Child ADHD | SNAP IV 26 | Greenspace (US)

Child ADHD SNAP IV 26

Recommended frequency: Every 4 weeks

Summary

The SNAP-IV 26-item scale is an abbreviated version of the Swanson, Nolan, and Pelham (SNAP) Questionnaire (Swanson, 1992; Swanson et al., 1983). Items from the DSM-IV criteria for attention-deficit/hyperactivity disorder (ADHD) are included for the two subsets of symptoms: Inattention (items 1–9) and Hyperactivity/Impulsivity (items 10–18). Also, items from the DSM-IV criteria for oppositional defiant disorder (ODD) are included (items 19–26) because ODD is often present in children with ADHD. The scale can be used by the parents and teacher of children and adolescents between the ages of 8 to 18.

Psychometric Properties of the SNAP-IV

To examine Swanson, Nolan, and Pelham-IV (SNAP-IV) psychometric properties, parent (N = 1,613) and teacher (N = 1,205) data were collected from a random elementary school student sample in a longitudinal attention deficit hyperactivity disorder (ADHD) detection study. SNAP-IV reliability was acceptable. Factor structure indicated two ADHD factors and an oppositional defiant disorder (ODD) factor. Parent and teacher scores varied by gender and poverty status (d = .49-.56) but not age; only teacher scores varied by race (d = .25-.55). Screening and diagnostic utility was evaluated with likelihood ratios (LRs) and posttest probabilities. Parent SNAP-IV scores above 1.2 increased probability of concern (LR > 10) and above 1.8, of ADHD diagnosis (LR > 3). Teacher hyperactivity/impulsivity scores above 1.2 and inattention scores above 1.8 increased probabilities of concern only (LR = 4.2 and >5, respectively). Higher teacher scores for African American children and race differences in measurement models require future study.

Sources:

1. https://pubmed.ncbi.nlm.nih.gov/18310593/
2. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3623293/
3. http://www.shared-care.ca/files/Scoring_for_SNAP_IV_Guide_26-item.pdf

The Scale

For each item, circle the number which best describes this child/adolescent:

	Just a little	Quite a bit	Very much
1. Often fails to give close attention to details or makes careless mistakes in schoolwork or tasks.	1	2	3
2. Often has difficulty sustaining attention in tasks or play activities.	1	2	3
3. Often does not seem to listen when spoken to directly.	1	2	3
4. Often does not follow through on instructions and fails to finish schoolwork, chores, or duties.	1	2	3
5. Often has difficulty organizing tasks and activities.	1	2	3
6. Often avoids, dislikes, or reluctantly engages in tasks requiring sustained mental effort.	1	2	3
7. Often loses things necessary for activities (e.g. toys, school assignments, pencils, or books.	1	2	3
8. Often is distracted by extraneous stimuli.	1	2	3
9. Often is forgetful in daily activities.	1	2	3
10. Often fidgets with hands or feet or squirms in seat.	1	2	3
11. Often leaves seat in classroom or in other situations in which remaining seated is expected.	1	2	3
12. Often runs about or climbs excessively in situations in which it is inappropriate.	1	2	3
13. Often has difficulty playing or engaging in leisure activities quietly.	1	2	3
14. Often is “on the go” or often acts as if “driven by a motor”.	1	2	3
15. Often talks excessively.	1	2	3
16. Often blurts out answers before questions have been completed.	1	2	3
17. Often has difficulty awaiting turn.	1	2	3
18. Often interrupts or intrudes on others (e.g. butts into conversations/games).	1	2	3
19. Often loses temper.	1	2	3
20. Often argues with adults.	1	2	3
21. Often actively defies or refuses adult requests or rules.	1	2	3
22. Often deliberately does things that annoy other people.	1	2	3
23. Often blames others for his or her mistakes or misbehavior.	1	2	3
24. Often is touchy or easily annoyed by others.	1	2	3
25. Often is angry and resentful.	1	2	3
26. Often is spiteful or vindictive.	1	2	3

Not at all

Just a little

Quite a bit

Very much

1. Often fails to give close attention to details or makes careless mistakes in schoolwork or tasks.

2. Often has difficulty sustaining attention in tasks or play activities.

3. Often does not seem to listen when spoken to directly.

4. Often does not follow through on instructions and fails to finish schoolwork, chores, or duties.

5. Often has difficulty organizing tasks and activities.

6. Often avoids, dislikes, or reluctantly engages in tasks requiring sustained mental effort.

7. Often loses things necessary for activities (e.g. toys, school assignments, pencils, or books.

8. Often is distracted by extraneous stimuli.

9. Often is forgetful in daily activities.

10. Often fidgets with hands or feet or squirms in seat.

11. Often leaves seat in classroom or in other situations in which remaining seated is expected.

12. Often runs about or climbs excessively in situations in which it is inappropriate.

13. Often has difficulty playing or engaging in leisure activities quietly.

14. Often is “on the go” or often acts as if “driven by a motor”.

15. Often talks excessively.

16. Often blurts out answers before questions have been completed.

17. Often has difficulty awaiting turn.

18. Often interrupts or intrudes on others (e.g. butts into conversations/games).

19. Often loses temper.

20. Often argues with adults.

21. Often actively defies or refuses adult requests or rules.

22. Often deliberately does things that annoy other people.

23. Often blames others for his or her mistakes or misbehavior.

24. Often is touchy or easily annoyed by others.

25. Often is angry and resentful.

26. Often is spiteful or vindictive.

Scoring the SNAP-IV

Symptom severity is rated on a 4-point scale. Responses are scored as follows:

Not at all = 0
Just a little = 1
Quite a bit = 2
Very much = 3

The scores in each of the three subsets (inattention, hyperactivity/impulsivity, and opposition/defiance) are totalled. A suggested scoring guideline is below:

Questions 1 – 9: Inattention Subset

< 13/26 = Symptoms not clinically significant
13 – 17 = Mild symptoms
18 – 22 = Moderate symptoms
23 – 26 = Severe symptoms

Questions 10 – 18: Hyperactivity/Impulsivity Subset

<13/26 = Symptoms not clinically significant
13 – 17 = Mild symptoms
18 – 22 = Moderate symptoms
23 – 26 = Severe symptoms

Questions 19 – 26: Opposition/Defiance Subset

< 8/24 = Symptoms not clinically significant
8 – 13 = Mild symptoms
14 – 18 = Moderate symptoms
19 – 24 = Severe symptoms

Suggested Targets:

<13/26 for inattention
<13/26 for hyperactivity/impulsivity
<8/24 for oppositional defiant disorder

If desired, the average rating for each subset can be calculated by totaling the scores for the items in the subset and dividing by the number of items. The average can be compared with cut-off scores suggestive of ADHD reported in the literature.