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Teacher knowledge of attention deficit hyperactivity disorder among middle school students in South Texas

ProQuest Dissertations and Theses, 2009
Dissertation
Author: Fred R. Jr Guerra
Abstract:
  Attention Deficit Hyperactivity Disorder (ADHD) is often the most frequently determined conduct disorder in children, and is expected to affect 3% to 7% of school-aged children in the United States. Due to the behavioral symptoms of ADHD, it is common for the identification of the disorder to be during the school-age years. For this reason, it is imperative for teachers to be the referring resource for the identification and evaluation for the diagnosis of ADHD. The study examined the knowledge and misconceptions middle school teachers in South Texas have in relation to ADHD. The study explored the relationships between teachers' demographic characteristics such as levels of education, number of years teaching, and past attention deficit hyperactivity disorder training, and their knowledge of ADHD. The data used for this study was collected using a validated survey instrument including questions associated with the etiology and epidemiology of ADHD. The sample for this study involved five predominately Hispanic middle schools in South Texas during the 2008-2009 school year. A one-way analysis of variance (ANOVA) procedure was administered to examine the differences among General Knowledge, Symptoms/Diagnosis, and Treatment, and Bachelors, and Masters/Doctorate degrees. The teachers' knowledge of ADHD was compared across those groups, respectively. The bivariate correlation design allows for the variables number of years teaching and past ADHD training to be correlated to the teachers' knowledge of ADHD. Results indicated that teachers' greatest area of knowledge dealt with identifying the symptoms/diagnosis of ADHD. There was a strong relationship between the knowledge factors and the scores on the survey and the differences among the means were statistically significant at the .05 level. An examination of the findings also indicated a non-significant correlation between the number of courses taken and the teachers' knowledge score. The number of years of teaching experience, or the level of education attainment did not make a statistically significant difference as well. This study suggests that teacher preparation programs in institutions of higher education and school districts have not been successful in the implementation and application of strategies that help the needs of diverse students in special education programs.

TABLE OF CONTENTS Page ABSTRACT Hi DEDICATION v ACKNOWLEDGEMENTS vi TABLE OF CONTENTS vii LIST OF TABLES xi LIST OF FIGURES xii CHAPTER I. INTRODUCTION 1 Statement of the Problem 4 Purpose of the Study 4 Research Questions 4 Research Hypotheses 5 Significance of the Study 6 Assumptions 6 Delimitations and Limitations of the Study 7 Definition of Terms 8 Organization of the Study 10 CHAPTER II. REVIEW OF LITERATURE 12 Introduction 12 Historical Overview of ADHD 13 Early Beginnings 13 The 1900s 14 vii

Characteristics of ADHD 16 Inattention 16 Impulsiveness 17 Hyperactivity 18 Etiology of ADHD 19 Epidemiology of ADHD 20 Neurobiology of ADHD 22 Diagnosising ADHD 24 Treatment of ADHD 26 ADHD and Demographics 28 Comorbid Psychiatric Disorder 30 Oppositional Conduct and Antisocial Disorder 30 Anxiety and Mood Disorder 32 Classroom and Educational Interventions 35 Classroom Settings 38 Interventions in School Settings 39 Setting Routines ...41 Teacher-directed Lessons 41 CHAPTER III. METHODOLOGY 42 Introduction 42 Research Questions 43 Null Hypotheses 43 Research Methodology 44 viii

Research Design 44 Population and Sample 46 Instrumentation 47 Reliability 48 Validity 49 Procedures 50 Analysis of Data 51 Summary of Methodology 52 CHAPTER IV. ANALYSIS OF DATA 54 Study Participants 55 Data Analysis 56 Analysis of Research Questions 58 Results Summary 62 CHAPTER V. SUMMARY, CONCLUSIONS, RECOMMENDATIONS 64 Analysis of Data Summary 64 Conclusions 66 Contributions to the Literature 67 Recommendations 69 General Recommendations 69 Recommendations for Further Study 71 Summary 72 REFERENCES 74 APPENDIX A. SURVEY INSTRUMENT 94 APPENDLX B. PERMISSION TO USE SURVEY 101 ix

