Skip to main content

Advertisement

SpringerLink
Log in

What Do Preschool Teachers Know About Attention-Deficit/Hyperactivity Disorder (ADHD) and Does It Impact Ratings of Child Impairment?

  • Original Paper
  • Published:
School Mental Health Aims and scope Submit manuscript

Abstract

Among preschool children referred for psychological assessment and intervention, attention-deficit/hyperactivity disorder (ADHD) is the most commonly diagnosed disorder. In order to create school-based interventions that are consistently and effectively implemented by teachers, it is important to understand teachers’ knowledge and beliefs about ADHD, as studies have identified lack of knowledge as a barrier to treatment integrity. The present study seeks to fill the important gaps of previous work and gain an understanding of preschool teachers’ knowledge and opinions of ADHD, and how knowledge of ADHD impacts teachers’ perceptions of child impairment across domains. The present study includes teachers (n = 107; 97.2% female; 59.2% Hispanic or Latino; 16.8% Black or African-American) of ethnically and linguistically diverse preschool students in an urban school setting who were being referred for a summer treatment program. Teachers’ knowledge of ADHD was investigated and related to teacher characteristics (i.e., education, years of experience, classroom type, professional development) and ratings of child impairment across domains. Overall, preschool teachers achieved 38.3% accuracy on the knowledge of ADHD measure, with highest levels of inaccurate knowledge related to the symptoms and treatment for ADHD. Generally, teachers with more misperceptions and knowledge gaps regarding ADHD rated children as more impaired on several domains. The results of the current study reveal large gaps in preschool teacher knowledge of ADHD. As such, there are important implications for future teacher training and professional development.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  • American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC.

  • Anderson, D. L., Watt, S. E., Noble, W., & Shanly, D. C. (2012). Knowledge of attention deficit hyperactivity disorder (ADHD) and attitudes towards teaching children with ADHD: The role of teacher experience. Psychology in the Schools, 49(6), 511–525.

    Google Scholar 

  • Angold, A., & Egger, H. L. (2007). Preschool psychopathology: Lessons for the lifespan. Journal of Child Psychology and Psychiatry, 48, 961–966.

    PubMed  Google Scholar 

  • Bekle, B. (2004). Knowledge and attitudes about attention-deficit hyperactivity disorder (ADHD): A comparison between practicing teachers and undergraduate education students. Journal of Attention Disorders, 7(3), 151–160.

    PubMed  Google Scholar 

  • Bennett, D. S., Power, T. J., Rostain, A. L., & Carr, D. E. (1996). Parent acceptability and feasibility of ADHD interventions: Assessment, correlates, and predictive validity. Journal of Pediatric Psychology, 21(5), 643–657.

    PubMed  Google Scholar 

  • Biederman, J., Faraone, S. V., Spencer, T. J., Mick, E., Monuteaux, M. C., & Aleardi, M. (2006). Functional impairments in adults with self-reports of diagnosed ADHD: A controlled study of 1001 adults in the community. Journal of Clinical Psychiatry, 67(4), 524–540.

    Google Scholar 

  • Borko, H., & Putnam, R. (1995). Expanding a teacher’s knowledge base: A cognitive psychological perspective on professional development. In T. R. Guskey & M. Huberman (Eds.), Professional development in education: New paradigms and practices (pp. 35–65). New York: Teacher College Press.

    Google Scholar 

  • Burchinal, M. R., Peisner-Feinberg, E., Pianta, R., & Howes, C. (2002). Development of academic skills from preschool through second grade: Family and classroom predictors of developmental trajectories. Journal of School Psychology, 40(5), 415–436.

    Google Scholar 

  • Campbell, S. B., & Ewing, L. J. (1990). Follow-up of hard to manage preschoolers: Adjustment at age 9 and predictors of continuing symptoms. Journal of Child Psychology and Psychiatry, 31, 871–889.

    PubMed  Google Scholar 

  • Cohen, J. E. (1988). Statistical power analysis for the behavioral sciences. Hillsdale, NJ: Lawrence Erlbaum Associates Inc.

