myAHD.com SNAP-IV-C Rating Scale

1 Rating M. Swnason, , University of Cali fornia, I rvine, CA 92715 Child's name:_____ Gender_____ Age:_____ Grade:_____Date: _____Ethnicity (check one which best applies) African-American Asian Caucasian Hispanic Other _____Completed by:_____ Type of Class _____ Class Size: _____For each of the 90 items, check the column which best describes this atal lJust aLi ttl eQuite ABi en f ails t o give close at t ention t o details or makes careless mistakes in schoolwork, work,or ot her en has diff iculty sustaining at t ention in t asks or play en does not seem t o listen when spoken t o en does not f ollow t hrough on instructions and f ails t o f inish schoolwork, chores, or en has diff iculty organizing t asks and en avoids, dislikes, or is reluctant t o engage in t asks t hat require sustained mental ef f ort( , schoolwork or homework) en loses t hings necessary f or t asks or activities ( , t oys, school assignments, pencils,books, or t ools)

2 En is distracted by extraneous st en is f orgetf ul in daily en has diff iculty maintaining alertness, orienting t o requests, or executing en f idgets with hands or f eet or squirms in en leaves seat in classroom or in ot her sit uations in whihc remaining seted is en runs about or climbs excessively in sit uations in which it is en has diff iculty playing or engaging in leisure activities en is "on t he go" or of t en acts as if "driven by a motor" en t alks en blurts out answers before questions have been en has diff iculty awaiting t urn19 Oft en interrupts or intrudes on ot hers ( , butt s into en has diff iculty sit t ing st ill, being quiet, or inhibiting impulses in t he classroom or at en loses t en argues with en actively defies or refuses adult requests or en deliberately does t hings t hat annoy ot her en blames ot hers f or his or her mistakes or en t ouchy or easily annoyed by ot en is angry and resentf en is spitef ul or en is en is negative, defiant, disobedient, or hostile t oward authority f en makes noises ( , humming or odd sounds) en is excitable, en cries en is en acts "smart" en is restless or en distrubs ot her en changes mood quickly and en easily f rustrated if demands are not met en t eases ot her children and interferes with t heir en is aggressive t o ot her children ( , picks f ights or bullies) en is destructive with property of ot hers ( , vandalism) en is deceitf ul ( , st eals, lies, f orges, copies t he work of ot hers, or "cons"))

3 En and seriously violates rules ( , is t ruant, runs away, or completely ignores classrules) persistent patt ern of violating t he basic rights of ot hers or major societal episodes of f ailure t o resist aggressive impulses (t o assault ot hers or t o destroy property) motor or verbal t ics (sudden, rapid, recurrent, non-rhythmic motor or verbal activity) repetit ive motor behavior ( , hand waving, body rocking, or picking at skin) obsessions (a persistent and intrusive inappropriate ideas, t houghts, or impulses) compulsions (repetit ive behaviors or mental acts t o reduce anxiety or distress) en is restless or seems keyed up or on en is easily f at en has diff iculty concentrating (mind goes blank) en is en has muscle t en has excessive anxiety and worry ( , apprehensive expectat ions) en has daytime sleepiness (unintended sleeping in inappropriate sit uations) en has excessive emotionality and at t ention-seeking en has need f or undue admiration, grandiose behavior, or lack of en has instability in relationships with ot hers, reactive mood, and , f or at least a week, has inflated self-esteem or , f or at least a week, is more t alkative t han usual or seems pressured t o keept , f or at least a week, has f light of ideas or says t hat t houghts are , f or at least a week, has elevated, expansive or euphoric , f or at least a week, is excessively involved in pleasurable but risky , f or at least 2 weeks, has depressed mood (sad, hopeless, discouraged) , f or at least 2 weeks, has irritable or cranky mood (not just when f rustrated) , f or at least 2 weeks, has markedly diminished interest or pleasure in , f or at least 2 weeks, has psychomotor agitat ion (even more active t han usual) , f or at least 2 weeks, has psychomotor retardation (slowed down in mostactivities)

4 , f or at least 2 weeks, is f at igued or has loss of , f or at least 2 weeks, has f eelings of worthlessness or excessive, , f or at least 2 weeks, has diminished ability t o t hink or low self-esteem most of t he t ime f or at least a poor concentration or diff iculty making decsisions most of t he t ime f or at least a f eelings of hopelessness most of t he t ime f or at least a is hypervigilant (overly watchful or alert) or has exaggerated st artle is irritable, has anger outbursts, or has diff iculty has an emotional ( , nervous, worried, hopeless, t earful) response t o st diff iculty gett ing st arted on classroom diff iculty st aying on t ask f or an entire classroom problems in completion of work on classroom problems in accuracy or neatness of writt en work in t he diff iculty at t ending t o a group classroom activity or diff iculty making t ransitions t o t he next t opic or classroom problems in interactions with peers in t he problems in interactions with st af f (t eacher or aide) diff iculty remaining quiet according t o classroom diff iculty st aying seated according t o classroom rulesSections below t o be completed by health care f ollowing are it ems t hat make up various subscales.

