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 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:
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.
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:
In updated versions of the Conners Scale, including the CRS-R, CBRS, and Conners 4, three more domains were added:
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:
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.
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.
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:
Some limitations that come with different versions of the Conners Rating Scale include:
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.
Here are some examples of how other tests for children and young adults compare to the Conners Rating Scale:
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.
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.
The Creyos ADHD Protocol is an online assessment tool with three key features for efficient and accurate ADHD screening:
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.
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:
Our protocol supports the diagnostic process with instantly-generated reports that include:
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.
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.
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.