C. Keith Conners, Ph.D. DSM-5 UPDATE - Paa .au

Conners 3rd Edition (Conners 3 ) Interpretative Considerations: Reports produced using the DSM-5 scoring option include DSM-5 Symptom Counts and interpretative considerations. Inattentive, Hyperactive-Impulsive, and Combined subtypes were reclassified as presentations in the DSM‑5. ADHD The following is a list of changes made in the DSM-5 to the diagnostic criteria for ADHD that required corresponding updates to the Conners 3 assessment. Tables 1a and 1b show the DSM-5 criteria for ADHD, the associated Conners 3 form items, and the response choices for when symptoms are Indicated, May be Indicated, or Not Indicated. Response Style Analysis CONNERS 3 –Teacher Scoring and Reporting Adjustments: Inconsistency Index The names of the Conners 3 DSM Scales for ADHD were updated to reflect this reclassification. A statement was added in the DSM-5 to the pre-amble for both ADHD Predominantly Inattentive Presentation (Criterion A1) and ADHD Predominantly HyperactiveImpulsive Presentation (Criterion A2) that explicitly Student's Name/ID: requires the diagnostician to rule out “oppositional behavior, defiance, hostility, or failure to understand Gender: M F Teacher's Name/ID: (Circle One) tasks or instructions,” as the primary causes of ADHD symptoms. Instructions: In the DSM-5, the symptom count was reduced for 1. For each of the following items, transfer the circled scores from the Scoring Grid into the appropriate boxes, below. Conduct Disorder Tobelow address 2.older For eachadolescents pair of items, subtract the lower value(17 from the higher and value and write the difference in the box directly each pair.the differential diagnosis consideration and adults years older), 3. Sum the Absolute Differences to get the Inconsistency Index Total (box A). Required Score Item Item added to Criterion A1 and Criterion A2, ifDSM-5 the 4.from Write the absolute differences that are equalof to 2Inattentive or 3 in box B. 6number to 5 ofsymptoms from each and/or May be Indic Criterion Number Score 5. Insert a checkmark in the box provided if a possible inconsistent response style is indicated. Indicated Symptom Count is probably met for any of the Hyperactive-Impulsive presentations. 1 2 A1 Item Item Item Item Item Item Item Item Item Item Item Item Item Item ADHD Item Itempresentations, Item Item Item the Item assessor must rule out 98 97 100 52 63 4 77 26 29 98 105 25 57 23 44 34 89 47 71 1 2 A2 105 Item The change to the symptom count7 for13 older these behaviors as the primary cause of theA3 ADHD 14 Score 1 2 adolescents (17–18-year-olds) is incorporated into Absolute symptoms. considerationA4 1 2 35 This interpretative A Difference scoring algorithms for the Conners 3 reports, such that 1 2 automatically appears in the Conners 3 Assessment A5 21 Inconsistency Index Total (A) 5 symptoms are required for the Symptom Count to 1 2 A6 27 Reports when the Symptom Count is probably Possible inconsistent response style indicated Number of Absolute 1 2 be probably met for ADHD Predominantly Inattentive A7 33 B met for any of the ADHD presentations (see the Differences 2 or 3 (B) if A 6 and B 2 1 2 A8 61 Presentation and ADHD Predominantly HyperactiveInterpretative Considerations for Table 1a and 1b, 10 1 2 A9 Presentation. ADHD Combined Presentation PI Impulsive and NI Scale Guidelines DSM-5 Symptom Count and Criterion Status 1 2 A10 Score 90 Instructions: requires 5 symptoms each from inattentive and 2 Requirements for ADHD). A11 40 1. Transfer the Total Raw Scores for both the Positive Impression (PI) and Negative Impression (NI) Scales from the Scoring Grid into the Raw Score column of the table, below. hyperactive-impulsive symptom For hand2. Insert a checkmark in the Interpretive Guideline box if thecriteria. response style is indicated. 