5 First f our rows provide t he cutof f sf or ADHD and ODD subscales. See instructions below f or f urther ofI t ems f orEachScaleAverageRatingPer I t emf or EachScaleTeacher5%Cutof fParent5%Cutof fAverage score f or ADHD-Inatt ention (it ems 1-9)2. 561. 78 Average score f or ADHD-Hyperactivity-Impulsivity (it ems 11-19)1. 781. 44 Average score f or ADHD-Combined t ype (it ems 1-9 and 11-19)2. 001. 67 Average score f or Oppositional I t ems (sum of it ems 21-28)1. 381. 88 Average score f or I natt ention/Overactivity I t ems (it ems 4, 8, 11, 31, and 32)Average score f or Aggression/Defiance I t ems (it ems 21, 23, 29, 34, and 35)Average score f or Conners I ndex it ems which is a general index of childhood problems (it ems4, 8, 11,21,32, 33, 36, 37, 38, and 39)Conduct Disorder (it ems 41, 42, 43, 44, and 45)I nt ermitt ent Explosive Disorder (it em 46)St ereotypic Movement Disorder (it em 48)Obsessive-Compulsive Disorder (it ems 49 and 50)Generalized Anxiety Disorder (it ems 51, 52, 53, 54, 55, and 56)Narcolepsy (it em 57)Histrionic Personality Disorder (it em 58)Narcissistic Personality Disorder (it em 59)Borderline Personality Disorder (it em 60)Manic Episode (it ems 61, 62, 63, 64, and 65)Dysthymic Disorder (it ems 74, 75, and 76)Postt raumatic St ress Disorder (it ems 77 and 78)Adjustment Disorder (it ems 79 and 80)

6 The SNAP-IV-C Rating Scale is a revision of t he Swanson, Nolan and Pelham (SNAP) Questionnaire (Swanson et al, 1983). The it emsf rom t he DSM-IV (1994) criteria f or ADHD are included f or t he t wo subsets of symptoms: inatt ention (it ems # 1-9) andhyperactivity/ impulsivity (it ems # 11-19). Also. it ems are included f rom t he DSM-IV criteria f or Oppositional Defiant Disorder (it ems #21-28) since it of t en is present in children with ADHD. I t ems have been added t o summarize t he I natt ention domain (# 10) and t heHyperactivity/ I mpulsivity domain (# 20) of ADHD. Two ot her it ems were added: an it em f rom DSM-II I -R (# 29) t hat was not included int he DSM-IV list f or ODD, and an it em t o summarize t he ODD domain (# 30). The 4-point response is scored 0-3 (Not at All=0, Just A Litt le=1, Quite a Bit=2, and Very Much=3). Subscale scores f or t he ADHD andODD subscales on t he SNAP-IV are calculated by summing t he scores on t he it ems in t he specific subset (eg.)

7 , I natt ention) and dividingby t he number of it ems in t he subset (eg., 9). The score f or any subset is expressed as t he Average Rating -Per-It em. The 5% cutof fscores f or t eachers and parents are provided. Compare t he Average Rating Per I t em score t o t he cut of f score t o determine if t he scoref alls within t he t op 5% of extreme scores. I n addition t o t he DSM-IV it ems f or ADHD and ODD, t he SNAP-IV-C contains it ems f rom t he Conners I ndex Questionnaire (Conners,1968) and t he I OWA Conners Questionnaire (Loney and Milich, 1985). The I OWA was developed using divergent validity t o separateit ems which measure inatt ention/overactivity (I / O items # 4, 8, 11, 31, 32) f rom t hose it ems which measure aggression/defiance (A/D items # 21, 23, 29, 34, 35). The Conners I ndex (it ems #4, 8, 11, 21, 32, 33, 36, 37, 38, 39) was developed by selecting t he it emswhich loaded highest on t he multiple f actors of t he Conners Questionnaire, and t hus represents a general index of childhood problems.

8 Finally, t he SNAP-IV-C includes t he 10 it ems (# 81-90) of t he Swanson, Kotkin, Agler, MyInn, and Pelham (SKAMP) Rating it ems are classroom manifestat ions of inatt ention, hyperactivity, and impulsivity (i. e. , gett ing st arted, st aying on t ask, interactionswith ot hers, completing work, and shift ing activities). The SKAMP may be used t o estimate severity of impairment in t he SNAP-IV-C Rating Scale by James Swanson, UCI, I rvine, CA. Printed with permission. All rights reserved. Copies may be made active members only.