Conners’ Teacher Rating Scale – Revised

Abstract

The Conners’ Teacher Rating Scale – Revised (CTRS-R) is a widely utilized psychometric instrument designed for teachers to assess behavioral problems and symptoms of psychopathology in children and adolescents, particularly those related to Attention-Deficit/Hyperactivity Disorder (ADHD). Developed by C. Keith Conners, the revised version (CTRS-R, 1998) offers expanded content, improved normative data, and a robust multi-factor model for evaluating various domains including cognitive difficulties, hyperactivity, anxiety, and conduct problems in the classroom setting. This tool is essential for clinical diagnosis, treatment monitoring, and educational planning.

Keywords

Conners’ Teacher Rating Scale, CTRS-R, ADHD, Attention-Deficit/Hyperactivity Disorder, Teacher Rating Scale, Externalizing Behaviors, Oppositional Defiance, Hyperactivity-Impulsivity, Childhood Behavior Assessment

Authors

C. Keith Conners, C. H. Goyette, R.F. Ulrich, J. D. A. Parker, G. Sitarenios, J. N. Epstein

Purpose

The primary purpose of the CTRS-R is to provide a standardized measure of behavioral symptoms and emotional disturbances observed in children within the school environment. It enables educators to systematically rate the frequency and severity of behaviors often associated with clinical conditions, most notably inattention, impulsivity, and hyperactivity, which are core diagnostic criteria for ADHD.

Furthermore, the scale aids in screening for other common comorbid issues such as difficulties with cognitive processing, Oppositional Defiant Disorder (ODD) symptoms, anxiety, and social challenges. The resulting profiles assist clinicians and school psychologists in making informed diagnostic decisions and in evaluating the effectiveness of interventions, whether pharmacological or behavioral.

Construct

The CTRS-R measures a multi-dimensional construct of behavioral and emotional functioning as manifested in a structured school environment. It shifts focus beyond just hyperactivity to encompass several clinically relevant domains. The scale captures externalizing behaviors (such as defiance and aggression) and internalizing behaviors (such as anxiety and withdrawal), as well as specific difficulties related to academic and organizational skills.

The instrument is structured around several distinct factors that reflect these constructs, allowing for a detailed profile rather than a single global score. Key constructs measured include inattention, impulsivity-hyperactivity, oppositional behavior, and traits related to perfectionism and social competence.

Validity

The validity of the CTRS-R has been extensively documented, demonstrating its ability to accurately measure the intended constructs and distinguish between clinical and non-clinical populations. Criterion validity, established through comparisons with standardized diagnostic interviews and other established measures, confirms that the scale effectively identifies children meeting diagnostic criteria for specific disorders, particularly ADHD subtypes.

The revision and restandardization conducted in 1998 ensured high clinical utility, showing strong differentiation between referred and non-referred samples. Construct validity is supported by the clear alignment of the derived factor structure with established diagnostic frameworks, such as the DSM criteria for ADHD and ODD, reinforcing its utility as a diagnostic aid.

Reliability

The CTRS-R demonstrates high levels of internal consistency (a measure of Psychometrics) across its various subscales, indicating that items within each subscale reliably measure the same underlying construct. The internal consistency coefficients (Cronbach’s Alpha) reported during the restandardization phase are robust:

• Cognitive Problems: .88 to .94
• Oppositional: .88 to .92
• Hyperactivity-Impulsivity: .88 to .95
• Anxious-Shy: .73 to .84
• Perfectionism: .85 to .91
• Social Problems: .90 to .93

These high reliability scores suggest that the scale provides stable and consistent measurement, crucial for both clinical assessment and research applications. Test-retest reliability is also generally strong, confirming the stability of the symptom ratings over appropriate intervals.

Factor Analysis

The revised version of the Conners’ Teacher Rating Scale (CTRS-R) was developed using comprehensive Factor Structure analysis to refine the scale items and structure. The analysis yielded a distinct multi-factor solution that is superior to earlier versions, providing targeted scores across several dimensions of child behavior. The identified factors are highly relevant to psychopathology observed in school-aged populations.

The primary factors extracted include: Cognitive Problems (reflecting inattention and organization issues), Oppositional (defiance, anger, and non-compliance), Hyperactivity-Impulsivity (restlessness, excessive movement, and lack of inhibition), Anxious-Shy (internalizing symptoms), Perfectionism (rigid, detail-oriented, and overly focused behavior), Social Problems (peer difficulties and isolation), and Psychosomatic (physical symptoms related to stress or emotion, although specific reliability data was not provided for this factor in the listed source).

Instrument

Test Type: Behavioral Rating Scale

Format: Paper-and-pencil questionnaire, typically completed by the child’s teacher or educator.

Language Available: Primarily English; translated versions are available for clinical use.

Population Group: Children and Adolescents

Age Group: Typically standardized for children aged 3 to 17 (depending on the specific version utilized).

Population Details: Used with both clinical populations (e.g., children referred for behavioral assessment) and general school populations for screening purposes.

Test Methodology: Teachers rate the frequency of specific behaviors on a 4-point Likert scale, where 0= Not True at all (Never, Seldom), 1= Just a Little True (Occasionally), 2= Pretty much True (Often, Quite a Bit), and 3= Very much True (Very Often, Very Frequent).

Keywords

Psychological assessment, Behavioral intervention, School psychology, Child psychopathology, Diagnostic screening, Multi-Health Systems, MHS, Rating scales

Authors

Author ORCID Identifier: Not provided in source material.

Affiliation Email addresses: Not provided in source material.

Correspondence Address: Information generally directed toward Multi-Health Systems (MHS), the publisher.

