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Anonymous wrote:School Psychologist here...I have given the conners thousands of times...I always wondered if any parent would get upset over the nature of some of the questions....but not once in my years as a veteran psych...until I saw this thread.
Same here!
I have been a school psychologist for 24 years. (To my school psych peeps- on the Conners 4 you can now disable conduct disorder questions and print out the questionnaires without them!) I do warn parents that the Connors is for ages 6 to 18 so a few of the questions are not appropriate for elementary school students, so don't be alarmed if there are a few questions about using a weapon, etc. They can skip those or put never or if they have occurred to call me to discuss it. The reason those questions are there is that they are from taken from the criteria to meet Conduct Disorder in the DSM-5. The criteria to meet it is:
A repetitive and persistent pattern of behavior in which the basic rights of others or major age-appropriate societal norms or rules are violated, as manifested by the presence of three (or more) of the following 15 criteria in the past 12 months from any of the categories below, with at least one criterion present in the past 6 months:
Aggression to people and animals
often bullies, threatens, or intimidates others
often initiates physical fights
has used a weapon that can cause serious physical harm to others (e.g., a bat, brick, broken bottle, knife, gun)
has been physically cruel to people
has been physically cruel to animals
has stolen while confronting a victim (e.g., mugging, purse snatching, extortion, armed robbery)
has forced someone into sexual activity
Destruction of property
has deliberately engaged in fire setting with the intention of causing serious damage
has deliberately destroyed others’ property (other than by fire setting)
Deceitfulness or theft
has broken into someone else’s house, building, or car
often lies to obtain goods or favors or to avoid obligations (i.e., “cons” others)
has stolen items of nontrivial value without confronting a victim (e.g., shoplifting, but without breaking and entering; forgery)
Serious violations of rules
often stays out at night despite parental prohibitions, beginning before age 13 years
has run away from home overnight at least twice while living in parental or parental surrogate home (or once without returning for a lengthy period)
is often truant from school, beginning before age 13 years
The disturbance in behavior causes clinically significant impairment in social, academic, or occupational functioning.
Thanks for this. My DD took this test for ADHD and it seemed like they were trying to determine if there was some severe behavior or personality disorder, not just ADHD and if you answered affirmative to these then it was not ADHD and something else. Seems an odd way to determine ADHD. As if well, it's not anti-social or borderline personality so must be ADHD, because there's nothing else left.
Is this really the best way to determine this?
yes
Comorbid conditions, confounding factors, and validation of screening tools to identify disorders are all at play. What do you prefer instead of one of the validated tools that is designed to distinguish the interplay of potentially comorbid and/or confounding disorders?
Look, if a child isn't following instructions, that could be because they have a problem with their hearing. Maybe they don't understand the language. Maybe they try but become easily distracted from the intended path. Maybe they don't hear the instruction because they are shifting focus on different sensations or moving their body. Maybe they can hear and understand, but don't want to follow instructions. Maybe they want to rile the teacher up and know that disobeying will do it.
These all can look the same. Just think about it. And now, how do you think someone is supposed to distinguish between these possible explanations in a systematic way that is validated in research trials to most closely approximate a more detailed assessment (since this is a screen we are talking about)?
No, you don’t screen a 9 year old for conduct disorder when the concern is anxiety or ADHD. The PP school psychologist already explained you can take the sexual/physical violence questions out for younger kids.
The older 3rd edition of the Conners you can't remove them, but the updated version (Conners 4) you can. It came out last year. There aren't that many questionnaires available. Another common questionnaire the BASC doesn't have all the DSM-5 ADHD symptoms for inattention and hyperactivity/impulsivity so I don't find it as helpful if there are concerns about ADHD. Test makers in general don't make school versions and clinic versions of questionnaires. There is one one version. In a school setting, I don't like that Conduct Disorder and Oppositional Defiant Disorder are categories. They are not helpful and can be upsetting. They are not special education eligibility criteria, so I often do not report those areas. I do not want a parent to take my report to a pediatrician and oppositional defiant disorder gets written down somewhere in their medical file.
The criteria for Oppositional Defiant Disorder is:
A pattern of angry/irritable mood, argumentative/defiant behavior, or vindictiveness lasting at least 6 months as evidenced by at least four symptoms of the following categories, and exhibited during interaction with at least one individual who is not a sibling:
Angry/Irritable Mood
1.Often loses temper
2.Is often touchy or easily annoyed
3.Is often angry and resentful
Argumentative/Defiant Behavior
4. Often argues with authority figures or, for children and adolescents, with adults
5.Often actively defies or refuses to comply with requests from authority figures or with rules
6.Often deliberately annoys others
7.Often blames others for his or her mistakes or misbehavior
Vindictiveness
8.Has been spiteful or vindictive at least twice within the past 6 months.
As a SCHOOL psychologist I am trying to find out why a student might lose their tempter, become angry, annoy others, and defy a teacher. Well, the number one reason is that a student CAN'T READ well. How miserable is your life as a student if you struggle each and everyday and have to spend 6 hours a day in class be told to do something that others can do. Think about a 4th grader sitting in class and the teacher has written the schedule on the board that morning. The student asks if there is music class or PE that day. The teacher is annoyed because it is clearly written on the board. Then the teacher tells the kid to get back to work reading a page and answering questions, and the student can neither read the 4th grade passage nor write sentences so the student annoys the kid seated next to him. The teacher tells the student to get back to work, the student obviously doesn't comply and is now angry. See how easy it is to meet Oppositional Defiant Disorder when you struggle. Of course there are teachers when filling out the rating scale that are going to rate the student off the charts for Oppositional Defiant Disorder, but that is not helpful at all. Same routine when a parent tells the kid to do homework.
There is so much money being spent in schools on the wrong things. Schools are constantly talking about equity and trauma/social-emotional learning. Equity isn't spending millions of money to TALK about social justice and social emotional learning, it is actually teaching ALL students to read and write on grade level. Obviously, there are more areas that need to be addressed but this is such a basic and measurable goal. Counseling a student for anger issues is ridiculous when the student is so below grade level. I really believe if you for a massive amount of money into second and third grade reading intervention classes and one-on-one tutoring, you can get most students decoding up to grade level. Comprehension might not be there do to lacking vocabulary and content knowledge but at a bare minimum a student would be functionally literate.