Abstract
Attention-deficit/hyperactivity disorder (ADHD) is among the most prevalent disorders of childhood and adolescence worldwide. Teachers are likely to play an important role in multiple stages of the help-seeking process (e.g., problem recognition) for children with ADHD. This study examined the relationship of prior exposure and ADHD training with teachers’ knowledge and misconceptions of the disorder in a multinational sample. Teachers (N = 2,307) from 9 countries (Czech Republic, Germany, Greece, Iraq, the Republic of Korea, Saudi Arabia, South Africa, United States, and Vietnam) completed measures of ADHD knowledge, prior exposure, and education or training related to ADHD. There was considerable variability in overall levels of knowledge and specific misconceptions across the countries sampled. Although the predictors of ADHD knowledge varied considerably across countries, some form of professional training and prior exposure to ADHD was associated with greater knowledge in the majority of countries. Implications for teacher training and the role teachers can play in the help-seeking process are discussed.
References
2009). ADHD and the role of medication: Knowledge and perceptions of qualified and student teachers. European Journal of Special Needs Education, 24, 423–436. 10.1080/08856250903223088
(1995). Revisiting the behavioral model and access to medical care: Does it matter? Journal of Health and Social Behavior, 36, 1–10. 10.2307/2137284
(2012). Knowledge of attention deficit hyperactivity disorder (ADHD) and attitudes toward teaching children with ADHD: The role of teaching experience. Psychology in the Schools, 49, 511–525. 10.1002/pits.21617
(2014). A multi-dimensional model of the origins of attitude certainty: Teachers’ attitudes toward attention-deficit/hyperactivity disorder. Social Psychology of Education, 17, 19–50. 10.1007/s11218-013-9235-5
(1996). Is childhood hyperactivity the product of western culture? Lancet, 348, 73–74. 10.1016/S0140-6736(05)64598-9
(2010). ADHD across cultures: Is there evidence for a bidimensional organization of symptoms? Journal of Clinical Child and Adolescent Psychology, 39, 362–372. 10.1080/15374411003691743
(2011). The impact of teacher credentials on ADHD stigma perceptions. Psychology in the Schools, 48, 184–197. 10.1002/pits.20536
(2000). ADHD-type behavior and harmful dysfunction in childhood: A cross-cultural model. American Anthropologist, 102, 823–828. 10.1525/aa.2000.102.4.823
(2000). Attitude and knowledge of attention deficit hyperactivity disorder and learning disability among high school teachers. Patient Education and Counseling, 40, 247–252. 10.1016/S0738-3991(99)00080-4
(2008). Psychiatric diagnosis - is it universal or relative to culture? Journal of Child Psychology and Psychiatry, 49, 237–250. 10.1111/j.1469-7610.2007.01854.x
(2012). An examination of teacher trainees’ knowledge of attention-deficit/hyperactivity disorder. School Mental Health, 4, 105–114. 10.1007/s12310-012-9071-3
(2014). The impending globalization of ADHD: Notes on the expansion and growth of a medicalized disorder. Social Science & Medicine, 122, 31–43. 10.1016/j.socscimed.2014.10.019
(2012). Challenging the public stigma of mental illness: A meta-analysis of outcome studies. Psychiatric Services, 63, 963–973. 10.1176/appi.ps.201100529
(2006). Teacher perceptions of classroom interventions for children with ADHD: A cross-cultural comparison of teachers in the United States and New Zealand. School Psychology Quarterly, 21, 171–196. 10.1521/scpq.2006.21.2.171
(1998). Reconceptualizing change in the cognitive construction of knowledge. Educational Psychologist, 33, 109–128. 10.1080/00461520.1998.9653294
(2006). Service Utilization among ethnic minority children with ADHD: A model of help-seeking behavior. Administration and Policy in Mental Health and Mental Health Services Research, 33, 607–622. 10.1007/s10488-006-0063-1
(2013).
(Adapting tests for use in other languages and cultures . In K. F. GeisingerB. A. BrackenJ. F. CarlsonJ.-I. C. HansenN. R. KuncelS. P. ReiseM. C. Rodriguez (Ed.),APA handbook of testing and assessment in psychology : Vol. 3. Testing and assessment in school psychology and education (pp. 545–569). Washington, DC: American Psychological Association. 10.1037/14049-0262003). The worldwide prevalence of ADHD: Is it an American condition? World Psychiatry, 2, 104–113.
