Conners· Adult ADHD Rating

Scales (CAARS TM)

Technical Manual

C. Keith Conners, Ph.D.,

Drew Erhardt, Ph.D., &
Elizabeth P. Sparrow, Ph.D.

I MHSBeyon d /~ssP.ssmen ts
Copyright © 1999, Multi-Health Systems Inc. All Rights Reserve
No part of this manual may be reproduced by any means without

MHS in the U.S.: P.O. Box 950, North Tonawanda, NY 14120-0

d.
permission from the publisher.

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 Conners' Adult ADHD Rating Scales (CAARS)

Contents
About the Authors .......................................................................... ......................................................................... ............. ix
Author·s Preface .................................................................................................................................................... ................ x
Publisher·sPreface ................................................................................................................................................................ xii

Qapter 1--lntroduction .............................................................................................................................................................. 1

Main Features of the CAARS ............................................................................................................... ............................ 1
CAARS Components ....................................................................................................................................................... 2
CAARS Long Forms .......................................................................... ........................................................................ 3
CAARS Short Forms ................................................................................................................................................. 3
CAARS Screening Forms ..................................... ..................................................................................................... 4
Uses of the CAARS .......................................................................... ..................................... ........................................... 4
Principles of Use ..................................... .......................................................................................................................... 4
User Qualifications ............................................................................................................... ..................................... ........ 4
Contents of this Manual ..................................... ..................................... ........................................................................ 4
Cllapter 2--Administration and Scoring of the CAARS ................................................................................................................ 5
Choosing a CAARS Form ..................................... ............................................................................................................ 5
Long Versus Short Forms .......................................................................... ................................................................ 5
Short or Screening Forms ... .. .... .... .. .......... ... .. .. .. ... .... ... ......... .... ...... ... .. .. .. .... ....... .. .. .. .... ..... ....... .... .. .... .... .. .. ........ ... .. . 5
Remote Administration .................................................................................................................................................... 6
Materials Needed ...................................................................................................... ...................................................... 6
Administration nme .......................................................................... ............................................................................... 6
Readability of the CAARS ..................................... ........................................................................................................... 6
Administration Procedure ............................................................................................................... .................................. 7
Scoring the CAARS ..................................... ..................................................................................................................... 8
Profiling the CAARS Scores .......................................................................... .................................................................... 9
Scoring and Profiling Examples ............................................................................................................... .......................... 9
Long Forms ............................................................................................................... ............................................... 9
Short Forms .......................................................................... ......................................................................... ........ 10
Screening Forms .......................................................................... ..................................... ..................................... 10
Chapter 3---4nterprelation and Use ............................................................................................................................................ 21
Interpretation of the CAARS ..................................... .......................................................................... ........................... 21
Interpreting Item Responses .................................................................................................................................. 21
Interpreting Subscale Scores ..................................... ............................................................................................ 22
Interpreting Profile Patterns ..................................... ..................................... .......................................................... 22
A Step-by-Step Guide for Interpreting the CAARS ......................................................................................................... 22
Step 1: Does the CAARS provide valid information about ADHD symptoms? ......................................................... 23
Step 2: Which item responses are elevated? ............................... ......................................................................... 23
Step 3: Examine subscale scores and the overall level of symptomatology? .......................................................... 23
Step 4: Integrate information from the self-report and observer forms. ................................................................. 23
Step 5: Integrate information from the CAARS and other sources of information. ................................................. 24
Step 6: Consider a diagnosis and define a set of recommendations. ..................................................................... 24
Case Studies .............................................................................................................. .................................... ............... 24
Case 1 (JenniferM., a 19-Year-Old Female) ..................................... ...................................................................... 24
Case 2 (Calvin D., an 18-Year-Old Male) .......................... :...................................................................................... 28
Case 3 (Scott P., a 53-Year-Old Male) .......................................................... .......................................................... 31
Case 4 (Thomas S., a 44-Year-Old Male) ................................... ............................................................................ 33
Case 5 (Meredith W., a 26-Year-Old Female) ......................................................................... ..................... ............ 34
Case 6 (James G., a 49-Year-Old Male) .................................... ............................................................................. 40
Conclusion ..................................................................................................................................................................... 43

V
 Conners· Adult AOHO Rating Scales !CAARS)
-----
Cllapter 4--Computar Admlnillrltlon and Scorfng .................. ••............. ••••... ••... ••••.. ·... ··.... ····....... ·····.. ·····....... ··... ·.. ··................ 45
General Information ..................••••••••••············.. ········.. ····.... ··············.. ···.. ·····.. ·······················.... ·····················.. ····.. ······· 45
Modes of Administration ....................................••••••••••••.. ••••••.. ••••••··················.. ············.. ····...... ····.. ······...... ··... ·.. ·•.. •..... 45
The CAARS and PsychManager ............................................................................ ........................... .............................. 45
Features of the CAARS Computer Program for Windows ................................................. •............. •............................... 45
Hardware. Software. and Documentation Requirements ........................... ................................. •.................................. 46
Using the CAARS Computer Program for Windows ............................ ............................... •........................... ................. 46
Advantages of Computerization ........................... ............................ .............................................................................. 47
Software Support ........................................................ .................................................................................................. 47
Furtherlnformation ............................ ........................................................ ........................... ......................................... 47
C111pt11r 5-MIISUl"NIN t of Adult ADHD and the Development of the CAARS ......................................................................... 49
Development of the CAARS ........................................................................................................................................... 50
Creation of the ADHD Index ............ ....................................................................................................................... 51
Creation of the Inconsistency Index ............................................................................................................. .......... 51
Creation of DSM-IV Symptom Scales ..................................................................................................................... 52
Creation of Short Forms ............................ ........................... .................................................................................. 52
Creation of Observer Scales ................................................................................................................................... 53
Concluding Remarks ............................ ...................................................... ........................... ......................................... 54
Chapter 6--Nonnl1ive Samples and Psychometric Properties of the CAARS ............................................................................ 55
Normative Data ........................... .................................................................................................................................. 55
Age and Gender Effects ............................ ............................................................................................................. ........ 55
Self-Report Forms ....................................................... ........................................................................................... 58
Observer Forms ............................ ........................... ............................................................................................... 58
Reliability ........................... ............................ ..... .................................................................................... ...................... 59
Internal Reliability ............................ ....................................................................................................................... 59
Mean Inter-Item Correlations ........................... ...................................................................................................... SO--
Test-Retest Reliability ....................................................... ............................ ......................................................... 60
Standard Error of Measurement ................................................................................... .......................................... 62
Reliability Summary ............ ........................................................ ....................................................... ..................... 63
Chapter 7-Vaidityofthe CAARS ............................................................................................................................................. fu
Factorial Validity ........................................................................................................................................ ..................... 67
Confirmatory Factor Analysis ...................................................... ........................... ............................ ............................. 67
CAAAS-S:L ....................................................................................................................................... .................... 67
CAARS-S:S...................................................... ............ ........................... .............................................................. 68
CAARS-0:L ........................... ............................................................................................................. ................... 68
CAARS-0:S....................................................................................................................................... .................... 68
lntercorrelations of the CAARS Scales ........................... ......................... ........................... ..... ....................................... 68
DiscriminantValidity ....................................................................................................................................................... 70
ADHD Index ........................................................................................................................................................... 70
Construct Validity ........................... ............................................................... ...................................................... ........... 71
Relationship between Childhood and Current Symptoms ........................... ........................... ................................. 71
Relationship between Self-Report and Observer Ratings ...................................................... ................................. 71
Validity Summary ................................................................ ........................... ................................................................ 71
Chaptlr ~ Comments ............................................................................................................................................ 73
RlfSIIICm ................................................................................................................................................................................ 75
11--dix A-E . . IPercenti·1es .......................................................................................................................................... . 11
,,,.,,..., mplflCI
Appendix B--ltems by Subscale ............................................................................................................................................ 135
Index.................................................................... .......................... ........................ ································································ 139

vi
 Chapter 1
Introduction

Attention-Deficit/Hyperactivity Disorder (ADHD) was • The CAARS were developed to employ Dr. Conners'
originally thought to be a condition specific to childhood 30 years of experience and research in the field of
or early adolescence. In recent years, however, research ADHD.
has consistently demonstrated that ADHD is often a chronic • The CAARS have parallel structure with the Conners'
condition that persists into adulthood. In addition to the Rating Scales-Revised (CRS-R; Conners, 1997),
core symptoms of ADHD, which involve problems in which improves the transition when used across the
attention, hyperactivity, and impulsivity, adults with this lifespan. Table 1.1 (overleaf) presents an overview of
disorder have been found to be at risk for a variety of other basic features shared by the CRS- R and the CAARS.
problems and conditions. For example, ADHD adults have
been found to be at risk for lower levels of educational
and occupational attainment, employment instability,
Main Features of the CAARS
substance abuse, and antisocial behavior (Barkley, The CAARS are a unique integration of theoretical
Murphy, & Kwasnik, 1996; Weiss & Hechtman, 1993). knowledge, clinical experience, empirical sophistication,
and state-of-the-art psychometric techniques. They are
A serious limitation in the assessment of adult ADHD has reliable and valid measures of adult ADHD-related
been the lack of reliable and valid measures of ADHD symptoms and behaviors. The CAARS offer many
symptoms for use with adult populations. The release of advantages to the practitioner:
the Conners' Adult ADHD Rating Scales (CAARS)
represents a major development in the assessment of the • A large normative database (N = 2,000)
psychopathology and problem behaviors associated \\i th Multidimensional scales that assess ADHD and
adult ADHD. The CAARS are a set of easily administered related symptoms and behaviors
self-report and observer-rated instruments designed to
assess symptoms and behaviors related to ADHD in adults. Matching forms for self-report and observer (e.g.,
friends, coworkers, family members) ratings
These instruments were developed with the follo\\ing Clinical and diagnostic relevance
issues and concerns in mind:
Long and short versions
The new instruments provide reliable and valid as-
ADHD Index, which contains the items that best dis-
sessment of ADHD-related symptoms across clinically
tinguish individuals with ADHD from non-clinical
important domains (e.g., home, work, and interper- individuals
sonal functioning).
Inconsistency Index, which is useful for detecting an
The new instruments discriminate between clinical and
inconsistent response style
nonclinical groups. This is an essential quality of a
useful instrument. Scales match the DSM-IV criteria for ADHD
The new instruments allow for multi.modal ac;sessmP-nt Easy administration, scoring, and profiling of results
(e.g., self-report and observer ratings), since multiple
sources of information are essential for an accurate Graphs to monitor progress
clinical picture. Excellent reliability and validity
Short forms have been developed for use in research Applicable in managed care situations
settings, where a quick screen for ADHD symptoms
is required, or where repeated testing is needed (e.g., The CAARS are suitable instruments for reporting on
treatment monitoring). adults ages 18 and up. Both self-report and observer forms
The instruments address ADHD symptoms directly utilize a 4-point (0 = Not at all, never; I =Justa little, once
linked to the criteria for the disorder in the Diagnostic in a while; 2 = Pretty much, often; 3 = Very much, very
and Statistical Manual of Mental Disorders, Fourth frequently), Likert-style format in which respondents are
Edition (DSM-IV) (APA, 1994). asked to rate items pertaining to their behavior/problems.
 l\llmflts' Adult AIJHD Hnting Scnlos (CAAl1S)

