The Conners Rating Scale is a standardized questionnaire that can be used to assess ADHD symptoms and related behavioral problems in children and adolescents. It can collect input from parents and teachers, as well as self-report data from the children themselves. This multi-informant approach gives clinicians a deeper look at how children’s ADHD symptoms present in different areas of their lives.
When paired with digitized ADHD assessment tools (like cognitive tests that collect objective data), the Conners Scale can be a valuable tool for helping providers diagnose ADHD and track symptoms. Here’s how the Conners Rating Scale works and its strengths and limitations.
The History of the Conners Scale ADHD Assessment
The Conners Rating Scale was first developed in the late 1960s by Dr. C. Keith Conners, a clinical psychologist and pioneer in ADHD research, to diagnose ADHD. It began as a teacher rating scale and was later adapted into a scale for parents. In 1997, the Conners Rating Scale—Revised (CRS-R) was created, and included a self-report for older children with ADHD symptoms.
In 2008, the Conners Third Edition (Conners 3) was released to reflect the latest research on ADHD and was updated again in 2022 to the Conners Fourth Edition (Conners 4). This update includes greater consideration for cultural sensitivity, gender-inclusive language, new item-level indicators, and more. It also offers online administration and reporting, which can be integrated more easily into electronic records than pen-and-paper tests.
The Conners Scale has several other versions for ADHD diagnosis, including the:
- Conners Early Childhood (EC) for children ages 2-6, which assesses child development milestones related to behavioral, social, and emotional health.
- Conners Adult ADHD Rating Scales (CAARS) for adults 18+, which includes a self-report and observer report.
- Conners Comprehensive Behaviour Rating Scales (CBRS) evaluates behavioral, social, and academic problems in children without focusing solely on ADHD.
What is the Conners Rating Scale For?
The Conners Rating Scale is used to assess symptoms of attention deficit hyperactivity disorder (ADHD) in children ages 6 to 18. It also assesses oppositional behavior, aspects of executive function, emotional dysregulation, learning difficulties, and social challenges (Conners et al., 1998). Today, the scale is one of the most frequently used ADHD assessment tools in education and clinical psychology (Purpura and Lonigan, 2009).
One of its biggest strengths is its multi-informant approach, which collects data from patients, their parents, and their teachers. If a child behaves very differently in school versus at home, the Conners Scale can help capture that data for a more accurate diagnosis. A more robust view of the child’s symptoms and experience makes it easier to act from a position of patient-centered care.
How Does the Conners Rating Scale Work?
The various versions of the Conners Rating Scale gather different data from parents, teachers, and sometimes the child or adolescent themselves about ADHD symptoms. Each respondent rates how often specific behaviors occur, which provides a snapshot of functioning across settings like home, school, and social environments.
This behavioral health assessment can typically be completed in about 20 to 30 minutes and is then scored either manually or digitally, depending on which version is being used. Results help clinicians identify patterns, compare behavior to peers in the same age group, and support diagnostic decisions (Conners Fourth Edition).
All versions of the Conners Rating Scale measure behavioral and cognitive domains, including:
- Inattention: getting easily distracted and struggling to focus
- Hyperactivity: excess movement, restlessness, and struggles to stay still
- Impulsivity: blurting things out, interrupting, and acting without thinking
- Executive functioning: struggles with organization, planning, and trouble shifting between tasks
- Learning problems: academic challenges and homework completion issues
- Oppositional behavior: defiance towards authority, temper outbursts, and conduct issues
In updated versions of the Conners Scale, including the CRS-R, CBRS, and Conners 4, three more domains were added:
- Emotional distress: mood swings, irritability, and difficulty managing anger
- Social and family difficulties: difficulty making or keeping friends, conflicts at home, and socially inappropriate behavior
- Anxiety, mood, and ADHD comorbidities: depression, anxiety, sleep disorders, autism spectrum disorder (ASD), oppositional defiant disorder (ODD), and conduct disorder (CD)
Different versions of the Connors Rating Scale
The Conners Rating Scale has both short and long versions. The long version is usually used for initial ADHD testing, and the short form may be used to follow up.
Here are the main differences between the Conners Scale for parents, teachers, and children:
- Conners Parent Rating Scale: This scale tracks a child or adolescent’s behavior in home settings. The long version has 117 items and can be completed in under 15 minutes, whereas the short version has 53 items and can be completed in half that time (Conners et al., 1998).
