Systematic Review and Meta-analysis: Screening Tools for Attention-Deficit/Hyperactivity Disorder in Children and Adolescents
Open accessAbstract
Objective This systematic review and meta-analysis aimed to determine the accuracies of a broad range of screening tools for attention-deficit/hyperactivity disorder (ADHD) in children and adolescents, and to compare the diagnostic accuracy of tools between population-based and clinical/high-risk samples, and across reporters. Method MEDLINE, PsycINFO, EMBASE, and PubMed were searched up until February 20, 2020, with no language restrictions. Studies reporting diagnostic accuracy of a screening tool against a diagnosis of ADHD in children and adolescents <18 years of age were eligible for inclusion. Meta-analyses were undertaken to provide pooled estimates of the area under the curve (AUC), and sensitivity and specificity of groups of measures. Results A total of 75 studies published between 1985 and 2021 reporting on 41 screening tools that were grouped into 4 categories (Achenbach System of Empirically Based Assessment [ASEBA], DSM-IV symptom scales, SDQ, and Other Scales) were retained. The pooled AUC for studies using a combined ADHD symptoms score was 0.82 (95% CI = 0.78-0.86), although this varied considerably across reporters (0.67-0.92) and populations (CI = 0.60-0.95). None of the measures met minimal standards for acceptable sensitivity (0.8) and specificity (0.8). Conclusion Most tools have excellent overall diagnostic accuracy as indicated by the AUC. However, a single measure completed by a single reporter is unlikely to have sufficient sensitivity and specificity for clinical use or population screening.
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There are varying levels of evidence for a link between joint hypermobility and ASD, DCD and anxiety disorders in child cohorts.
“Additionally, there are varying levels of evidence for a link with ASD, 20,22,23 DCD 24–28 and anxiety disorders. 29,30”
From No association between joint hypermobility, musculoskeletal pain and neurodevelopmental problems in a school-based sample of 11-year-old children (2025) · cites this paper as [27]
The Discussion and sensitivity-analysis passages concern the accuracy of ADHD screening tools, not joint hypermobility. Searches for joint hypermobility with ASD, DCD, and anxiety disorders found no passage in our copy addressing the claimed links. The supplied passages have no page numbers. (LLM, conf=0.78)
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References 25 · Cited by 81
Research works printed but not linked: 20
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- Authors
- Mulraney, M., Arrondo, G., Musullulu, H., Iturmendi-Sabater, I., Cortese, S., Westwood, S. J., Donno, F., Banaschewski, T., Simonoff, E., Zuddas, A., Döpfner, M., Hinshaw, S. P., & Coghill, D.
- Affiliations
- The University of Melbourne (AU)
- University of Southampton (GB)
- University of Toronto (CA)
- University of Nottingham (GB)
- University of Wolverhampton (GB)
- University of Cagliari (IT)
- Heidelberg University (DE)
- NIHR Maudsley Biomedical Research Centre (GB)
- University of Cologne (DE)
- University of California, San Francisco (US)
- Corresponding author
- Mulraney, Melissa
- ORCID
- Venue
- Journal of the American Academy of Child & Adolescent Psychiatry
- Publisher
- Elsevier BV
- Published
- 2022-08
- Volume
- 61
- Issue
- 8
- Pages
- 982-996
- ISSN
- 0890-8567 (ISSN-L)
- OpenAlex
- W4200403482
- Cited by
- 81
- References
- 25
- Citations by year
- 2026: 14 · 2025: 32 · 2024: 17 · 2023: 15 · 2022: 3
- FWCI
- 1.56
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Journal of the American Academy of Child & Adolescent Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Kölner Universitäts PublikationsServer (Universität zu Köln) (publishedVersion)
- ePrints Soton (University of Southampton) (acceptedVersion)
- UNICA IRIS Institutional Research Information System (University of Cagliari) (submittedVersion, other-oa)
- Research Portal (King's College London) (submittedVersion)
- Funders
- Eli Lilly and Company
- Children's Hospital Foundation
- Ministerio de Ciencia, Innovación y Universidades
- Royal Children's Hospital Foundation
- University of Oxford
- European Commission
- Deutsche Forschungsgemeinschaft
- Servier
- H. Lundbeck A/S
- Medical Research Council
- Economic and Social Research Council
- National Institute of Mental Health
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Attention Deficit Hyperactivity Disorder
- Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
- Life Sciences › Neuroscience › Cognitive Neuroscience › Autism Spectrum Disorder Research
- Keywords
- attention deficit hyperactivity disorder, diagnostic accuracy, children, adolescents, ASEBA, Strengths and Difficulties Questionnaire, sensitivity and specificity, mass screening
- MeSH terms
- Adolescent, Attention Deficit Disorder with Hyperactivity, Child, Humans, Mass Screening, Sensitivity and Specificity, Diagnostic and Statistical Manual of Mental Disorders
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