1 2 A12 31 A lifespan-specific example was added to Criterion Score Interpretive Guideline 1 2 scoring, the QuikScore Raw forms are updated to note the A15 54 A1h in the DSM-5, Total Symptom C Positive Impression (PI) different symptom count requirements forPossible individuals positive response style indicated if Raw Score 5. illustrating how the symptom of distraction may present in older adolescents. 16 years of age 17 years of response style Negative Impression (NI) and younger, versus those Possible negative indicated if Raw Score 5. Symptom criteria probably met if Total Sympt age and older (see Figure 1). An interpretative consideration is includedNOTE: in The theConners 3–T does not assess Criterion A13 (staying out at n (sum all chec DSM-5 Symptom Counts or Criterion A14 (running away from home). These criteria have been int most teachers do not have the opportunity to observe these infractions. Conners 3 Assessment Report to account for this Instructions: change (see Interpretative Considerations for Table 1a). 1. For each item number listed below, transfer the circled score from the Scoring Grid into the Item Score column. 2. If the Item Score is equal to a number in either Required Score column, circle that number in the May be Indicated or Indicated column. NOTE: Do not circle anything if the Item Score does not match any number in either Required Score column or if the item has been omitted. 3. Insert a checkmark in the ( ) column if a score has been circled in either Required Score column. a) For ADHD Inattentive Criterion A1d, insert a checkmark only if a Required Score has been circled for both items 73 and 57. b) For ADHD Hyperactive-Impulsive Criterion A2c, insert a checkmark if a Required Score has been circled for either (or both) items 24 or 7. c) For ADHD Hyperactive-Impulsive Criterion A2e, insert a checkmark if a Required Score has been circled for either (or both) items 17 or 78. 4. Count all checkmarks and write the sum in the Total Symptom Count box. 5. Insert a checkmark in the box at the bottom of the table if the symptom criteria is probably met. Impairment Instructions: For each item listed in the Impairment table below, refer to the Figure 1. referConners 3–Teacher QuikScore Form -that Symptom Requirements NOTE: Please to the Conners 3 Manual and DSM-5 Update for exceptions may alter the Count Total Symptom Count. ADHD Inattentive C. Keith Conners, Ph.D. DSM-5 Criterion Item Number Item Score Required Score May be Indicated ( ) Indicated DSM-5 Criterion Item Number Item Score 113. The student’s problems seriously affect friendship 37 2 3 A2a 4 2 111 2 3 A2b 1 2 3 2 3 73 2 3 57 2 3 A1e 103 2 3 A1f 60 A1g 92 2 3 A1h 23 2 3 A1i 88 2 3 A1d 2 BOTH items circled 3 Total Symptom Count (sum all checkmarks) Age 16; Symptom criteria probably met if Total Symptom Count 6 Age 17; Symptom criteria probably met if Total Symptom Count 5 ADHD Combined A2c A2d 3 24 1 2 3 7 1 2 3 2 3 32 17 1 2 3 78 1 2 3 50 2 3 A2g 9 2 3 A2h 76 2 3 A2i 29 2 3 A2e A2f ( ) Indicated A1b 69 112. The student’s problems seriously affect schoolwo Required Score May be Indicated A1a A1c 2 Item ADHD Hyperactive-Impulsive EITHER item circled EITHER item circled Total Symptom Count Conners 3 ADHD Inde Instructions: 1. For each item listed below, transfer the circled score from th 2. Transpose each score by following the Transposing Rule an 3. Sum the transposed scores to obtain the Total Transposed 4. Determine the probability of a classification of ADHD by circ Item 4 Item 7 Item 13 0, 1 2 3 0 1 2 0, 1 2 3 0 1 2 Statements for Item Score determining if 0,the 1 2 TotalTransposing Symptom Rule 0 1 Count is probably Transposed met. Score 3 2 Total Transposed Score 0 1 2 3 4 5 Probability (%) 19 39 51 52 58 6 0 (sum all checkmarks) Age 16; Symptom criteria probably met if Total Symptom Count 6 Age 17; Symptom criteria probably met if Total Symptom Count 5 Symptom criteria probably met if symptom criteria probably met for ADHD Inattentive and ADHD Hyperactive-Impulsive Conners 3

