Parents report more ADHD symptoms than do teachers in children with epilepsy

Children with epilepsy have a high rate of attention deficit/hyperactivity disorder (ADHD), yet parent–teacher agreement on ADHD symptoms in epilepsy is unknown despite the need to assess symptoms across settings such as home and school. Parent–teacher agreement on ADHD ratings was investigated in 208 children with epilepsy (mean age = 11.2, SD = 3.6) using the ADHD Rating Scale IV, along with associations with demographic variables, epilepsy severity, adaptive level, and quality of life. Children were four times more likely to be identified as having clinically elevated ADHD symptoms when parent ratings were the benchmark versus teachers. Agreement was highest for children with more severe ADHD symptoms, for the Hyperactivity-Impulsivity dimension of behavior, and for children with broadly normal adaptive behavior. Higher parent and teacher ADHD ratings were related to reduced quality of life, but unrelated to epilepsy severity. Exclusive reliance on parent or teacher ratings may yield variable rates of ADHD symptoms in children with epilepsy.

Research Highlights
► ADHD is common in children with epilepsy
► An ADHD diagnosis requires information from home and school, yet parent-teacher agreement about ADHD symptoms in epilepsy is unknown
► Parents of children with epilepsy rated their children as having more severe ADHD symptoms than did teachers in this study
► This differs from what is usually reported in children with ADHD who do not have epilepsy, where teachers usually report higher ADHD symptoms
► Relying only on either parent or teacher ratings may yield different rates of ADHD symptoms in children with epilepsy