Sign Up
Login
Try for Free
Login
The Conners 4 (Conners 4th Edition) is a multi-informant rating scale measuring ADHD symptoms, co-occurring problems, and functional impairment for ages 6 to 18, with parent, teacher, and self-report forms. Psychologists, school psychologists, and pediatric clinicians use it in ADHD evaluations, school assessments, and treatment monitoring. This page covers how to write up Conners 4 results, with a fictional sample and a results-section template.
Psychologists, school psychologists, and pediatric clinicians; publisher qualification level B
IEP and Section 504 teams, pediatricians and prescribers, payers, testing-accommodations reviewers, parents
300 to 700 words for the results section · administration about 12 to 15 minutes per full-length form
Multi-informant ADHD rating scale
ADHD referrals and differential diagnosis, school and special-education evaluations, medication and treatment monitoring, accommodation applications
Published by MHS (2022); described here for write-up purposes, no test content reproduced
The Conners 4th Edition (Conners 4) is a multi-informant rating scale measuring ADHD symptoms, co-occurring problems, and functional impairment in young people ages 6 to 18, published by Multi-Health Systems (MHS) in 2022 under the authorship of C. Keith Conners, whose rating scales have anchored child ADHD assessment since the late 1960s. Parent and Teacher forms cover ages 6 through 18 and a Self-Report covers ages 8 through 18, each in three lengths: full-length, Short, and a 12-item ADHD Index. Administration and scoring are fully digital, on the MHS Online Assessment Center+ or Q-global through the Pearson distribution channel: paper responses can be entered by the examiner, but hand scoring is not possible, and results are T-scores and percentiles against combined United States and Canada norms. Edition status matters as of July 2026: MHS discontinued Conners 3 paper and hand-scored products at the end of 2023, so new Conners work runs on the Conners 4, with the Conners Early Childhood covering ages 2 to 6 and the CAARS 2 covering adults.
The load-bearing rule for write-ups: the Conners 4 describes probability, not diagnosis. Its T-scores quantify how a young person's reported behaviors compare with same-age peers, and its ADHD Index expresses how closely a response pattern resembles those of youth already diagnosed with ADHD, useful evidence, never a verdict. A DSM-5-TR ADHD diagnosis requires symptoms in two or more settings, onset before age 12, and functional impairment, none of which a single rating form can establish. That is why Conners 4 results enter a psychological evaluation report or a diagnostic evaluation as one converging data source, and why the sentence that turns a score into a diagnosis is the one reviewers flag first.
School psychologists write up Conners 4 results inside special-education and Section 504 evaluations; clinical child psychologists use it for diagnostic clarification when ADHD is the referral question; pediatricians, psychiatric nurse practitioners, and child psychiatrists use it to document symptom baselines and medication response; and pediatric neuropsychologists fold it into a neuropsychological report as the ADHD-specific rating layer alongside performance testing. It is the right tool when the question is ADHD-shaped and you need symptom-level, DSM-aligned detail with impairment ratings across home and school. When the question is broadband, what else might be going on, a system such as the BASC-3 surveys externalizing, internalizing, and adaptive domains in one pass, and many evaluations use both. In primary care, the free NICHQ Vanderbilt scales cover screening for ages 6 to 12, and at the transition to adulthood the CAARS 2 takes over from age 18. The Conners 4 write-up is where symptom detail, impairment, and informant perspective get integrated into one defensible account.
No statute, payer, or publisher mandates a results-section format. The sequence below follows the interpretation order the publisher's own materials teach, validity first, critical items next, then scales, then integration, because a write-up that mirrors it survives review: every score arrives with its foundation already stated. Each section carries the pitfall that most often undermines it.
Measures, raters, and norms. Name the instrument and edition, the form length each rater completed (full-length, Short, or ADHD Index), each rater's relationship and setting, administration dates, and the norm set used (combined-gender by default, gender-specific if selected). Pitfall: writing "the Conners" with no edition or form length. The Conners 4 restructured scales and dropped others, so an unnamed edition leaves reviewers unable to tell which instrument, and which norms, produced your T-scores.
Validity and response style, first. Before any score, state each protocol's Response Style Analysis results, Negative Impression Index, Inconsistency Index, Omitted Items, and Pace, and the interpretive consequence in plain language. Pitfall: importing Conners 3 validity vocabulary. The Positive Impression scale no longer exists, and a report that cites one announces that the template predates the instrument.