DSM-5 Update CD Scoring and Reporting Adjustments: Criterion A in the DSM-5 divides ODD symptom Revisions made in the DSM-5 to the diagnostic criteria for criteria into three types of behaviors, including Angry/ CD did not impact Criterion A symptoms (those symptoms Irritable Mood, Argumentative/Defiant Behavior, and assessed by the Conners 3); they are essentially identical to Vindictiveness. As a result of this change, diagnostic those printed in the DSM-IV-TR. Table 2 shows the DSM-5 Conners 3–T Assessment Report for Test Admin Date: 11/11/2013 criteria for ODD were reordered as follows: criteria for CD, the associated Conners 3 form items, and the response choices for when symptoms are Indicated, May be DSM-5 Conduct Disorder Criterion A1 in the DSM-5 is in the same order it was Indicated, or Not Indicated. the DSM-IV-TR DSM-5 Symptoms: Criterion A Item Teacher's in Rating Criterion Status Aggression to People and Animals Number 0 1 2 Scoring and Reporting Adjustments: A1. 98 A2. 105 A3. 14 None. Interpretative Considerations:35 A4. A5.changes were made to the interpretative 21considerations No for CD. Table 2 includes interpretative considerations for CD A6. 27 that A7. apply to the DSM-5 Symptom Scales;33however, these notes are identical to the interpretative considerations for Destruction of Property the DSM-IV-TR Symptom Scales. The notes A8. 61are provided in this supplement to facilitate interpretation of the Symptom A9. 10 Count for DSM-5 scoring. Deceitfulness or Theft 3 ? Criterion A2 in the DSM-5 was Criterion A6 in the DSM-IV-TR Indicated ü Criterion A3 in the DSM-5 was Criterion A7 in the Indicated ü DSM-IV-TR Indicated ü Criterion A4 in the DSM-5 was Criterion A2 in the Indicated ü DSM-IV-TR Indicated ü Indicated ü Criterion A5 in the DSM-5 was Criterion A3 in the DSM-IV-TR Indicated ü Criterion A6 in the DSM-5 was Criterion A4 in the Indicated¹ ü DSM-IV-TR Indicated¹ ü Criterion A7 in the DSM-5 was Criterion A5 in the DSM-IV-TR A10. 90 Indicated ü Criterion A8 in the DSM-5 is in the same order it was A11. 40 Indicated ü ODD in the DSM-IV-TR A12. 31 Indicated ü Table 3 shows the DSM-5 criteria for ODD, the associated In the Conners 3, symptom criteria are reordered Serious Violations of Rules Conners 3 form items, and the response choices for and ü labeled as they are in the DSM-5 (i.e., Angry/ A15. 54 Indicated² when symptoms are Indicated, May be Indicated, or Not Irritable Mood, Argumentative/Defiant Behavior, and ¹Both Criterion (fire setting) andthat Criterion A9the (destruction were indicated. In order to meet Criterion A9, Indicated. ThereA8are two changes affected reportingof property) Vindictiveness; see Figure 2) in all of the ODD tables the assessor must confirm that property was destroyed other than by fire-setting (Criterion A8). and scoring of the Conners 3 scales, and some other in the reports. Similarly, the change to the order of interpretative considerations. symptom criteria for ODD is incorporated ²In order for Criterion A15 (truancy) to be indicated the assessor needs to ensure this criterion occurred before theinto agethe of 13 years. ODD table in the DSM-5 Symptom Counts section of the QuikScore forms (see Figure 3). Note: The Conners 3–T does not assess Criterion A13 (staying out at night without permission) or Criterion A14 (running away from home), as most teachers do not have the opportunity to observe these infractions. Figure 2. Conners 3–Teacher Assessment Report - DSM-5 Symptom Table DSM-5 Oppositional Defiant Disorder DSM-5 Symptoms: Criterion A Angry/Irritable Mood Item Number 0 A1. 62 A2. 56 A3. 38 Teacher's Rating 1 2 3 ? ü ü ü Indicated Indicated Indicated Argumentative/Defiant Behavior A4. 47 A5. 71 A6. 59 A7. 64 ü ü ü ü 51 ü Vindictiveness A8. Criterion Status Indicated Indicated Indicated Indicated Indicated Symptom criteria reordered and labeled. 3