- Conners Teacher Rating Scale: The teacher rating scale gives insight into classroom behaviors, where behavioral problems associated with focus, attention, and concentration may stand out (Hvidsten and Valle, 2021). The long version is 109 items long, and the short form is 49. This form can be completed by multiple teachers to determine whether problem behaviors are consistent across different classrooms.
- Conners Self Report Scale for Older Children (8-18): The longer version of the Conners Self-Report includes 118 questions, and the short form includes 51. This scale can help to reveal internal experiences that parents/teachers might not see, which may be especially useful for girls, whose symptoms of ADHD often manifest internally (Quinn and Madoo, 2014).
Where the different Conners Rating Scales are pen and paper questionnaires, the Conners Continuous Performance Test 3rd Edition (Conners CPT 3) is a computerized neuropsychological test that measures attention-related difficulties for children ages 8 and older. It can be complementary to other Conners questionnaires, but does not measure as many domains of cognition as other objective assessment tools, like those offered by Creyos.
Interpreting Scores on the Conners Scale
Scores are reported using T-scores, which indicate how far a result deviates from typical behavior for someone of the same age and gender. This allows clinicians to compare the child’s behavior to what’s typical for their peer group. Each behavioral domain produces its own subscale score, and when multiple informants report similar concerns, confidence in the findings increases.
For example, if a child scores high (T-score of 60 or above) in the hyperactivity scale on both the parent and teacher forms and also notes in their self-report that they struggle with sitting still, results may support a hyperactive-impulsive ADHD diagnosis when combined with clinical training and judgment.
However, because this data is subjective, results can be skewed by response bias, cultural norms, language barriers, or limited insight into the child’s baseline behavior and cognition (Rietz et. al, 2016). For example, Black and Hispanic boys with ADHD are frequently misdiagnosed with ODD or CD as opposed to their white peers (National Academies of Sciences, Engineering, and Medicine, 2024).
To get a complete look at the child's ADHD symptoms, subjective report scales are best combined with objective cognitive data. Solutions such as those offered by Creyos help gather both types of data so providers can make informed diagnosis and treatment decisions.
The Strengths and Limitations of the Conners Rating Scale
In the United States, an estimated 7 million children between the ages of 3 to 17 have been diagnosed with ADHD at some point (Center for Disease Control, 2022). With the rise of ADHD diagnoses, more parents may be interested in getting their children tested as symptoms arise (Danielson et. al, 2024).
The Conners Rating Scale is widely used for identifying ADHD symptoms and related concerns, but like any tool, it has both strengths and limitations.
Some of this ADHD rating scale’s strengths include:
- Its multi-informant approach offers a full picture of a child’s behavior across a variety of environments.
- T-scores that consider age and gender provide standardized results that may reduce interpretation bias (Conjin et. al, 2023).
- A comprehensive symptom assessment that considers emotional and social challenges rather than only mild to severe behavioral problems associated with ADHD.
- Digital administration options in Conners 4, which simplifies test-taking, scoring, and reporting for more accessible use in clinical or school settings (Cibrian et. al, 2024).
Some limitations that come with different versions of the Conners Rating Scale include:
- A lack of objective performance data can let biases, perception differences, or ADHD stigma skew results. While Conners CPT-3 gathers objective data, it is limited compared to cognitive assessment tools.
- Limited insight into comorbidities, which can require several more assessments to reach a complete and accurate diagnosis.
- Less comprehensive insight into the cognitive challenges associated with ADHD, such as response inhibition, sustained attention, memory, and planning.
While the Connors Rating Scale is a very useful tool for diagnosing ADHD, a more diverse set of diagnostic tools can help address its limitations.
Comparing the Conners Scale and Other ADHD Tests
Here are some examples of how other tests for children and young adults compare to the Conners Rating Scale:
- SWAN (Strengths and Weaknesses of ADHD Symptoms and Normal Behavior Scale): Measures ADHD traits on a behavioral spectrum, capturing both strengths and weaknesses. Unlike the Conners’ problem-focused model, the SWAN takes a balanced, strengths-focused approach. This scale is best suited for detecting subtle behavioral differences in adolescents under 18.
- Vanderbilt ADHD Diagnostic Rating Scale (VADRS): A DSM-aligned tool for children ages 6–12 that gathers input from parents and teachers, while screening for ADHD and common comorbidities like ODD and anxiety. This scale is more concise than the Conners and is often used in pediatric settings for initial screening.
- ADHD Rating Scale–5: A DSM-5-based checklist for children ages 5–17. Popular in schools and clinics for its simplicity, though it lacks the broader behavioral and emotional symptom assessment provided by the Conners Scale.