Critical items and indicators. State that the Self-Harm and Severe Conduct critical items and the Sleep Problems Indicator were reviewed, whether anything was endorsed, and what action followed. If they were disabled at administration, say so. Pitfall: silence. A reviewer who cannot tell whether critical items were checked reads the omission as "not checked," and in a record that later matters, so may a board.
DSM symptom scales, both metrics kept distinct. Report the ADHD Inattentive, ADHD Hyperactive/Impulsive, Total ADHD Symptoms, ODD, and CD scales with their T-scores, and the Symptom Counts alongside as absolute tallies. Write elevations as "consistent with" DSM-5-TR Criterion A, never as the diagnosis. Pitfall: conflating the metrics. A T-score is relative to norms; a Symptom Count is an absolute tally; one cannot stand in for the other, and the Total ADHD Symptoms scale has no count at all.
Content scales. Move through the six full-length Content Scales, Inattention/Executive Dysfunction, Hyperactivity, Impulsivity, Emotional Dysregulation, Depressed Mood, Anxious Thoughts, integrating raters within each scale rather than summarizing printouts in sequence. Pitfall: citing scales the administered form does not contain. The Short form carries only the first four, and Conners 3 scales such as Learning Problems or the Global Index no longer exist.
Impairment and functional outcome scales. Report Schoolwork, Peer Interactions, and Family Life, and connect them to the DSM impairment requirement: symptom elevation without documented functional impact supports nothing. Pitfall: expecting Family Life from a teacher protocol. The Teacher form does not include it; only parent and self-report do.
ADHD Index, correctly framed. Give the probability band and its plain-language meaning: the score expresses how similar this profile is to those of young people already diagnosed with ADHD, useful screening weight and nothing more. Pitfall: the Index written as confirmation. "The ADHD Index confirms the diagnosis" is the single most flagged sentence in Conners write-ups.
Cross-informant integration. One paragraph stating where raters converge, where they diverge, and what the divergence means. Modest agreement is the empirical norm, parent ratings typically run higher than teacher ratings, and divergence usually carries setting information. Pitfall: averaging raters into a verdict, or crowning one correct. A home-elevated, school-average profile is a finding about settings, not a scoring dispute.
Interpretive summary and recommendations linkage. Answer the referral question directly, keep band language normative with its plain-language meaning, state what the scores do not establish, and tie every recommendation to a specific finding, ending with the re-rating plan: who gets re-rated, with which form length, and when. Pitfall: recommendations that could follow any profile. If nothing in the results section makes a recommendation necessary, either the recommendation or the results section is incomplete.
MEASURES AND RATERS Instrument/edition: Conners 4 Form length: [full / Short / Index] Raters: [role, relationship, setting, form, date completed] Norm set: [combined-gender / gender-specific] VALIDITY / RESPONSE STYLE (every rater, before any score) [Negative Impression, Inconsistency, Omitted Items, Pace: classification + interpretive consequence; flagged protocols handled in writing, not silently] CRITICAL ITEMS AND INDICATORS [Self-Harm + Severe Conduct critical items, Sleep Problems Indicator: reviewed, endorsed or not, action taken] DSM SYMPTOM SCALES (per rater: T-score AND Symptom Count) Inattentive: [T / count] Hyperactive/Impulsive: [T / count] Total ADHD Symptoms: [T only] ODD / CD: [T / count] ["consistent with" DSM criteria, never "diagnostic of"] CONTENT SCALES (integrate raters within each scale) [Inattention/Exec Dysfunction, Hyperactivity, Impulsivity, Emotional Dysregulation, Depressed Mood, Anxious Thoughts; name only scales the administered form contains] IMPAIRMENT & FUNCTIONAL OUTCOME Schoolwork: [ ] Peer Interactions: [ ] Family Life (parent and self-report only): [ ] ADHD INDEX [Probability band + plain-language meaning; screening weight] CROSS-INFORMANT INTEGRATION [Convergence, divergence, what divergence means (settings, perspective); do not average it away] INTERPRETIVE SUMMARY (answer the referral question) [Bands as normative description; measurement error; what the scores do NOT establish on their own] RECOMMENDATIONS LINKAGE [Each recommendation tied to a finding; re-rating plan: who, which form length, when] Evaluator signature / credentials: Date:
Free to use and share, no signup. The PDF includes a one-page cheat sheet with section-by-section pitfalls and a pre-sign checklist; the DOCX is the blank results-section skeleton, ready to adapt.
