Environmental exposures have been linked to childhood problems with overactivity, attention, and impulse control, and an increased risk of attention deficit hyperactivity disorder (ADHD) diagnosis. Two approaches to identify these types of exposure-related neurobehavioral problems include the use of computerized tests, such as the Behavioral Assessment and Research System (BARS), as well as the use of behavior rating scales. To assess comparability of these two types of measures, we analyzed data from 281 children aged 6 to 14 years enrolled in a 5-year research study investigating coal ash exposure and neurobehavioral health. All children lived in proximity of coal ash storage sites. We administered six computer tests from the BARS and obtained behavior measures from the parent-completed Child Behavior Checklist (CBCL) ADHD DSM oriented scale. BARS test performance was associated with age indicating that the tests could be used to evaluate neurodevelopmental changes over time or across a wide age range. Tests within the BARS including Continuous Performance (CPT) false alarm (standardized estimate 1.57, 95% confidence interval (CI) (0.67, 2.48), adjusted p = 0.006), Selective Attention (SAT) wrong count (standardized estimate 2.8, 95% CI (1.17, 4.44), adjusted p = 0.006), and SAT proportion correct (standardized estimate -2.45, 95% CI (-4.01, -0.88), adjusted p = 0.01) were associated with attention and impulse control problems on the CBCL after adjustment for multiple comparisons. Findings support that the BARS can contribute to research on environmental exposures by assessing subclinical behaviors related to ADHD such as sustained attention, impulse control, response inhibition, associative learning, and short-term memory. Future research can examine relationships of these BARS measures with biomarkers of neurotoxic exposures related to living near coal ash storage sites to better identify the potential risk for ADHD-related behaviors among children living near coal ash storage sites.

环境暴露与儿童时期的过度活跃、注意力和冲动控制问题以及注意力缺陷多动障碍 (ADHD) 诊断风险增加有关。识别这些类型的暴露相关神经行为问题的两种方法包括使用计算机化测试，例如行为评估和研究系统 (BARS)，以及使用行为评定量表。为了评估这两种测量方法的可比性，我们分析了 281 名 6 至 14 岁儿童的数据，这些儿童参与了一项为期 5 年的煤灰暴露和神经行为健康研究。所有儿童都住在煤灰储存地点附近。我们从 BARS 进行了六项计算机测试，并从父母完成的儿童行为检查表 (CBCL) ADHD DSM 导向量表中获得了行为测量。BARS 测试表现与年龄相关，表明这些测试可用于评估随时间或跨广泛年龄范围的神经发育变化。BARS 内的测试包括连续性能 (CPT) 误报（标准化估计 1.57，95% 置信区间 (CI) (0.67, 2.48)，调整后的 p = 0.006），选择性注意 (SAT) 错误计数（标准化估计 2.8, 95% CI (1.17, 4.44), 调整后的 p = 0.006) 和 SAT 比例正确（标准化估计 -2.45, 95% CI (-4.01, -0.88), 调整后的 p = 0.01）与 CBCL 的注意力和冲动控制问题有关多重比较调整后。研究结果支持 BARS 可以通过评估与 ADHD 相关的亚临床行为，如持续注意力、冲动控制、反应抑制、联想学习和短期记忆。未来的研究可以检查这些 BARS 措施与生活在煤灰储存地点附近的神经毒性暴露生物标志物的关系，以更好地确定生活在煤灰储存地点附近的儿童与 ADHD 相关行为的潜在风险。