The Attention and Executive Function Rating Inventory (ATTEX): Psychometric properties and clinical utility in diagnosing ADHD subtypes

This study presents a new inventory, the Attention and Executive Function Rating Inventory (ATTEX), and examines the psychometric properties and the clinical utility of ATTEX in indentifying the attention deficit hyperactivity disorder combined type (ADHD-C) and the ADHD predominantly inattentive type (ADHD-I) in school environments. A normative sample of Finnish 7- to 15-year-old children and adolescents (N = 701) and a clinical sample consisting of children with ADHD-C (N = 190) and ADHD-I (N = 25) were examined with the ATTEX and the ADHD Rating Scale-IV. The ATTEX and its scales had good internal consistency reliability (0.67-0.98) and criterion validity (0.68-0.95). Normative data was provided for the total normative sample and for boys and girls separately. Gender differences were noted in the ATTEX scores, boys having consistently higher scores on all ATTEX scales. The effect of age was significant only for one of the ten scales, the Motor hyperactivity scale, 7-year-olds having more problems of hyperactivity than 14-year-olds. Lower parent education level and the child's learning difficulties were related to higher ratings of EF problems in ATTEX. When different cutoff scores for boys and girls were applied, ATTEX was sensitive in identifying children with attention deficit disorders. In addition, ATTEX was accurate in differentiating children with ADHD-I from children with ADHD-C. In this Finnish sample, ATTEX showed solid psychometric properties and could be used as a reliable tool in the diagnostic evaluation of ADHD-C and ADHD-I.