For the self-report fonns. the respondents nre nsked lo rnle

their own c:-..-pcrienccs. while for the obsetver forms. the
( I K to 2 9 years old, 30 to 39 years old, 40 to 49 years old
and 50 years old and older). '
•
respondents arc asked to rate n particular person (e.g.,
friend. coworker. or family member). The CAARS were Interpretation of the CAARS should be based on individual
designed with the higher scores indicating increasing item responses, T-scores for the various scales, the ADHD
symptom levels. Index, the Inconsistency Index, and an integration of the
assessment information with other clinical material. The
Normative data for the CAARS come from large integration of CAARS scores with other sources of data
conmmnity-based samples (N= 2,000) ofnonclinical adults (e.g., interviews, observations, formal testing) gives the
collected throughout the United States and Canada from administrator ofthe instrument a more comprehensive and
1996 until 1998. Each of the short scales (self-report and systematic view of the individual being assessed than might
observer) take about 10 minutes to administer, and each be obtained from a single information source.
of the long scales takes less than 30 minutes. Scoring each
scale will rarely require more than 10 minutes with the
handscorable QuikScore forms, or a few seconds with the CAARS Components
computer program. The CAARS consists of two types of forms: 1) c~s
for self report (or client) ratings, and 2) CAARS--0 for
The CAARS QuikScore forms include a Profile form that observer (family/peer/supervisor) ratings. The self-report
allows for the visual display of the individual's assessment and observer forms were created to provide multimodal
scores and comparisons with an appropriate normative assessments of the same behaviors and problems and
group. Raw scores are converted automatically to T-scores contain an identical set of scales, subscales, and indexes.
when the Profile form is completed. No special scoring Multiple sources of information are essential for an accurate
templates are needed, since all of the scoring information clinical assessment. Whenever practical, it is best to collect
is provided on the QuikScore form. Separate norms are both self-report and observer information.
provided for men and women in different age intervals
Table 1.2 (overleaf) presents the names of the various
CAARS forms and their abbreviations.

Table 1.1
Basic Features Shared by the CRS-R and CAARS

Featmea CR~R CAARS

Assess key AOHD Inattention Inattention

symptoms Hyperactivity Hyperactivity
lmpulsivity lmpulsivity

Assess other crinically Oppositional Emotional !ability

relevant syl'J1)toms Conduct problems Problems with self-concept
Interpersonal problems

Contain scales linked to the Separate subscales for the Separate subscales fur the
DSM criteria for AOHD inattentive and hyperactive- inattentive and h~peractwe-
impulsive subtypes impulsive subtypes

Age-specmc norms 3 to 17 years of age 18 years of age and older

Gender-specific norms Yes Yes

Long and short forms Yes Yes

Short forms designed for Yes Yes

treatment monitoring

Forms for nutimodal Self-report forms Self-report forms

assessment Parent forms Observer forms
Teacher forms

ADHD lnde)( distingiishes clincal and Yes Yes

non-cfinical subjects, using ADHD sy111>toms

2
 Introduction

Tabla 11 Index is also included on the long forms. This index

Scalaa of the CAARS and Their Abbreviations contains the best set of items for distinguishing ADHD
adults from nonclinical adults. The last measure on the
Self.fleport Scale Abbreviations No. of Items
long forms is the Inconsistency Index, which is useful in
CAARS Sett-Report: Long Version CAARS-S:L 66 identifying random or careless responding. Table 1.3 lists
CAARS Sett-Report: Short Version CAARS-S:S 26 the measures that appear on the self-report (CAARS-S:L)
CAARS Sett-Report: Screening Version CAARS-S:SV 30
and observer (CAARS-0:L) long forms.
Obaetver Scale Abbreviations No. of Items
Tabla 1.3
CAARS Observer: Long Version CAARS--0:L 66 Measures Contained in the Long Forms
CAARS Observer: Short Version CAARS-0:S 26 (Salt-Report and Observer)
CAARS Observer: Screening Version CAARS-0:SV 30
Factor-Derived Subscales

Within the two types of forms (self-report and observer) • Inattention/Memory Problems
• Hyperactivity/Restlessness
there are long, short, and screening versions of the CAARS:
• lmpulsivity/Emotional Lability
• Problems with Sett-Concept
The long versions (CAARS-S:L and CAARS--0:L)
contain a group of scales that were empirically de- DSM-IV ADHD Symptom Subacales
rived to assess a broad range of problem behaviors,
such as inattention or memory problems, hyperactiv- • Inattentive Symptoms
• Hyperactive-Impulsive Symptoms
ity, impulsivity, and poor self-concept. The long forms • Total ADHD Symptoms
take more time to administer and score, but they con-
vey more detailed information, including the Incon- ADHD Index
sistency and ADHD Indexes.
• The short versions of the CAARS are used when ad- lnconsistllncy Index
ministration time is limited or where multiple admin-
istrations over time are needed. Two different types
of short forms are available: the CAARS-S:S and the CAARS Short Forms
CAARS-0:S. They contain fewer items of the identi- The self-report (CAARS-S:S) and observer (CAARS-0:S)
cal factor-derived subscales that appear on the long short forms have 26 items and 6 subscales. Four
forms, plus the full ADHD and Inconsistency Indexes. abbreviated, factor-derived scales assess a cross-section
• The screening versions of the CAARS (CAARS- of ADHD-related symptoms and behaviors: a 5-item
S:SV and the CAARS-0:SV) contain the DSM-IV Inattention/Memory Problems subscale, a 5-item
ADHD Symptom measures and the ADHD Index, Hyperactivity/Restlessness subscale, a 5-item lmpulsivity/
which may be useful when a quick screen is needed Emotional Lability subscale, and a 5-item Problems with
for DSM-IV symptoms for ADHD. Self-Concept subscale. These scales use subsets of items
from the long form. See chapter 5 for a description of the
Information on which form is appropriate in specific
procedure used to develop the short forms. The 12-item
instances is provided in chapter 2.
ADHD Index is also included on the fom1S, as well as the
Inconsistency Index. Table 1.4 lists the measures that
CAARS Long Forms appear on the self-report (CAARS-S:S) and observer
The self-report (CAARS-S:L) and observer (CAARS- (CAARS-0:S) short forms.
O:L) long forms have 66 items and 9 subscales. There are
four factor-derived scales that assess a cross-section of Tabla 1.4
ADHD-related symptoms and behaviors: a 12-item Measures Contained in the Short Forms
Inattention/Memory Problems subscale, a 12-item (Self-Report and Observer)
Hyperac;tivity/Restlessness subscale, a 12-item
Factor-Derived Subscales
lmpulsivity/Emotional Lability subscale, and a 6-item
Problems with Self-Concept subscale. There are also three • Inattention/Memory Problems
• Hyperactivity/Restlessness
DSM-IV ADHD symptom measures that assess ADHD • lmpulsivity/Emotional Lability
symptoms according to the criteria set listed in the DSM- • Problems with Self-Concept
IV (APA, 1994): a 9-item Inattentive Symptoms subscalc,
ADHD Index
a 9-item Hyperactive-Impulsive Symptoms subscale, plus
a Total ADHD Symptoms subscale. A 12-item ADHD Inconsistency Index

3
Gonnms' Adtrlt AOHD Ratin g Scales (CAARS)

obs erve r mea sure s that are best used by clin·icians as part
CAARS Screening forms . . .
test users need to tak
of an ove rall chru cal eval uati on. All
obse rver (CA AR S- a responden:
T he self -rep ort (CA AR S-S :SV ) and into acco unt any factors that may influence
s and 3 DSM -IV ADHD s, or factors that
O:S V) scre enin g fom ts hav e 30 item to inac cura tely repo rt his or her symptom
symptom measures that ~ ADH
D symptoms acco rdin g tely report symptoms
may infl uen ce an obse rver to inac cura
-IV (APA, 1994): a 9-
to tl1e criteria set outlined in the DSM of the indi vidu al bein g asse ssed .
, a 9-it em Hyperactive-
item Inattentive Symptoms subscaJe
Total ADHD Symptoms
lmpulsi\le Symptoms subscale, and a
subscale. The 12-item ADHD Inde x
is also included on the User Qualifications
RS shou ld have an
fomlS. Tab le 1.5 lists the measures
that app ear on the self- All user s of inst rum ents like the CAA
r (CA AR S-0 :SV ) es and limitations of
repo rt (CA AR S-S :SV ) and obs erve und erst and ing of the basi c prin cipl
psy cho logi cal test
screening fomlS. The screening forms are usef
ul whe n a quick psy cho logi cal test ing, esp ecia lly
bilit y and validity,
screen for DSM -IV ADHD sym ptom
s is required. inte rpre tatio n. Spe cific issu es of relia
disc usse d in chap ters 6
as they pert ain to the CAA RS, are
CAA RS are easy to
Table 1.5 and 7 of this man ual. Alth oug h the
s
Me uur n Contained in the Screening Form adm inis ter and scor e, enc oura ging
thei r use by rese arch
(Self-Report and Obaerver) ultim ate responsibility
assi stan ts and othe r sup port staff, the
inte rpre tatio n mus t be
for adm inis trat ion, sco ring, and
OSM-N AONO Syap taa S..c alea gniz es the limi tatio ns
assu med by an indi vidu al who reco
• lnattantMI SVn1,toms of psyc holo gica l test ing.
• tfyperactMH"1)tllsive SVn1,toms
• i>tal AOHD SVn1,toms be fam ilia r with the
All user s of the CA AR S sho uld
ing dev elop ed by the
stan dard s for psy cho logi cal test
tion (AP A, 198 5).
Am eric an Psy cho logi cal Ass ocia
uld also be mem bers
Qua lifie d user s of this type of test sho
Uses of the CAARS ofprof essi ona l asso ciat ions that end
orse a set ofstan dard s
cal test s, or lice nse d
The CAA RS mea sure a cros s-se ctio
n of AD IID- rela ted for the ethi cal use of psy cho logi
cho logy , edu cati on,
~-m ptom s and beh mio rs in adu
lts. The y can be used as prof essi ona ls in the area s of psy
field .
part of a routine scre enin g in a num
ber of settings, such as med icin e, social wor k, or an allie d
~ clin ics, resi dent
ial trea tme nt centers, prisons,
psycbiatric hospitals, and priv ate
prac tice offices. The
of mon itori ng ADI ID Contents of this Manual
CAA RS are also useful in the con text ual prov ide deta iled
oftrea tme nt Pote ntia l test users The rem aini ng chap ters of this man
~ ~ \l\"C r the com se of the CA AR S, the
, soc ial wor kers , info rma tion abo ut the adm inis trat ion
incl ude psy cho logi sts, phy sici ans tatio n and use of the
selo rs. The CAARS are scor ing proc edu res, and the inte rpre
JISJchiab.ists, researchers, and coun ual des crib es the
md ul tool s for pro vidi ng the prac titio
ner or AD IID test resu lts . In add itio n, the man
of the CA AR S, the
ed info rma tion abo ut bac kgr oun d and dev elop men t
1c:s ca.d ltt ..ith stru ctur ed and norm and the psyc hom etric
an indn idua l
com pute rize d vers ion of the CAA RS,
2 desc ribe s the bas ic
prop erti es of the scal es. Cha pter
CA AR S are not sco ring the var iou s
The self -rep ort ver sion s of the proc edu res for adm inis teri ng and
unw illin g or una ble to xes. Cha pter 3 pres ents
rec --1111c:oied for persons who are CAA RS form s, subs cale s, and inde
to a questionnaire. The inte rpre tati on of the
ulO p"Q le to resp ond ing hon estly a disc ussi on of the app rop riat e
vidu als who are clin ical and rese arch
CAARS are not reco mm end ed for indi CAA RS, and thei r pote ntia l uses in
ondents who hav e be help ful dur ing the
diiforiallcdoueverdy impaired. For resp sett ings. Six case stud ies that may
r can read alou d the d in cha pter 3. Cha pter
poor reading abilities, the adm inis trato inte rpre tatio n pha se are also incl ude
re.co rd the answ ers on com pute rize d vers ion
CAA RS ilam to the individual and 4 outl ines the ben efits of usin g the
info rma tion desc ribi ng
the QuikScore form. of the CAA RS. Cha pter 5 prov ides
men t of the CA AR S.
the theo retic al rati ona le and dev elop
ples for the CA AR S
Principles of Use Cha pter 6 desc ribe s the norm ativ e sam
cho met ric pro pert ies
RS are not inte nde d and pres ents info rma tion on the psy
The lat mer lbouJd know that the CAA of the vari ous scal es, sub scal es, and
inde xes. Cha pter 7
tion in a clin ical
to be lhe only JOurces of info rma dity of the CA AR S .
titute for a com plet e pres ents info rma tion on the vali
~ The CAARS are not a subs Cha pter 8 prov ides con clud ing com
men ts.
tipl e sou rces of
clin ical assessment that util izes mul
f self -rep ort and
information. lbe inst rum ents are brie
4
 Chapter 2
Administration and Scoring of the CAARS

