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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)

    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
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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