APPENDIX C. SUPERINTENDENT OF SCHOOLS PERMISSION LETTERS 104 APPENDIX D. CAMPUS PRINCIPAL PERMISSION LETTERS 108 APPENDLX E. INTERNAL REVIEW BOARD APPLICATION 114 APPENDLX F. APPROVAL OF INVESTIGATION (IRB) 126 VITA 128 x

LIST OF TABLES Table Page 3.1 Descriptive Statistics and Alpha Coefficients for KADDS across Five Studies 49 4.1 Demographic Characteristics for Highest level of Education 56 4.2 Demographic Characteristics for Number of Courses Taken related to ADHD 57 4.3 Demographic Characteristics for Number of Years of Teaching Experience 58 4.4 Descriptive Statistics for Average Score Performance on Subscales 59 4.5 Descriptive Statistics for Scores on Surveys 60 XI

LIST OF FIGURES Figure Page 4.1 Scatterplot of Years of Teaching Experience and Teacher Knowledge Score 61 4.2 Scatterplot of Number of ADHD Courses Taken and Teacher Knowledge Scores 62 xii

CHAPTERI INTRODUCTION Children spend most of their time in classrooms and other school settings. Here they are expected to follow rules, act in socially proper ways, play a part in academic activities and not interrupt the learning development or activities of others (Kleynhans, 2005). The work of the teacher becomes even more demanding when some learners have Attention Deficit Hyperactivity Disorder (ADHD), as their troubles with attention span, managing their impulse and activity level often obstruct activities in the classroom and socially (DuPaul & Stoner, 2003). ADHD is the most modern analytical marker applied to explain people that possess major problems with attention, hyperactivity, and impulsivity; the most diagnosed psychiatric children's disorder (American Psychiatric Association [APA], 2000). Epidemiological studies indicated that among 3% and 7% of children in the United States will be diagnosed with ADHD (Barkley, 1998b). It is likely that there will be a minimum of one child with ADHD in all classrooms in every school (Kleynhans, 2005). Children that demonstrate symptoms of having ADHD are often referred for assessment in the child's elementary school years, due to the fact that children are asked to engage in activities that contradict the main character of the disorder, such as paying attention, following instructions and staying seated in a controlled classroom environment (Barkley, 1998a). Many teachers recognize the main characteristics of ADHD, especially the key symptoms of ADHD. Teachers recognize, for example, that children with ADHD are restless (Kleynhans, 2005). They often base their reasons for 1

2 referral on key symptoms. The difficulty with this is that quite a few of these key symptoms have unfortunate helpful diagnostic influence (Sciutto, Terjesen, & Bender- Frank, 2000). Many studies have shown that ADHD training is not part of teachers' initial training (Holz & Lessing, 2002; Jerome, Gordon, & Hustler, 1994). For that reason, teachers often learn about ADHD through actual classroom experiences of teaching students that have a confirmed diagnosis for ADHD (Kleynhans, 2005). ADHD can have wide-ranging effects on the lives of the people who experience problems due to having the disorder. Adolescents with ADHD often have severe problems in many areas of performance, including educational success and interaction with peers (Wolfe & Mash, 2006). ADHD is also extremely comorbid (coexisting) with other troublesome behavior disorders, including oppositional defiant disorder (Wolfe & Mash, 2006). The evidence of ADHD is diagnosed by the main symptoms of this disorder (inattention, impulsivity, hyperactivity), its supplementary related characteristics (cognitive deficits, interpersonal complications, speech & language impairments, and task problems) and the comorbid disorders which often predict the increase of even more severe troubles and unfortunate results in adolescence and adulthood. (Wolfe & Mash, 2006, p. 98) There have been numerous investigate studies in the area of ADHD; the increase in research has been surprising. Much of this research has been in the range of measurement (e.g. Angelo, Volpe, DiPerna, Gureasko-Moore, Nebrig & Ota, 2003; Hartnett, Nelson & Rinn, 2004); treatment (e.g. Fabiano & Pelham, 2003; Miranda, Presentacion & Soriano, 2002) and the etiology of this disorder (e.g. Barkley, 1998a).

