Teachers' evaluations for the detection of primary‐school children with attention deficit hyperactivity disorder

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  • This article was downloaded by: [Ams/Girona*barri Lib]On: 17 October 2014, At: 05:18Publisher: RoutledgeInforma Ltd Registered in England and Wales Registered Number: 1072954 Registeredoffice: Mortimer House, 37-41 Mortimer Street, London W1T 3JH, UK

    European Journal of Special NeedsEducationPublication details, including instructions for authors andsubscription information:http://www.tandfonline.com/loi/rejs20

    Teachers' evaluations for the detectionof primaryschool children withattention deficit hyperactivity disorderMaria Kypriotaki a & George Manolitsis aa Department of Preschool Education , University of Crete , GallosUniversity Campus, Rethymno, Crete, GreecePublished online: 26 Jul 2010.

    To cite this article: Maria Kypriotaki & George Manolitsis (2010) Teachers' evaluations for thedetection of primaryschool children with attention deficit hyperactivity disorder, European Journalof Special Needs Education, 25:3, 269-281, DOI: 10.1080/08856257.2010.492940

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  • European Journal of Special Needs EducationVol. 25, No. 3, August 2010, 269281

    ISSN 0885-6257 print/ISSN 1469-591X online 2010 Taylor & FrancisDOI: 10.1080/08856257.2010.492940http://www.informaworld.com

    Teachers evaluations for the detection of primary-school children with attention deficit hyperactivity disorder

    Maria Kypriotaki* and George Manolitsis

    Department of Preschool Education, University of Crete, Gallos University Campus, Rethymno, Crete, GreeceTaylor and FrancisREJS_A_492940.sgm(Received 18 August 2009; final version received 8 February 2010)10.1080/08856257.2010.492940European Journal of Special Needs Education0885-6257 (print)/1469-591X (online)Original Article2010Taylor & Francis253000000August 2010MariaKypriotakimkypriotaki@edc.uoc.gr

    The early detection of children with attention deficit hyperactivity disorder(ADHD) by teachers can contribute to the prevention of secondary disorders in achild and this can have serious implications for the childs overall development.The aims of the present study were to examine: (1) the validity of the originalassessment of the teachers in detecting school-age children nominated as childrenwith ADHD by their teachers; and (2) the factors that influence teachersevaluations on a rating scale assessing ADHD, such as childs gender, the parentslevel of education, the childs social and academic behaviour in the classroom, theteacherstudent relationship, as well as the teachers cooperation with the parents.Teachers were asked to fill in a Greek standardised rating scale for the detectionof children with ADHD and a student behaviour questionnaire for 420 primary-school students nominated as children with ADHD by teachers. The studysfindings showed that teachers detect far more students with ADHD than thenumber expected from the norms based on the standardised ADHD rating scale.Teachers not only nominated more boys than girls as students with ADHD, butalso made more accurate identifications for girls than for boys, particularly in thelater primary-school grades. Childrens age or parental educational backgrounddid not influence the teachers initial nominations or their later ratings. Multipleregression analyses indicated that the teachers beliefs about a childs peerrelations and the quality of teacherchild relationships predicted teachers ratingson the ADHD scale more than other factors did.

    Keywords: attention deficit hyperactivity disorder; primary school; teachers;evaluation

    Introduction

    Attention deficit hyperactivity disorder (ADHD) is central among the disorders ofchildhood (Kerns, Eso, and Thomson 1999) and constitutes the most common schoolproblem presenting serious consequences for the learning processes. The frequencythe disorder is met among school-age children varies between 3% and 7% (AmericanPsychiatric Association 2000). This percentage rises significantly when children eval-uation scales are administered to parents and teachers (Havey et al. 2005; Rinn andNelson 2009). The basic symptoms of this disorder are inattention, impulsiveness andhyperactivity (Brandau and Pretis 2004; Pisecco, Huzinec, and Curtis 2001) or acombination of the three (Nowacek and Mamlin 2007). The criteria for determining

    *Corresponding author. Email: mkypriotaki@edc.uoc.gr

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  • 270 M. Kypriotaki and G. Manolitsis

    ADHD require the presence of symptoms in two or more settings, such as school andhome (De Nijs et al. 2004) with a duration of at least six months (Mrug, Hoza, andGerdes 2001). The determination of the frequency of ADHD presents a considerablediscrepancy owing to the conceptual approach of the researchers, the data collectiontools, and the size and type of the population in question (Kalantzi-Azizi andKarademas 2004). This disorder is diagnosed at least three times more often in boysthan in girls (Barkley 1998).