(2009). National variation of ADHD diagnostic prevalence and medication use: Health care providers and education policies. Psychiatric Services, 60, 1075–1083. 10.1176/ps.2009.60.8.1075
(2006). Knowledge and attitudes towards attention deficit hyperactivity disorder among elementary school teachers. Patient Education and Counseling, 63, 84–88. 10.1016/j.pec.2005.09.002
(2000). Teacher perceptions of the incidence and management of attention deficit hyperactivity disorder. Education, 121, 412–420.
(2000). Learning counter-intuitive science concepts: What have we learned from over a decade of research? Reading & Writing Quarterly: Overcoming Learning Difficulties, 16, 89–98. 10.1080/105735600277971
(2005).
(Issues, designs, and technical guidelines for adapting tests into multiple languages and cultures . In R. K. HambletonP. F. MerendaC. D. Spielberger (Eds.), Adapting educational and psychological tests for cross-cultural assessment (pp. 3–38). Mahwah, NJ: Lawrence Erlbaum.2009). A psychometric examination of the knowledge of ADHD scale (Unpublished master’s thesis). Department of Educational Psychology and Special Education, University of Saskatchewan, Saskatoon, Saskatchewan, Canada.
(2002). Measuring teacher attitudes and expectations toward students with ADHD: Development of the test of knowledge about ADHD (KADD). Journal of Attention Disorders, 5, 133–142. 10.1177/108705470200500301
(2004). Knowledge of social anxiety disorder relative to attention deficit hyperactivity disorder among educational professionals. Journal of Clinical Child and Adolescent Psychology, 33, 366–372. 10.1207/s15374424jccp3302_18
(2011). International variation in treatment procedures for ADHD: Social context and recent trends. Psychiatric Services, 62, 459–464. 10.1176/ps.62.5.pss6205_0459
(2008). Teachers’ perceptions of young children with ADHD in Korea. Early Child Development and Care, 178, 399–414. 10.1080/03004430701321829
(2007). Conocimientos, concepciones erróneas y lagunas de los maestros sobre el trastorno por déficit de atención con hiperactividad [
(Teachers’ knowledge, misconceptions, and lacks concerning attention deficit hyperactivity disorder ]. Psicothema, 19, 585–590.1994). A comparison of American and Canadian teachers’ knowledge and attitudes towards attention deficit hyperactivity disorder (ADHD). The Canadian Journal of Psychiatry / La Revue canadienne de psychiatrie, 39, 563–567.
(2008). Efficacy of teacher in-service training for attention-deficit/hyperactivity disorder. Psychology in the Schools, 45, 918–929. 10.1002/pits.20342
(2010). Assessment of stigma associated with attention-deficit hyperactivity disorder: Psychometric evaluation of the ADHD stigma questionnaire. Psychiatry Research, 178, 363–369. 10.1016/j.psychres.2009.04.022
(2004). Knowledge about attention-deficit/hyperactivity disorder: A comparison of in-service and preservice teachers. Psychology in the Schools, 41, 517–526. 10.1002/pits.10178
(2007). Cultural variations in mothers’ attributions: Influence of child attention-deficit/hyperactivity disorder. Child Psychiatry and Human Development, 38, 135–153. 10.1007/s10578-007-0047-8
(2007). The construction of fear: Americans’ preferences for social distance from children and adolescents with mental health problems. Journal of Health and Social Behavior, 48, 50–67. 10.1177/002214650704800104
(2008).
(Cultural factors and the use of psychotropic medications . In C. H. NgK. LinB. S. SinghE. Chiu (Eds.), Ethno-psychopharmacology: Advances in current practice (pp. 123–134). New York, NY: Cambridge University Press. 10.1017/CBO9780511544149.0111998). Confirmation bias: A ubiquitous phenomenon in many guises. Review of General Psychology, 2, 175–220. 10.1037/1089-2680.2.2.175
(2005). Perceptions of ADHD in China and the United States: A preliminary study. Journal of Attention Disorders, 9, 413–424. 10.1177/1087054705281123
(2008). Does knowledge about attention-deficit/hyperactivity disorder impact teachers’ reported behaviors and perceptions? School Psychology Quarterly, 23, 436–449. 10.1037/1045-3830.23.3.436
(2010). Primary school teachers’ knowledge and misperceptions of attention deficit hyperactivity disorder (ADHD). South African Journal of Education, 30, 457–473.
(2013). Mental health surveillance among children—United States, 2005–2011. Morbidity and Mortality Weekly Report, 62(Suppl 2), 1–35.
