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Protocol - Attention-Deficit Hyperactivity Disorder Symptoms - Child

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Protocol Name from Source:

The Strengths and Weaknesses of Attention-Deficit/Hyperactivity Disorder Symptoms and Normal Behavior Scale (SWAN)

Availability:

Publicly available

Description:

The Strengths and Weaknesses of Attention-Deficit/Hyperactivity Disorder Symptoms and Normal Behavior Scale (SWAN) is an 18-question, parent- or teacher-reported rating scale to assess for the indication of attention-deficit hyperactivity disorder (ADHD) in children.

"Weaknesses" are scored as positive and the "strengths" are scored as negative because the usual ratings (i.e., in the Swanson, Nolan, and Pelham [SNAP] Questionnaire) are ratings of "symptom severity." This keeps the average rating-per-item of the SWAN aligned with the average rating-per-item of the SNAP if the negative item ratings of the SWAN are set to 0 before averaging the items.

Protocol:

For each item listed below, how does this child compare to other children of the same age? Please select the best rating based on your observations over the past month.

Compared to other children, how does this child do the following:

1. Give close attention to detail and avoid careless mistakes

[ ] far below

[ ] below

[ ] slightly below

[ ] average

[ ] slightly above

[ ] above

[ ] far above

2. Sustain attention on tasks or play activities

[ ] far below

[ ] below

[ ] slightly below

[ ] average

[ ] slightly above

[ ] above

[ ] far above

3. Listen when spoken to directly

[ ] far below

[ ] below

[ ] slightly below

[ ] average

[ ] slightly above

[ ] above

[ ] far above

4. Follow through on instructions & finish school work/chores

[ ] far below

[ ] below

[ ] slightly below

[ ] average

[ ] slightly above

[ ] above

[ ] far above

5. Organize tasks and activities

[ ] far below

[ ] below

[ ] slightly below

[ ] average

[ ] slightly above

[ ] above

[ ] far above

6. Engage in tasks that require sustained mental effort

[ ] far below

[ ] below

[ ] slightly below

[ ] average

[ ] slightly above

[ ] above

[ ] far above

7. Keep track of things necessary for activities

[ ] far below

[ ] below

[ ] slightly below

[ ] average

[ ] slightly above

[ ] above

[ ] far above

8. Ignore extraneous stimuli

[ ] far below

[ ] below

[ ] slightly below

[ ] average

[ ] slightly above

[ ] above

[ ] far above

9. Remember daily activities

[ ] far below

[ ] below

[ ] slightly below

[ ] average

[ ] slightly above

[ ] above

[ ] far above

10. Sit still (control movement of hands/feet or control squirming)

[ ] far below

[ ] below

[ ] slightly below

[ ] average

[ ] slightly above

[ ] above

[ ] far above

11. Stay seated (when required by class rules/social conventions)

[ ] far below

[ ] below

[ ] slightly below

[ ] average

[ ] slightly above

[ ] above

[ ] far above

12. Modulate motor activity (inhibit inappropriate running/climbing)

[ ] far below

[ ] below

[ ] slightly below

[ ] average

[ ] slightly above

[ ] above

[ ] far above

13. Play quietly (keep noise level reasonable)

[ ] far below

[ ] below

[ ] slightly below

[ ] average

[ ] slightly above

[ ] above

[ ] far above

14. Settle down and rest (control constant activity)

[ ] far below

[ ] below

[ ] slightly below

[ ] average

[ ] slightly above

[ ] above

[ ] far above

15. Modulate verbal activity (control excess talking)

[ ] far below

[ ] below

[ ] slightly below

[ ] average

[ ] slightly above

[ ] above

[ ] far above

16. Reflect on questions (control blurting out answers)

[ ] far below

[ ] below

[ ] slightly below

[ ] average

[ ] slightly above

[ ] above

[ ] far above

17. Await turn (stand in line and take turns)

[ ] far below

[ ] below

[ ] slightly below

[ ] average

[ ] slightly above

[ ] above

[ ] far above

18. Enter into conversation & games (control interrupting/intruding)

[ ] far below

[ ] below

[ ] slightly below

[ ] average

[ ] slightly above

[ ] above

[ ] far above

Scoring Instructions:

Each question of the SWAN is scored on a seven-point scale, where Far Below Average = 3, Below Average = 2, Somewhat Below Average = 1, Average = 0, Somewhat Above Average = -1, Above Average = -2, and Far Above Average = -3.

