Children with Attention Deficit Hyperactivity Disorder and their Teachers: A review of the literature

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  • This article was downloaded by: [University of North Carolina]On: 11 November 2014, At: 12:46Publisher: RoutledgeInforma Ltd Registered in England and Wales Registered Number: 1072954 Registeredoffice: Mortimer House, 37-41 Mortimer Street, London W1T 3JH, UK

    International Journal of Disability,Development and EducationPublication details, including instructions for authors andsubscription information:http://www.tandfonline.com/loi/cijd20

    Children with Attention DeficitHyperactivity Disorder and theirTeachers: A review of the literatureJulie M. Kos a , Amanda L. Richdale b & David A. Hay ca Australian Council for Educational Research , Australiab RMIT University , Australiac Curtin University of Technology , AustraliaPublished online: 22 Aug 2006.

    To cite this article: Julie M. Kos , Amanda L. Richdale & David A. Hay (2006) Children withAttention Deficit Hyperactivity Disorder and their Teachers: A review of the literature,International Journal of Disability, Development and Education, 53:2, 147-160, DOI:10.1080/10349120600716125

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    http://www.tandfonline.com/page/terms-and-conditionshttp://www.tandfonline.com/page/terms-and-conditions

  • International Journal of Disability, Development and EducationVol. 53, No. 2, June 2006, pp. 147160

    ISSN 1034-912X (print)/ISSN 1465-346X (online)/06/02014714 2006 Taylor & FrancisDOI: 10.1080/10349120600716125

    Children with Attention Deficit Hyperactivity Disorder and their Teachers: A review of the literature

    Julie M. Kosa*, Amanda L. Richdaleb and David A. HaycaAustralian Council for Educational Research, Australia; bRMIT University, Australia; cCurtin University of Technology, AustraliaTaylor and Francis LtdCIJD_A_171580.sgm10.1080/10349120600716125International Journal of Disability, Development and Education1034-912X (print)/1465-346X (online)Original Article2006Taylor & Francis532000000June 2006JulieKosjulie.kos@facs.gov.au

    There is considerable evidence regarding the academic and social difficulties children withAttention Deficit Hyperactivity Disorder (ADHD) experience, but less is known about what theirteachers do and should know. This article provides a summary of this evidence, including informa-tion on the difficulties experienced by students with ADHD, the relationships between teachers andstudents with ADHD, pre-service and in-service teachers knowledge and attitudes toward ADHD,and in-service teachers behaviour toward children diagnosed with the condition. Teachers needincreased awareness of the family circumstances of children with ADHD, more knowledge ofthe conditions commonly comorbid with ADHD, and insight into these childrens relationshipwith peers.

    Keywords: Attention Deficit Hyperactivity Disorder; Attitudes; Behaviour; In-service teachers; Knowledge; Pre-service teachers

    Introduction

    The classroom may represent one of the most difficult places for children withAttention Deficit Hyperactivity Disorder (ADHD), most probably because thissetting requires children to engage in behaviours that are contrary to the core symp-toms of the disorder. Much research has been conducted involving childrens behav-iour problems within educational settings, and this article will provide a detaileddescription and analysis of the literature in this area. The article is divided into threeparts. The first focuses on the difficulties experienced by school-aged students with

    *Corresponding author. Australian Council for Educational Research, Private Bag 55, Camberwell,VIC 3124, Australia. Email: Kos@acer.edu.au

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  • 148 J. M. Kos et al.

    ADHD, including academic difficulties (e.g., poor academic performance, beingretained in grade level, suspension, and expulsion), and problems experienced form-ing and maintaining peer relationships. The second part, which describes researchpertaining to teachers and students with ADHD, reviews the existing literatureconcerning teachers knowledge and attitudes, along with studies addressing teach-ers classroom management of children with ADHD. The final part of the articleprovides a summary of the literature, suggestions for how ADHD can be handledbetter at the level of teachers, schools, and the education system, as well as sugges-tions for future research to increase our understanding of the interrelationshipbetween ADHD behaviours, the education system, and families.

