The development and content validation of a clinical screening scale to identify attention-deficit hyperactivity disorder cases based on the gender perspective: an e-Delphi study

Abstract

Background: Although many studies analyse gender differences in the clinical expressionof Attention-Deficit Hyperactivity Disorder (ADHD) and prevalence studies show that girls withADHD are underdiagnosed, there are no instruments that are sensitive to the detection of girls withADHD. Objective: The objective of this study is to develop a self-report early detection instrumentfor boys and girls with ADHD aged 7 to 16, which includes the gender perspective and is sensitive tothe detection of girls with ADHD. Methods: The scale was developed and the items that comprisedit were created from the thematic analysis of ADHD and its evaluation in children based on thediagnostic criteria of the DSM-5-TR. A modified e-Delphi method involving a three-round websurvey was used to establish a consensus on the content of the scale. Ten experts were recruited toform a professional panel. The panel members were asked to assess the differential symptomatologyof ADHD in boys and girls, the dimensions to be evaluated, and the importance of scale items toevaluate the content. Results: A consensus was reached regarding 13 total items distributed in threedimensions: inattention; hyperactivity/impulsivity; and, a third dimension, internalisation, whichincludes symptoms most present in the expression of ADHD in girls. Conclusions: To the best of ourknowledge, the development of this scale using the Delphi method is the first specific scale used foridentifying ADHD that also addresses the gender perspective and the differential symptomatologybetween boys and girls. However, we must proceed to the analysis of psychometric properties, as thescale requires an exhaustive study of its reliability and validity. We can anticipate that this scale willprovide relevant and reliable information that can be used for the identification of ADHD in bothboys and girls.