CAARS forms are easy to administer and score. The

administration process for tl1e two longest forms (CAARS-
Choosing a CAARS Form
S:L and cAARS-0:L) can take Jess than 30 minutes; the With the availability ofsix CAARS fonns, practitioners mll
shorterforms(CAARS-S:S, CAARS-S:SV, CAARS-0:S, wonder which form is most appropriate in a partiaJJar
and CAARS-0:SV) take about 10 minutes. The various assessment situation. Whenever possible or practical_
forms are set at a North American fourth-grade reading level responses should be obtained from the indnidnal being
(Dale & Chall, 1948) and are designed to be administered to assessed, as well as observer ratings from at least one
adults aged 18 and up. Responses are entered on one of the individual who is .familiar l\'ith the i.ndi\-idoal bemg ~
six QuikScore forms. The QuikScore forms can be used to
quickly score the CAARS and transfer the results to a Profile Long Versus Short Forms
form (contained within each of the six CAARS forms). The There are several relevant considerations for deciding
Profile fonn allows for the visual display ofthe respondent's whether to use a long or short CAARS form. The long form
assessment scores and draws comparisons to an appropriate collects more information and is more comprehensn-e for
normative age and gender group. clinical or research purposes, so it should bi- adm:i:uisrered
whenever possible. The long form encompasses core
As noted in chapter 1, the CAARS consist of two types of symptoms ofADIID, DSM-IV criteria for ADHD and rel.mi
forms: one set offorms for self-report ratings and the other problem areas, as well as an index to detect inconsistenl
set for observer ratings. The scales and scoring for the responding.
self-report and observer forms are identical, although the
norms are different The long forms (CAARS-S:L and The short form is ideally suited to those clinical and resean:b
CAARS-0:L) are comprised of 66 items and contain 9 situations where it is important to reduce administration
subscales. The short forms (CAARS-S:S and CAARS- time. The long form generally takes about three times ton.,,oer
O:S) are comprised of 26 items and contain 6 subscales. to complete than the short form. Consequent!)·. when che
The screening forms (CAARS-S:SV and CAARS-0:SV) scales are going to be readministered freque:nt.l)· (e.g.. in
are comprised of 30 items and contain four subscales. managed care settings), the short form is usually preferable.

Since some of the behaviors and symptoms measured by On occasion, it might be helpful to use both versions. foe
the CAARS change over time, the administration of a form example, long form at baseline and follow-up. and shon
should be completed in one sitting in the presence of a form for intermittent evaluation.
trained examiner. lf necessary, however, the CAARS can
be administered over the phone, or the respondent can
Short or Screening Forms
complete the instrument at home. lf either of these
When practitioners or researchers are deciding which short
procedures is followed, special care should be taken that
form to use, they should consider the situation and their
the respondent clearly understands the instructions for
own preferences. Both the short and the screening forms
completing the form. The CAARS can also be completed in
are about the same length. The CAARS-S:S and the
a group format. The shorter CAARS forms (CAARS-S:S,
CAARs-o:S assess the core symptoms of ADHD. as ,,ell
CAARS-S:SV, CAARS-0:S, and CAARS-0:SV) are
particularly suited for those group testing situations in
as related problem areas. 1n addition. these short forms
include the Inconsistency Index; this ma~ pro,ide useful
which respondents have a limited amount of ~me to complete
information when there is concern about the ,-alidi~ of the
the form.
respondent's or observer·s ratings.
When using the observer forms from the CAARS, it is
TI1e CAARS- S:SV and the CAARS-0:S\' screen for the
essential that the observer has a close, personal
core symptoms of ADHD, including S)lllplon l.S of all three
relationship with Ute person being assessed. The observer
DSM-IV subtypes of ADHD. On!~ the sub.scales most
should al.so have seen the client's behavior recently. An
directly relevant to ADHD diagnosis are represented -
appropriate person to complete the observer fom1 might be
the ADHD Index and the DSM-IV subscales.
a spouse, parent, adult child, close friend, or coworker.
5
 Conners' Adult ADHD Rating Sc111As ICMRS)
The test mntcrlnls needed nrc ns follows:
Remote Administration for ench respondent
• 1111 lntnct CAARS QulkScoro fom1
Tilc CAARS should be ndministercd in the presence or n
. d men ta1 health profcssionnl or ndminlstrntor • 11 son-lend pencil (prefcrnbly without nttachcd eras-
trame
whenever possible. Howc,-cr. there will be situntlons In ers), or
which it is only possible to obtain infunnntion by sending • 11 bnll-polnt pen
the QuikScorc funus to the respondent ·s home. tr necessary.
items ma_y also be !'Cid aloud over the phone. In these
cases.. the administrator should remind the respondent to
Administration Time
complete the items independently. without input from Most adults can complete the long fonns (CAARS-S:L
others. In addition, the respondent should not disassemble. nnd CAARS-0:L) in less than 30 minutes and the shorter
damage. or deface the fumts. since doing so would make it forms (CAARS-S:S, CAARS-S:SV, CAARS-0:S. and
difficult or i~ible to score them. The respondent CAARS-0:SV) in about 10 minutes. Respondents with
should also be reminded to complete the assessment at a reading difficulties or whose native language is not English
sm__ele sitting rather than complete different parts of the may taJce slightly longer. Those respondents who taJce less
assessment at different times. The administrator should t11an 10 minutes on the longer CAARS forms or less than 5
alwavs obtain infom1ed consent from respondents before minutes on the shorter forms may be responding
an administration and debrief them afterwards. When haphazardly. Respondents who taJce longer than 30 minutes
performing a remote administration, the administrator on the longer forms or longer than 15 minutes on the shorter
should adhere as closely as possible to the procedures forms may have difficulties with reading, comprehension,
e.'1)1ained in this chapter. It is also important to set a deadline or decision making.
for the return of the forms. In addition, it is highly
recommended that the practitioner set up a face-to-face
meeting or interview with the respondent before or after a Readability of. the CAARS
CAARS administrntion. Readability analyses were conducted on the CAARS using
the Dale-Chall formula (Dale & Chall, 1948). Harrison (1980)
The results obtained from a remote administration must be found the Dale-Chall formula to be the most valid and
interpreted with caution. For example, on all such CAARS accurate of the nine most commonly utilized readability
reports, add the following phrase: "The data obtained formulas. The Dale-Chall formula is based on semantic
requires additional validation because a non-standard (word) difficulty and syntactic (sentence) difficulty.
administration procedure was used." In the absence of
external validating information, it is highly advisable to Computations to determine sentence length and word
perform a follow-up administration, using the standard length were performed for all CAARS items. The number of
onsite protocol complete sentences are counted and divided into the
number of words to determine average sentence length
(WDS/SEN). Next, the number of "unfamiliar'' words
Materials Needed {UFMWDS) are counted. A word is considered unfamiliar
The CAARS can be administered in paper-and-pencil if it does not appear on a list of 3,000 ''familiar" words
format using MHS QuikScore forms. The CAARS compiled by Edgar Dale (revised in 1983). "Familiar" words
administrator should note that each of the six QuikScore are known by 80 percent of children in the fourth grade.
fOIDlS(CAARS--S:L, CAARS-S:S, CAARS-S:SV, CAARS-- Consideration of the amount of familiar and unfamiliar
0 :L, CAARS-0:S, and CAARS-0:SV) includes all
words included increases the accuracy of the reading level
necessary information for administering, scoring, and
assessment. The grade reading level is determined using
profiling the particular measure. No special scoring the following fonnula:
templates are required. The CAARS QuikScore forms
contain special aids that make scoring the various scales Grade=(0.1579xPERCENTUFMWDS)+(0.0496xWDS/
quick and accurate. Since these forms contain SEN)+ 3.6365 .
transformation tables from raw scores to standardized T-
scores, there is no need to perform tedious hand Use of tl1e Dale-Chall procedure for the CAARS items
conversions using conventional normative tables. produces a North American fourth grade reading level. As
such, the CAARS scales can confidently be administered
to most adults.The results of the readability analysis are
shown in Table 2.1.

