Teachers predict ADHD more accurately than parents: findings from a large epidemiological survey.

Objective: Observational reports of parents and teachers might conflict in the diagnostic process of pediatric Attention-Deficit/Hyperactivity Disorder (ADHD). This study investigates the diagnostic accuracy of parents and teachers in identifying ADHD in children, focusing on the influences of parental education level, child gender, and age.

Methods: Data were derived from the Turkish Epidemiological Survey in Childhood Psychopathologies, encompassing 5,830 children aged 6-13 years. ADHD diagnoses were determined using a semi-structured interview and impairment ratings from both parents and teachers. Both groups completed the ADHD Rating Scale-IV to identify ADHD-related symptoms. Diagnostic accuracy was evaluated by comparing sensitivity, specificity, positive predictive value, and negative predictive value across informants. Parental education was categorized into lower (LEL) and higher education levels (HEL).

Results: Teachers exhibited significantly higher diagnostic accuracy (93.7%) compared to parents (89.9%, p < 0.001), a trend consistent across gender and age groups. Teachers predicted ADHD in girls (95.2%) with greater accuracy than boys (92.1%), and similar patterns were observed for parents (girls: 92.0%, boys: 88.0%, p < 0.001). Parents with HEL demonstrated better diagnostic performance (91.3%) than those with LEL (89.4%, p < 0.05), though both were outperformed by teachers. Accuracy slightly declined in older children (10-13 years), but the differences were statistically insignificant.

Conclusion: The findings highlight teachers' superior ability to predict ADHD, likely due to their comparative observational advantages in structured settings. Parental education and child gender also influenced diagnostic performance. These results underscore the importance of incorporating teacher reports into diagnostic protocols while addressing socio-educational disparities to improve parent-reported accuracy.