3 There is also a huge sum of research on comorbid disorders (e.g. Biederman, Faraone, Mick, Moore, & Leon, 1996; Jensen, Martin, & Cantwell, 1997). The study in the area of education has been disposed toward the academic and social problems learners with ADHD practice in the classroom (e.g. DuPaul & Eckert, 1997; Pfiffner & Barkley in Barkley, 1998). A small number of studies have measured teachers' knowledge, perceptions and beliefs of ADHD in the middle schools. This is unexpected; teachers are seen as one of the utmost influential specialists of knowledge to the diagnosis of ADHD because of their contact with students on a daily basis in a range of pertinent situations (Pelham & Evans, 1992). Teachers are typically the ones who submit students for ADHD assessment, thus achieving a key element in the screening for ADHD (Lawson, 2004). These assessments have been used as a gauge of a child's symptoms (Pelham & Evans, 1992). Furthermore, the demonstrative measure in the Diagnostic and Statistical Manual for Mental Disorders (APA, 2000) necessitates that the hyperactive, impulsive or inattentive symptoms should exist in two or more environments (e.g. at school and at home). This necessity shows the importance of teachers' acquired knowledge in making the diagnosis (Wolraich, Lambert, Baumgaertal, Garcia-Tornel, Feurer, Bickman, & Doffing, 2003). The psychologist or medical practioner needs thorough information from schools to help them to make a diagnosis (Kleynhans, 2005). The goal of diagnosis is not just the diagnosis itself, but also, based upon the information gathered, to plan interventions that are likely to be successful (DuPaul & Stoner, 2003). A study of 401 primary care pediatricians established that more than half of them relied only on school reports in arriving at their diagnosis of ADHD (Carey, 1999).

4 Statement of the Problem Noteworthy is the fact that children with ADHD must meet the psychiatric criteria for the circumstance (Moore, 2004). It is crucial for teachers to be capable of recognizing the characteristics of ADHD, and implementing proper classroom modifications. The research has clearly indicated that teachers do not have enough accurate information about ADHD to properly serve students who have either been diagnosed with the disorder, or are in need of identification (Jerome et al., 1994). Several of the obstacles that distinguish ADHD, in cooperation with terms such as inattention and hyperactivity/impulsivity, may impede a child's classroom conduct and their capability to be taught, resulting in lower academic success and diminished performance in the school surroundings (Chronis, Jones, & Raggi, 2006). Teachers have to cope with learners that have special needs, such as those who have ADHD. This research can be a possible source of information for local teachers and administrators, and a benefit for learners in their classrooms. Purpose of the Study The rationale of this study was to determine middle school teachers' knowledge versus their misconceptions regarding attention deficit hyperactivity disorder. This study also determined whether teacher knowledge of ADHD is related to level of education, training, and years of teaching experience. Research Questions The study was guided by the following research questions: 1. What are the levels of teacher knowledge in teacher subscale scores on the KADDS instrument for General Knowledge, Symptoms/Diagnosis, and

5 Treatment that indicates where the greatest lack of knowledge of ADHD exists? 2. What is the relationship between teachers' knowledge of ADHD and the demographic characteristics of level of education groups? 3. What is the relationship between teachers' knowledge of ADHD and the number of years teaching experience? 4. What is the relationship between teachers' knowledge of ADHD and the number of ADHD courses taken? Research Hypotheses Research Question One was answered utilizing descriptive statistics. Research Question Two was tested utilizing a between-group analysis. Research Question Three made comparisons among levels of education, years of teaching, and ADHD training. Hi- There is a statistically significant difference in teacher ADHD knowledge scores among the subscales General Knowledge, Symptoms/Diagnosis, and Treatment. H2- There is a statistically significant difference in teacher ADHD knowledge scores among the level of education groups (Bachelors, Masters/Doctorate). H3- There is a statistically significant relationship between teacher ADHD knowledge scores and number of years teaching. H4- There is a statistically significant relationship between teacher ADHD knowledge scores and the number of ADHD courses taken.