6
 Administration and Scoring of the CMRS

Table2.1 ventory is a list of questions that ask about problems

CAARS Rtadablllty Lavala and behaviors that people sometimes experience. On
the observer forms (CAARS-0:L, CAARS-0:S, and
Fonn % of Unflmlll1r Word, Ortde Equlvallnt CAARS-O:SV). the instructions ask the respondent
CAARS- S:L 14.31 4 to make his or her rating with respect to a particular
CAARS- S:S 10 .77 4 person's recent behavior. To help avoid bias and fak-
CAARS-S:SV 16.20 4 ing, verbally emphasize that the scale has no right or
CAARS- 0:L 15 .66 4 wrong answers. You should also emphasize that all
CAARS- 0:S 18.48 4
CAARS- 0:SV 15.69 4 answers are confidential.

It is essential at this early stage in the assessment

Administration Procedure process that the respondent has read the instructions
and understands the procedure. For respondents who
Although it is best to administer the CAARS to respondents
have reading difficulties, it may be necessary for you
o~e at a time, group administration is possible (especially to read the instructions aloud while the respondent
with the shorter fonns). In either case, the administration reads along on his or her own fonn.
should be conducted in a quiet setting that is free from
distractions or disturbances. An administrator should 5. Make sure that the respondent understands that he or
almost always be present when the respondent is she must read each item carefully and then make a
completing a CAARS form. Group administration of any rating by circling the appropriate number: "O" for "Not
CAARS form is not recommended for respondents with at all, or never," "I" for "Just a little once in a while "
reading difficulties. The basic steps in the test "2" for "Pretty much, often," and "3:' for "Very muc~
very frequently."
administration process of any CAARS form are as follows:
6. Instruct the respondent to select the "best" answer if
1 Ensure that the respondent has a writing instrument.
he or she is not sure how to answer a particular item.
2 Help the respondent feel comfortable and relaxed. No item should go unanswered. Sometimes respon-
dents will ask how to respond to, or how to under-
3. Explain to the respondent that the purpose of the ad- st3:11ct, particular items. Some respondent inquiries re-
ministration session is to learn more about his or her qwre a clarification of instructions and will be straight-
feelings and behaviors. Explain that there are no time forward to answer. Other inquiries may be less straight-
limits. It is essential that the respondent fully under- forward, and care must be taken to respond to the
stands the nature of the CAARS administration pro- inquiry in a way that will not bias the response. Often,
cess, so that you obtain truly informed consent. it will be sufficient to say, ·"That's fine, but for now,
please answer as best you can, and we can discuss
4. Give the respondent a copy of the CAARS form. For that item after you have finished"
the self-report fonns (CAARS-S:L, CAAR8-S:S, and
CAAR8-S:SV}, ask the respondent to complete the 7. If the respondent wants to change an answer, instruct
name and demographic sections on the form. For the him or her to draw an "X'' through the original re-
observer forms (CAARS-O:L, CAARS-O:S, and sponse and circle the correct response. Attempts to
CAARs-0:SV}, the respondent will be asked to com- erase an answer will make the scoring page smudged
plete the demographic section for him or herself as and difficult to read. For this reason, the original re-
well as for the person being described. The respon- sponse should not be erased.
dent should also indicate his or her relationship with
8. When the respondent has completed the form, quickly
the person being evaluated by placing a checkmark in
check it to ensure that all items have been completed.
the appropriate box near the top of the QuikScore form.
Obtain answers for all unaddressed items, and ask the
For the observer forms, the age and gender of the respondent whether he or she had difficulty under-
observer are not used in scoring and as a result, if it standing particular items.
facilitates administration, completion of this informa-
9. After the CAARS is completed, initiate a brief discus-
tion may be presented to the respondent as optional.
sion with the respondent. This postadministration
The age and gender of the person being described
debriefing provides a good opportunity for respon-
does, however, affect the scoring and therefore this
dents to reveal other details about themselves. Re-
information is always required. spondents can elaborate on certain items and their
answers, and ask questions. In this sort of discus-
The first page of the CAARS form also provides in-
sion, you may also be able to gauge the respondents'
structions and explains to the respondent that the in-
degree of candor and learn a little more about their

7
 Conners' Adult ADHD Rating Scales (CAARS)
2 For all CAARS fom1s. make sure that the responses
personalities and backgrounds. Although you may have transferred clearly to the scoring sheet.
be scheduling a fom1al feedback session. it is impor-
tant to e.\'.plain the ne.,1 steps and reiterate what the 3. Ensure that responses are unambiguous and that all
results will be used for. Finally, thank the respondents data are complete (i.e., check that the respondent has
and reassure them that the responses given will re- not missed or double scored any items). You may de-
main confidential and will be used toward positive and cide to contact the respondent before proceeding.
helpful ends. Postadministration debriefing can be
fairly brief and does not need to become a lengthy If missing items are unavoidable (which sometimes
discussion with the respondent. Respondents often occurs in group testing situations), score these items
will be eager to find out what their responses mean, as "O." Substituting zeros for real responses will bring
and may ask you to make interpretive comments dur- down raw scores and T-scores. This underestimation
ing or after an administration. It is very important not can be compensated for by multiplying the obtained
to make any interpretive comments during or immedi- raw score by the total number of items on that subscale
ately after an administration. Interpretation of the or index and then dividing by the total number of items
CAARS should only be completed by qualified pro- that had responses. For example, if a respondent ob-
fessionals and only after carefully reviewing all avail- tained a raw score of6, but answered only 3 of 5 items
able infonnation. Proper interpretation is not possible
on a particular subscale, the score may be adjusted by
without ample reflection on the responses and results, multiplying the obtained raw score (6) by the number
and this generally cannot be done within a few sec-
ofitems (5) on the full subscale (6 x 5 = 30). The result
onds. "Offthe cuff" interpretive remarks only serve to
should be divided by the number of items that had
detract from the assessment process. Instead, you
responses (3) to get the adjusted raw score (30 + 3) of
should say that the responses need to be processed
10. You should take into account the number of sub-
and examined. If applicable, you should be prepared
stitutions for missing items when interpreting CAARS
to tell the respondents when and where the feedback
session will occur, and who will be providing this de- results. As a general rule, if more than two items are
~ed feedback. If necessary, make an appointment missing for a particular subscale, the score for that
with the respondent to discuss the CAARS results. subscale should be considered invalid. Overall, iffive
or more items are missing from the long form or
You may now score the respondent's CAARS form. three or more are missing from the short versions,
then the entire protocol should be considered invalid.

Scoring the CAARS 4. The scoring sheet beneath the item/response portions
ofthe CAARS QuikScore fonns is formatted like a grid,
Raw scores and T-scores for the six CAARS fonns can be
and all the scoring is done on that grid. The scales,
calculated by non-practitioners because of the simplicity subscales, and indexes are identified horizontally across
of the calculation. However, interpretation of this the top of the grid. For each item, follow the horizontal
information must be undertaken by an experienced mental line across to any white boxes that appear in the row.
health professional. The instructions for handscoring the In each white box, write the circled response number
QuikScore forms appear below. (e.g., ifthe number" l" is circled, then write "I" in each
white box that appears on that line). For the CAARS
Handscoring the CAARS long forms (CAARS-S:L and long forms only (CAARS-S:L and CAARS-0:L),
CAARS--0:L) takes under IO minutes; handscoring the numbers from the right side of the scoring grid are
shorter forms (CAARS-S:S, CAARS-S:SV, CAARS--0:S, ~tten in the white boxes that have the arrow(s) point-
and CAARS-0:SV) take less than 5 minutes. The numbers mg to the left. Numbers from the left side of the scor-
on the forms may be added easily without the use of a ing grid are written in the white boxes that have the
calculator, but the use of such a device, particularly on the arrow(s) pointing to the right.
long forms, may expedite the scoring process slightly and
ensure greater accuracy. 5. Add the numbers in the white boxes for each colwnn
and write the sum in the appropriate box at the botton;
of the columns.
I. To use the self-scoring feature of a particular CAARS
form, separate the QuikScore fonn at the perforation.
6. For the CAARS long forms only (CAARS-S:L and
The scoring sheet is found between the response
sheets for the two long fonns (CAARS-S:L and CAARS-0:L), Box G is obtained by adding the totals
for columns E and F.
CAARS--0:L) and underneath the response sheet for
the four shorter forms (CAARS-S:S, CAARS-S:SV,
7. For tllose CAARS fonns that include the Inconsis-
C.AAR~:S, and C ~:SV). No conversion
tency Index (CAARS-S:L, CAARS-S:S, CAARS-0:L,
tables or scoring stencils are required.
and CAARS-0:S), write the circled response for the