- Brown Attention-Deficit Disorder Scales (BADDS): Targeted assessment of executive function issues (inability to focus, disorganization, struggles with planning) rather than only external behaviors. There are both self- and observer-report options for children, adolescents, and adults—useful for uncovering more subtle, internalized ADHD symptoms.
Creyos Health’s standardized health questionnaires include both the SWAN and the VADRS, with results that automatically integrate into patients’ reports. Discover our full list of questionnaires here.
Comparing the Creyos ADHD Protocol and the Conners Rating Scale
The Creyos ADHD Assessment Protocol combines interactive cognitive tasks and behavioral questionnaires to assess various aspects of attention and executive function through a series of scientifically validated performance indicators, or “markers” of ADHD. Unlike the Conners’ survey format, Creyos combines the objective and subjective assessment of the cognitive, behavioural, and psychological symptoms of ADHD for a more dynamic, performance-based view across age groups.
While rating scales have long been used to screen for ADHD, researchers warn that misunderstandings about how to use these tools may lead to mass overdiagnosis (Harrison et. al, 2023). In fact, Dr. Keith Conners himself expressed regret for how ADHD is diagnosed and treated based on only limited clinical data (Psychology Today, 2016).
In contrast, the Creyos ADHD Protocol gathers a detailed combination of subjective and objective data to detect markers associated with ADHD and improve clinical decision-making. While the Creyos ADHD Protocol does not automate diagnosis, it is a valuable supplement to the diagnostic process that can be smoothly integrated into primary care.
By using Creyos’ software, Telapsychiatry was able to reduce ADHD overdiagnosis by 30% in their clinic. The objective data that Creyos collects plays a key role in determining whether symptoms of ADHD are actually a sign of a different condition, and gets patients on track for appropriate treatment.
Creyos ADHD Protocol: Online Cognitive Tasks, Behavioral Questionnaires, and Automated Reports
The Creyos ADHD Protocol is an online assessment tool with three key features for efficient and accurate ADHD screening:
Cognitive Tasks
Research shows that Neurocognitive impairment is associated with ADHD, particularly in the domains of attention and inhibitory processes, as well as executive functioning and processing speed (Shameem Agha et. al, 2023; Jackson and Wild, 2021; Hennessy, 2024).
Creyos's cognitive tasks gather objective patient data by assessing 14 markers that have scientifically supported associations with ADHD. Ten of these markers are identified from our Spatial Planning, Token Search, Feature Match, and Double Trouble tasks. The other four markers are based on the Sustained Attention to Response Task (SART), a continuous performance test that measures attention in repetitive, unstimulating, or distracting situations.
Standardized Behavioral Questionnaires
The Creyos protocol also gathers subjective data with the use of age-appropriate questionnaires. Where the cognitive tasks gain insight into patients’ cognitive function, these questionnaires give patients the opportunity to share their experience, allowing for greater whole-person care.
The protocol includes the following standardized rating scales:
- The Adult ADHD Self-Report Scale (ASRS)
- The Vanderbilt ADHD Diagnostic Rating Scale (VADRS)
- The Strengths and Weaknesses of Attention-Deficit/Hyperactivity Symptoms and Normal Behavior Scale (SWAN)
Reporting
Our protocol supports the diagnostic process with instantly-generated reports that include:
- At-a-glance insights to allow for quicker decision-making
- Automated scoring that reduces the risk of human error and administrative burden
- Doctor and patient-friendly presentation to support discussions about treatment plans
- Automatic integration into patients’ electronic health records (EHRs)
Similar to the Conners Rating Scale, the protocol also shows how patients’ scores compare to demographic norms on cognitive tasks and how they compare to established cutoffs on standardized questionnaires.
Combining Objective and Subjective Data in ADHD Screening
The Conners Rating Scale is a long-trusted tool for ADHD screening, but as ADHD diagnoses become more common and complex, combining subjective and objective performance-based assessments is necessary to allow for more accurate and personalized care. By combining behavioral context with real-time cognitive data, clinicians can better assess ADHD symptoms and avoid misdiagnosis.
Written By Avi Meehan
Avi Meehan is an author, editor, and SEO copywriter based in Ontario, Canada. They write about a wide range of topics, including nonprofit and event management, cognition and mental health, and more. Through their legacy memoir writing service, Recollections, they help aging individuals explore and document their life stories.
Reviewed by Mike Battista, Director of Science & Research at Creyos
Mike Battista specializes in brain health, cognition, and neuropsychological testing. He received his PhD in personality and measurement psychology at Western University in 2010 and has been doing fun and useful stuff in the intersection between science and technology ever since.