The Conners 4 is not recommended for individuals who possess reading abilities below the recommended level (specifically, a 5th grade reading level for the Parent and Teacher forms and a 3rd grade reading level for the Self-Report form). If a rater cannot read the Conners 4 (e.g., the rater’s reading level is lower than the recommended grade level), the examiner can read the instructions and items aloud for them (for detailed information, see chapter 2, Administration). Raters may approach their tasks with varying degrees of insight, observational skill, candor, bias, and defensiveness, all of which may need to be evaluated by the clinician when considering the accuracy and usefulness of the results.

Interpretive guidelines provided in this manual should be carefully examined to avoid inaccurate or unsupported interpretations. To obtain a comprehensive view of an individual, the examiner must combine the Conners 4 results with information gathered from other sources and measures, including information obtained through interviews, observations, other rating scales, various types of cognitive testing, and record reviews. The Conners 4 is not by itself a diagnostic tool; rather, it informs diagnosis with objective norm referenced data. Results should also be combined with direct clinical observation and interpreted within the context of any factors that may influence results, such as socially desirable responding, cultural factors affecting familiarity with rating scales, interpretation of test items or comfort level in endorsing symptoms, misunderstanding of item content, or biased or careless responding. The Conners 4 should, therefore, not become a substitute for a trained and experienced clinician’s overall judgment regarding diagnosis, conceptualization, treatment planning, or treatment outcome. The diagnostic process is a dynamic one that requires the synthesis of information gathered from different sources over time and the judicious use of clinical judgment. Combining Conners 4 results with information from a variety of sources helps to ensure a more accurate and comprehensive assessment of the individual.

MHS (the publisher) and the author are not responsible for the use of the Conners 4 in any manner other than that which is outlined in this manual. If the assessor intends to use the Conners 4 in any way other than that which is outlined in this manual, the assessor must justify its use. Further, the assessor should be mindful that assumptions of interpretation of the T-scores may be violated if the tool is used for individuals outside of the age range outlined for each rater form.

The Conners 4 was carefully and rigorously developed to provide a set of items and scales that meaningfully contribute to the identification of ADHD in youth, including frequently occurring ADHD-related problems. Any rating scale has inherent limitations; however, when used appropriately, the Conners 4 can be extremely useful in eliciting information from the individual being evaluated and others who know this individual well, informing clinical diagnosis, treatment planning, and measuring treatment outcome.