8
 /1 1h11111i nl111t11111111111 '. 11:111,r,11 iA tt 111r.tl/lft'.,

I<, t1c11111 lt~ccl 111 lhc hoth1111 oft he 11111111.'111111 t)11lk ~ orc I,1.c11l1J lho corrc,1 sw; rn1cw1ry col1111111 r,,r the rc-
rorm Fnr cnch of'lhc M1>11h 11 of 1111111hcn1, cf1k11l111c thti •11011,l1rnf 'I h<J uv.c m1111,c et1htt11111l arc 11,Rpl:ryetl 1111
nb,mlutc dtffcrc11c<' between the two 1111111hc1~ (l .c , Ille l'mfllc f11rr11, IK n ycnr nM11. 11, 1'J year old,, ,i, 1
Hitht rnct the ,m111llc1Item l'Cill""'IIC 11eorc fh1111 the 1111 ,w, 41J ycnr old11, or 111 ycur 01<111 or older)
one). For cxnmi,lc. If the rc•1>111m~• for 11 ,,nlr orllc111H
2. 011 Ille f'rofllc form, circle Ilic et,rrc~f')fl11tll11,-,, raw o/'//rc
w1111 "I" nnd ·· , :· the nh11oh11c l111Yi:m.,ncll would he
"2." Add the MnhNol11tc-dtlfcl'c11cc NCMCli to uct the 11111111,cr~ from '"c fj(;(,rin11, Ahcc1 The rnw 'lCOrc r,,,
Ht1h~ nlc A IHclrclcd 111 ,me or lhc four col11rr111'l 11 ntlcr
lnconstr.1cncy Index rnw 111.:orc.
lhc lcllcr A, lhc raw fj(;(,re for suhllealc Fl goc~ in one
R. lJsln~ 1hc lnco1111llncncy Index rnw 11eorc, co111plclc of the four col111n1111 under lhc letter A, and rv, on y011
1hc rclcv11111 l11con11l111cncy lndc,c C'rltcrln h1for11111tlo11 11111111 circle the raw ~re numhcr in !he correct age
hi lhCbox lnbcllcd "lnoom1INtc11cy Index Ouldc" 111111 rn11gc column to obtain accurate results. If a raw 'lCl)re
nppcn~ 11C11r tho bo110111 of the Qulk Score form . If the cxcccde11 the highe,it value print.ed on the Profile form .
nnswcr ts "yes" to the crtterlo11 q11e11tlo11, there 111uy be circle the top HCOre and print the raw number al. the
i.ome Inconsistency to the responses. The results lop,
should be inte'1)rctcd with cautlo11.
Note: Por the observer forms, it is the gender and age
of the ,,cnon being de~rlbed that determines the age
You may now prome the CAARS scores. column and gender that are used on the Profile form .
(Do not use the age and gender of the observer).
Profiling the CAARS Scores l Using a ruler, connect the circled scores on the Profile
Each of the three types of CAARS forms (long, short and form with solid lines to obtain the profile shape.
screening) generate a different number of raw scores. The 4. Determine the T-scores by following an imaginary hori-
raw scores are converted into standard T-scores on the zontal line from the circled raw score across to either
appropriate CAARS Profile form. A T-score is a standard outside column of the Profile fonn. You (ora qualified
score with a mean of SO and a standard deviation of 10 in all mental health professional) may now interpret the re-
samples and across all scales. T-scores allow practitioners sults as explained in chapter 3.
to compare subscale results within a single CAARS form
and to compare subscale results across various CAARS
forms. The CAARS Profile forms for the long versions Scoring and Profiling
(CAARS-S:L and CAARS-0:L) are two-sided, with T-score
information for males presented on one side and T-score
Examples
information for females on the other. For the short versions As described in this chapter, it is a relatively simple task to
(CAARS-S:S, CAARS-0:S, CAARS-S:SV; CAARS- score and profile any of the CAARS fonns. Examples of
O:SV), the profile sheet is one-sided with the profile area completed CAARS QuikScore fonns are shown in this
for males on the left side, and the profile area for females on section.
the right side. For both males and females, T-score
information is available for four different age groups (18- Long Forms
29 year olds, 30-39 year olds, 4<49 year olds, and 50 year The respondent in this example is a 35-year-old female,
olds or older). N.K. Figure 2.1 shows a completed response sheet for the
CAARS-S:L. Note that N.K. circled the appropriate number
Before filling out a CAARS Profile form, check the ("0," "l," "2," or "3") for each item. The administrator
bwfing at the top~ the fonn to ascer1ain whether it is the should carefully check to make sure that all items are rated
form for males or females. It would be a major error to at the end of the testing situation. If the respondent did
convert and plot the scores using the wrong set of gender not press heavily enough, the markings on the middle
nonns. When profiling an observer form (CAARS-0:L, scoring sheet will not be clear. Consequently, be sure to
CAARS-0:S, CAARS-0:SV), be sure to plot the scores retain the front and back response sheets of the form.
according to the age and gender of the person being
Figure 2.2 shows the completed scoring sheet for the
described (not the observer). Transfer the raw scores from
CAARS-S:L, using the answers presented in Figure 2.1.
the total boxes at the bottom of a particular CAARS scoring
Scores have been transferred into the boxes and then
sheet to the appropriate Profile form using the following
summed within each column. The total scores for each
procedure:
subscale were then calculated and recorded in the
appropriate boxes. The administrator followed the

9
Conners' Adult AOHD Rating Scales (CAARS)
Figure 2.6 show11 n complcled C'AARS--S:S Profile form for
instmctions on the sooting fonn. using selected items to R. P.·s scores 011 the varlo111111cale11. Nole 1hal !he raw score
s
calculnte the tnconsistenC)' lndcs . Profile
from the scorin g sheer hnvc been 1rnn11ferrcd to the
d
Figure 2.3 shows a oompleted CAARS-S:L Pronle funn for fonn. where they arc plotted. The scores hnve been plotte
n labeled
on the "Mnlc" side of the form and in the colum
N.K. ·s scores on the various scales . Note thnt the raw
M2 (30-39 year olds), which is appropriate for a respondent
scores from the scoring sheet have been transferred to the
Profile fuml where they arc plotted. The scores have been of this gender and age.
plotted on the "Female.. side of the funn and in the column
labeled F2 (30-39 years old). which is appropriate fur a Screening Version Forms
respondent of this gender and age. Note also that for the The respondent In this example is a 55•year-old male, D.S.,
Inattention/Memory Problems scale, N.K. had a raw score s
who is describing a 28•year-old female, PS. Figure 2.7 show
(35) that was above the highest T-score shown on the fonn. a completed response sheet for the CAARS--0:SV Note
When this occurs. the practitioner should circle the highe
st ,"
that D.S. (the observer) circled the appropriate number ("O
number and write the raw nwuber at the top in order to "l," "2," or "3") for each item. The admi nistra tor carefully
show that the respondent had an extreme score that was checked to make sure that all items on the sheet were rated
beyond the range of scores printed on the fonn. g
and then retained the front sheet in case the middle scorin
sheet was not clear.
Short Forms
The respondent in this example is a 35-year-old male,
RP. Figure 2.8 shows the completed scoring sheet for the
7.
Figure 2.4 shows a completed response sheet for the CAARS-0:SV using the answers presented in Figure 2.
CAARS-S:S. Note that RP. circled the appropriate number Scores were transferred into the boxes and were then
('O," "'I," "'2," or "'3") for each item. (The administra
tor summed within each column.
should carefully check to make sure that all items were
the Figure 2. 9 shows a completed CAARS-0:SV Profile fonn
rated at the end of the testing situation and retained
le scorin g sheet for D.S.'s ratings of P.S. on the various scales. Note that
front sheet of the form in case the midd to
was not clear.) the raw scores from the scoring sheet were transferred
d
the Profile fonn where they were plotted. They were plotte
n,
Figure 2.5 shows the completed scoring sheet for the on the "Female" side of the form, and in the "Fl" colum
of
CAARS-S:S using the answers presented in Figure 2.4. which is appropriate for a female subject, 18-29 years
age. This screening fonn would be incorrectly profiled
if
Scores were transferred into the boxes and were then
summed within each column. The administrator then plotted according to the observer's gender and age (55-
followed instructions on the scoring form to use select
ed year-old male).
items to calculate the Inconsistency Index.

10
 Administration and Scoring of the CAARS

Flglrd.1
S. . . AllponHlh11tfori1WRl-S:L

CAARS-Self•Raport: Long V1r1lon (CAARS-S:L)

by C. K. Connett, Ph.D., D. Erhardt, Ph.D., & E. P, lparrow, M.A.

Nute: N.K.
BINW1te: OS/~\ / b~ Aae:35._ Today'• D1te:.1./_/J1Jj_B_
Mom Dly "- MOIIIII 0., Y•

lillll hN u.d below arc ilans conccrni"I behaviors or problems ,ometlmcs expaicnc:ed by ldalb. Read -,. item carcflally aid decide bow
mac:11 ar bft ftequendy each Item des:ribcs you recently. Indicate your n:spomc for each i1an by ciR:ling Ole nmnt,e, ai. Gui, csponds to your choice.
U-tt 1lle ~ ale: 0 "'Not ■ II~ never; I =Justa lltlle, once In I while;
2 .. ~ _., often; and 3 = V«y much, very frequently.

2 l

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3
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3
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3
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3
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3
' 3.
Item, continued on back pase...

■
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\1aari, - •• ·

11
Connn, ~· Mull Al)lm R11tlng So,ilm; ICANlS)

CAAR8-S11f-R1port: Long V1ralon (CAARS-8:L)

Ir C. K. eon...,...D.• D. !rttardl, Ph.D.•• E. P. a,.rrow, M.A.

■
MHS
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12
 Admlnislrntion end Scoring of !he CAARS

....,.u
Sanplt Setrlltg SIINt for tit• CAAIIS-S:L

CAARS-Self•Report: Long Veralon (CAAR8-S:L)

by C. K. Conner1, Ph.D., D. l!ltlardl, ,t1.D., I I. P. .,.now, Ph.D.
Cllelit m:.-1N..1.:._._f<.:. .,_._ __ _ __ _ _ _ _ _ _ __ _ Gncler: M ©
(CftloO.)

lllt._te:05 /~/--"-3 Aae:_3!i_ Tod1y'1 D■te:_u_/J.1j_i8. N1nw. _ __ _ _ _

~ Tnnslw cln:led mnben Into Wllhaded boxes ICl'OSI •h row, • indicated on eiltler side al fie ICOrir'I -1d-
. Each cln:led ll\lltber will be copied once or twlc:e. , - - - - - -- -- - - - - .

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,.· ··a· ······ ·2·· ··· ··(!) ·· · ·· ··0·· ·
SI::@:::::::~:::::::.~ .::::::I: :
sz •••·~ • • • ••• • •~ • . . .. . . . ~ .•. . . . . ~ .•

To o"C•i• raw Jcorco, add th •••bcrs ia Ibo

wlaila llo.u1 (or eac• cola•• (A lo If) a ■ d enter • lncomisteacy ladex
I.lie ... la tlte boa at Illa bouom or lbe col1mu .
G . Guide
Is tho lnc:omistaic:y Index
10TAL8orgJala'?
□ yes t1II no
lflllc-wcr is ,u.• lhal may
bo,ome~islrnq,IIOlllo
n::ll)Oll,tCS. 'lllctaullssbouldbc
inapn:lcd widl cuim.