Scenario: a pediatrician refers an 11-year-old for evaluation after two years of escalating attention and behavior concerns at school and at home, the classic cross-setting ADHD referral. Parent, teacher, and self-report full-length forms were administered. This is the results section only, condensed but structurally complete. All details are fictional.
Student: C.R., 11 (grade 5) · Referral: K. Iyer, MD (pediatrics), attention and behavior concerns at school and home · Evaluator: R. Vasquez, PsyD, Licensed Psychologist · Ratings completed: 07/06 to 07/09/2026 · Report date: 07/15/2026
Measures and raters: The Conners 4th Edition (Conners 4) was administered as part of a broader evaluation: full-length Parent form completed by C.R.'s mother; full-length Teacher form completed by his grade 5 classroom teacher, who taught him daily across the school year just ended; and the full-length Self-Report, completed by C.R. All forms were administered online and scored against the Conners 4 combined-gender norms. T-scores have a mean of 50 and a standard deviation of 10; higher scores mean more reported concerns.
Validity and response style: On all three protocols, the Negative Impression Index, Inconsistency Index, and Omitted Items fell within acceptable limits, and response pacing was unremarkable. All three profiles are considered interpretable, and each rater had adequate recent opportunity to observe.
Critical items and indicators: The Self-Harm and Severe Conduct critical items were reviewed for all raters; none were endorsed. The Sleep Problems Indicator was not elevated. No further action was indicated.
DSM symptom scales: Parent and teacher ratings converge on inattentive and hyperactive/impulsive symptoms. On the ADHD Inattentive Symptoms scale, the parent T-score of 76 (Very Elevated, above the 99th percentile; Symptom Count 8 of 9) and teacher T-score of 70 (Very Elevated, approximately the 98th percentile; Symptom Count 7 of 9) indicate many more inattentive behaviors than are typical for his age. ADHD Hyperactive/Impulsive Symptoms were similarly Elevated to Very Elevated (parent T = 71, Symptom Count 7; teacher T = 65, Symptom Count 6). Total ADHD Symptoms T-scores were 75 (parent) and 69 (teacher). C.R.'s self-report was consistent in direction but more moderate (Inattentive T = 64, Slightly Elevated; Hyperactive/Impulsive T = 58, Average). Oppositional Defiant Disorder and Conduct Disorder symptom scales were Average for all raters, with Symptom Counts of one or zero. Symptom Counts are absolute tallies that contribute to, but do not establish, DSM-5-TR Criterion A.
Content scales: The same pattern holds at the content level. Inattention/Executive Dysfunction was Very Elevated for the parent (T = 74) and Elevated for the teacher (T = 69) and C.R. (T = 66), with both adult raters describing difficulty sustaining focus, following multi-step directions, and finishing work. Hyperactivity (parent T = 69; teacher T = 66) and Impulsivity (parent T = 68; teacher T = 65) were Elevated across adult raters. Emotional Dysregulation, Depressed Mood, and Anxious Thoughts were Average for all raters, offering no rating-scale support for a mood or anxiety alternative to the referral question.
Impairment and functional outcome: Impairment ratings track the symptom picture. Schoolwork impairment was Very Elevated for the parent (T = 77) and teacher (T = 72) and Slightly Elevated on self-report (T = 63). Peer Interactions ratings were Slightly Elevated for the parent (T = 64) and Average for the teacher (T = 58). On the two forms that assess it, the parent and self-report, Family Life impairment was Elevated for the parent (T = 66) and Slightly Elevated on self-report (T = 61), consistent with the homework and morning-routine conflict described at intake. The Teacher form does not include the Family Life scale.
ADHD Index: The parent and teacher ADHD Index probabilities fell in the Very High band and the self-report in the High band, meaning the response patterns resemble those of young people diagnosed with ADHD more than those of the general population. The Index expresses similarity, not certainty; it carries screening weight and is not a diagnosis.
