6285 Assessing the role of ASEBA questionnaires in the diagnostic pathway for ADHD

Objectives Diagnostic pathways for attention deficit hyperactivity disorder (ADHD) are facing increasing demands and lengthening waiting lists across the United Kingdom.¹ The local assessment pathway uses a referral form based on a modified Swanson, Nolan and Pelham Rating Scale (SNAP-IV),² that considers the core symptoms of ADHD with additional qualitative information from home and school. After referral triage, a further broadband scale questionnaire, the Achenbach System of Empirically Based Assessment (ASEBA), is then sent to the family and school to be completed for use in the assessment process. The project objective was to explore whether the ASEBA questionnaires add to the diagnostic process for ADHD compared to the information gathered by the referral form, and how they influenced the time taken for assessment on the ADHD pathway. Methods 50 cases referred to the local ADHD pathway between 1stSeptember 2021 and 31st December 2021 were randomly selected. The timepoint each referral reached different stages within the diagnostic process was reviewed. The completed referral forms were assessed using the SNAP-IV scoring criteria. The ASEBA questionnaires were also reviewed. Quantitative scores for both SNAP-IV and ASEBA were compared to the diagnostic outcome. Results 31 of the 50 cases received a diagnosis of ADHD combined type. These patients had median SNAP-IV scores on their referral form corresponding to moderate (score 18- 22) to severe (score 23–27) symptoms of ADHD (table 1). Importantly, there was reasonable agreement between scores for both SNAP-IV and ASEBA questionnaires (agreement in 78.7% to 95.7% of cases). Notably, the processing of ASEBA questionnaires from the point of referral required a median time of 75.5 days (table 2). Conclusion The ASEBA questionnaire is helpful in completing a broad and in-depth assessment but is time consuming for respondents and incurs a significant monetary and time cost. There is reasonable agreement between the quantitative scores obtained using the modified SNAP-IV questionnaire and ASEBA questionnaires. Scores correlate with the ultimate diagnostic outcome for the pathway. Based on this service evaluation, the role of ASEBA questionnaires within the local diagnostic pathway is being reviewed. References Young S, Asherson P, Lloyd T, Absoud M, Arif M, Colley WA, Cortese S, Cubbin S, Doyle N, Morua SD, Ferreira-Lay P. Failure of healthcare provision for attention- deficit/hyperactivity disorder in the United Kingdom: a consensus statement. Frontiers in Psychiatry. 2021 Mar 19;12:649399. Hall CL, Guo B, Valentine AZ, Groom MJ, Daley D, Sayal K, Hollis C. The Validity of the SNAP-IV in Children Displaying ADHD Symptoms. Assessment. 2020 Sep;27(6):1258–1271. doi: 10.1177/1073191119842255. Epub 2019 Apr 16. PMID: 30991820.