    Google Scholar 

  • Coles, E. K., Owens, J. S., Serrano, V. J., Slavec, J., & Evans, S. W. (2015). From consultation to student outcomes: The role of teacher knowledge, skills, and beliefs in increasing integrity in classroom management strategies. School Mental Health, 7, 34–48.

    Google Scholar 

  • Cornett-Ruiz, S., & Hendricks, B. (1993). Effects of labeling and ADHD behaviors on peer and teacher judgments. Journal of Educational Research, 86, 349–355.

    Google Scholar 

  • Domitrovich, C. E., Bradshaw, C. P., Poduska, J. M., Hoagwood, K., Buckley, J. A., Olin, S., et al. (2008). Maximizing the implementation quality of evidence-based preventive interventions in schools: A conceptual framework. Advances in School Mental Health Promotion, 1, 6–28.

    PubMed  PubMed Central  Google Scholar 

  • DuPaul, G. J., & Kern, L. (2011). Young children with ADHD: Early identification and intervention. Washington D.C: American Psychological Association.

    Google Scholar 

  • Durlak, J. A., & DuPre, E. P. (2008). Implementation matters: A review of research on the influence of implementation on program outcomes and the factors affecting implementation. American Journal of Community Psychology, 41, 327–350.

    PubMed  Google Scholar 

  • Egger, H. L., & Angold, A. (2006). Common emotional and behavioral disorders in preschool children: Presentation, nosology, and epidemiology. Journal of Child Psychology and Psychiatry, 47(3), 313–337.

    PubMed  Google Scholar 

  • Evans, S. W., Owens, J. S., & Bunford, N. (2014). Evidence-based psychosocial treatments for children and adolescents with Attention-Deficit/Hyperactivity Disorder. Journal of Clinical Child and Adolescent Psychology, 43(4), 527–551. https://doi.org/10.1080/15374416.2013.850700.

    Article  PubMed  Google Scholar 

  • Evans, S. W., Owens, J. S., Wymbs, B. T., & Ray, A. R. (2018). Evidence-based psychosocial treatments for children and adolescents with Attention-Deficit/Hyperactivity Disorder. Journal of Clinical Child and Adolescent Psychology, 47(2), 157–198.

    PubMed  Google Scholar 

  • Fabiano, G. A., Pelham, W. E., Waschbusch, D. A., Gnagy, E. M., Lahey, B. B., Chronis, A. M., et al. (2006). A practical measure of impairment: Psychometric properties of the impairment rating scale in samples of children with attention deficit hyperactivity disorder and two school-based samples. Journal of Clinical Child and Adolescent Psychology, 35, 369–385.

    PubMed  Google Scholar 

  • Gadow, K. D., DeVincent, C. J., Pomeroy, J., & Azizian, A. (2004). Psychiatric symptoms in preschool children with PDD and clinic and comparison samples. Journal of Autism and Developmental Disorders, 34(4), 379–393.

    PubMed  Google Scholar 

  • Gilliam, W. S. (2005). Prekindergarteners left behind: Expulsion rates in state prekindergarten systems. New Haven, CT: Yale University Child Study Center.

    Google Scholar 

  • Gilliam, W. S., Maupin, A. N., Reyes, C. R., Accavitti, M., & Shic, F. (2016). Do early educators’ implicit biases regarding sex and race relate to behavior expectations and recommendations of preschool expulsions and suspensions? Yale Child Study Center.

  • Graziano, P. A., Slavec, J., Hart, K., Garcia, A., & Pelham, W. E., Jr. (2014). Improving school readiness in preschoolers with behavior problems: Results from a summer treatment program. Journal of Psychopathology and Behavioral Assessment, 36(4), 555–569.

    Google Scholar 

  • Greene, R., Beszterczey, S. K., Katzenstein, T., Park, K., & Goring, J. (2002). Are students with ADHD more stressful to teach? Patterns of teacher stress in an elementary school sample. Journal of Emotional and Behavioral Disorders, 10, 79–89.

