ORIGINAL ARTICLE Multi-domain Predictors of Attention Deficit/Hyperactivity Disorder Symptoms in Preschool Children: Cross-informant Differences John V. Lavigne 1,2 • Karen R. Gouze 1,2 • Joyce Hopkins 3 • Fred B. Bryant 4 Ó Springer Science+Business Media New York 2015 Abstract Numerous studies indicated that agreement between parent and teacher ratings of symptoms of atten- tion-deficit/hyperactivity disorder in children of all ages is poor, but few studies have examined the factors that may be associated with rater differences. The present study examined the contextual, parent, parenting, and child fac- tors associated with rater differences in a community sample of 4-year-old children. Parents and teachers of 344 4-year-olds recruited from preschools and pediatric prac- tices completed the preschool versions of the Child Symptom Inventory. Measures of socioeconomic status, family stress and conflict, caretaker depression, parental hostility, support-engagement, and scaffolding skills, and child negative affect (NA), sensory regulation (SR), effortful control (EC), inhibitory control, and attachment security were obtained either by parental report or obser- vational measures. v 2 difference tests indicated that child factors of EC and SR, and contextual factor of stress and conflict, contributed more to parent-ratings of ADHD-I and ADHD-HI than to teacher-ratings of those same types of symptoms. Two factors contributed more to teacher-than to parent-rated ADHD-I, NA and caretaker depression. Results indicate there are differences in factors associated with ADHD symptoms at home and school, and have implications for models of ADHD. Keywords ADHD Á Parent–teacher agreement Á Informant discrepancies Á Preschoolers Á Temperament Introduction Attention deficit hyperactivity disorder (ADHD), by defi- nition, is a disorder whose symptoms must be present in ‘‘two or more settings (e.g. at home, school, or work),’’ cause functional impairment, and emerge before age 12 [1]. To establish that ADHD symptoms are present in multiple settings, professional organizations such as the American Academy of Pediatrics [2, 3] and others [4] recommend obtaining information from both parents and teachers when evaluating and treating children with ADHD. Although cross-situational symptom manifestation is required to meet DSM diagnostic criteria, studies of inter-rater agreement for children of all ages show only low to moderate levels of agreement between teachers and parents whose locus of convenience for observing those symptoms are, respec- tively, school and home [5–8]. In a study of over 6000 children ages 4–17, for example, correlations between parent and teacher reports for both hyperactive-impulsive and inattentive symptoms ranged from 0.18 to 0.44. Agreement is slightly better for hyperactive-impulsive (r = 0.33–0.44) than inat- tentive (r = 0.18–0.32) symptoms [6], but at the highest level of agreement (r = 0.44) only 19 % of the variance in parent and teacher ratings is shared. When agreement between diagnostic categories is measured with kappa scores rather than correlations, agreement is also very low, ranging from -0.05 to 0.41 in two reports [7, 9]. & John V. Lavigne jlavigne@luriechildrens.org 1 Department of Child and Adolescent Psychiatry (#10), Ann & Robert H. Lurie Children’s Hospital of Chicago, 225 East Chicago Avenue, Chicago, IL 60611, USA 2 Feinberg School of Medicine, Northwestern University, Chicago IL, USA 3 Department of Psychology, Illinois Institute of Technology, Chicago IL, USA 4 Department of Psychology, Loyola University Chicago, Chicago, IL, USA 123 Child Psychiatry Hum Dev DOI 10.1007/s10578-015-0616-1