    Difficulties Experienced by Students with ADHD

    Research has generally focused on the academic and social difficulties students withADHD experience within educational settings (e.g., Barkley, Fischer, Edelbrock, &Smallish, 1990; DuPaul & Eckert, 1997, 1998). The findings from this researchhave shown that children with ADHD often experience a myriad of difficulties atschool related to the core symptoms of the disorder; namely, inattention, impulsiv-ity, and overactivity. However, there may be gender differences regarding the sever-ity of these problems. For example, Abikoff et al. (2002) reported that while boyswith ADHD show significant behavioural problems in the classroom, girls with thedisorder are more likely to have predominantly inattentive symptoms and are littlemore disruptive than typically developing children.

    In addition, or possibly as a result of ADHD-related problems, children withADHD frequently experience lowered academic performance, are retained in grade,or are suspended or expelled from school (American Psychiatric Association [APA],2000; Marshall, Hynd, Handwerk, & Hall, 1997; Pfiffner & Barkley, 1990). A childwith ADHD may exhibit various behaviour problems within the classroom that aredependent on their ADHD symptom profile. For example, a child with predomi-nantly inattentive symptoms might have difficulty following teacher instructions andrules, staying on task and completing set work (Pfiffner & Barkley, 1990).Conversely, a child experiencing impulsivity might call out in class without permis-sion or talk with other students at inappropriate times. Finally, an overactive childmight experience problems staying seated, playing with objects not related to the settask (e.g., playing with a pencil when instructed to read silently), rocking in chairs,and repetitively tapping their hands or feet (DuPaul & Stoner, 2003). Most childrenwith ADHD, however, exhibit behaviour problems related to at least two of thesethree core symptom groups (APA, 2000).

    Given these behaviours, it is not surprising that these children have considerabletrouble at school (Pfiffner & Barkley, 1990). The academic performance of studentswith ADHD is often compromised because of their difficulties with sustaining atten-tion (DuPaul & Stoner, 2003). Students with ADHD usually find it difficult toconcentrate long enough to complete set tasks, and academic performance mayfurther be impaired by an inherent tendency to be disorganisedto misplace books,

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  • Children with ADHD and their Teachers 149

    stationery, and other materials needed to complete school work (APA, 2000;DuPaul & Stoner, 2003). Moreover, being overactive and impulsive in the class-room can often mean that the student with ADHD is not paying attention to the taskat hand, and this may result in the child first misunderstanding what is required tocomplete that task, and subsequently failing to satisfactorily complete it. Luckily,however, the behavioural difficulties observed in children with ADHD can often bereduced when novel and interesting tasks are presented, especially when the task iseasy or repetitive (Greene, 1995; Zentall, 1993), and when the tasks are presented tothe child at a level they understand (DuPaul & Power, 2000).

    ADHD-related behaviours are disruptive in the classroom (Pfiffner & Barkley,1990), not only to teachers but also to other students (DuPaul & Stoner, 2003).This may be one of the reasons why ADHD children have such a difficult time form-ing and maintaining friendships with peers (Barkley, 1998; Kellner, Houghton, &Douglas, 2003). Research has consistently shown that children with ADHD tend tohave a lot of difficulty with peer relationships (e.g., Barkley, 1998; Erhardt &Hinshaw, 1994; Gresham, MacMillan, Bocian, Ward, & Forness, 1998; Hinshaw &Melnick, 1995; Pfiffner & McBurnett, 1997). According to Gresham et al. (1998),up to 70% of children with ADHD experience unreciprocated friendships withpeers. Furthermore, typically developing children report not wanting to befriendtheir peers with ADHD (Wheeler & Carlson, 1994), particularly those who experi-ence difficulties with overactivity (Jenkins & Batgidou, 2003).

