Journal of Attention Disorders

Objective: To identify what primary and secondary school teachers know about ADHD in children and, furthermore, to identify which factors predict their knowledge. Method: A 29-item questionnaire about ADHD was distributed to a random, nationwide, and representative sample of Danish primary and secondary school teachers. Data were analyzed descriptively and by hierarchical regression analysis. Results: A total of 528 teachers were included. Most teachers identified the symptoms of ADHD (79%-96%) and effective classroom intervention strategies (75%-98%). However, knowledge about other characteristics, etiology, prognosis, and treatment was inconsistent, for example, only 56% and 17% correctly rejected diet as a cause and effective treatment for ADHD. Among the strongest predictors for correct knowledge was having been provided postgraduate education about ADHD. Conclusion: Teachers require knowledge about ADHD to successfully include and manage children with ADHD and, additionally, to ensure positive working environments for teachers and support constructive school–home working collaborations.

Objective: This overarching synthesis brings together the findings of four systematic reviews including 138 studies focused on non-pharmacological interventions for ADHD used in school settings. These reviews considered the effectiveness of school-based interventions for ADHD, attitudes toward and experience of school-based interventions for ADHD, and the experience of ADHD in school settings. Method: We developed novel methods to compare the findings across these reviews inductively and deductively. Results: Key contextual issues that may influence the effectiveness and implementation of interventions include the relationships that pupils with ADHD have with their teachers and peers, the attributions individuals make about the etiology of ADHD, and stigma related to ADHD or intervention attendance. Conclusion: Although we found some positive effects for some outcomes and intervention categories, heterogeneity in effect size estimates and research evidence suggests a range of diverse contextual factors potentially moderate the implementation and effectiveness of school-based interventions for ADHD.

Objective: The objective of this study was to evaluate the relationship between school climate and ADHD medication treatment among adolescents in Medicaid in Georgia. Method: School climate and Medicaid claims data were aggregated for 159 GA counties. County-level school climate percentile and medicated ADHD prevalence were calculated. The t tests and regression models evaluated the relationship between school climate, medicated ADHD, and demographics, weighted by county population. Poorer 2008 school climate (<25th percentile) was regressed on 2011 medicated ADHD prevalence, controlling for potential confounders. Results: The prevalence of medicated ADHD was 7.8% among Medicaid-enrolled GA adolescents. The average county-level prevalence of medicated ADHD was 10.0% (SD = 2.9%). Poorer school climate was associated with lower rates of medicated ADHD (p < .0001); along with demographics, these factors accounted for 50% of the county variation in medicated ADHD. Conclusion: School climate is associated with medicated ADHD among adolescents in Medicaid. Additional research may reveal whether high medicated ADHD may reflect a lack of access to non-pharmacological therapies in some communities.

Objective: Physical educators’ implicit theory of children’s deviant behavior in primary education was investigated and compared with diagnostic criteria. Method: A total of 60 physical education (PE) teachers reported deviant behaviors during lessons. Experts sorted these behaviors together with the official diagnostic criteria into categories based on perceived similarity in content. Results: Hierarchical cluster analysis on the derived similarity matrix among the behaviors suggested that PE teachers focus more on attention problems, disobedience, and aggressiveness when internalizing behaviors, such as anxiety and low energy, were less reported. Conclusion: PE teachers may be important and useful informants on children’s behavior in school settings.

Objective: To test the acceptability, satisfaction, and effectiveness of a web-based intervention for teachers of elementary school–aged children with ADHD. Method: Elementary classroom teachers (N = 58), along with their students with ADHD, participated in a randomized controlled trial. The program consisted of six sessions that included evidence-based intervention strategies for reducing ADHD symptoms and impairment in the classroom setting. Teachers also had access to a moderated Discussion Board and an online ADHD coach. Questionnaire data were electronically collected from teachers and parents pre-intervention, post-intervention (6 weeks), and after an additional 6-week follow-up. Results: Intent-to-treat analyses found significant improvements based on teacher (but not parent) reports of core ADHD symptoms and impairment for the Teacher Help for ADHD treatment group. Teachers reported a high level of acceptability and satisfaction. Conclusion: Web-based ADHD interventions have the potential to reduce the barriers to treatment utilization and implementation that are common problems for school-based ADHD interventions.

Objective: The aim of this article is to evaluate the efficacy of a brief in-service training workshop at increasing primary school teachers’ ADHD knowledge and sense of self-efficacy. Method: Teachers from 10 schools participated in the study (n = 274) and were allocated into either an intervention or waitlist control group. Teachers’ ADHD knowledge and self-efficacy were assessed following the provision of a brief training workshop on ADHD. Knowledge and self-efficacy retention were also assessed at a 1-month follow-up. Results: Within the intervention group, ADHD knowledge and self-efficacy increased following the intervention (both ps < .001). Knowledge increased more than twofold, from very low to high levels, although increases in self-efficacy were more modest. Both knowledge and self-efficacy decreased at the 1-month follow-up but, nevertheless, remained higher than baseline levels (p < .001). Conclusion: Results demonstrate that a brief training workshop can increase primary school teachers’ ADHD knowledge and self-efficacy. Whilst increases in self-efficacy were modest, our findings suggest that a brief professional development intervention can be utilized to greatly increase teachers’ ADHD knowledge, providing a cost-effective, practical solution to address this well-evidenced gap in teachers’ training and knowledge about the disorder.

Objective: The hypothesis behind this study was that trained teachers using cooperative learning procedures with children in their classroom (aged from 6 to 10 years) can influence the social skills of children with ADHD symptoms and their acceptance by their peers. Method: The study involved 30 children with ADHD symptoms attending 12 different classes, where cooperative learning was adopted in some, and standard practices in others. ADHD children’s symptoms, social skills, and cooperative behavior were assessed by means of a teacher’s questionnaire, and the social preferences of the children in their class were collected. Results: Changes emerged in teachers’ assessments of the children’s cooperative behavior in the experimental classes. Improvements in the sociometric status of children with ADHD symptoms were only seen in the cooperative learning classes. Conclusion: These results show the importance of well-structured intervention in classes that include children with ADHD symptoms. Implications of these findings for future intervention are discussed.

Objective: This study investigated the effectiveness of the Positivity & Rules Program (PR program), a behavioral teacher program targeting ADHD symptoms in the classroom involving both student-focused and classroom-focused programs. Method: Primary school children with ADHD symptoms (N = 114) were randomly assigned to the PR program (n = 58) or control group (n = 56). Teacher and parent ratings were used to assess behavioral, social, and emotional functioning at baseline, during and after the intervention. Intervention effects were assessed using intention-to-treat multilevel analyses. Results: Teachers reported positive effects on ADHD symptoms and social skills (.01 < f² > .36). Effects did not generalize to the home setting. Conclusion: The PR program holds promise for improving classroom behavior in children with ADHD symptoms and might prevent escalation of problem behavior