    As a result of ADHD symptoms, impulsiveness and hyperactivity, a considerablenumber of children that suffer from this disorder face major difficulties at school (Kos,Richdale, and Hay 2006) and home. They are being rejected by their peers (Mrug,Hoza, and Gerdes 2001), and later when they become teenagers and adults withADHD they will often have social and communication skills deficits (Robbins 2005).Children with ADHD are in danger of school failure (LeFever et al. 2002), pooracademic achievement (Pisecco, Huzinec, and Curtis 2001), and they are more proneto accidents (Barkley 1998) and exhibiting delinquent behaviour. The increasedfrequency of the disorder, its chronic nature if it is not addressed in time and alsothe presence of multiple problems in children with ADHD, makes necessary the useof valid and reliable psychometric tools that will identify children with this disorder(Kalantzi-Azizi, Aggeli, and Efstathiou 2005).

    The importance of early detection of children with ADHD and children in dangerof developing ADHD is essential to ensure proper psychoeducational treatment(Sauver et al. 2004). Early diagnosis is often a difficult process, because manyproblems associated with ADHD are characteristics of other disorders as well(Sciutto, Terjesen, and Bender Frank 2000). What is more, ADHD characteristics aremanifested together with other related problems, such as learning difficulties, stressand depression (Reuner and Oberle 2000), oppositional defiant disorder (Dpfner,Schrmann, and Frhlich 1998), conduct disorder (Pelham, Fabiano, and Massetti2005), Tourette syndrome (Spencer et al. 1998) and so on. Owing to the complexityof the disorder and associated problems, an assessment from an interdisciplinarygroup is necessary (Kypriotaki 2004; Sciutto, Terjesen, and Bender Frank 2000).

    The role the teacher plays in this assessment is determinative (Kypriotakis 2001)because of his immediate involvement in the learning process, the consequent behav-iour of the student inside the school environment, the students performance, and therelationship of the student with other fellow students. Further, the teacher can detectearly, unidentified deficiencies and contribute to the prevention of secondarydisorders in a child through the learning requirements established in the classroom.Teachers contribute important information, because of their extensive contact withchildren in structured and unstructured activities and social situations (Atkins,Pelham, and Licht 1985; De Nijs et al. 2004) and their knowledge of abilities/behaviours that suit the childrens age (Lauth, Heubeck, and Mackowiak 2006). Often,the teacher becomes part of the referral procedure of a child with special educationalneeds (Rinn and Nelson 2009; Stevens, Quittner, and Abikoff 1998). In addition, his/her reports are used in the assessment (Biederman et al. 2004; Sciutto, Terjesen, andBender Frank 2000) and in the implementation of an individualised educationalprogramme (Vereb and DiPerna 2004).

    Many times the teachers are the first to acknowledge that a child cannot concen-trate or is hyperactive; nevertheless, they often make mistaken judgments concerningstudents with ADHD (Amador-Campos et al. 2006; Rinn and Nelson 2009; Sciutto,Terjesen, and Bender Frank 2000; Stevens, Quittner, and Abikoff 1998) and many

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  • European Journal of Special Needs Education 271

    teachers have limited knowledge of the nature, the symptoms, the causes, the manage-ment and the interventions that are related to ADHD (Jerome, Gordon, and Husler1994).

    Previous studies have indicated that teachers knowledge of ADHD primarilycomes from media or friends and relatives and not from scientific resources (Ghani-zadeh, Bahredar, and Moeini 2006; Stormont and Stebbins 2005). Furthermore,parents often complain that their children with ADHD do not get the proper guidanceand support at school owing to lack of teacher knowledge (Concannon and Tang2005). Inconsistent diagnosis can worsen a situation and contribute to the recurrentfailure of a student inside the classroom (Baum and Olenchak 2002).