Conners 3rd Edition (Conners 3 ) Age: / / Name/ID: Birth Date: (Circle One) Month Day Year Conduct Disorder Oppositional Defiant Disorder Item 61 Item 25 Item Number Item A1 38 A2 A3 A1 67 A2 24 A 1 nt response style A4 indicated 3 A5 62 A6 74 e Raw Score column of the table, below. A7 87 A8 94 Score 4. w Score 5. t 3 25 A3 59 2 86 2 13 A8 72 A9 82 A10 78 1 1 3 3 47 A6 ( ) May be Indicated 3 38 A4 A5 Inconsistency Index Total (A) 2 Day Year Month Day Year 2 3 2 3 3 A11 16 2 A12 52 A13 91 2 A14 8 A15 33 2 Oppositional Defiant Disorder Required Score Change 1 ( ) toIndicated order of criteria. 2 3[Note: There are 2 3 different item 1 2 3 numbers for 1 2 3 criteria A2 to 1 2 3 A7 in table (a) 1 2 3 vs. (b)]. 2 3 1 2 3 1 2 3 2 3 to Change 1 2 3 criterion 1 2 score 3 status 1 2 3 requirements for ODD 1 2 3 Criterion Total Symptom Count A8. 3 3 Total Symptom Count Trim parts 2, 3, 4 & 5 to 17.125 in. Item 43 Required Score Item Item Item DSM-5 May beNumber Indicated Score ScoreCriterion Indicated Copyright 2008 Multi-Health Systems Inc. All rights reserved. In the United States, P.O. Box 950, North Tonawanda, NY 14120-0950, 1-800-456-3003. In Canada, 3770 Victoria Park Ave., Toronto, ON M2H 3M6, 1-800-268-6011, 1-416-492-2627, Fax 1-416-492-3343. DSM-IV-TR Criterion ( ) Month / / (b) DSM-5 Symptom Scale (a) DSM-IV-TR Symptom Scale air. Birth Date: / / Years Months MonthQuikScore Day Year Conners 3–Self-Report Form F Grade: and Criterion Status Score RequirementsAdministration Date: Administration Date: Change toGender: Order ofM / / Symptom Criteria Required Score DSM-5 Criterion Item Number Item Score A1 67 A2 74 2 3 A3 87 2 3 A4 24 2 3 A5 1 A6 3 2 3 A7 62 2 3 A8 94 2 3 May be Indicated 2 met Symptom probably Symptom criteria probably if Totalcriteria Symptom Countmet 4if Total Symptom Count 3 3 2 3 1 Total Symptom Count (sum all checkmarks) (sum all checkmarks) (sum all checkmarks) ( ) Indicated Symptom criteria probably met if Total Symptom Count 4 NOTE: The Conners 3–SR does not assess Criterion A7 (forced sexual activity). This criterion has been intentionally omitted due to the sensitive nature of this criterion. criterion Summary In the DSM-5, a frequency qualifier was added to Criterion A8 of “atImpairment least twice within the past 6 Instructions: With the of the DSM-5, it was necessary to review months,” for spiteful or item vindictive behavior. items 31 or For each listed in the Impairment table below, refer to the Scoring Grid and circle the release score. dh)and circle the39. score. 1 and 17. the Conners 3 Manual and associated materials (i.e., the (or both) items 20 or 7. 55.Criterion status score requirements are updated on the Impairment (or both) items 66 or Impairment QuikScore forms, Conners 3 Software Program, and Not true at all/ Just a little true/ Pretty much true/ Very much true/ Conners 3–SR accommodate frequency Not true at all/ Just a littleto true/ Pretty much true/the Very much true/ qualifier Item never occasionally veryneed often to online components, including reports)often to assess the never occasionally often very often added to Criterion A8 (see Figure 3). Specifically, for 0 1 Scales. This 2 review led 3to the 95. I have problems that make school really hard for me. update the DSM Symptom 0 1 2 3 or vindictive behavior to be tive-Impulsive the symptom of spiteful 1 2 3 96. I have problems that make friendships really hard for me. determination0that with some 0 1 2 3 small modifications scoring classified as May be Indicated on the Conners 3–SR, Required Score 0 1 2 Scales could 3 97. I have problems that make things really hard for me at home. 0 1 2 3 me. and interpretation of the DSM Symptom be ( ) May be Indicateda response of 1 [Just a little true (Occasionally)] is ndicated aligned with the diagnostic criteria in the DSM-5. The required. Previously, a response of 1 was classified as 2 3 Conners 3 ADHD Index Conners 3 Manual contains most of the material required to 2 3 Not Indicated. However, it was determined that the Instructions: administer, score, 1. For itemtrue listed below, transfer