derived to allow for diagnostic interpretation, especially where the nature of peoples lives will
be changed based on the information. However, the test is suitable at the level of a research aid,
or screening tool, as well as an aid to monitor changes in treatment.

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