    There are a number of possible reasons for the difficulties that children withADHD experience with peers. It may be that they tend to perform behavioursconsidered controlling, trouble-making, and aggressive (Erhardt & Hinshaw, 1994;Hinshaw & Melnick, 1995). These behaviours are likely to be perceived by peers asnegative and thus prompt rejection by the peers from play activities. Second, chil-dren with ADHD may have difficulty reading social cues from their peers, andrespond inappropriately as a result (Atkinson, Robinson, & Shute, 1997). Childrenwith ADHD are not purposefully nasty; rather, they often have low self-esteem(Wheeler & Carlson, 1994), report feeling lonely and sad about not being liked bytheir peers, and desperately want to fit in (Chipkala-Gaffin, 1998; Gresham et al.,1998). Finally, research has also suggested that teachers attitudes and behaviourtoward a student with ADHD can impact on other students perceptions of thatchild (Atkinson et al., 1997).

    Teachers and Students with ADHD

    While teachers are concerned about the social difficulties experienced by studentswith ADHD, they tend to be most concerned with their problematic behavioursinvolving control, discipline, achievement, and listening to and complying withinstructions (Kauffman, Lloyd, & McGee, 1989). Further, Li (1985) showed thatthere is a general perception among teachers that acting-out behaviours are signifi-cantly more problematic than withdrawn behaviours. This finding might be the resultof withdrawn behaviours being less disruptive to the classroom environment than

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  • 150 J. M. Kos et al.

    overt problem behaviours, or alternatively teachers believe that internalising prob-lems have a far better prognosis than externalising childhood problems (DeStefano,Gesten, & Cowen, 1977).

    Teachers tend to perceive children with ADHD as requiring extra teaching timeand effort (Atkinson et al., 1997), a perception that seems to be a reflection of real-ity. Teachers have been shown to modify their teaching as a result of having astudent with ADHD in their class, particularly by providing greater structure androutine and by preparing work in greater detail (Atkinson et al.).

    Given the nature and frequency of the negative behaviours exhibited by studentswith ADHD, it is not surprising that teachers often feel pessimistic about teachingchildren with the condition (Kauffman et al., 1989). Although teachers might bepessimistic, they generally perceive themselves as being competent to handle thesedifficulties in the classroom. Kauffman et al. asked 77 primary and secondary schoolteachers to complete a 30 min questionnaire assessing demographic details andbeliefs about adaptive and maladaptive classroom behaviours. Usable data werecollected from 61 teachers, and results showed that most of the teachers believedthey were capable of both teaching students critical skills such as listening andfollowing classroom rules, and also in managing unacceptable behaviours in theclassroom such as stealing and tantrums. It should be noted, however, that thesample was derived from teachers enrolled in an in-service course in behaviourmanagement. Therefore, it is likely that these teachers were not representative oftypical teachers.

    Research has also indicated that teachers attitudes are mediated by theirperceptions of competence (Brophy & McCaslin, 1992; Li, 1985; Rizzo & Vispoel,1991). Rizzo and Vispoel asked 94 physical education teachers to rate their atti-tude and perceived competence regarding teaching students with disabilities. Find-ings revealed that the more competent a teacher felt, the more favourable theirattitudes were regarding teaching these students. Moreover, while training andattitudes were not related, there was a significant positive correlation betweenperceived competence and years of teaching experience. Further research hasdemonstrated that teachers who have previously taught a student with ADHD aregenerally more confident in their ability to teach students with ADHD than areteachers without this experience (Reid, Maag, Vasa, & Wright, 1994). Reid et al.also showed that severity of student behaviour problems, class size and lack oftraining time were the most troublesome issues to teachers management ofADHD within the classroom.

    Teachers Knowledge and Attitudes Regarding ADHD

    ADHD most often presents in the early school years, and is quite pervasive acrossprimary and secondary schooling with an average of one child per classroom havingthe disorder (Barkley, 1998). Therefore, primary school teachers are most likely tobe among the first people to notice ADHD-related behaviours in children (Tannock& Martinuseen, 2001).

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