Permissions & Fee and Test Year

The Conners’ Rating Scales are proprietary instruments published by Multi-Health Systems (MHS), requiring purchase and professional qualifications for administration and interpretation. The original Teacher Rating Scale was introduced in 1969. The comprehensive revision and restandardization (CTRS-R) referenced in the source was published in 1998.

The original PDF instruments can be found via these links:

• https://stevensonwaplak.com/wp-content/uploads/2011/03/connorsteacher.pdf
• http://www.kangospediatrics.com/docs/teacher_add_adhd_short.pdf
• http://www.pathgroupatl.com/resources/conners_scale.pdf

Reference’s

• Conners, C. K. (1969). A Teacher Rating Scale for Use in Drug Studies with Children. American Journal of Psychiatry, 126(6), 554-888.
• Goyette, C. H., Conners, C. K., Ulrich, R.F. (1978). Normative data on Revised Conners Parent and Teacher Rating Scales. Journal of Abnormal Child Psychology, 6(2), 221- 236.
• Epstein, M. H., & Nieminen, G. S. (1983). Reliability of the Conners Abbreviated Teacher Rating Scale across raters and across time: Use with learning disabled students. School Psychology Review, 12(4), 457-459.
• Conners, C. K. (1989). Manual for Conner’s Rating Scales. N. Tonawanda, NY: Multi-Health Systems.
• Conners, C. K., Sitarenios, G., Parker, J. D. A., and Epstein, J. N. (1998). Revision and Restandardization of the Conners Teacher Rating Scale (CTRS-R): Factor Structure, Reliability, and Criterion Validity. Journal of Abnormal Child Psychology, 26(4), 279-291.

Items of the Conners’ Teacher Rating Scale – Revised

IMPORTANT: The following scale items must be preserved in their original language and must not be changed in any way.

CTRS-R Full Scale Items (Examples)

1. Defiant
2. Restless in the “squirmy” sense
3. Forgets things he/she has already learned
4. Appears to be unaccepted by group
5. Feelings easily hurt
6. Is a perfectionist
7. Temper outbursts; explosive, unpredictable behavior
8. Excitable, impulsive
9. Fails to give close attention to details or makes careless mistakes in schoolwork, work, or other activities
10. Sassy
11. Is always “on the go” or acts as if driven by a motor
12. Avoids, expresses reluctance about, or has dif1iculllcs engaging in tasks that require sustained mental effort (such as schoolwork or homework)
13. Is one of the last to be picked for teams or games
14. Is an emotional child
15. Everything must be just so
16. Restless or overactive
17. Fails to finish things he/she starts
18. Does not seem to listen to what is being said to him/her
19. Actively defies or refuses to comply with adults’ requests
20. Leaves seat in classroom or in other situations in which remaining seated is expected
21. Poor in spelling
22. Has no friends
23. Timid, easily frightened
24. Keeps checking things over and over
25. Cries often and easily
26. Inattentive, easily distracted
27. Has difficulty organizing tasks or activities
28. Has difficulty sustaining attention in tasks or play activities
29. Has difficulty waiting his/her turn
30. Not reading up to par
31. Docs not know how to make friends
32. Sensitive to criticism
33. Seems over-focused on details
34. Fidgeting
35. Disturbs other children
36. Talks excessively
37. Argues with adults
38. Cannot remain still
39. Runs about or climbs excessively in situations where it is inappropriate
40. Lacks interest In schoolwork
41. Has poor social kills
42. Has difficulty playing or engaging in leisure activities quietly
43. Likes everything neat and clean
44. Fidgets with hands or feet or squirms in seat
45. Demands must be met immediately…….. easily frustrated
46. Blurts out answers to questions before the questions have been completed
47. Spiteful or vindictive
48. Short attention span
49. Loses things necessary for tasks or activities (e.g., school assignments, pencils, books, tools, or toys)
50. Only pays attention to things he/she is really interested in
51. Shy, withdrawn
52. Distractibility or attention span a problem
53. Things must be done the same way every time
54. Mood changes quickly and drastically
55. Interrupts or intrudes on others (e.g., butts into others’ conversations or games)
56. Poor in arithmetic
57. Does not follow through on instructions and fails to finish schoolwork (not due to oppositional behavior or failure to understand instructions)
58. Easily distracted by extraneous stimuli
59. Restless, always up and on the go

Conner’s Abbreviated Teacher Rating Scale (CATRS) Items

1. Restless or overactive
2. Excitable, impulsive
3. Disturbs other children
4. Fails to finish things he/she starts, short attention span
5. Constantly Fidgeting
6. Inattentive, easily distracted
7. Demands must be met immediately, easily frustrated
8. Cries often and easily
9. Mood changes quickly and drastically
10. Temper outbursts; explosive/unpredictable behavior

Additional Teacher Observations (Examples)

Please circle the problems the child exhibits during the school day. Additional descriptions or examples are appreciated.

• Refusal to do as asked
• Short attention span
• Lack of tolerance for tasks not enjoyed
• Cannot wait or take turns
• Does not work with group
• Over-conforms to rules
• Seeks attention excessively
• Cannot work alone
• Easily confused or disoriented
• Forgetful, needs constant reminders
• Relationships with other children
• Frustrated
• Not interested
• Unhappy
• Overly sensitive to criticism
• Shows signs of anxiety (crying, nail biting)
• Puts blame for behavior on external causes
• Will not speak up
• Antisocial tendencies (e.g., steals, lies)
• Speaks inappropriately (e.g., curses)
• Hurries through work
• Works too slowly
• Easily distracted from work
• Difficulty changing activities
• Tires easily
• Doesn’t try
• Withdrawn