Rutter scales

Behaviour has been measured by direct observation in a controlled environment (Winneke, 1979 Harvey et al 1984), or more economically by means of short forced-choice questionnaires (several studies, e.g. Yule et al, 1984 Hatzakis et al, 1985 Vivoli et al, this volume, have used the scale adapted by Needleman et al, 1979, or a modification of it) or standardized behavour rating scales completed by the mother or the teacher. The two standardized scales which have been most used are the Conners scales (Conners, 1969, 1973) and the Rutter Scale (Rutter, 1976). The longer the scale the more reliable it is likely to be, and summated scores or factor scores are likely to be more reliable than individual ratings, but practices and methods of factor analysis are also of relevance. In normal populations rarely occurring behaviours, although they may be of great significance, contribute too little to factor solutions, and so are eliminated. 

Where standardized behaviour ratings such as the Conners and Rutter scales have been used some studies have found significant lead-related differences in both mothers and teachers scales (Silva et al, 1984) some with teachers scales only (mothers scales were not administered) (Lansdown et al, 1983). Other studies have not found significant differences on either mothers or teachers scales (Smith et al, 1983 Lansdown et al, 1986) or found none where only a mother s rating was obtained (McBride et al, 1982) (partial scoring only). 

Parents behaviour ratings such as the Conners and Rutter scales are usually found to be independent of broad social indicators, such as social class, so controlling for these would not be expected to have an effect on results. 

Rutter The question you pose must be answerable within a many available data sets. Any of the large-scale longitudinal studies should be able to provide data on this. 

An additional concern that should be recognized here is that many aspects of medical practice vary, often geographically and sometimes in more complex patterns. A procedure may be done frequently in one facility and rarely in another, which wo d seem to have a similar patient base. At the international scale, the variations can be striking. Rutter and Donaldson provide an interesting examination of some of these issues. In assessing the needs for a device, patterns of treatment that are relative to the problem should be examined careftilly. 

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