6 Significance of the Study The knowledge teachers have about ADHD may influence how they correspond with and educate children with ADHD. As a result, teachers may have a better understanding of learners with ADHD, which may stop them from having a negative outlook of these learners or labeling them (Holz & Lessing, 2002). Studies have established that teachers provided incorrect recommendations to parents of children with ADHD and that parents regularly followed that advice (DiBatista & Sheppard in Kos, Richdale & Jackson, 2004). According to Pfiffher and Barkley (1998), teachers often have a mediocre understanding of the character, path, and consequences of ADHD, and they have a tendency to lack the understanding about proper mediations for the students with ADHD. Knowledge of this disorder is crucially important to apply useful interventions (Miranda et al., 2002). The classroom can be seen as a vital and fitting location where the personal, social and academic progress of children with ADHD can be sustained by interventions implemented by teachers. The success of these interventions at school depends heavily on the teacher's readiness to deal with students that have ADHD (Miranda et al., 2002). Assumptions For the purpose of this study, the following assumptions were made: 1. Teachers involved in the study contributed freely and provided correct, autonomous responses to the items on the survey instrument. 2. Teachers involved in this study have a broad understanding of ADHD.

7 3. Data were collected in a standardized manner and handled professionally to ensure reliability in data gathering and analysis. 4. The instrument, The Knowledge of Attention Deficit Disorders Scale (KADDS), is research-tested and represents well the levels of knowledge teachers have of ADHD. Delimitations of the Study 1. The study was limited to research of middle school (7th and 8th grade levels) classroom teachers. 2. This study investigated teachers' knowledge and misconceptions with regard to ADHD. Conclusions regarding other disorders should not be made based on the findings from this study. 3. The sample in this study was limited to teachers in five middle schools in South Texas. 4. The data collections for this study were limited to one school semester. Limitations of the Study 1. Teacher scores for KADDS did not distinguish teachers' misconceptions (wrong answers) from teachers' lack of knowledge ("Don't Know") responses. 2. The study was only concerned with the knowledge and misconceptions of middle school teachers. Any generalization of the findings to teachers at elementary and high school levels may not be suitable.

8 Definitions of Terms Attention Deficit Hyperactivity Disorder (ADHD) is a neurological condition that causes a difficulty with inattention and hyperactivity-impulsivity that are developmentally disproportionate with the age of the child (American Psychiatric Association, 2000). Attention Deficit Hyperactivity Disorder (ADHD) Training - For the purpose of this study, ADHD training will be measured by answering the question "amount of college courses taken" in their post secondary, graduate or doctoral academic preparation studies dealing with ADHD. Comorbid refers to two or more coexisting medical conditions or disease processes that are additional to an initial diagnosis (Mosby 's Pocket Dictionary of Medicine, Nursing & Health Professions, 2010). Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-R) is a manual published by the American Psychiatric Association, listing the official diagnostic classifications of mental disorders. The DSM recommends the use of a multiaxial evaluation system as a holistic diagnostic approach. It consists of five axes, each of which refers to a different class of information, including mental and physical data. Axes I and II include all of the mental disorders, classified broadly as clinical syndromes and personality disorders; axis III contains physical conditions and disorders; and axes IV and V provide a coded outline of supplemental information that may be useful for planning individual treatments. (Mosby's Pocket Dictionary of Medicine, Nursing & Health Professions, 2010).

9 Diagnosis is the act or process of discovering or identifying a diseased condition by means of a medical examination, laboratory test, etc. {Webster's New World College Dictionary, 2000). Dopamine is a naturally occurring sympathetic Nervous System neurotransmitter that is the precursor of norepinephrine. {Mosby 's Pocket Dictionary of Medicine, Nursing & Health Professions, 2010). Epidemiology is the study of the determinants of disease events in populations {Mosby's Pocket Dictionary of Medicine, Nursing & Health Professions, 2010). Etiology is the science of the causes or origins of disease {Webster's New World College Dictionary, 2000). Functional Magnetic Resonance Imaging (FMRI) is a radiographic technique for imaging brain activity in which a rapid succession of scans, designed to detect increases in oxygen consumption in various regions of the brain, reflects small changes in blood flow and increase activity in certain cells {Mosby's Pocket Dictionary of Medicine, Nursing & Health Professions, 2010). Knowledge is the acquaintance with facts; range of information, awareness {Webster's New World College Dictionary, 2000). Level of Education - For the purpose of this study, level of education will be measured by the level of educational attainment, Bachelor's, Master's, or Doctorate. Misconception is conceiving wrongly; interpret incorrectly; misunderstand (Webster's New World College Dictionary, 2000). Norepinephrine Receptors are receptors of an adrenergic hormone that acts to increase blood pressure by vasoconstriction but does not affect cardiac output. It is

