ADHD Symptoms and Diagnosis The Conners 3 Is An ADHD Assessment for Children and Teens—Here's What to Know By Amy Marschall, PsyD Amy Marschall, PsyD Dr. Amy Marschall is an autistic clinical psychologist with ADHD, working with children and adolescents who also identify with these neurotypes among others. She is certified in TF-CBT and telemental health. Learn about our editorial process Updated on July 07, 2023 Learn more." tabindex="0" data-inline-tooltip="true"> Medically reviewed Verywell Mind articles are reviewed by board-certified physicians and mental healthcare professionals. Medical Reviewers confirm the content is thorough and accurate, reflecting the latest evidence-based research. Content is reviewed before publication and upon substantial updates. Learn more. by Daniel B. Block, MD Medically reviewed by Daniel B. Block, MD Daniel B. Block, MD, is an award-winning, board-certified psychiatrist who operates a private practice in Pennsylvania. Learn about our Medical Review Board Print Phynart Studio / Getty Images Table of Contents View All Table of Contents What Is the Conners 3 Used For? How Do I Complete the Conners 3? How Is the Conners 3 Scored? Potential Limitations of the Conners 3 Understanding Your Conners 3 Scores Close The Conners 3 is a norm-referenced assessment used in diagnosing attention-deficit/hyperactivity disorder (ADHD) in children and teens. The Conners 3 is developed and distributed by Multi-Health Systems Inc. (MHS). It utilizes observation reports from parents or guardians as well as teachers to determine whether the child meets the Diagnostic and Statistical Manual of Mental Disorders (DSM) diagnostic criteria for ADHD. There is also a self-report form available for children ages eight and up. What Is the Conners 3 Used For? The Conners 3 will help determine whether any symptoms your child or teen may be displaying are indicative of ADHD. Tests for Specific ADHD-Related Symptoms Some practitioners who test for ADHD will use the Conners 3 when evaluating a client who is between six and 18 years old. It has scales to measure: Attention issues Impulsivity Defiance Learning problems Social skills In addition, it measures how closely the client’s presentation matches the diagnostic criteria for ADHD, oppositional defiant disorder (ODD), and conduct disorder. It identifies how closely the client’s symptoms match the criteria for ADHD to help the evaluator determine whether a diagnosis of ADHD might explain those symptoms. Measures Norm-Referenced Behavior When you complete the Conners 3, the evaluator scores the measures to get norm-referenced ratings on each of the scales. This helps them determine whether the client is experiencing an issue outside of what is typical for the age group including (but not limited to): FocusHyperactive behaviorAggression For instance, it is not unusual for a seven-year-old to sometimes have difficulty staying in their seat during school. A fourteen-year-old who argues with their parents from time to time is not necessarily displaying defiant behavior at a clinically significant level. Norm-referenced ratings tell the evaluator what symptoms go beyond typical behavior and might be clinically significant. Creates Symptoms Checklists In addition to these ratings, the Conners 3 creates symptom checklists for ADHD, ODD, and conduct disorder to determine whether the client’s symptoms match the DSM diagnostic criteria. According to the DSM, a client must have six symptoms of either inattentive or hyperactive-type ADHD in order to meet the criteria and be diagnosed. If a client has six or more inattentive symptoms and six or more hyperactive/impulsive symptoms, they can be diagnosed with ADHD combined type. Getting an Appropriate Diagnosis Since many diagnoses can have similar symptoms, the symptom count and norm-referenced rating scales help the evaluator determine whether the client’s symptoms are due to ADHD, another diagnosis, or both. I Think I Have ADHD: What to Do and Where to Go How Do I Complete the Conners 3? The Conners 3 consists of a series of questions presented in a Likert-scale format. The answers for each question are listed as follows: Not true at all/Never, Just a little true/Occasionally, Pretty much true/Often, and Very much true/Very often. How to Answer the Questions Answer the questions honestly and as accurately as you are able. You have the choice to indicate that you do not know how to answer a question, but if you skip too many questions, the evaluator might not be able to score your Conners 3. On Paper or Online Some evaluators have paper forms for the Conners 3, which you can complete with a pen or pencil by circling your answers to each question.Others use the MHS portal to administer it online. If your evaluator uses the MHS portal, you will receive a link via email, and you can complete the Conners 3 on any device with a web browser through their encrypted portal. If the evaluator requested that the teacher complete the teacher form of the Conners 3, they will either send you the link or give you the paper form to pass on to the teacher, or they will obtain an appropriate release to send the Conners 3 directly to the teacher. If your child is completing the self-report form, the evaluator will explain to them how to complete the measure. How Is the Conners 3 Scored? When scoring the Conners 3, the evaluator first looks at validity