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Assessing Attention-Deficit/Hyperactivity Disorder Using an RTI Approach Renée M. Tobin W. Joel Schneider Steven Landau Abstract It is important to note, that current law is not written in an RTI framework Based on findings from over 30 years of research on the topic, School psychologists are increasingly adopting a response to for the assessment of behavior disorders; however, this approach is expected Pelham and his colleagues (2005) provide guidelines for best intervention (RTI) approach to the assessment and treatment of for the assessment of learning disabilities, and many students with ADHD practices in assessment of ADHD, and these guidelines map readily children. This presentation describes evidence-based assessment have learning disabilities. Therefore, we advocate that school psychologists onto the RTI model. Using Pelham et al.’s suggestions, we align move closer to an RTI approach as it pertains to assessment and intervention- traditional and contemporary methods of assessment for ADHD with of ADHD based on a chapter to appear in the fifth edition of planning for students with ADHD. As such, assessment data collected within the current RTI approach, as shown in Figure 1. Best Practices in School Psychology (Tobin, Schneider, Reck, & the RTI framework may identify clear links to intervention targets and Landau, in press). Specifically, an ADHD assessment strategy is provide data regarding meaningful changes in children’s behaviors in presented that follows guidelines prescribed by Pelham, response to assessment-based interventions. Table 1. Selected List of Evidence-Based Assessment Methods for ADHD Fabiano, and Massetti (2005). This presentation also describes assessment in the context of RTI and three-tier model of service Measure Relevant references delivery for children with ADHD. Introduction Narrow-band Behavior Rating Scales Following the now universally embraced movement towards evidence- based treatment (EBT) for children’s behavior disorders, there has been a Conners’ Rating Scales-Revised (CRS-R) Conners (1997) recent call for evidence-based assessment (EBA). In line with this movement, an ADHD assessment strategy is presented that follows ADHD-IV Rating Scale DuPaul, Power, Anastopoulos, & Reid (1998) guidelines prescribed by Pelham, Fabiano, and Massetti (2005), and involves four assessment objectives: assessment for diagnosis (i.e., the Broad-band Behavior Rating Scales categorical/psychiatric determination), assessment of impairment (i.e., Child Behavior Checklist (CBCL) and Teacher Report specification of impaired domains of functioning), assessment for Form (TRF) from the Achenbach System of Empirically Achenbach & Rescorla (2004) intervention planning, and outcome evaluation of treatment. Based Assessment (ASEBA) Within these domains, several assessment methods are available. Parent Report Form (PRS) and the Teacher Report Form (TRS) from the Reynolds & Kamphaus (2004) These procedures have been used in a traditional, diagnosis-driven Behavior Assessment System for Children (BASC-2) approach to the assessment of ADHD; however, they are also appropriate for use in a dynamic and fluid problem-solving approach to assessment. Direct Observations These procedures are based on the Pelham et al. (2005) model, are consistent with the School Psychology Blueprint for Training and Direct Observation Form McConaughy & Achenbach (2004) Practice III, and focus on the child’s areas of impairment at school, in peer relations, and in the family. The difference between what we Student Observation System from the BASC-2 Reynolds & Kamphaus (2004) prescribe and the traditional, diagnosis-driven assessment of ADHD does not involve a difference in methods selected, but a difference in the Individualized Target Behavior Evaluation (ITBE) Pelham et al. (2005) questions to be addressed throughout the assessment process. This method also allows for a more frequent examination of the assessment Functional Assessments data informing decisions to remove interventions that are no longer necessary as well as those involved in exiting children from services. DuPaul, Eckert, & McGoey (1997); No specific form Table 1 presents a list of evidence-based methods for the assessment of Gresham, Watson, & Skinner (2001) ADHD. Although purposes may differ, many of the same assessment strategies Interviews are employed in both the RTI model and traditional models. Differences lie in the formality of the process through which levels of services and the Unstructured Parent Interview (no specific form) Barkley (2006); O’Neill et al. (1997) method of special education eligibility are determined. If the intervention produces a desirable change in behavior at one of the lower tiers of Source intervention and returns the child’s behavior within normal limits, the Tobin, R. M., Schneider, W. J., Reck, S. G., & Landau, S. (in child will no longer require intervention. If, however, the child progresses press). Best practices in the assessment of children with through the tiered model of research-based interventions, and significant attention-deficit/hyperactivity disorder: Linking assessment to progress is not apparent, the child may be a viable candidate for more response-to-intervention. To appear in A. Thomas & J. Grimes intensive intervention, ultimately at the level of special education (eds.), Best Practices in School Psychology: Vol. V. Washington, services. Thus, these methods allow for continuous hypothesis generation Figure 1. An RTI approach to the assessment of ADHD in children D.C.: National Association of School Psychologists. and testing throughout the process.
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