the circled score from the Scoring Grid into the Item Score row. and interpret the assessment. This update 3 row. frequency of “Just a each little (Occasionally)” applies Grid into the Item2Score 2. Transpose each score by following the Transposing Rule and enter the score into each Transposed Score box. score into each 2 Transposed Score box. 3 better reporting and scoring changes, and interpretative 3. Sum the transposed to obtain the Total Transposed circle this score in the Probability Score table. to atable. behavior that meets scores symptom criteria if Score, thendetails circle this score in the Probability Score 4. Determine the probability of a classification of ADHD by circling the corresponding Probability score. 2 3 score. esponding Probability considerations that need to be taken into account when using it occurs at least twice within the past 6 months. 1 Item 2 3Item Item Item Item Item Item Item Item Item Item Item Item Item Item Item 6 63 not change 9 21 34 35 43 50 61 interpret 63 DSM-5 symptom criteria to score and the DSM Symptom did on15the 43 count50requirements 61 3 35 2 34 Item Score Symptom Scales on the Conners 3. 2 3 Conners 3–P and Conners 3–T; existing criterion 2 1 32 30, 1 2 3 0, 1 2 3 0, 1 2 3 0, 1 2, 3 0, 1 2, 3 0, 1 2 3 0, 1 2, 3 0, 1 2, 3 0, 1 2 3 0, 1 2, 3 0, 1 2, 3 0, 1 2 3 0, 1 2, 3 0, 1 2, 0, 3 1 0, 2 3 status score requirements for this frequency Transposing Ruleaccount of 0 1 2 0 1 2 0 1 0 2 0 1 2 0 1 0 2 0 1 2 0 1 2 03 spiteful 2 0 or 1 2vindictive 0 1 0 2 0 10 21 2 0 1 2 behavior. Transposed Score d column. s been omitted. EITHER item circled EITHER item circled 2 3 otal Symptom Count Total Transposed Score Total Interpretative Considerations:Transposed Score (sum all checkmarks) et if Total Symptom Count 6 Criterion A now states that the symptoms that define Conners 3 ADHD Index Probability Score Total Transposed Score interaction must be “exhibited during with3 at least 016 117 218 4 5 6 7 8 9 10 11 6 7 8 ODD 9 10 11 12 13 14 15 Probability (%) 59 66 73 78 83 87 91 94 DHD 78 Inattentive and 73 83 one 87 individual 91 94 who 96 97 not98a sibling.” 98 26 99 35 99 44 99 52 is et if TotalIndex SymptomProbability Count 5 DHD Score To address this change, the following interpretative consideration should be taken into account when the Symptom Count is probably met for ODD: “ODD Criterion A states that symptoms must be exhibited during interaction with at least one individual who is not a sibling. If the Symptom Count is probably met for ODD, follow-up is recommended to ensure this requirement is satisfied” (see Interpretative Considerations for Table 3). This interpretative consideration automatically appears in the Conners 3 Assessment Reports when the Symptom Count is probably met. 4 12 13 14 15 16 17 18 96 97 98 98 99 99 99 Trim parts 2, 3, 4 & 5 to 17.125 in. FigureMonths 3. Years Copyright 2008, 2014 Multi-Health Systems Inc. All rights reserved. In the United States, P.O. Box 950, North Tonawanda, NY 14120-0950, 1-800-456-3003. In Canada, 3770 Victoria Park Ave., Toronto, ON M2H 3M6, 1-800-268-6011, 1-416-492-2627, Fax 1-416-492-3343. Age:

1a 1b 1c 1d 1e 1f 1g Often fails to give close attention to details or makes careless mistakes in schoolwork, at work, or during other activities (e.g., overlooks or misses details, work is inaccurate). Often has difficulty sustaining attention in tasks or play activities (e.g., has difficulty remaining focused during lectures, conversations, or lengthy reading). Often does not seem to listen when spoken to directly (e.g., mind seems elsewhere, even in the absence of any obvious distraction). Often does not follow through on instructions and fails to finish schoolwork, chores, or duties in the workplace (e.g., starts tasks but quickly loses focus and is easily sidetracked). Often has difficulty organizing tasks and activities (e.g., difficulty managing sequential tasks; difficulty keeping materials and