ebook_ADHD2019

58 Rohde, Buitelaar, Gerlach & Faraone between sources have been understood and clarified. Questionnaires and direct observations can be helpful to support the assessment and construct a broad view of the strengths and difficulties of the subjects. Information on all domains of daily functioning is crucial to document resilience and impairment. Important are- as of potential impact for children include parent–child interactions, parenting practices, and parental stress, as well as school and academic functioning, peer relationships, and engagement in leisure activities. 18 School information can be ob- tained directly from teachers (by phone, e-mail, written school reports or scales), or through observation in the classroom. In adults, relations with significant others and at functioning at work should also be assessed. 4 The clinician needs to assess that the child has the requisite number of symp- toms, if they are developmentally inappropriate and pervasive across more than one setting, whether they are associated with a significant degree of impairment and cannot be accounted for by an alternative explanation. It is also necessary to consider, and assess for, a wide range of possible comorbid or coexisting disorders, as mentioned above. Although in primary care this procedure can be easily conducted through a cli- nical interview, the use of the ADHD module of an interviewer-based semi-struc- tured interview, such as the Schedule for Affective Disorders and Schizophrenia for School-age Children (K-SADS) or the Development and Wellbeing Assess- ment (DAWBA) may be helpful in specialized settings. Both have many advanta- ges: The schedules are both available in several languages and can be downloaded from the internet (see K-SADS screener at Advanced Center for Intervention and Services Research [ACISR] for Early Onset Mood and Anxiety Disorders 30 and the various DAWBA translations at Youth in Mind 31 ). The K-SADS has several advantages in that it is semi-structured and allows for a normal conversational flow. It also provides probes and examples in everyday life for each symptom, and also operationalizes the word ‘often’ in most items and reminds the clinician to discriminate ADHD symptoms from those due to other types of psychopatho- logy. On the other hand, the DAWBA is a structured assessment, which means it can be delivered by non-clinicians including graduate students. Thus, it can be used in situations where it is more difficult to access trained clinicians. It can also be administered online (or by telephone) with multiple informants and different versions for different types of informant (parent, teacher, self-report), adding to accessibility in certain situations. Both the K-SADS and the DAWBA offer initial screening questions which if positive are followed up by full sets of questions to assess comorbidities or differential diagnostic problems. 18 The KSADS screener can be available for free. In adults, the use of the DIVA.2 is recommended as an alternative for establishing the diagnosis of ADHD. A comparable diagnostic interview schedule is ACE+. 32 Both DIVA and ACE+ normally require around 1hour to be completed. Current and past ADHD symptoms are investigated in both interviews. Comorbid conditions are not part of the DIVA interview, 16 but a