■
MRS
~ ~.,._I&
0 19'1, Al • ......_ la 1M U.I.A., r.o. lloa Ho. Nar1II T_....., NY 141J0.493Q. (100 .
laC...., J71U ~ M""°.. T-ON MZII JM6, (100)26MOl1 ..........._ +l-41M92..J6ll Pu, +l-41MV2.JM:I or(lll)MIMCM

13
Conners' Adult AOHO RAting ScAIA~ (GMRSl
AfJft2.3
1
Sllfflpft Prefllt Form tor dlt CAAA~:L

CAARS---Self-Report : Long Version (CAARS- S:L) - Profile For Females

Gender: M @
Oimt ID: N. IL - - - - - - ----- ---- (ClrdeOlle)

Btrthdatt:~/iLt_J.J A1e:_?6_ Tod1y'1 D1te:JL / J.]J_!:18 N1me: _ __ __

---- - · · Miffl 1:-.,, Yea _..:.M<!lllfl
:.::::.:.:::---O~
ly -Yw
- -- - - - -
r - - -- ---· ~- - - - -~
- - -- . ... .• ------------
E. DSM-IV lnllfentMI Symptoml
i A. lnattentk,n/Memorf Problemt
F1 .: f',emeles 1810 29yearsofage F. DSM-IV Hyper~lmpuftiye Symptoms
i F2 "' Females 30 lo 39 )'ell"I of age B. Hype, ac:tMty/RHtlfflrMIH
C. lmpulstvtty/Emotlonal L.abllity G. DSM-IV AOHD SymptDml Total
J F3 : Fem111es 40 lo 49 yeer1 of age H. ADHD Index
I i:. ., Females so )'9lf'S of age or older D. Problem• with Self-Concept

C D E F G H
B
i F1 F2 F3 F4 F1 F2 F3 F◄ F1 F2 F3 F4 F1 F2 F3 F• F1 F2 F3 F4 f1

: 1-9
•• 17
,i 17 ~: 21 21
• •
20 19 18 •
19 17 17
13 • 13 12
• 12 13 13 11 11 15 15 14 14
28 21 24 24
'O Z1 •
2D 19 18 18 66
84
"' - - 2020 282823 1717 93
112
e1 • • 111 17 19 19 - 18 12 • 12 - • - • - 25 2!5 22 tll 12
80 17 111 15 111 21 19 18 18 11 11 12 14 14 13 13 111 111
5111 ,. 15 • • 2ll ,a . 11 11 10 12 10 10 • - • • 15 eo
~ 13 =' !:
58 · • 14 15 • • - • - 13 13 12 12
: : 10 11 11 12 12 15 ~: 14 :
13
56 13 • 13
• 17 15 1 11 11 11 S7
54 13 12 12 - • - 14 145
15 14 13 -
• 12 \l!r"-~
11 14 14 13 13 5e
55
53 12 11 12 18 14 13 13 13 13 12 • - t:S 12 12 54
53
- 15 • • • 12 • 11 11 8 17 13
~51
52 11 11 7 11 11
51 11 10 • 14 13 12 12 12 • B • 7 7 111 12 12
511 10 • 12 1111 11 • 10 10 17 17
10 II II 10
~
411 9 13 • • 11 7 7 18 111 15 15 11 10
411 8 8 8 12 11 10 10 10 • t II 7 8 6 7 7 • • • - 15 15 9 9
11 10 49
50
,;r 10 9 8 8 10 8 8 8 8 14 14 14 14
411 8 . 7 7 11 II II II 8 8 5 6 8 II 8 13 10 10 48
.t6 7 7 108 8 8 ; 5 5 5 7 7 13 13 13 9 • 8 8 47
!; 8 8 8 11 e
7 7 7 a 7
5
•
4
5 7 7 12 12 12 12 a 7 7 -46
42 85 5 5 5 8 7
8 8 8 8 4 4 4 5 5 8 11 11 • 8 4S
: •• ,,,, '' ,. 3 ••• 10101111 ,, •• :
3Q 4 4 • 5 ◄ 4 5 11 5 5
3
3 3 3 4 4 5 5 5 10 10 II 5 5 42
41
38 3 3 • 2 6 3 2 2 • - ,: : : 9 9 5 II
37
38
35
22215433
1
0110
.. 3 2 2
3211
3
24
5
:, 3 2
,2
11
0
2
11
2 3 3
44
4 4
77
8888 4
5
◄334403839
·00 2 00 1322 -10 00 3333 51177 342 37

: :· 02,: ~. 22 22 ::·· ,1 ,,::

31 1 1 1 1 1 2 2 ,. ,. 3o4
30 11 224""4 200 33
29 0 0 0 1 1 0 1 32
28 0 31
z, 00 0033 30
28 0 0 29
25 2 2 28
• - . • . • ~ ~ ll

■MHS =~i,,"'.....-:::'.:;-"'""'"-•.,uu ,:._ · · · · · · · · : : · 0IIJIIIO. OH M2H lM6, (Illa) ~ I I ' . . 950, Nmdi 1----. NY 141~ , _
~
· - - - . +l◄ IM9'Z-lfa21. .... +l◄ I'" _ ,...,, 4'6-lCIQJ,
-.-ll4l m (la) S46-4414.

14
 Mministrnlioo ;wirl ScOl'ing of thq CAAR.5

,....u
.... A 111!11 1._flrth WM-t:S

CAARS-Stlf•Rtport: Short V1r1lon (CAARS-8:S)

by C. K. Connert, Ptl.D., D. !rtt1nl, Ptt.D., I !. P. lpa,row, Ph.D.

Cllfflt ID:_uB~,.!.-P.~.- - - - - - - - - - - - -
{8 0.1,
Gn4er:fC«lr
111..... .._:~/J. ..j~ Ap:.!t5 _ TNay•• D1te:1LJJS_1...ie_

IClliietilM. UjW!lleuced "1 ....._ Rad eacll i1lml C8'dllllJ • - - ~

tw,..._: l.iad below are ilfflll w,il,c bthnicn ar pl'Olllems relpOMt
mud! ar how hqocntty ach i1ffll delmlles yo11 l'lmldy. lndic:ale ,uur far adt i1ffll "1 drdins die 11U111ber 11111 ~,w ....... ia '1f1(fl cllnitt.
1k die fbllawifll 9Cale: 0 ,. NCll II Ill. never; I • Just I little. once in I while;
l•~mach .oftm:an d 3•Vrrymud l, ,,rry lftquently.

3
3
3
3
3
3
)
3
3
3
3
3
3,
3
~
3
3
3
3
3
3

3
3-
3
3·
3

15
Cot)nfli~· Adult AOHll R"ti11n ScAlo~ (CM l~S) I
Flgure2.5 8,-S·S
Sample Scoring Shtlt for tht CAAR .

CAARS-Self-Report Scale: Short

by C. K. Connera, Ph.D., 0. Erhardt, Ph,D,, a
v:r: . •
ion (CAARS -8:S)
sparrow, Ph.D.

Gender:@ F
CtieatID:JRUP~.- - - - - - - -- - - - (Circle One)

C:./ aO. Name: _ _ __ _

BirtlKlate:"~ / 1 :-i / ' ·)
~ ....12.. ~
•-: 35 I ...::.LO-
Today's Date:ll.__:/.....!.w-
"A"' - Mondi Dey Yea
,..... °'->' v-

••• actioas: Trwftr circled munbers into the unshaded boxes across each row, .
a indicated below. Each circled nianber will be copied once or twice.

D E """' f
Q 1 G) J l

...() .. ... . (1) ... :::~::::::::~::::: 2

:::~:::::: :G):::.·ch ....... !·....)

.. '6' .. .. ... ~ ...... ~ .. ..... 3· ....:
... () ....... (D ::::::~ ::::::::~: :: ::
sr :
6
6
.lo' ..... .·1 . 2 3 7

_..,_L--i·!-f· ... 2 : ::::c ::.

10

II

12
•1 ·Y·:•·•·•···~
____e,;;--i ...

· ·CQ} · · · · ·
: L::
o.... ...i'h ... . .. 2· 3
·2· · · · · · · · 3· · · · · IJ
12

13
· · ·~- · · · · · · (!)...... ·2· ...... . 3" ....••
•• . . .Q.. . . ... (jJ . •. . . . •2.. .... • •3••. . . I i
15
··.·o·· ·····m ·· ···· ·2 ··· ···· ·3··· ·· 16
16 .. .. .. .... ..... .....I¥ ..... .·3·· .. .
17 .. .o...... ..~ .... .. ~ ..... .. .. .... 11

. .~ . . . .. .~. . .. . • .~ •. . . . . •, ~ . . . .. 11

··@
···o······ Y·······
···· ···1· !········!·····:
· · · · ·,--,,,;,_ · · · · · · · 3··· · ·
... • .. . . • • . , • • • . • • •':-,,!) • .. . • . . ..... . 21

....I·o· .....
. ....·m·
9) ..... ·&. ....... ~-....:
..... ·2 · . ... . . . j' . . .. 2,

···o·······m·······2· · · · · · · · 3·· · ·· ll

~____,_c__ ::®:::::: ~ :::: ·.:: :~::: ·.:::·_~::::: l6

7 9 3 :·'f..- (J_ To obtai ■ raw scores , add the ■ umb e rs in 1bc

white bou1 for each coluaa (A lo F.) and eller
!be , . . ia Ille box al tbc bottom of tbc colomos
·A B C D E

16
 Administration and Scoring of the CAARS

Figure 2.6
Sample Profile Form for the CAARS-S:S

CAARS-Self-Report· Short Version (CAARS-S:S) Profile Form I

Gender ~ F
Client ID: R. P ( ircle One)

Age: 35 Today's Date: 11 /15 lj,K_

y.,.,
Name:
Birthdate: 02 / 12/ b3
v..,
Monlh Day
Month Day ---
F1 = Females 18 to 29 years of age A. Inattention/Memory Problems
=
M1 Males 1a to 29 years of age
F2 = Females 30 to 39 years of age
B. Hyperactivit y/Restlessn ess
C. lmpulslvlty/Emot ional Lab ility
=
M2 Males 30 to 39 years of age
=
F3 Females 40 to 49 years of age D. Problems with Self-Concept
=
M3 Males 40 to 49 years of age
=
F4 Females 50 years of age or older E. ADHD Index
M4 = Males 50 years of age or older
,-~ -- --

PROFILE FoR MALES PROFILE f ()R FF:MALF:S

B C D E A B C D E
A Ft F2 F3 F4 T
M1 M2 M3 M4 M1 M2 M3 M4 Ft F2 F3 F4 F1 F2 F3 F4 Ft F2 F3 F4 F1 F2 F3 F4
T M1 M2 M3 M4 M1 M2 M3 M4 M1 M2 M3 M4

