First step: Childhood attention deficit and hyperactivity disorder screening test development study

Objective: The aim of this study was to develop a brief, comprehensible, and parent-administered screening tool to facilitate the early and accurate identification of childhood Attention Deficit Hyperactivity Disorder (ADHD) in primary care settings. Materials and Methods: This descriptive, cross-sectional, and prospective study was conducted between December 1, 2024, and May 30, 2025, in Family Health Centers in Düzce, Türkiye. The study included 355 parents of children aged 6 to 18. Participants completed a Sociodemographic Data Form, the DSM-IV-Based Screening and Assessment Scale for Conduct Disorders in Children and Adolescents developed by Atilla Turgay, and the Attention Deficit and Hyperactivity Disorder Screening Test Development Form, which we developed based on a comprehensive literature review. Following the parents' consultation with the child psychiatrist, a clinical diagnosis was made. After conducting reliability and validity studies and ROC analyses on this developed form, it was shortened by selecting the ten most effective items for diagnosis from the attention deficit and hyperactivity-impulsivity sections. Results: Of the participating children, 54.1% were male, with a mean age of 10.83±3.34 years. The internal consistency coefficients (Cronbach's alpha) of the developed scale were 0.95 for the attention deficit subscale and 0.91 for the hyperactivity-impulsivity subscale. McDonald's Omega values were 0.90 and 0.91, respectively. Test-retest reliability was excellent, with ICCs of 0.95 for attention deficit and 0.88 for hyperactivity-impulsivity. Exploratory Factor Analysis (EFA) confirmed a unidimensional structure for each subscale, explaining 72.38% and 69.1% of the total variance, respectively. Confirmatory Factor Analysis (CFA) indicated good model fit (RMSEA=0.077; CFI=0.964). Receiver Operating Characteristic (ROC) analysis revealed optimal cut-off points of ≥5 for attention deficit and ≥4 for hyperactivity-impulsivity, with Area Under the Curve (AUC) values of 0.97 for both subscales, indicating excellent discriminative power. Agreement with clinical diagnosis was high (Kappa=0.86 for attention deficit and 0.73 for hyperactivity-impulsivity), surpassing the diagnostic agreement of the Turgay scale (Kappa=0.31 and 0.51). Content validity was confirmed by expert evaluation, and face validity was supported by impact scores above 1.5 for all items. Conclusion: This short and simple 10-question ADHD screening test is suitable for the Turkish language, psychometrically sound, and easily understandable by parents.. Psychometric analyses have shown that the test has high internal consistency and temporal stability. It has high diagnostic validity and shows strong agreement with clinical diagnosis. This test can be used as an effective and practical tool for the early diagnosis of children with suspected ADHD in primary healthcare settings. Keywords: Attention Deficit, Hyperactivity, Screening Test, Impulsivit