scales. Validity scales assess how someone took a psychological test and determines whether the scores are accurate and can be interpreted. The Conners 3 has three validity scales: The Inconsistency Index assesses how you responded to similar questions to detect attentive responding. If you complete the Conners 3 by randomly selecting answers, the consistency scale will reflect this.The Negative Impression Index looks at uncommon negative responses to determine if you may have over-reported symptoms.The Positive Impression Index assesses uncommon positive responses to see if you might have under-reported symptoms. If you respond attentively and honestly, the validity scales should reflect that. However, sometimes parents who are overwhelmed by their child’s problem behaviors might unintentionally respond in an overly negative manner when completing the evaluation. Similarly, a parent who feels defensive when completing the measure might inadvertently under-report symptoms. Children with low self-esteem sometimes endorse items on the Negative Impression Index as well, meaning that they present themselves as having a lot of negative qualities because they believe it is true. The evaluator will then look at the content scores and DSM scores to see what symptoms are outside of the typical range and what diagnostic criteria they might be consistent with. They will next review the symptom counts to see how many symptoms were indicated. The Conners 3 also has critical items for potential immediate safety concerns, such as starting fires or engaging in sexually aggressive behavior, to address with you. Potential Limitations of the Conners 3 While the Conners 3 can be helpful in determining whether your child has ADHD, there are some limitations. Other Tests May Be Needed to Make an Accurate Diagnosis It is very rare to make a diagnosis based on a single assessment measure. Even if you, your child, and your child’s teacher complete all three Conners 3 forms, the evaluator might administer a cognitive assessment to get more information about your child’s functioning and abilities or, if age-appropriate, a personality test to see if your child meets criteria for another diagnosis in addition to or instead of ADHD. Regardless of what measures are used in determining a diagnosis, the evaluator will also consider your child’s personal history as well as behavioral observations to provide context for the scores. ADHD Masking May Skew Results The Conners 3 is an assessment tool that measures behaviors. Since ADHD and other neurodivergent diagnoses are brain differences, they can impact behavior. However, some people with ADHD mask or hide their symptoms. As a result, it is possible for someone with ADHD to not meet the criteria based on the Conners 3. The Conners 3 Excludes Other Sexes/Genders In addition, the Conners 3 requires that clients be identified as either male or female in order to score the measure. This creates an issue if the client is nonbinary. Understanding Your Conners 3 Scores After administering the Conners 3 (and any other assessment measures they use), the evaluator should meet with you to go over the scores and explain what they mean. Ask questions or let them know if you are confused or do not understand something. You can also contact the evaluator after that appointment if more questions arise. Remember, symptoms like executive dysfunction can occur due to diagnoses other than ADHD, so even if your child does not meet the criteria for ADHD, this does not mean that they are not having a hard time. Girls, especially, are underdiagnosed due to masking symptoms. In addition, because it is possible to mask symptoms it is OK to get a second opinion from another evaluator if you still suspect that you, your child, or your teen has ADHD. You can also re-test later if symptoms persist after another diagnosis has been treated. A Word From Verywell If your child is struggling with attention, impulse control, defiance, or other symptoms that you suspect might indicate ADHD, the Conners 3 is one tool that can help you and their treatment team determine their diagnosis. If you or a loved one has been diagnosed with ADHD, understand that you're not alone and that treatment is available to you. How Is ADHD Treated for Children and Adults? 5 Sources Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Conners, CK. Conners Third Edition (Conners 3). Los Angeles, CA: Western Psychological Services; 2008. Diagnostic and Statistical Manual of Mental Disorders: DSM-5. 5th ed., American Psychiatric Association, 2013. Walls BD, Wallace ER, Brothers SL, Berry DTR. Utility of the Conners’ Adult ADHD Rating Scale validity scales in identifying simulated attention-deficit hyperactivity disorder and random responding. Psychological Assessment. 2017;29(12):1437-1446. Schuck RK, Tagavi DM, Baiden KMP, et al. Neurodiversity and autism intervention: reconciling perspectives through a naturalistic developmental behavioral intervention framework. J Autism Dev Disord. Published online October 13, 2021. Walters A. Girls with ADHD: Underdiagnosed and untreated. The Brown University Child and Adolescent Behavior Letter. 2018;34(11):8-8. By Amy Marschall, PsyD Dr. Amy Marschall is an autistic clinical psychologist with ADHD, working with children and adolescents who also identify with these neurotypes among others. 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