10 synthesized by the adrenal medulla, the peripheral sympathetic nerves, and the Central Nervous System (Mosby 's Pocket Dictionary of Medicine, Nursing & Health Professions, 2010). Perception is the act of perceiving or the ability to perceive; awareness; comprehension (Webster's New World College Dictionary, 2000). Positron Emission Tomography is a computerized radiographic technique that uses radioactive substances to examine the metabolic activity of various body structures (Mosby's Pocket Dictionary of Medicine, Nursing & Health Professions, 2010). Symptom is any circumstance, event, or condition that accompanies something and indicates its existence or occurrence; sign; indication (Webster's New World College Dictionary, 2000). Treatment is the act, manner, method, etc. of treating, or dealing with, a person, thing, or subject (Webster's New World College Dictionary, 2000). Years of Teaching Experience - For the purpose of this study, years of teaching experience will be measured by the number of years as a state licensed teacher in a classroom environment. Organization of the Study This study is structured into five chapters. Chapter I provides the introduction, statement of the problem, purpose of the study, research questions, research hypotheses, significance of the study, assumptions, delimitations and limitations, definition of terms and the organization of the study. Presented in Chapter II is a review of literature relevant to the study. Chapter III contains the methodology and procedures beginning with the

11 research design, research questions, null hypotheses, research methodology, subjects of study, instrumentation, as well as data collection procedures, analysis of data, and a summary. The explanation of data preparation, descriptive statistical analysis, and the four guiding research questions and hypotheses data analyses are presented in Chapter IV. The dissertation is concluded with Chapter V, which focuses on an overall summary of the data analysis, conclusions, contributions to the literature, and recommendations for implementation of the results and further research.

CHAPTER II REVIEW OF LITERATURE Introduction Attention Deficit Hyperactivity Disorder (ADHD) is a neurological condition whose foundation is the complexity that involves the inattention and hyperactivity- impulsivity qualities that are conflicting with the age of the child (APA, 2000). This state becomes visible in a few youngsters in the pre-school and elementary academic years (National Institute of Mental Health [NIMH], 2006). Research is now identifying that ADHD is not a condition of alertness, or attention, as had been realized. Most confidently it is the works of advance malfunction in the brain circuitry that supports restraint and willpower (Pierangelo & Giuliani, 2008). The need of guidelines for ones' self diminishes additional vital brain capacity critical in support of attention, including the capability to impede instantaneous compensation for achievement later on (Barkley, 1998b). The way youngsters with ADHD behave may consist of tremendous hyperactivity. The elevated levels of liveliness and the following conduct are frequently misinterpreted. The display of the dysfunction that may necessitate distinct intervention is usually met with apprehension or denial (Pierangelo & Giuliani, 2008). Youngsters with ADHD display a series of characteristics and at significance levels. Additionally, quite a few youngsters with ADHD regularly are at minimum normal intellect and contain a variety of character uniqueness and vitality (Pierangelo & Giuliani, 2008). 12

