When Rating Scales Fall Short: LLM-Assisted Discovery of ADHD Signals in Turkish Teacher Narratives
For clinicians and researchers in ADHD diagnosis, this work demonstrates that NLP can uncover complementary signals from teacher narratives, potentially improving screening accuracy, though it is an incremental step in applying existing methods to a new domain.
The study analyzed Turkish teacher narratives and CTRS-R:S scores for ADHD screening, finding that narrative-based models captured distinct behavioral patterns missed by structured assessments, with minimal overlap in misclassifications, suggesting complementary signals. The LLM-assisted theme discovery revealed attention, behavioral, and family-related patterns.
Attention Deficit Hyperactivity Disorder (ADHD) is one of the most common neurodevelopmental disorders in childhood, and its diagnosis relies on assessments combining clinician judgment with standardized rating scales and reports from parents and teachers. While structured instruments such as the Conners' Teacher Rating Scale-Revised Short Form (CTRS-R:S) quantify ADHD-related behaviors, teachers also provide open-ended narratives that may contain complementary signals not captured by structured assessments. However, it remains unclear to what extent teacher narratives encode signals overlooked by rating scales. In this study, we analyze de-identified Turkish teacher evaluation forms collected during clinical ADHD assessments, including both CTRS-R:S scores and open-ended teacher narratives. We compare predictive signals from structured scores and narrative text and identify cases where structured assessments fail to clearly distinguish ADHD from non-ADHD students while narrative-based models capture distinct behavioral patterns. Notably, these cases show minimal overlap with those missed by the narrative model, suggesting that structured and narrative information encode complementary signals. To interpret these differences, we apply a large language model (LLM)-assisted theme discovery pipeline that reveals distinct attention, behavioral, and family-related patterns, highlighting the potential of natural language processing (NLP) to uncover clinically relevant signals from teacher narratives and to complement traditional ADHD screening tools.