Cross-informant integration: Agreement across the three raters is strong for this instrument class, where modest cross-informant correspondence is the norm. The parent's somewhat higher elevations than the teacher's follow the typical direction of informant differences and plausibly reflect the lower structure of the home setting, particularly around homework and routines; C.R.'s more moderate self-ratings are common for his age and do not undercut the adult consensus. No rater's data were discounted.
Summary: Conners 4 results show convergent parent and teacher elevations on inattentive and hyperactive/impulsive symptom scales with corroborating self-report, High to Very High ADHD Index probabilities, documented impairment in schoolwork, peer, and family functioning, and no rating-scale support for a mood, anxiety, or conduct alternative. These findings are consistent with DSM-5-TR Criterion A symptom presence across home and school. They are rating-scale evidence: elevations relative to same-age peers, subject to measurement error, and not by themselves a diagnosis. Integrated with the developmental history, clinical interview, and records reviewed elsewhere in this evaluation, they support a diagnosis of ADHD, combined presentation, made on the full evaluation rather than on any score.
Linkage to recommendations: The cross-setting symptom and Schoolwork impairment findings support recommendations 1 and 2 (school consultation regarding classroom supports, and discussion of evidence-based treatment options with the referring pediatrician). The Family Life impairment elevations support recommendation 3 (parent behavioral training with a homework-routine focus). Recommendation 4 sets the monitoring plan: re-rate with the parent and teacher Conners 4 Short forms in 10 to 12 weeks to measure response.
This sample is fictional and for educational purposes. It does not describe a real child or record, and the scores are invented for illustration and correspond to no real child or record.
Writing these after every session? BastionGPT drafts complete notes from bullets, dictation, or a transcript.
Generate a note from bulletsWrite the results section knowing which decision it will feed, and label the rules honestly. The diagnosis itself runs on DSM-5-TR criteria: several symptoms in two or more settings, several symptoms present before age 12, and clear evidence that symptoms interfere with functioning (summarized for clinicians on the CDC's clinical care page); the AAP clinical practice guideline adds, as professional policy, that evaluation should gather rating-scale information from parents and school personnel across settings (Pediatrics, 2019); choosing the Conners 4 as that instrument is convention, and no statute requires two informants or names any test. In US schools, ADHD is listed by name in the IDEA other-health-impairment definition, but eligibility turns on whether the condition "adversely affects a child's educational performance" (34 CFR 300.8(c)(9)), no single measure may be the sole criterion (34 CFR 300.304(b)(2)), and the Department of Education's 2016 ADHD guidance confirms a diagnosis alone does not finish the analysis: IDEA eligibility also requires that the student need special education, while Section 504 runs its own substantial-limitation standard with no test list. Payer-side rules are policy, not law: rating-scale work bills inside the psychological-testing code families (96130 and 96131 for evaluation services, 96136 through 96139 for administration and scoring, 96146 for a single automated instrument), brief standardized instruments have their own family (96110, 96112, 96113, 96127) under Medicare's statutory screening exclusion (WPS article A57481), and current NCCI edits pair 96127 against the testing codes with no modifier bypass, so the brief-instrument code does not ride the same claim day as 96130-series testing. Stimulant prior-authorization checklists commonly expect documented DSM criteria, cross-informant scales, and impairment as plan policy, and testing-accommodation bodies run separate applications: College Board requires a request even with an IEP or 504 plan in place and says approval can take up to seven weeks, while ACT's documentation criteria ask for rating-scale measures from multiple sources and state that failure to finish timed tests cannot demonstrate impairment in isolation. Prescribers should date-stamp the telehealth context: DEA and HHS extended controlled-substance telemedicine flexibilities through December 31, 2026 (Fourth Temporary Extension) with the permanent special-registration framework still in rulemaking, and the enforcement backdrop, including Cerebral's 2024 non-prosecution agreement with a $3,652,000 forfeiture over its ADHD prescribing practices, has made documented, defensible assessment the industry's survival trait. In Canada, the CADDRA practice guidelines (4.1 edition, 2020) build ADHD assessment around a free toolkit of scales such as the SNAP-IV-26 and the Weiss functional impairment measures, so a commercial instrument such as the Conners 4 enters as clinician choice rather than toolkit default, carrying combined US-Canada norms that travel well. In Australia, the evidence-based ADHD guideline lists Conners rating scales among usable tools (its 2022 edition cites the Conners 3), recommends that a diagnosis never be made "solely based on rating scales or observational data," and its cited meta-analysis found no child ADHD screening tool met acceptable sensitivity and specificity, both above 0.8; the MBS complex-neurodevelopmental-disorder assessment items add their own scope rules, with items 135 and 289 explicitly not intended for standalone ADHD assessment without other neurodevelopmental comorbidity. Everywhere, rating-scale results support, and never substitute for, the clinical assessment.
