If a rater cannot read the Conners 4 (e.g., the rater has poor eyesight or their reading level is lower than the recommended grade level), the examiner can read the instructions and items aloud. Read-aloud accommodations can be provided in-person or remotely via telephone or video conference; however, given the confidential nature of the Conners 4 responses, a secure telehealth platform that adheres to local privacy laws for protection of information should be used.

To increase honest responding, the rater should be given a separate device to complete the online form or a separate paper form to follow during the reading and should mark their own responses. If a rater cannot record their own responses (e.g., due to limited motor skills), the examiner can mark the rater’s responses on the form (online or paper). This option is not ideal given the demand characteristics of the situation. By requiring the rater to provide a verbal response to the items for the examiner to record, the privacy that is typically afforded to a rater when completing a rating scale is removed. This lack of privacy can impact honest self-disclosure (Clark-Gordon et al., 2019; Grysczynski et al., 2019). Rater responses can also be shaped by social desirability (i.e., the tendency to modulate responses to questions in order to look good and/or avoid looking bad; Burger, 2008). In other words, the validity of responses can be affected, and thus, deviation from the standardized procedure should be noted with the test scores and indicated when reporting the results.

In addition to following the Administration Procedure , the examiner should be vigilant in preventing inadvertent reinforcement of any responses (e.g., avoid saying “good answer” or “I agree” to a given response). The examiner should avoid emphasizing the importance of any particular item and ensure that the rater responds to the items independently, without input from others. Clarification of the meaning of a word to facilitate accurate responding is permitted, but any attempt to guide the rater towards a particular response is not acceptable. All items should be read with an even, clear, and consistent tone.