Summary of the PADDS Report Features
The PADDS System and Summary Reports represent a cutting edge advancement in Evidence-based Assessment. This process presents the incremental input of multiple forms of information that research has shown to be most reliable and valid for ADHD assessment. The PADDS system relies on comparison of two well-defined reference groups namely ADHD and Non-ADHD. Each component is calculated in additive or subtractive manner for and against a diagnosis in consideration of the ADHD base rate of 4%. The inputs are displayed in a real time format via a computer generated Nomogram presenting an individual and an overall predictive index of likelihood ratios establishing evidence for or against a diagnosis. Results are likewise presented in a normalized, relative Standard, T/Z-Score, and percentile rank format for comparison to the non-clinical reference group.
Parent and Teacher Ratings
The PADDS first step inputs consist of Parent and Teachers ratings of the behavioral criteria for ADHD based on criteria set by the Diagnostic and Statistical Manual of Mental Disorders Fourth Edition-Revised. Specifically, these criteria as rated by short form SNAP-IV (Swanson et al., 1992, with permission 02/08). The SNAP scales offer categorical and dimensional input across the 18 core diagnostic items from the DSM-IV. Each scale has been evaluated to set a threshold for ascribing clinical significance based on the number of items endorsed in conjunction with a threshold for severity. The thresholds were added to the original DSM-IV criteria to reduce the rate of over identification that can occur when only number of items endorsed is used. These behavioral criteria when used in the above-described manner have produced solid sensitivity and specificity in identifying ADHD cases relative to non-clinical reference groups (Zolotor and Mayer, 2004; Green, et al. 1999). These authors report the sensitivity and specificity of various short form ADHD checklists ranging between .70 and .97 percent with the most productive being the SNAP-III R/SNAP-IV which has estimated between 90 to 97 percent sensitive and specific.
Using the Ratings Scales in Conjunction With the PADDS System
The SNAP-IV forms are included for parent and teachers to complete along with the CADI or they can be copied or printed from the PADDS Tools menu and then input with the CADI or independent of the CADI. The CADI input is generated via a separate report function and does not have to be used to score and report the behavior ratings along with the cognitive subtests of the PADDS system. If the CADI is not used, it is advised to do some other form of co-morbid condition screening. If the SNAP-IV scales are not used, other ratings such as Vanderbilt or Brief may be input when running the scoring function for the cognitive subtests by placing a check mark in an assigned box which will trigger the automatic calculation and conversion of sensitivity and specificity set at a default of 90%.
This results in the assignment of a standard likelihood ratio and allows the result from the parent, teacher or both to be incrementally input along with performance on three cognitive tests of executive functions. The second component of the PADDS Summary Report consists of the review of the Computer Assisted Diagnostic Interview or CADI which enables the clinician to review multiple potential areas of concern as highlighted by the parent or informant that can be relevant to ruling out comorbid or exacerbating conditions for a given child. This cross validation represents a semi-structured interview and develops a preliminary treatment plan to help support decisions for further assessment and/or referral.
PADDS Research
- Psychometric Properties
- ROC of PADDS
- Clinical Demographics
- Incremental validity
- System Components
- Target Test Development
- Manual Research Excerpt
- Research Opportunities
- Our Important Associates
PADDS Links
- Purchase PADDS.
- PADDS Upgrade
- PADDS FAQ
- PADDS Tutorials
- Sample Forms & Reports
- Published Works
- Testimonials.
- About PADDS.
- Informational Handout
- PADDS Brochure(pdf)
- Installation and Use pdf
- PADDS Quick Start Guide
Sample Reports(pdf)
- Cognitive Tests (TTEF)
- SNAP-IV Parent/Teacher
- Case Study Reports
- PADDS Scoring
- Bell Curve Description
- CADI (Diagnostic Interview)
Forms and Protocols (pdf)
The third component of the PADDS system represents objective assessment of a child's executive functions and working memory. The Target Tests of Executive Functioning have demonstrated superior ability as an adjunct to cross validate behavioral observation and background report. The process is quick and enjoyable and demonstrates superior Reliability, Validity, Sensitivity/Specificity, and Positive and Negative Predictive power over any other measure of its kind currently available (Please refer to the psychometric development and performance section of the PADDS Clinical Manual). These Executive measures were designed to be enjoyable, engaging and ecologically valid by requiring demands that are more consistent with those required in the typical classroom setting. Extensive research has shown that children routinely report them as "fun but hard", typically avoiding the strong negative emotions that are commonly evoked when taking traditional CPTs.
The fourth and final component is the nomographic display of the individual and cumulative inputs. This evidence is evaluated stepwise via the calculation of likelihood Ratios applied incrementally with a Fagan's Nomogram, the results produce an overall predictive index that is compared to a conservative base rate of 4% (ADHD prevalence at 4%). When these components are used in conjunction with clinical judgment they have proven to be highly effective for consideration of diagnosis, in highlighting and documenting a need for further evaluation or actions, and may allow the clinician to evaluate their own diagnostic practices and effectiveness over time.