    Google Scholar 

  • Gutman, L. M., Sameroff, A. J., & Cole, R. (2003). Academic growth curve trajectories from 1st grade to 12th grade: Effects of multiple social risk factors and preschool child factors. Developmental Psychopathology, 39(4), 777–790.

    Google Scholar 

  • Hamre, B. K., & Pianta, R. C. (2001). Early teacher-child relationships and the trajectory of children’s school outcomes through eighth grade. Child Development, 72(2), 625–638.

    PubMed  Google Scholar 

  • Han, S., & Weiss, B. (2005). Sustainability of teacher implementation of school-based mental health programs. Journal of Abnormal Child Psychology, 33, 665–679.

    PubMed  Google Scholar 

  • Heckman, J. J. (2000). Policies to foster human capital. Research in economics, 54(1), 3–56.

    Google Scholar 

  • Jerome, L., Washington, P., Laine, C. J., & Segal, A. (1999). Graduating teachers’ knowledge and attitudes about attention-deficit hyperactivity disorder: A comparison with practicing teachers. The Canadian Journal of Psychiatry, 11(1), 35–74.

    Google Scholar 

  • Kos, J. M., Richdale, A. L., & Hay, D. A. (2006). Children with attention deficit hyperactivity disorder and their teachers: A review of the literature. International Journal of Disability, Development, and Education, 53(2), 147–160.

    Google Scholar 

  • Kos, J. M., Richdale, A. L., & Jackson, M. S. (2004). Knowledge about attention deficit/hyperactivity disorder: A comparison of in-service and preservice teachers. Psychology in the Schools, 41(5), 517–526.

    Google Scholar 

  • Lai, K. (2018). Estimating standardized SEM parameters given nonnormal data and incorrect model: Methods and comparison. Structural Equation Modeling: A Multidisciplinary Journal, 25(4), 600–620.

    Google Scholar 

  • Lavigne, J. V., LeBailly, S. A., Hopkins, J., Gouze, K. R., & Binns, H. J. (2009). The prevalence of ADHD, ODD, depression, and anxiety in a community sample of 4-year-olds. Journal of Clinical Child and Adolescent Psychology, 38(3), 315–328.

    PubMed  Google Scholar 

  • Martinussen, R., Tannock, R., & Chaban, P. (2011). Teachers’ reported use of instructional and behavior management practices for students with behavior problems: Relationship to role and level of training in ADHD. Child & Youth Care Forum, 40(3), 193–210.

    Google Scholar 

  • Massetti, G. M., Lahey, B. B., Pelham, W. E., Loney, J., Ehrhardt, A., Lee, S. S., et al. (2008). Academic achievement over 8 years among children who met modified criteria for attention deficit/hyperactivity disorder at 4–6 years of age. Journal of Abnormal Child Psychology, 36, 399–410.

    PubMed  Google Scholar 

  • McClelland, M. M., Cameron, C. E., Connor, C. M., Farris, C. L., Jewkes, A. M., & Morrison, F. J. (2007). Links between behavioral regulation and preschoolers’ literacy, vocabulary and math skills. Developmental Psychology, 43, 947–959.

    PubMed  Google Scholar 

  • McGoey, K. E., Eckert, T. L., & DuPaul, G. J. (2002). Early intervention for preschool-age children with ADHD: A literature review. Journal of Emotional and Behavioral Disorders, 10(1), 14–28.

    Google Scholar 

  • Mistry, R. S., Biesanz, J. C., Chien, N., Howes, C., & Benner, A. D. (2008). Socioeconomic status, parental investments, and the cognitive and behavioral outcomes of low-income children from immigrant and native households. Early Childhood Research Quarterly, 23(2), 193–212.

    Google Scholar 

  • Molina, B. S. G., & Pelham, W. E. (2003). Childhood predictors of adolescent substance use in a longitudinal study of children with ADHD. Journal of Abnormal Psychology, 112, 497–507.

    PubMed  Google Scholar 

  • Muthén, L. K., & Muthén, B. O. (1998–2010). Mplus user’s guide (6th ed.) Los Angeles, CA: Muthén & Muthén.