Edition currency is the second defensibility layer. The Conners 4 restructured the instrument, not just the norms: the Positive Impression scale is gone, the Response Style Analysis now runs on the Negative Impression Index, Inconsistency Index, Omitted Items, and Pace, separate Hyperactivity and Impulsivity content scales replaced the old combined scale, and Conners 3 furniture such as the Global Index and Learning Problems scale no longer exists. MHS discontinued Conners 3 paper and hand-scored products on December 31, 2023 and converts remaining online uses one for one, so treat Conners 3 baselines as a stated limitation and re-baseline on the Conners 4 rather than comparing T-scores across editions, whose norms and scales differ. Name the edition, form length, and norm set (combined-gender by default, gender-specific if selected) in every report; and note that scoring is digital-only on the publisher's and distributor's platforms, so a "hand-scored Conners 4" in a record is a red flag on its face. Access boundaries are publisher rules with professional-ethics backing: the Conners 4 is a qualification-level B instrument, purchase and administration are restricted accordingly, and item content is protected test material, so route records requests that touch protocols through your test-security obligations and put your integration and conclusions, the write-up itself, in the ordinary record where they belong.
Conners is a registered trademark of Multi-Health Systems, Inc.; the Conners 4 is published by MHS and distributed by Pearson. BastionGPT is not affiliated with, or endorsed by, the publisher. This page reproduces no test items, stimuli, norms, or scoring materials.
There is no payer audit series for rating-scale write-ups; the accountability literature here is psychometric, and for the Conners 4 it is unusually one-sided. The instrument is reviewed in the Buros Center's 22nd Mental Measurements Yearbook, where the published review judges it well designed and well normed while flagging the May 2019 to March 2020 standardization window (pre-pandemic data, a caveat worth stating at re-evaluations), small samples in several reliability studies, and confirmatory-only analyses awaiting independent replication. Independent, non-publisher validation of the 2022 edition is essentially absent as of mid-2026, nearly every published figure traces to the manual, and at least one widely copied citation for the instrument's psychometrics, a supposed 2023 "Tatar et al." paper, appears in no database and its DOI resolves to nothing. Meanwhile cross-informant agreement in this instrument class averages r = .28 across 341 studies. Those findings predict the write-up failures. The BastionGPT Clinical Advisory Board sees the same errors most often in Conners 4 write-up reviews:
BastionGPT is specifically trained, tuned, and clinically tested on psychological and psychoeducational evaluation reports.
See how clinicians use it day to day on the AI therapy notes page.
Many BastionGPT users report saving more than 90 minutes per day on documentation.
HIPAA-compliant with a signed BAA on every plan. Your data is never used to train models. BastionGPT drafts, you review and sign.
Every Conners 4 scale reports a T-score, a standard score with a mean of 50 and a standard deviation of 10, plus a percentile against the combined US and Canada norms; higher scores mean more reported concerns. The publisher's classification bands, running from Low through Average, Slightly Elevated, Elevated, and Very Elevated, are normative descriptions: how elevated the rating is relative to same-age peers, subject to measurement error. The DSM Symptom Scales add Symptom Counts, absolute tallies that are a different metric from the T-score. Write bands as bands, pair each with its plain-language meaning, and let the diagnosis, if any, come from the whole evaluation.
No. The ADHD Index expresses how closely a response pattern resembles those of young people already diagnosed with ADHD compared with the general population, reported as a probability with a qualitative band from Very Low to Very High. It is screening evidence: a high value says "this profile looks like the profiles of diagnosed youth," not "this child has ADHD," and a diagnosis still requires the DSM-5-TR package of cross-setting symptoms, onset before age 12, impairment, and a clinical evaluation. "The ADHD Index confirms the diagnosis" is the single most flagged sentence in Conners write-ups; the defensible framing is "consistent with," inside a full evaluation.