13 Scientific studies conducted worldwide have found that between 2% and 29% of children and adolescents demonstrate symptoms of inattention only or in combination with symptoms of hyperactivity and impulsivity that are relentless enough to meet the measure of being diagnosed with ADHD (APA, 2000). The present classification for combined type ADHD requires at least six out of nine indications of inattention and no fewer than six out of nine symptoms of hyperactivity/impulsivity (Daley, 2006). Additionally, there should be a little impairment from symptoms in two or more environments for example, home or school and obvious confirmation of considerable impairment in social, school or work performance (Daley, 2006). By exploring secondary teachers' knowledge and misperceptions, about ADHD, could bring to light much needed information. In Chapter II, the focal point is by reviewing the history, characteristics, diagnosis, treatment, and epidemiologic issues connecting to ADHD. An extensive appraisal of the teachers' knowledge of the disorder and classroom strategies is also reviewed. Historical Overview of ADHD Early Beginnings ADHD was originally characterized by Dr. Heinrich Hoffman in 1845. Dr. Hoffman, a physician, was also an author of books on medicine and psychiatry. He also wrote poetry and later became involved in writing for youngsters as he could not locate appropriate books for his three-year-old son. The outcome was a manuscript of rhymes that incorporated drawings, regarding youngsters and their uniqueness. "The Story of Fidgety Philip" was an ideal depiction of a small child that had ADHD (Pierangelo & Giuliani, 2008).

14 "Phil, stop acting like a worm The table is no place to squirm." Thus speaks the father to his son, Severely says it, not in fun. Mother frowns and looks around Although she doesn't make a sound. But, Philip will not take advice, He'll have his way at any price. He turns, And churns, He wiggles And jiggles Here and there on the chair; "Phil, these twists I cannot bear." (Hoffman as cited in Silver, 1993, p. 3) The 1900s It was not until 1902 in London, in a set of lectures given by George Frederic Still (Barkley, 1998a), about the silliness of certain children led to the idea of hyperactivity. These children were described as having the need of intentional control, attention, appropriate control, and excessive activity (Barkley, 1998a). In the United States, awareness of these behaviors became prevalent after quite a few children survived an epidemic of encephalitis lethargic, around 1917, commonly identified as sleeping sickness (Rafalovich, 2001). These children showed difficulty in attention, cognitive aptitude, hyperactivity, and impulsivity. Rafalovich (2001) emphasized that this

15 rationalization remains the primary feature of today's neurochemically based ADHD researchers. ADHD has gone through several names including Hyperactive Syndrome, Hyperkinesis, Hyperactive Disorder of Childhood, and Minimal Brain Dysfunction (Conrad & Potter, 2000). The first authentic approval of what is now identified as ADHD as a known categorization was in 1968 (American Psychiatric Association as cited in Barkley, 1998a) in which the phrase hyperactive reaction of childhood was used (Silver, 1993). Hyperactivity was seen as the crucial predicament of ADHD. In the 1970s, this analysis stretched out to incorporate troubles in attention and impulse management as principal features of this disorder (Barkley, 1998a). The name of the disorder became ADD (attention deficit disorder, with or without hyperactivity). Highly developed research has made it apparent that impulsiveness and hyperactivity that was seen in children with ADD with hyperactivity was decidedly linked to each other, and that they shape a lone problem of inadequate restraining control (Barkley, 2000). Limited restraining control was viewed as the key symptom amongst the problems connected to attention in ADHD. Restraining control helped separate ADHD from other childhood disorders and guided to the current name Attention Deficit Hyperactivity Disorder (Barkley, 2000). Given that, thousands of medical documents on the dysfunction have been in print, giving advice on its character, path, origin, and management (NIMH, 2006). Inattention, hyperactivity, and impulsivity are the fundamental symptoms of ADHD. A child's academic success is frequently dependent on academic skills that allow a student to get needed information, finish assignments and contribute in classroom activities and discussions (Forness & Kavale, 2001).

