The Influence of a Behavior Rating Scale on School Psychologists’ Diagnostic Decision-Making

Abstract

Psychologists are increasing their use of behavior rating scales as part of their diagnostic assessments. While behavior rating scales have many advantages, there are numerous cautions to using them, particularly for diagnostic purposes. It is unknown, however, how much influence a behavior rating scale has on a professional's diagnostic impression. Using an experimental design, a national sample of 330 school psychology practitioners from the United States provided diagnostic impressions on one of four scenarios. Two scenarios had evaluation data that supported a diagnosis of Attention-Deficit/Hyperactivity Disorder (ADHD) with one scenario including behavior rating scale standard scores in the average range and one with scores in the clinically significant range. The other two scenarios had evaluation data that did not support a diagnosis of ADHD but also had one with standard scores in the average range and one with scores in the clinically significant range. The findings revealed that behavior rating scale scores do influence school psychologists' diagnostic decisions. However, consistent with recommended best practices, other sources of evaluation data have a stronger influence on school psychologists' diagnostic decisions.