Abstract
who usually made the referral for initial evaluation orders, then it is not unreasonable to conclude that Teachers’ knowledge about ADHD and other for children suspected of having ADHD. When there is a need to effectively support teachers in their disorders can affect how children’s behaviors are Snider, Busch and Arrowood (2003) asked 145 acquisition of accurate knowledge and appropriate perceived, how children are treated in the class- Wisconsin teachers to name the one person who classroom practices regarding ADHD as well as room, and whether or not they are referred for recommended initial ADHD assessment most other disorders (e.g. Brook, Watemberg, & Geva, additional assessment. There is evidence to suggest often, 64% indicated that it was teachers. 2000). Third, ADHD is considered a disruptive that specialized training, both for pre-service and Information provided by teachers regarding chil- disorder which commands attention from class- practicing teachers, can have beneficial effects in dren who exhibit symptoms of ADHD is given a room teachers. Barnett et al. (2002) reported that terms of increasing knowledge and teacher confi- lot of credence in the diagnostic process, but an parents’ and teachers’ referrals are dominated by dence when working with children. This article important consideration is whether teachers have concerns about disruptive and dangerous behav- focuses on teacher’s knowledge of just one child- enough knowledge about ADHD to make unbi- iors. hood disorder, ADHD, because there is a plethora ased judgments of these children’s behaviors. The high identification rates for ADHD by of studies indicating that ADHD is over-diagnosed In the United States, it is generally accepted teachers compared to the rates reported in DSM- and that classroom teachers want additional that ADHD is diagnosed in approximately 3 to IV-TR (APA, 2000) indicate that there is a prob- knowledge about ADHD. However, the needs of 7% of the general population, with at least a 1:3 lem that must be addressed. Assuming that the the teachers vary across many different variables. female:male ratio (American Psychiatric prevalence rates for ADHD in the DSM-IV-TR Thus the provision of inservice training to teachers Association [APA], 2000). However, the results of are accurate, one possible way of thinking about regarding ADHD must be based on actual needs. some studies using teachers as informants suggest this problem is that teachers inaccurately identify The authors believe that school psychologists that if teachers (rather than psychologists, psychia- children with problems because of a lack of knowl- should be the best trained persons in the schools to trists, or physicians) were in charge of diagnosis, edge about normal development. Alternatively, conduct needs assessments in the schools, and prevalence rates would be much higher, something teachers may accurately identify children with when appropriate provide inservice training to more akin to 8.1 to 16.1 percent of the general problems, but may also misattribute these prob- teachers and other school personnel regarding population (Gaub & Carlson, 1997; Nolan, lems because of a lack of knowledge about psy- ADHD and other childhood disorders. The pro- Gadow, & Sprafkin, 2001; Wolraich, Hannah, chopathology (e.g. Kos, Richdale, & Hay, 2006). vision of such training has benefits for children, Pinnock, Baumgaertel, & Brown, 1996; Wolraich, Either way, the importance of providing appropri- other school personnel and the school psycholo- Hannah, Baumgaertel, & Feurer, 1998). When ate teacher training is highlighted. If teachers have gists. Recommendations are made on how to Glass and Wegar (2000) asked 225 elementary not had adequate and/or meaningful preservice incorporate training in conducting needs assess- teachers to estimate the percentages of children training regarding childhood disorders, then such ments and workshops for teachers regarding with ADHD in their classrooms, 72% of the training needs to occur at the inservice level. ADHD into school psychology training programs. teachers estimated prevalence rates between 6% The gaps in teachers’ knowledge regarding psy- It is asserted that these recommendations would be and 26% or more. Havey, Olson and chopathology could adversely affect school psy- appropriate for providing training in any of the McCormick (2005) found that when 52 rural chologists’ practice in three important ways: 1) childhood disorders, not just ADHD. teachers were asked to use their own judgment to inappropriate referrals to the child study team that indicate how many children in their classrooms take time away from other legitimate referrals; 2) A Review of the Literature on Teachers’ they thought had ADHD, the range was 0 to 24% resistance of teachers to individual or classroom- Knowledge of ADHD and Implications for with a mean of 8.61%.When the same respon- based interventions because of a lack of knowledge Trainers of School Psychologists. dents completed behavior rating scales on children or belief in the interventions; and 3) the time spent in their classrooms, the scores of 23.9% of the chil- addressing situations 1 and 2 above could limit the Introduction dren were high enough to identify them as having time school psychologists have to spend in preven- Because many parents have little exposure to significant ADHD symptoms. tion or proactive systems-level interventions (e.g. what is expected normatively in terms of children’s This manuscript focuses on teachers’ knowl- Franklin & Duley, 2002; Kratochwill, Elliott, & behavior, and because ADHD is a disorder that is edge and attitudes about ADHD for three main Callan-Stoiber, 2002; Zins & Erchul, 2002). most evident in structured settings, it is teachers, reasons. First, it is a relatively common disorder in School psychologists should have the special- rather than parents, who first tend to notice diffi- the school age population and is likely to have been ized knowledge base to be able to provide training culties and refer children to child study teams for a) discussed in teacher preparation programs; b) and support to other school personnel (e.g., Knoff, possible further assessment (e.g. Andrews, 1999; dealt with by practicing teachers in their own class- 2002). Fagan (2002) noted that training programs Carney, 2001; Tannock & Martinussen, 2001; rooms; and c) covered as an inservice topic. over the “past several decades have seen an Rafalovich, 2005). Achenbach and McConaughy Second, teachers’ knowledge and perceptions improved balance of psychology- and education- (1987) reported that 50 to 80% of initial referrals about ADHD might be viewed as a litmus test for related content”, but also stated that “many forms for ADHD diagnosis came from teachers. In teachers’ knowledge and perceptions about other of preparation [should] be available in order to bet- Gerken, Khoury, Copley, and McKeever’s (1991) less common childhood disorders. If teachers do study of 488 Iowa teachers, they found that 60% not understand or have misconceptions about one of the teachers indicated that they were the person of the most commonly diagnosed childhood dis- “Teachers’ Knowledge...” continued on page 22
