Validity of DSM‐IV Attention‐Deficit/Hyperactivity Disorder for Younger Children

Little is known about the validity of the diagnosis of attention-deficit/hyperactivity disorder (ADHD) in young children. Moreover, the results of the DSM-IV field trials raised concerns that inclusion of the new predominantly hyperactive-impulsive type of ADHD in DSM-IV might increase the likelihood of the diagnosis being given to active but unimpaired preschool and primary school children. The validity of DSM-IV criteria for each subtype of ADHD was evaluated in 126 children, aged 4 through 6 years, and 126 matched comparison children. Probands and controls were classified by using structured diagnostic interviews of the parent and a DSM-IV checklist completed by the teacher. Children who met DSM-IV criteria for each subtype of ADHD according to parent and teacher reports differed consistently from controls on a wide range of measures of social and academic impairment, even when other types of psychopathology and other potential confounds were controlled. When diagnosed by means of a structured diagnostic protocol, all three DSM-IV subtypes of ADHD are valid for 4– through 6–year-old children in the sense of identifying children with lower mean scores on measures of adaptive functioning that are independently associated with ADHD. J. Am. Acad. Child Adolesc. Psychiatry, 1998, 37(7):695–702.