    Research studies concerning teacher assessment of children with ADHD focus onthe teachers knowledge (for review see Kos, Richdale, and Hay [2006]) of the symp-toms of ADHD (Bacchini, Affuso, and Trotta 2008; Nowacek and Mamlin 2007;Vereb and DiPerna 2004), the causes, the frequency the disorder is manifested (Glassand Wegar 2001; Havey et al. 2005), the treatment (Glass and Wegar 2001; Haveyet al. 2005; Kerns Eso, and Thomson 1999; Snider, Busch, and Arrowood 2003;Kasten, Coury, and Heron 1992) and the potential referral of children that are consid-ered to have ADHD (Yang and Schaller 1997). Moreover, previous studies examinedfactors associated with teachers which influence their judgment of children withADHD (Kos, Richdale, and Jackson 2004; Sciutto, Terjesen, and Bender Frank 2000;Stevens, Quittner, and Abikoff 1998; Stormont and Stebbins 2005; Vereb and DiPerna2004), factors that influence students behavioural and academic outcomes (Sherman,Rasmussen, and Baydala 2008) and the traits of students that influence teacherassessment of therapy approval (Pisecco, Huzinec, and Curtis 2001) and referral ofthese children (Sciutto, Nolfi, and Bluhm 2004).

    For example, Kos, Richdale, and Jackson (2004) conclude that the experience ofan ADHD student in the classroom is related to teachers knowledge of the disorder.Accordingly, Sciutto, Terjesen, and Bender Frank (2000) showed that experience withan ADHD student was an important factor which allowed teachers to learn more aboutthe disorder and that their self efficacy and years of teaching experience are factorsthat are associated with their knowledge of ADHD. In contrast, Stevens, Quittner, andAbikoff (1998) found that teachers experience with a student with ADHD, teachersknowledge and their educational status were not significant predictors of theirestimations of ADHD and oppositional defiant disorder (ODD).

    In a recent study, Stormont and Stebbins (2005) showed that the educational statusof primary-school teachers is related to their knowledge of the disorder; however, theyears of teaching experience, the nature of occupation (full- vs. part-time) and theknowledge they think they possess were not related to the disorder. In another studyby Vereb and DiPerna (2004), who conducted research on teacher knowledge ofADHD and its treatment and teachers beliefs on the different forms of treatment,found that the teachers knowledge of the disorder, the years of educational experiencewith students with ADHD and their training were positively correlated with theirtemperate attitude towards medication. To summarise, teachers judgment of childrenwith ADHD seems to be influenced by their knowledge of ADHD characteristics.However, there are conflicting findings regarding the importance of years of teachingexperience and teachers general educational status in identifying children withADHD.

    The degree to which the teachers original assessment is applicable is an importantissue because the early detection of children with ADHD from teachers can contribute

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  • 272 M. Kypriotaki and G. Manolitsis

    to the prevention of secondary disorders in a child and this can have serious implica-tions for the childs overall development. Teacher assessments are often used to helpdetermine a diagnosis, the appropriate educational setting and therapies that wouldbenefit the student (Brown 1985, cited in Stevens, Quittner, and Abikoff 1998). Thus,teachers need to know the characteristics of ADHD so as to alleviate difficulties thatcome up (Harlacher, Roberts, and Merrell 2006). The aims of the present study wereto examine: (1) the validity of the initial teacher assessment in detecting primary-school children nominated as children with ADHD by their teachers; and (2) thefactors that influence teachers evaluations on a rating scale assessing ADHD, such aschilds gender, the parents level of education, the childs social and academic behav-iour in the classroom, the teacherstudent relationship and the teachers cooperationwith the parents.

    Method

    Sample

    The study sample comprised 420 primary-school children (712 years old) who wereinitially nominated as children with ADHD by 365 teachers. At first, 79 primaryschools (48 from urban and 31 from rural areas) from the island of Crete, Greece, wererandomly s...

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