Subscale scores on the SWAN are calculated by summing the scores on the items in the specific subset (e.g., Inattention) and dividing by the number of items (e.g., 9) to express the summary score as the Average Rating-Per-Item.

If omitted, the item is dropped, not set to 0. If more than half the items are omitted, then the use of the scale score is probably not valid.

ADHD-In

ADHD-H/Im

#1_______

#10_______

#2_______

#11_______

#3_______

#12_______

#4_______

#13_______

#5_______

#14_______

#6_______

#15_______

#7_______

#16_______

#8_______

#17_______

#9_______

#18_______

Total = _______

Total = _______

Average = _______

Average = _______

Total for all 18 items = _________

Average for all 18 items = ________

© Dr. James Swanson

Personnel and Training Required

None

Equipment Needs

None

Requirements

Requirement CategoryRequired
Average time of greater than 15 minutes in an unaffected individualNo
Major equipmentNo
Specialized requirements for biospecimen collectionNo
Specialized trainingNo

Mode of Administration

Self-administered

Life Stage:

Child, Adolescent

Specific Instructions:

None

Research Domain Information

Release Date:

May 12, 2010

Definition

A questionnaire to assess attention-deficit/hyperactivity disorder (ADHD), a condition characterized by patterns of inattention, hyperactivity, and impulsivity that is more pronounced than in other individuals at similar developmental levels (APA, 2000).

Purpose

This measure is used to screen an individual for attention-deficit/hyperactivity disorder (ADHD) and to assess the severity of symptoms. ADHD is found in 3%-7% of school-aged children and demonstrates a familial pattern because first-order relatives of affected individuals are at higher risk for ADHD and other disorders, such as mood, anxiety, and learning disorders. The severity and course of ADHD are also influenced by environmental factors, such as school and family (APA, 2000).

Selection Rationale

The Strengths and Weaknesses of Attention-Deficit/Hyperactivity Disorder Symptoms and Normal Behavior Scale (SWAN) was vetted against similar protocols and selected because it is a validated, parent- or teacher-reported instrument that is relatively low burden for investigators and respondents.

Language

English, French

Standards

StandardNameIDSource
Common Data Elements (CDE)Child Attention Deficit Hyperactivity Disorder Assessment Score3075464CDE Browser
Logical Observation Identifiers Names and Codes (LOINC)Attention deficit hyperac child proto62751-3LOINC

Process and Review

[link[phenx.org/node/103|Expert Review Panel 4]] (ERP 4) reviewed the measures in the Neurology, Psychiatric, and Psychosocial domains.

Guidance from ERP 4 included the following:

  • No changes

Source

Swanson, J., Deutsch, C., Cantwell, D., Posner, M., Kennedy, J. L., Barr, C. L., Moyzis, R., Schuck, S., Flodman, P., Spence, M. A., & Wasdell, M. (2001). Genes and attention-deficit hyperactivity disorder. Clinical Neuroscience Research, 1, 207-216.

Swanson, J., Schuck, S., Mann, M., Carlson, C., Hartman, K., Sergeant, J., Clevenger, W., Wasdell, M., & McCleary, R. (2005). Categorical and dimensional definitions and evaluations of symptoms of ADHD: The SNAP and the SWAN ratings scales.

General References

American Psychiatric Association (APA). (2000). Diagnostic and statistical manual of mental disorders (4th ed., text rev.). Washington, DC: Author.