belongings in order; messy, disorganized, work; has poor time management; fails to meet deadlines). Often avoids, dislikes, or is reluctant to engage in tasks that require sustained mental effort (e.g., schoolwork or homework; for older adolescents and adults, preparing reports, completing forms, reviewing lengthy papers). Often loses things necessary for tasks or activities (e.g., school materials, pencils, books, tools, wallets, keys, paperwork, eyeglasses, mobile telephones). DSM-5 Criterion A I have trouble keeping myself organized. Avoids or dislikes things that take a lot of effort and are not fun. Avoids or dislikes things that take a lot of effort and are not fun. I don’t like doing things that make me think hard. SR P T SR T SR P Has difficulty organizing tasks or activities. T Loses things (for example, schoolwork, pencils, books, tools, or toys). Loses things (e.g., schoolwork, pencils, books, tools, or toys). I lose stuff that I need. Has trouble organizing tasks or activities. I have trouble finishing things. I have trouble following instructions. P SR T Has trouble keeping his/her mind on work or on play for long. Has trouble keeping his/her mind on work or play for long. I have trouble keeping my mind on what I am doing. Does not seem to listen to what is being said to him/her. Does not seem to listen to what is being said to him/her. I have trouble keeping my mind on what people are saying to me. Does not follow through on instructions (even when he/she understands and is trying to cooperate). Fails to complete schoolwork, chores, or tasks (even when he/she understands and is trying to cooperate). Does not follow through on instructions (even when he/she understands and is trying to cooperate). Fails to complete schoolwork or tasks (even when he/she understands and is trying to cooperate). 92 5 97 51 60 28 21 103 – – – 2 2 2 2 – – – – – – – 1, 0 1, 0 1, 0 1, 0 1, 0 1, 0 1, 0 1, 0 1, 0 1, 0 -or1,0 1, 0 -or1,0 1, 0 -or1,0 – 2 – – – – – – 1, 0 -and1, 0 1, 0 1, 0 1, 0 1, 0 1, 0 1, 0 1, 0 1, 0 – – – Not Indicated Table continued next page. 3, 2 3, 2 3, 2 3 3 3 3 3, 2 3, 2 3, 2 -and3. 2 61 -and17 84 3, 2 -and3. 2 73 -and57 3, 2 -and3. 2 68 -and79 P P T SR P T SR I make mistakes by accident. 3, 2 -or3 3, 2 3, 2 3, 2 3, 2 3, 2 3, 2 31 -or39 95 111 63 35 69 42 It is hard for me to pay attention to details. SR 3, 2 3, 2 37 Doesn’t pay attention to details; makes careless mistakes. 47 Doesn’t pay attention to details; makes careless mistakes. Item # T Item Indicated P Form May be Indicated Table 1a. DSM-5 Symptom Count and Criterion Status Score Requirements for ADHD DSM-5 Symptom Count Requirements: ADHD Predominantly Inattentive Presentation: At least 6 of the 9 symptoms for individuals 16 years of age; at least 5 of the 9 symptoms for individuals 17 years of age. ADHD Combined Presentation: Meets criteria for both Inattentive and Hyperactive-Impulsive presentations. DSM-5 Update 5

6 DSM-5 Criterion A 1ha Form (Continued) DSM-5 Symptom Count and Criterion Status Score Requirements for ADHD Item 101 23 77 2 88 32 Item # Indicated 3, 2 3, 2 3 3, 2 3, 2 3 May be Indicated – – 2 – – 2 1, 0 1, 0 1, 0 1, 0 1, 0 1, 0 Not Indicated a Criterion A1h states that in older adolescents, the tendency to be easily distracted by extraneous stimuli may include unrelated thoughts as the source of distraction. Follow-up is recommended to check if Criterion A1h has been met for older adolescents. ADHD Criterion A states that symptoms are not solely a manifestation of oppositional behavior, defiance, hostility, or failure to understand tasks or instructions. I

Conners 3 ADHD Index Instructions: 1. For each item listed below, transfer the circled score from the Scoring Grid into the Item Score row. 2. Transpose each score by following the Transposing Rule and enter the score into each Transposed Score box. 3. Sum the transposed scores to obtain the Total Transposed Score, then circle this score in the .