The concordance between parent and teacher reports of DSM-IV attention deficit hyperactivity disorder (ADHD) and its symptoms was studied in 74 clinically referred children examined at Queens College, the City University of New York, and Mount Sinai School of Medicine, New York. Agreement between parents and teachers on structured diagnostic interview regarding diagnoses of ADHD is poor, and with no agreement for ADHD subtypes. Diagnosis based on either parent or teacher reports was positive for either inattentive or hyperactive-impulsive subtypes, but when both reports were used, most cases met only the criteria for ADHD combined type. Parent reports of behavior in school were more highly correlated with their child’s behavior at home than with teacher reports of the child’s behavior in school. 
COMMENT. Both teacher and parent questionnaires should be obtained for the diagnosis of ADHD subtypes, and one or other report alone is insufficiently reliable.
A family study perspective of DSM-IV ADHD subtypes showed that rates of ADHD among relatives of each subtype group were greater than rates among relatives of controls. Rates were not significantly higher among relatives of combined-typed probands compared to relatives of other probands. The subtype of the relative was not always the same as that of the proband, but hyperactive-impulsive ADHD was found almost exclusively among relatives of hyperactive-impulsive probands. The clinical differences among subtypes may be attributed to nonfamilial causes.