Cornish, K. M., Manly, T., Savage, R., Swanson, J., Morisano, D., Butler, N., Grant, C., Cross, G., Bentley, L., & Hollis, C. P. (2005). Association of the dopamine transporter (DAT1) 10/10-repeat genotype with ADHD symptoms and response inhibition in a general population. Molecular Psychiatry, 10(7), 686-698.

Hay, D. A., Bennett, K. S., Levy, F., Sergeant, J., & Swanson, J. (2006). A twin study of attention-deficit/hyperactivity disorder dimensions rated by the Strengths and Weaknesses of ADHD Symptoms and Normal Behavior (SWAN) Scale. Biological Psychiatry 61(5), 700-705.

Lubke, G. H., Muthén, B, Moilanen, I. K., McGough, J. J., Loo, S. K., Swanson, J. M., Yang, M. H., Taanila, A., Hurtig, T., Jarvelin, M. R., & Smalley, S. L. (2007). Subtypes versus severity differences in attention-deficit/hyperactivity disorder in the Northern Finnish Birth Cohort. Journal of the American Academy of Child and Adolescent Psychiatry, 46(12), 1584-1593.

Polderman, T. J. C., Derks, E. S., Hudziak, J. J., Verhulst, F. C., Posthuma, D., & Boomsma, D. I. (2007). Across the continuum of attention skills: A twin study of the SWAN ADHD rating scale. Journal of Child Psychology and Psychiatry, 48(11), 1080-1087.

Swanson, J. M., Wigal, T., & Lakes, K. (2009). DSM-V and the future diagnosis of attention-deficit/hyperactivity disorder. Current Psychiatric Reports, 11(5), 399-406.

Young, D. A., Levy, F., Martin, N. C., & Hay, D. A. (2009). Attention deficit hyperactivity disorder: A Rasch analysis of the SWAN Rating Scale. Child Psychiatry and Human Development, 40(4), 543-559.

Protocol ID:

121502

Variables:

Export Variables
Variable NameVariable IDVariable DescriptionVersiondbGaP Mapping
PX121502_Control_InterruptingPX121502180000Enter into conversation & games (control interrupting/intruding)4N/A
PX121502_Await_TurnsPX121502170000Await turn (stand in line and take turns)4N/A
PX121502_Close_Attention_To_DetailPX121502010000Give close attention to detail and avoid careless mistakes4N/A
PX121502_Sustain_AttentionPX121502020000Sustain attention on tasks or play activities4N/A
PX121502_Listen_When_Spoken_ToPX121502030000Listen when spoken to directly4N/A
PX121502_Follow_Through_ChoresPX121502040000Follow through on instructions & finish school work/chores4N/A
PX121502_Organize_Tasks_ActivitiesPX121502050000Organize tasks and activities4N/A
PX121502_Engage_Mental_EffortPX121502060000Engage in tasks that require sustained mental effort4N/A
PX121502_Keep_Track_Of_Activity_ItemsPX121502070000Keep track of things necessary for activities4N/A
PX121502_Ignore_Extraneous_StimuliPX121502080000Ignore extraneous stimuli4N/A
PX121502_Remember_Daily_ActivitiesPX121502090000Remember daily activities4N/A
PX121502_Sit_StillPX121502100000Sit still (control movement of hands/feet or control squirming)4N/A
PX121502_Stay_SeatedPX121502110000Stay seated (when required by class rules/social conventions)4N/A
PX121502_Modulate_Motor_ActivityPX121502120000Modulate motor activity (inhibit inappropriate running/climbing)4N/A
PX121502_Play_QuietlyPX121502130000Play quietly (keep noise level reasonable)4N/A
PX121502_Settle_DownPX121502140000Settle down and rest (control constant activity)4N/A
PX121502_Control_Excess_TalkingPX121502150000Modulate verbal activity (control excess talking)4N/A
PX121502_Control_Blurting_OutPX121502160000Reflect on questions (control blurting out answers)4N/A