  • Noell, G., Witt, J., Gilbertson, D., Ranier, D., & Freeland, J. (1997). Increasing teacher intervention implementation in general education settings through consultation and performance feedback. School Psychology Quarterly, 12, 77–88.

    Google Scholar 

  • Ohan, J. L., Cormier, N., Hepp, S. L., Visser, T. A. W., & Strain, M. C. (2008). Does knowledge about attention-deficit/hyperactivity disorder impact teachers’ reported behaviors and perceptions? School Psychology Quarterly, 23(3), 436–449.

    Google Scholar 

  • Ohan, J. L., Visser, T. A. W., Strain, M. C., & Allen, L. (2011). Teachers’ and education students’ perceptions of and reactions to children with and without the diagnostic label “ADHD”. Journal of School Psychology, 49, 81–105.

    PubMed  Google Scholar 

  • Owens, J. S., Coles, E. K., Evans, S. W., Hiawan, L. K., Girio-Herrera, E., Holdaway, A. S., et al. (2017). Using multi-component consultation to increase the integrity with which teachers implement behavioral classroom interventions: A pilot study. School Mental Health, 9, 218–234.

    Google Scholar 

  • Owens, J. S., Evans, S. W., Coles, E. K., Holdaway, A. S., Himawan, L. K., Mixon, C. S., et al. (2020). Consultation for classroom management and targeted interventions: Examining benchmarks for teacher practices that produce desired change in student behavior. Journal of Emotional and Behavioral Disorders, 28(1), 52–64.

    Google Scholar 

  • Owens, J. S., Holdaway, A. S., Zoromski, A. K., Evans, S. W., Himawan, L. K., Girio-Herrera, E., et al. (2012). Incremental benefits of a daily report card intervention over time for youth with disruptive behavior. Behavior Therapy, 43, 848–861.

    PubMed  Google Scholar 

  • Pelham, W. E., & Fabiano, G. A. (2008). Evidence-based psychosocial treatments for attention deficit/hyperactivity disorder. Journal of Clinical Child and Adolescent Psychology, 37, 184–214.

    PubMed  Google Scholar 

  • Pelham, W. E., Fabiano, G. A., & Massetti, G. M. (2005). Evidence-based assessment of attention deficit hyperactivity disorder in children and adolescents. Journal of Clinical Child & Adolescent Psychology, 34(3), 449–476.

    Google Scholar 

  • Poznanski, B., Hart, K.C., & Cramer, L. (2018). Are teachers ready? Preservice teacher knowledge of classroom management and ADHD. School Mental Health.

  • Redden, S. C., Forness, S. R., Ramey, C. T., Ramey, S. L., Brezausek, C. M., & Kavale, K. A. (2003). HS children with a putative diagnosis of ADHD: A four-year follow-up of special education placement. Education & Treatment of Children, 26, 208–223.

    Google Scholar 

  • Reinke, W. M., Stormont, M., Herman, K. C., Puri, R., & Goel, N. (2011). Supporting children’s mental health in schools: Teacher perceptions of needs, roles, and barriers. School Psychology Quarterly, 26(1), 1–13.

    Google Scholar 

  • Reynolds, C. R., & Kamphaus, R. W. (2004). Behavior assessment system for children (2nd ed.). Circle Pines, MN: American Guidance Service.

    Google Scholar 

  • Rimm-Kaufman, S. E., & Pianta, R. C. (2000). An ecological perspective on the transition to kindergarten: A theoretical framework to guide empirical research. Journal of Applied Developmental Psychology, 21(5), 491–511.

    Google Scholar 

  • Ros, R., & Graziano, P. A. (2017). Social functioning in children with or at risk for attention-deficit/hyperactivity disorder: A meta-analytic review. Journal of Clinical Child and Adolescent Psychology, 47(2), 213–235.

    PubMed  Google Scholar 

  • Rostain, A., Power, T., & Atkins, M. (1993). Assessing parents’ willingness to pursue treatment for children with attention-deficit hyperactivity disorder. Journal of the American Academy of Child and Adolescent Psychiatry, 32, 175–181.