16 Characteristics of ADHD Youngsters and adults that have ADHD are generally characterized as containing relentless problems with lack of concentration and or spontaneity/hyperactivity (Barkley, 1998a). These individuals are supposed to show signs of uniqueness prematurely, to a point that is not well-matched for their age or developmental stage. Across dissimilar situations that hinder their ability to pay attention, control their movement, interfere with their impulses, and handle their individual behavior connected to rules, time, and the future (Barkley, 1998a). Inattention By description, children who have ADHD exhibit difficulties with attention comparative to normal children of the same age and gender (Mirsky, 1996). However, attention is a multidimensional construct that has to do with alertness, arousal, selectivity, constant attention, distractibility, or length of apprehension, among others (Mirsky, 1996). Research has recommended that children with ADHD have their greatest difficulties with determination of effort, or sustaining their attention to tasks (Douglas, 1983). These difficulties may be obvious in free-play settings, as confirmed by shorter continuance of play with each toy and repeated variations in play with an assortment of toys (Zentall, 1985). However, they are seen often in conditions requiring the child to maintain attention to dull, boring, repetitive tasks (Barkley, DuPaul, & McMurrary, 1990) such as independent schoolwork, homework, or chore performance. Parents and teachers frequently explain these attentional problems in terms such as "Doesn't seem to listen," "Fails to finish assigned tasks," "Daydreams," "Often loses things," "Can't concentrate," "Easily distracted," "Confused or seems to be in a fog"

17 (Barkley et al., 1990, p. 775). Research using straight observations of child behavior discovered that off-task behavior or not paying attention to work is transcribed considerably more often for ADHD children and adolescents than for learning-disabled or normal children (Fisher, Barkley, Edelbrock, & Smallish, 1990). Impulsiveness ADHD is often linked with an absence in restraining behavior in answer to situational stress or what may be called impulsivity, once more comparative to others of the equivalent mental age and gender. Like attention, impulsivity is also multidimensional in character (Kindlon, Mezzacappa, & Earls, 1995). The type of impulsivity repeatedly associate with control of behavior, the incapability to wait for an answer, postpone satisfaction or to restrain prevailing responses are the individually most often identified in children having ADHD (Barkley, 1997b). Clinically, these children are distinguished to react hastily to circumstances without delaying for directions to be finished or sufficiently appreciating what is necessary to accomplish (Barkley, 1997b). Rash or sloppy mistakes are the outcome (Barkley, 1998a). These children do not regard the possible harmful, critical, or yet hazardous cost that could be linked with demanding circumstances or conducts. Thus they appear to engage in numerous, needless chance taking (Barkley, 1998a). Verbally, they often say things indiscreetly without regard for the feelings of others or for the social consequences to themselves. Blurting out answers to questions prematurely and interrupting the conversations of others are commonplace (Barkley, 1998a). The layman's impression of these children, therefore, is often one of poor self-

Full document contains 142 pages
Abstract:   Attention Deficit Hyperactivity Disorder (ADHD) is often the most frequently determined conduct disorder in children, and is expected to affect 3% to 7% of school-aged children in the United States. Due to the behavioral symptoms of ADHD, it is common for the identification of the disorder to be during the school-age years. For this reason, it is imperative for teachers to be the referring resource for the identification and evaluation for the diagnosis of ADHD. The study examined the knowledge and misconceptions middle school teachers in South Texas have in relation to ADHD. The study explored the relationships between teachers' demographic characteristics such as levels of education, number of years teaching, and past attention deficit hyperactivity disorder training, and their knowledge of ADHD. The data used for this study was collected using a validated survey instrument including questions associated with the etiology and epidemiology of ADHD. The sample for this study involved five predominately Hispanic middle schools in South Texas during the 2008-2009 school year. A one-way analysis of variance (ANOVA) procedure was administered to examine the differences among General Knowledge, Symptoms/Diagnosis, and Treatment, and Bachelors, and Masters/Doctorate degrees. The teachers' knowledge of ADHD was compared across those groups, respectively. The bivariate correlation design allows for the variables number of years teaching and past ADHD training to be correlated to the teachers' knowledge of ADHD. Results indicated that teachers' greatest area of knowledge dealt with identifying the symptoms/diagnosis of ADHD. There was a strong relationship between the knowledge factors and the scores on the survey and the differences among the means were statistically significant at the .05 level. An examination of the findings also indicated a non-significant correlation between the number of courses taken and the teachers' knowledge score. The number of years of teaching experience, or the level of education attainment did not make a statistically significant difference as well. This study suggests that teacher preparation programs in institutions of higher education and school districts have not been successful in the implementation and application of strategies that help the needs of diverse students in special education programs.