Comparison of DSM-IV ADHD Combined and Predominantly Inattention Types: Correspondence Between Teacher Ratings and Direct Observations of Inattentive, Hyperactivity/Impulsivity, Slow Cognitive Tempo, Oppositional Defiant, and Overt Conduct Disorder Symptoms

ABSTRACT The study examined the correspondence between teacher ratings and direct observations of inattention (I), hyperactivity/impulsivity (H/I), oppositional defiant disorder/overt conduct disorder (ODD/overt CD), and slow cognitive tempo (SCT) symptoms. Teacher ratings of kindergarten children on the DSM-IV I and H/I symptoms were first used to create an ADHD-combined type (CT), ADHD-predominantly inattention type (IT), and a comparison group (CG). Direct observations of classroom behavior showed the CT and IT groups to be similar in I symptoms and significantly higher than the CG. Direct observations also showed the CT group to be significantly higher on the H/I and ODD/overt CD symptoms than IT and CG with the latter two groups not differing on the HI and ODD/overt CD symptoms. There was also evidence that the SCT symptoms were uniquely associated with the IT of ADHD. The implications of these results for the DSM-IV ADHD subtypes and the importance of direct observations in the study of ADHD are discussed.