Not directly. The Conners 4 changed the scale architecture, the items, and the norms: separate Hyperactivity and Impulsivity scales, a new Total ADHD Symptoms scale, no Positive Impression scale, and combined US-Canada norms collected in 2019 and 2020. Published convergence between corresponding Conners 3 and Conners 4 scales varies widely, so a Conners 3 baseline is context, not a comparison point. MHS discontinued Conners 3 paper and hand-scored products at the end of 2023 and converts online uses one for one. The defensible pattern for monitoring: re-baseline on the Conners 4, name both editions in the record, and state the cross-edition limitation in text.
No authority names it. DSM-5-TR sets the diagnostic criteria, and the AAP guideline recommends rating-scale data from more than one setting as professional policy, without naming an instrument. For special education, ADHD is listed in the IDEA other-health-impairment definition, but eligibility requires adverse educational impact and forbids any single measure as the sole criterion (34 CFR 300.304(b)(2)), and federal guidance is explicit that a medical diagnosis alone does not settle it; Section 504 runs its own substantial-limitation standard with no test list. The Conners 4's role is evidentiary convention: a norm-referenced, multi-informant way to document what the criteria and categories actually ask about.
By bandwidth, budget, and age. The Conners 4 is the ADHD specialist: DSM-aligned symptom scales with Symptom Counts, ADHD-relevant content scales, impairment ratings, and an ADHD Index, for ages 6 to 18. The BASC-3 is broadband, surveying externalizing, internalizing, school, and adaptive domains when the differential is wide, and many evaluations use both. The free NICHQ Vanderbilt scales cover primary-care screening for ages 6 to 12, at zero cost but without the Conners 4's profile depth and impairment architecture. At age 18 the hand-off is the CAARS 2, the adult Conners, published by MHS in 2023. The write-up rule is the same everywhere: name what you used and why it fit the referral question.
Document the second setting another way, and say so. DSM-5-TR requires evidence of symptoms in two or more settings; it does not require a teacher rating form, and no statute mandates two informants. When teacher forms do not come back, the accepted moves are school records and report cards, direct classroom observation, a school-staff interview, or ratings from another adult who sees the child in a structured setting, each named in the report as the cross-setting evidence. The write-up then states the limitation plainly: one informant rated, corroboration drawn from records, interpret accordingly. What reviewers flag is not the missing form; it is a report that claims cross-setting evidence it never documents.
No fixed interval exists in any rule. The publisher's own stability studies used re-rating windows of roughly two to four weeks, and the AAP guideline calls for structured follow-up of treatment response as policy, without prescribing a schedule. In practice, evaluators re-rate around meaningful change points, a medication start or adjustment, a new school term, a treatment-plan review, and use the Short form to cut respondent burden, since it keeps the core symptom scales while dropping two content scales and the Inconsistency Index. The write-up rule: name the interval, the form length, and the raters, and compare like with like, the same rater on the same form length, rather than mixing lengths across time points.
No. Conners 4 items are copyrighted, restricted test materials: the instrument sells only to qualified professionals at the publisher's qualification level B, and reproducing items in reports, advocacy documents, or web pages breaches the publisher's terms and the test-security obligations in APA Ethics Standard 9.11. That is also why this page shows a results-section skeleton and a fictional write-up rather than any test content. In a report, describe what elevated scales measure in your own words and report the scores; for records requests that touch raw protocols, route the response through your test-security obligations rather than reflexively printing the packet. Parents who want to understand the instrument can be shown the publisher's public materials.
Yes. Paste your score summary (forms, raters, T-scores, Symptom Counts, classifications) and it drafts the results-section narrative for your review: validity and critical items addressed first, both DSM metrics kept distinct, informants integrated rather than averaged, and the ADHD Index framed as probability. It can also cross-check a draft you wrote for score-versus-narrative mismatches, band-label drift, and Conners 3 vocabulary left in a Conners 4 report, and produce a plain-language version of the findings for parents and teachers. BastionGPT is HIPAA-compliant with a signed BAA on every plan, your data is never used to train models, and drafting from scores you paste means no protocol or item content ever needs to leave your records.
The instrument facts and compliance claims on this page trace to these sources, last verified July 2026:
Educational content, not legal or billing advice. Sample notes are fictional. Follow your organization's policies and your board, payer, and jurisdiction requirements.