    PubMed  Google Scholar 

  • Rushton, S., Giallo, R., & Efron, D. (2020). ADHD and emotional engagement with school in the primary years: Investigating the role of student-teacher relationships. British Journal of Educational Psychology, 90, 193–209.

    Google Scholar 

  • Ryan, C.L., & Bauman, K. (2016). Educational attainment in the United States: 2015. U.S. Census Bureau.

  • Sanetti, L. M. H., & Kratochwill, T. R. (2009). Treatment integrity assessment in the schools: An evaluation of the treatment integrity planning protocol. School Psychology Quarterly, 24, 24.

    Google Scholar 

  • Sciutto, M. J., Terjesen, M. D., & Bender-Frank, A. S. (2000). Teachers’ knowledge and misperceptions of attention-deficit/hyperactivity disorder. Psychology in the Schools, 37(2), 115–122.

    Google Scholar 

  • Shaw, D. S., & Gilliam, M. (2017). Early childhood predictors of low-income boys’ pathways to antisocial behavior in childhood, adolescence, and early adulthood. Infant Mental Health Journal, 38(1), 68–82.

    PubMed  Google Scholar 

  • Stormont, M., & Stebbins, M. S. (2005). Preschool teachers’ knowledge, opinions, and educational experiences with attention deficit/hyperactivity disorder. Teacher Education and Special Education, 28(1), 52–61.

    Google Scholar 

  • Stuart, G. W., Tondora, J., & Hoge, M. A. (2004). Evidence-based teaching practice: Implications for behavioral health. Administration and Policy in Mental Health, 32(2), 107–130.

    PubMed  Google Scholar 

  • U.S. Department of Labor, Bureau of Labor Statistics. (2019). Occupational outlook handbook. Preschool Teachers.

  • Volpe, R., & Fabiano, G. A. (2013). Daily behavior report cards: An evidence-based system of assessment and intervention. New York: The Guilford Press.

    Google Scholar 

  • Watson, D., Clark, L. A., Chmielewski, M., & Kotov, R. (2013). The value of suppressor effects in explicating the construct validity of symptom measures. Psychological Assessment, 25(3), 929–941.

    PubMed  PubMed Central  Google Scholar 

  • Webster-Stratton, C., Reid, M. J., & Beauchaine, T. P. (2013). One-year follow-up of combined parent and child intervention for young children with ADHD. Journal of Clinical Child & Adolescent Psychology, 42(2), 251–261.

    Google Scholar 

  • Wichstrom, L., Berg-Nielsen, T. S., Angold, A., Egger, H. L., Solheim, E., & Sveen, T. H. (2011). Prevalence of psychiatric disorders in preschoolers. The Journal of Child Psychology and Psychiatry, 53(6), 695–705. https://doi.org/10.1111/j.1469-7610.2011.02.

    Article  PubMed  Google Scholar 

Download references

Funding

The research reported here was supported by the Institute of Education Sciences, U.S. Department of Education, through Grant R324A120136, as well as a local grant from The Children’s Trust. The opinions expressed are those of the authors and do not represent the views of the Institute, the U.S. Department of Education, or The Children’s Trust.

Author information

Authors and Affiliations

  1. The School READY Lab, Center for Children and Families, Department of Psychology, Florida International University, 11200 S.W. 8th Street, Miami, FL, 33199, USA

    Bridget Poznanski, Katie C. Hart & Paulo A. Graziano

Authors
  1. Bridget Poznanski
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Katie C. Hart
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Paulo A. Graziano
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Bridget Poznanski.

Ethics declarations

Conflict of interest

Bridget Poznanski declares that she has no conflicts of interest. Katie C. Hart declares that she has no conflicts of interest. Paulo A. Graziano declares that he has no conflicts of interest.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Poznanski, B., Hart, K.C. & Graziano, P.A. What Do Preschool Teachers Know About Attention-Deficit/Hyperactivity Disorder (ADHD) and Does It Impact Ratings of Child Impairment?. School Mental Health 13, 114–128 (2021). https://doi.org/10.1007/s12310-020-09395-6

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12310-020-09395-6

Keywords

Search

Navigation