90
~~Jf f
3,f , , ;it ""
89
88 15 ••n • •tt
-#~30
87 , 3t.3>,e
• a 32
86 - ~5
14 35 31 32
13 ~If &~:» - ~
85 . ,,., , , , 21U
• ., 34>" . .. 1'-4
84 14
·• 3,? 31 13 . 31' 29-2!- • G
83 14 15 · · ,. 3) , - 2'182:
82
13
.>,,;~_~'f!}:,2~ 3_o _ , _1,3 ·; ~ • : .. · ' 12 .,:/4, , 3 -0 - 81
81 14 14 13 12
• - 28 ,29 28 14 13 ,. ; -
80 , '14 .717, 79
15 • 31 • , 28 . · ' . .. 14
79
78 15
13
. 1S 14 , , 13 ~ 12 ·1s 1S 12 • 27 • •25 - • 12 13 1S 1S ;,a ,- - 25 71
13 12 • 13 13 12 11 15 15 21 Z 25 77
77 13 12 • • 14 •• 30 • 27 •
29 28 • 24 11 :14 :14 79
76 12 14 • 12 15
11 12 14 13 15 15 7, 25 2l 75
75 14 14 13 • 14 14 11 • 25 28 . •
12 14 12 12 14 • 14 :14 2l 74
74 11 13 • 12 • 11 28 • 25 23
11 11 10 25 22 73
73 11 12 13 • 11 14 13 • 27 24 • 22
15 13 12 • 13 • • 24 • 13 13 12 10 14 • 14 • 24 2l 22 n
72 13 21 71
12 11 10 13 • 10 26 23 • 21 10 11 13 • 13
71
12 12 • 22 23 • 11 10 11 11 13 • 2l 22 21 70
70 11 10 12
25 - 2220 12 11 10 9 9 13 • 3l 69
69 12 10 14 · 11 10
24 21 • 10 12 12 • 12 22 21 3l 88
88 • 12 11 10 12 •
11 11 9 · • 21 19 10 10 10 12 • 21 19 19 67
67 11
232020· .9 11 10 8 12 11 3l 66
66 11 9 10 13 • 65
11 22 • • 18 11 11 3l 19 16 18
65 • 11 10 10
19 19 17 9 11 11 64
64 10 10 10 8
8 • 8 10 9 10 19 18 f7 f7 93
63 10 9 8 12 • 21 18
• 18 18 10 10 10 18 115 82
62 10 9 9 10 9
20 17 17 • 10 17 18 81
61
9 8 17 15 80
60 9 • 7 19 • • 15
. 7 • 18 16 • • 7 9 9 16 15 59
59
18 15 • 14 7 7 6 8 16 14 14 56
58 8 7
• 6 17 • 15 13 7 8 7 15 15 57
57 8
8 • 6 • 14 14 · 6 8 8 8 13 13 58
56 7
7 6 16 • • 12 6 6 14 14 55
55
7 6 7 6 6 5 5 13 12 12 54
54 7
53 8 5 7 7 13 53
52 8 12 12 11 11 52
51 6 10 5 6 5 5 s 5 6 10 51
50 4 4 6 8 11 11 10 50
49 10 10 9 4 4 4 9 9 49
48 5 12 9 9 8 5 4 4 4 10 10 48
47 11 4 4 3 3 5 5 8 8 47
48 8 8 7 4 9 48
45 4 3 10 3 3 4 3 3 7 7 45
44 9 7 7 6 4 4 8 44
43 3 2 2 6 6 2 2 3 3 7 7 6 6 43
42 3 2 2 2 2 1 2 3 2 6 42
41 1 2 5 5 4 2 2 3 3 2 6 5 5 41
40 1 2 1 2 1 • 1 7 1 2 1 1 4 40
39 2 8 4 1 1 1 2 5 4 39
38 2 1 1 0 1 0 3 3 1 2 1 3 3 38
37 1 • 0 0 0 5 2 1 0 0 0 4 37
:,e 1 4 2 2 1 0 0 0 0 1 0 0 2 2 36
35 0 0 1 1 2 3 1 1 35
:w 0 0 :w
33 0 2 0 0 33
32 0 1 32
31 0 31
30 30
29 29
28 26

• MHS~opyrighl () IC/98, Mwti-Health Sy11tms Inc. All righls rtS<Md. In lhc U.S.A. , P.O. Bo., 950, Nonh Tonall'llllda_ NV 1412~5-0.
Camda, i 77o VICIOna Pait. Ave., Tororuo, ON Mlli 3M6, (IOO) 261~1 I. lnl<matlonol, +1-116-192-2627. Fa.t. +1-116-192-3343
(IIOOJ 456-3003.
or (WI) 5,I0-1,111,1,

17
 Corm@ls' Adult AOHO Roting Scnles (CAARS)

Rgur92.7
Sllfflple ResponH Sheet for th9 CAARS-0:SV

CAARS-Observer: Screening Version (CAARS -0:SV)

Ph D D Em•rdt. Ph D., & E. P. Sparrow, Ph.D .
by c. K. conn•,., ., , , -r ,' .• ,, • ,
t.$ ~ •, ... 't
~
, ,l

- •
ftl90P(BJ:IPtGDf$C'1llllD
YourN1111e: D.'5.
"

l=i~ Ast:~ ] Gender: (M) F ,__.,_,., Age:55"

Circle One

/ 98 I 1m tllls penon'1: □ spouse;!I parent □ tibling

,:::.:-.,11

□ other:
I Nay'a Datt:,ll___! Ho
~ Olly "- how mud! ot how hquffldyacll ilan

The person being described---

3
3
3
'3
3
3
3
,' ~o: '•
3
i '
3
®
3
3
3
3
3
3
3
3
3
3

3
3
3
3
3
3
3
3

■ MHS c..,...01M. ~s,._i...,.. . . .__

la~17'1DV....MA o...T-.,,ON M211JM6,~)~l~~8- :,,,9SO.Na,11,T....... NYl41~,(I00)456-l0 01 .
. +l -416-49l.-K27. P'u, +I-IIM92-134J or ( I l l ) ~-

18
 J\cfm,nistr otion nncf Sr.ormri nl thn CMIIS

f9,rl2.8
Sample Scoring Shllt for tflt WRS-0:SV

CAARS-Observer: Screening Version (CAARS-0:SV)

by C. K. Connera, Ph.D., D. Erhardt, Ph.D., & E. P. Sparrow, Ph.D.

P1MON BEING DESCJUBFJ) ,J ·r • :'' 0..vtJt ~

#

:a---:.~
IN...: E5 Age: ~e
J 'lad•y•• Date:...1.L/l~__/_.98..1 ua .. is peno■'a: □ spouse
Mm6 Dir Ya
I
YoorName:
Gender: (M

I
D,5
F
Cilde C.. 1---.11

parent □ sibling □ other:

A1e:!5°5
1-....n
---

lutractions: Transfer circled oumbm into the imshadcd boxes across each row, u indicalcd below.
Each circled number will be copied once.
Tnm&radi _ . . _ . _ ,

B C D
I . L_J
~
I bot dJlt Joob fiu llrJls.

··1······(p······~·······~···~·

·f.-~..·····~·
. ..ch ..· ·'...•·i·!·••·... ·....··!·~-....
· ·•:
JO

II

12
J-i-- .. ...m
----'"'---I .. (1).. .. .. .
r r:
2. .. .. .. . ~.. .. ::
:::~:.::::::(:·:::~ :: .: .. @::. fl
JJ

14
.. -~-.... .·n\·.... 0. ... .... ~-... u

15
16
:@::::: :&
0
' r:::::: :~::: :: :::;::::::
2 3 11
17

JI

19

20

21 ,., •• i ••·••t••··••t ••~

0 (D 2 3 ll

n
::I ::::::w.:::::: :~::::::::~::::: z:

2J 0 G) 2 3 ZJ

'.IA

:u

27

21
•4•:•
·· l ·· ·· ..99) ..•••••1••••·•• r---··:
···cb····-- -~ •••=
29

JO
:. '......
::@::::::~::::::}::::::: :::::::
8 ·7 - .. 17
~' -
To obt111 raw ,cores, add th au ■ bua 1a t•c ·A+B
wlilitc bo• et for eaclil col••• (A to D) ud cater
I.Ille 11■ io Ille box 11 tbe bono■ of tbe colu111n1

A B 15 D
C

■
MHS
~ O 1991, - S , U . lc Al,..._,_ lalMU.S.k_ P.O. U..9'0, Nanll T. . - _ NT J41 l lM,.UO, (III0)4)6JQ01.
loC..0... J110~ rwt.-..
T -, ON Mlll JMi, (1111) 26MOJJ ........._, ♦ J-4JM92-l62l Fa. • 1-416--ffl-lkl ar(III) _ ,

19
 - -------------------
Conners' Adult AOHD Rating Scales (CAARS)
Agure2.9
Sample Profile Form for di• CAARS-0:SV

CAARS-Observer: Screening Version (CAARS-0

:SV)_~rofile Form
-_-=-i l
Name: _ _.P-'.--'$"'---_ __ _ _ _
Gender: ~f!?
Ag e:~

Today's Date J1-. tJfa. -l ,.

M1 = MM 18 to 29 years of age
I am tbi•
J ___
You~N;me: P,S
Ge nde r:~ ~(. ..-,

peno ■'1: □ spouse.,, parent □ sibling □ other:

F1 = Females 18 to 29 years of age
Ag e:~

A. DSM-IV Inattentive Symptoms

B. DSM-IV Hyperactive/Impulsive Symptoms
-=, _

M2 "' Males 30 to 39 years of age F2 = Fem1le1 30 to 39 years of age

F3 = Females -40 to -49 years of age C. DSM-IV ADHD Symptoms Total
M3 = MIies 40 to -49 years of age D. ADHD Index
M-4 "' MIies 50 years of age or older F-4 = Females 50 years of age or older

P1w1•11 .1 F,m fn1 ,1.1-:s

P1m1111 F,m :\I \I 1,
B C D
C D A
A B
T Ml Ml Ill Ml Ill M2 MUiM M1 M2 M3 M4

, tt. 1• ._., 19, 19 • • 37 37 , 34 34 -,24 • • 22 - 75

, .,_ ·
- 74- 2121· :• • · - ~ • • -.• - '9 39 32 ·
27 • . • .22 -21
21 17 17 31 3•V 33 33 . • 23 22, • 74
32 ·
· 38 38 31 · 31 2fl 25 25 ~ • • • • · ' • ' • 35 35 32 32 23 • 21 21 . 13
, T3 :, · · -.,'i11 "1 : _20 20 18 ·1 , • · · 11 18 11 18 • •
• , 72
20 20 • . - • • • • .-37 37 30 30 24 . 21 20 20 • • 18 11 3-4 3-4 31 ,, - 22 •
72
31 31 . 25 ·24 • -•
22 - 20 20 71
~
18 -18 15 15 33 . 33 • •
• 71
70
• • • 17 17
1t 11 - - • • • • 35 35 ~~ 24 " " 18 18 17 17 17 17
• •
•
15
-
15 32 32 30 30 • 21 • • 70
22 _ 18 • • •8 • 8
•
Ill
11
•
11
•
11
•
18
•
11 11
• ·
•
14
•
14
34
33
34
33
29 21
27 27
_
23 •
22
• ! ! !!
1 8 18 18
• • 14
• •
I◄
31 31 29 28
30 30 21 28
21 20 19 19
20 • • •
811
811
32 32 2fl 28 22 2121 18 29 29 27 27 . 19 18 19 «7
61 17 17 15 15 17 17 . •
• . l7 _17 }1 ~5 ~5 15 15 • •
14 I◄
13 13 31 31 2S 17 88
Ill · · 14 14 • .
30 30
25
24 24 21
20
• 20 • l8 l8 · · · · 21 21 28 28 19 -
• 11 • •
17
85
86 18 18 - • 18 18 • •
15 15 • • • • 13 13 27 27 25 25 e4
15 15 12 12 29 29 23 23 • It 19 18
14 14 • . · 2 · · • 24 24 18 17 16 16