. (2001). The effect of child characteristics on teachers’ acceptability of classroom-based behavioral strategies and psychostimulant medication for the treatment of ADHD. Journal of Clinical Child Psychology, 30, 413–421. 10.1207/S15374424JCCP3003_12
(2007). The worldwide prevalence of ADHD: A systematic review and metaregression analysis. The American Journal of Psychiatry, 164, 942–948. 10.1176/appi.ajp.164.6.942
(1995). The acceptability of interventions for attention-deficit hyperactivity disorder among elementary and middle school teachers. Journal of Developmental and Behavioral Pediatrics, 16, 238–243. 10.1097/00004703-199508000-00005
(2005). Attention-deficit/hyperactivity disorder in a diverse culture: Do research and clinical findings support the notion of a cultural construct for the disorder? Biological Psychiatry, 57, 1436–1441. 10.1016/j.biopsych.2005.01.042
(2003). Who first suggests the diagnosis of attention-deficit/hyperactivity disorder? Annals of Family Medicine, 1, 171–174. 10.1370/afm.3
(2013). Wissen und Fehlannahmen von deutschen Lehrkräften über die Aufmerksamkeitsdefizit-/Hyperaktivitätsstörung (ADHS) [Knowledge and misconceptions of German teachers about attention-deficit/hyperactivity disorder (ADHD)]. Psychologie in Erziehung und Unterricht, 60, 143–153. 10.2378/peu2013.art12d
(2015). ADHD knowledge, misconceptions, and treatment acceptability. Journal of Attention Disorders, 19, 91–98. 10.1177/1087054713493316
(2004). Effects of child gender and symptom type on referrals for ADHD by elementary school teachers. Journal of Emotional and Behavioral Disorders, 12, 247–253. 10.1177/10634266040120040501
(2004). [Psychometric properties of the Knowledge of Attention Deficit Disorders Scale]. Unpublished test development data, Department of Psychology, Muhlenberg College, Allentown, PA.
(2000). Teachers’ knowledge and misperceptions of attention-deficit/hyperactivity disorder. Psychology in the Schools, 37, 115–122. 10.1002/(SICI)1520-6807(200003)37:2<115::AID-PITS3>3.0.CO;2-5
(2003). Teacher knowledge of stimulant medication and ADHD. Remedial and Special Education, 24, 46–57. 10.1177/074193250302400105
(2000). The relationship between learning disabilities and attention-deficit hyperactivity disorder: A national survey. Developmental Disabilities Bulletin, 28, 18–38.
(2009). Theory of test translation error. International Journal of Testing, 9, 78–91. 10.1080/15305050902880835
(2002). Concurrent development of dual language assessments: An alternative to translating tests for linguistic minorities. International Journal of Testing, 2, 107–129. 10.1207/S15327574IJT0202_2
(2012). Using multivariate statistics (6th ed.). Boston, MA: Pearson.
(2004). Naïve psychological science: The prevalence, strength, and sources of misconceptions. The Psychological Record, 54, 15–25.
(2004). ADHD is best understood as a cultural construct. The British Journal of Psychiatry, 184, 8–9. 10.1192/bjp.184.1.8
(2014). Rating scales as predictors—The old question of scale level and some answers. Psychometrika, 79, 357–376. 10.1007/s11336-013-9343-3
(2000). Methodological issues in psychological research on culture. Journal of Cross-Cultural Psychology, 31, 33–51. 10.1177/0022022100031001004
(2004). Teachers’ knowledge of ADHD, treatments for ADHD, and treatment acceptability: An initial investigation. School Psychology Review, 33, 421–428.
(2008). Children’s stigmatization of childhood depression and ADHD: Magnitude and demographic variation in a national sample. Journal of the American Academy of Child & Adolescent Psychiatry, 47, 912–920. 10.1097/CHI.0b013e318179961a
(2005). A comparison of teachers and parents knowledge and beliefs about attention-deficit/hyperactivity disorder (ADHD). School Psychology International, 26, 192–208. 10.1177/0143034305052913
(2009). Assessment of teacher and school psychologist knowledge of attention-deficit/hyperactivity disorder. Psychology in the Schools, 46, 951–961. 10.1002/pits.20436
(2003). Teachers’ screening for attention deficit/hyperactivity disorder: Comparing multinational samples on teacher ratings of ADHD. Journal of Abnormal Child Psychology, 31, 445–455. 10.1023/A:1023847719796
(