!: !: ;
84 · · U 13 • _ 20 • • • • • 13 2
28 21 13
113 15 15 - •
14 14 II II ~ :: i :: 19 18 18 15 14 14 . . ;3 ;3 !! 3 ;3 8
;7 ; ; ;
• 14 .
5 5 :
8I
:
80
;
•
4
;
4
~2 ~2
• 11 11 ;3 ;3 : : 25
25 20 20
;
1
!
7 _17 4 ! •
13 l3
• l 2 12
• •
• • II 11
12 12 • •
24 24 22 22
23 23 21 21 15 1
4 =
10 o 24 2· 19 19 ;5 14 ;3 •13 ;
511
511
13
·
13
· ;o ;a ;2 ;2 .
1 23 2i 1I l8 ! 7 :: :: ~3
_ _
12 12
;, ;,
II II
; ;
• • 10 ID
11 11 -
22 22 20 2
21 21 19 • • •
58

,2 • • • • _ 12 0 0 20 20 1 11 14 13 12 12 57
ST 12 9 9 17 17 18
15 • • . 9 9
5II • • I 8 II II • 22 22 • • 14 14 19 19 13 • • - 56
• 13 13 11 10 10 • 55
11 11 • . . 8 8 21 21 18 II 8 8 18 18 17 17 • 12 11 11
55 • _ IO 9 9
54 10 10 8 I 10 10 • 20 20 15 15 14 17 18 18 12 11 10 • 54
7 7 19 19 14 14 13 12 12 • 8 15 15 10 53
: t t 52
8 9 11 11 13 13 • 11 II 9 15 14 14 11 10 9
S 7 7 12 • • . 9 51
17 17 12 12 14 14 13 13 •
1 50
,: • • 8 8 8 e 1 1 ,e 18 11 11 11 10 10 1
9 7
• • 12 12 10 9 8
7 8 49
48 15 15 10 10 , 13 13 11 11 a
14 u . 8 48
1 1 5 s 10 9 8 8 8 6 e 5 5 12 12 • .
7 7 6 5 13 13 ,
9 8 1 6 5 5 11 11 10 10 8 7 6 7 (7
47
48 I I 4 ◄ 8 8 4 4 12 12 I 8 9 7
• 5 4 4 5 5 5 5 4 4 10 10 ' 9 8 48
11 11 7 7 8 7 7 8 5 45
45 6 5 3 9 9 I I
10 10 I I . 8 8 4 4 4 44
.:: z : 5 5 3 3 1877 5
a 5 ◄
7 5 33 4433 43
424411 9155
3 3 7 7 8 a
I e 4 4 e 5 • 3 2 2 6855 5 4 3 4 42
41 3 3
oa
• 4
22 7733 ◄ 4 11 332t
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20
 Chapter 3
Interpretation a~d Use

This chapter describes the interpretive strategy for using clinical settings with respondents who wish to elicit special
the CAARS. This interpretive strategy begins with consideration. Extremely high scale scores on the CAARS
consideration of the validity of the responses, then should always be suspect, especially T-ICOrH that exceed
proceeds with a survey of the responses at the item level, 80. Note that such extreme scores usually indicate severe
shifts to interpreting individual scales, examines whether symptomatology, but may on occasion be the result of
scores on the various scales represent a pattern that has symptom exaggeration or malingering. Interpretation of
diagnostic implications, and interprets these results in the externe scores can be clarified by comparing the infonnation
context of other information about the individual's provided by the respondent to other independent sources
symptoms and behaviors . of information that have been obtained . If large
discrepancies exist between the respondent and the other
Interpretation of the CAARS sources, then the possibility of malingering is magnified .
Faking good (also called social desirability) is a persistent
Before the CAARS scales can be interpreted, it is crucial to
problem in psychometric testing. Respondents high in
consider threats to the validity of the measures . Although social desirability are more likely to present themselves in
self-report measures like the CAARS assess a variety of a positive manner and, as a result, may bias their responses
ADHD-related symptoms, CAARS scores are subject to
to test items in what they consider to be a favorable
several possible biases. For example, some individuals tend
direction. To reduce the potential for social desirability,
to underestimate or underreport symptoms in the service
respondents should be reassured about the confidentiality
of presenting a favorable evaluation of themselves or a
of their responses . Co-administration of the CAARS with
family member. Gender and cultural differences also may
the Paulhus Deception Scales (PDS) is recommended for
influence reporting. While the CAARS show excellent test-
more formal assessment of socially desirable responding.
retest reliability and validity, these and other factors may
lead to poor test-retest reliability and suspect validity in
the individual's responses. Thus, it is important to ask Interpreting Item Responses
about the circumstances under which the respondent The first step in interpreting the results from any CAARS
completed the questionnaire and also to ask directly about form is to examine individual item responses. By perusing
whether the individual had difficulty in interpreting or the "Very much, very frequently" or "Pretty much, often"
understanding particular items. response categories, it is often apparent which types of
symptoms are problematic for the individual. For example,
It is important to assess whether the results are a valid an individual may endorse many inattention/memory
representation of the individual's true feelings and problems, but few hyperactivity/restlessness or
experiences. An important validity concern is the poSSibility impulsivity/emotional lability symptoms . When perusing
of random responses. Random responding can result from individual items, it is important to look for consistency in
a group testing situation where there are poorly motivated the pattern of responses and not to overinterpret any
individuals, or when disoriented clinical respondents individual response with respect to predictive power for a
complete the scales in a random manner. In addition, in particular clinical disorder. In this context, the CAARS
unusual testing situations where there is a fixed time limit contain no "critical items," that is, items that are weighted
(e.g., research settings), respondents may answer parts of as more important than other items.
the CAARS at random to finish the assessment in the
allotted time. Symptoms at the item level may be important indicators of
idiograpbic treatment targets (i.e., targets defined at the
Two basic types of faking response biases have been point at which treatment is tailored for the individual). For
identified in the test development literature : "faking bad" example, an individual with primarily attentional problems
and "faking good." Faking bad occurs when the individual might be treated differently from another individual with
attempts to present himself or herself in a negative light. primarily hyperactivity problems. All of the CAARS forms
This type of deliberate malingering may be encountered in make it easy to pinpoint several of the more important
ADHD-related symptoms, which in turn allows the clinician
21
"' di\.""""\\ At"-\ <"''l~hl-.~"''\\ ,lln.,1 ""'' dink11l h\tt1'icw. Tlbl13.1
ltl.'I\\ f\:'\ k" \'l'n\\i~ ~imihn 8\'l'''"lCh t" l\\l\1~· other
l\ lfttllp1tllvt Ouldlln• for T.Scorn and Plfc -.,
'""'~1" ~''-~ at'I\\ ~'"'I"''"\.~ th.,t "\I\''
All"'"'S tbt cl,n ~"' "' ~nd It~ time on s~inp
be pre~n, nml Ptniltlllt
v"ule,

"'-' '<' nN ~"Cl\~-,~ 1om~ that

\'C\\\~imc-nt Ucms fur cn~h
c-.,A RS -~~~k af\:' ~\'\;'\\ in ai-'l}C-1\dix B t\'I fudlt
•• GaWe~

tl\tc the Above 70 98 -t Very much above av

in~ tl\' \n "\f ,tcm ~ n.~s.. M
66 to 70 95- 98 uch above averageeraq~
61 to 65 86- 94 Above average
56 to GO 74- 85 Slightly above average
~ Subscale Scores 45 to 55 27- 73 Average
lnt~ rp1t tatio n of the C' AARS 1tqu ifcs a 40 to 44 16- 26 Slightly below averag e
general 35 to 39 6- 15 Below average
understandil\g of tbc nature of ADHD ~,uptoms 30 to 34 2-5
ncross Much below average
the ~ span. Gi\U\ ~ an \tnderstandit\g. the Below 30 <2 Very much below averag e
CAARS
are ~ - to interpret baS'Cd on an analysis of wher
e a how an individual's scores compare to those of adult
puti al)a r indh idua rs scores fulls with respe s or
ct to the the same age range and gender from the normative
C.A. .~fq )Ula tion nonns.. Fore.,,uuple.. an indhiidual sample
'"ith However, these are merely approximate guidelines
a T--scorc abo\' C 70 on the ADHD lnde.~ is likely . There
to have
si,__enificant k\'elS of S)'lllptoms that may meet is no reason to believe that there is a meaningful differ
diagnostic cnee.
critcriL 9lCh ~ in the DSM-IV (APA, 1994). for example, between a T-score of 55 and a T-sco
re of 56_
Do not use these guidelines as absolute rules
.
"\lt1hen ugn g this strategy (i.e., using T-score
norms to
compare the indi..-idual's responses to populatio Some practitioners may be more familiar with perce
n norms) ntiles
it is important to note at the outset that popu Guidelines for percentile ~ e n t are also given
lation norms in Table
in this case must represent an appropriate com 3.1. A percentile expresses the percentage of individual
parison s in
group. For the CAARS, normative comparis the normative group who scored lower than the respo
ons are nden t
presented by gender and age for a large normative So, for example, if"Steven" scored at the 9Qlkpercentile
sample. on
High T-smrcs represent a problem~lower T-sco the Hyperactivity/Restlessness subscale, then Stev
res suggest en's
that the individual does not present particular score on the Hyperactivity/Restlessness subscale
symptoms was
or sets of symptoms. 1be T-score is a standardiz higher than 90 percent of other men his age. The perce
ed score ntile
with the USlCfol feature that each subscale will suggests that Steven has more hyperactivity problems
have the than
same mean and standard deviation. Such a feature a large percentage of other men his age, which indic
allows ates
the test user to dircctl:y oompare the scores on the possi.bility of a clinically significant probl
one subscale em. Percentiles
to the Sl00reS on another. Such a oomparison derived empirically from the normative data are shmY
is not possible n in
if the raw scale scores are not transformed because appendix A, by age and gender.
there is
a different number of items comprising many
of the
subscales. Thus. the range of possible raw score Interpreting Profile Patterns
s for the
various su.bscales, before T-score transform When interpreting the CAARS, the clinician will
ation, is want to
diffi:rent. examine the pattern of elevated scale scores in addit
ion to
considering individual T-scores (or percentiles). Whe
T-scores have a mean of 50 and a standard deviation re no
of l 0. T-score is above 65, the CAARS is not indic
The T-scores used with the CAARS are linea ative of
r T-scores. clinically elevated symptoms. When one T-score
Linear T-sc.orcs do not transform the actual distn is abow
butions 65, then the pattern is marginal. In turn, the
of the variables in any way; heoc:e, while each varia greater the
ble has number of scales that show clinically relevant eleva
been transformed to have a mean of 50 and a tions
standard (T-scores above 65), the greater the likelihood
deviation of 10, the distributions of the subscale that the
scores do CAARS scores indicate a moderate to severe probl
not change. Variables that are not normally distr em.
ibuted in
the raw data will continue to be non-normally distr
ibuted
after the transformation. A Step-by-Step Guide for
As a general guide, T-scores can be interpreted
using the
Interpreting the CAARS
guidelines provided in Table 3.1 . These guidelines The following section describes a step-by-step guide
describe for
interpreting the CAARS.

22