Is ADHD a ‘real’ disorder?

In many western countries, attention deficit hyperactivity disorder (ADHD) has achieved celebrity status, such that it probably no longer requires introduction. The disorder is a global phenomenon, spreading rapidly as result of the increasing dominance internationally of US psychiatric models, the need for new markets for major pharmaceutical companies, increasing use of the internet by parents and professionals and changing approaches to schooling. There is a broad consensus among international experts and organisations that ADHD is a genuine neurodevelopmental disorder based on empirical research. However, many critics have questioned the legitimacy of ADHD. This paper reviews the arguments for and against the ADHD construct. First, the review examines the literature and research endorsing ADHD as a ‘real’ disorder. Second, the criticisms levelled against the ADHD construct are examined.     

Knowledge and attitudes towards attention-deficit hyperactivity disorder (ADHD): a comparison of teachers and teaching assistants

ABSTRACT

Attention-deficit hyperactivity disorder (ADHD) rates in classrooms have increased considerably in recent years. Previous literature has acknowledged the significance of teachers’ knowledge and attitudes towards ADHD when making referral and intervention decisions. Using Mulholland, Cumming and Jung’s (2015) knowledge (SASK) and attitude (SASA) scales, ADHD training and perceived support were compared across public school teachers (n = 165) and teaching assistants (TAs) (n = 157) in the UK. Results indicated that teachers and TAs displayed adequate levels of knowledge, and TAs held better knowledge and more positive feelings towards ADHD than teachers. Training increased knowledge for TAs, but not for teachers, and training and support appeared important for both the teachers and TAs’ attitudes. Both teachers and TAs reported inadequate training and expressed a desire for further ADHD training, and a significant association was found between knowledge and attitudes for teachers only. The implications for these findings are discussed.     

Knowledge and Misperceptions about Attention Deficit Hyperactivity Disorder (ADHD) Among School Teachers in Mumbai,India

Teachers play an important role in the diagnosis and management of Attention Deficit Hyperactivity Disorder (ADHD). There are no published studies on Indian teachers’ knowledge of ADHD. In the present study, the aim was to assess knowledge and misperceptions about ADHD among schoolteachers in Mumbai. A total of 106 teachers from 12 English-medium schools completed the Knowledge of Attention Deficit Disorders Scale and a demographic questionnaire. Overall, the teachers lacked adequate knowledge of ADHD, with only 49% of the responses being correct. Repeated measures ANOVA results indicated that the teachers’ scores on the three subscales of the measure were significantly different (F = 7.96, p < .01), with the score being highest on the symptoms subscale. In conclusion, teachers in Mumbai need training on general information and treatment of ADHD, with a focus on correcting common misperceptions that they have with regards to ADHD.     

Doctors diagnose,teachers label: the unexpected in pre-service teachers’ talk about labelling children with ADHD

A study in an Australian university investigated 150 pre-service teachers’ responses to and participation in discourses of attention deficit hyperactivity disorder (ADHD). Interesting data surfaced around the notion of ‘labelling’ children with ADHD. It seemed that the pre-service teachers did not believe ‘ADHD’ to be a label. Whilst the literature reviewed acknowledged diagnosing a child with ADHD to be tantamount to labelling (that is, ‘ADHD’ is a medical diagnostic label), the pre-service teachers in this study differentiated diagnosis from labelling and cast labelling as occurring in the classroom sometime pre- or post- diagnosis. Speaking of diagnosis and labelling in this way re-defines an object of dominant labelling discourse: ‘doctor as labeller’ is replaced with notions of ‘teacher as labeller’. Using Foucault’s ‘rules of discursive formations’ to frame its analysis, this study pondered the pre-service teachers’ conceptions of labelling and in doing so revealed a ‘teacher as labeller’ discursive formation. This article provides examples of how this discursive formation features in pre-service teachers’ talk and outlines an important implication of the ‘teacher as labeller’ discursive formation, namely that it enables teachers to cement their role in the ADHD medical diagnostic apparatus.     

The antithesis of inclusion? The emergence and functioning of ADHD special education classes in the Swedish school system

The neuropsychiatric paradigm has substantial impact on schools. The increase in the number of pupils being diagnosed with attention-deficit/hyperactivity disorder (ADHD) is an expression of the medicalisation of deviance. There is also an increase in educational classes specially designed to meet the needs of children with ADHD. This is contrary to the notion of inclusion and in conflict with the Swedish school law. Thus, it is important to obtain knowledge about Swedish ADHD classes. A questionnaire was sent to all Swedish municipalities (290, response rate 76%) regarding schooling for pupils with ADHD. As many as 40 Swedish municipalities have classes specifically designed for pupils with ADHD. Although the classes are said to be specifically designed for ADHD problems, they are not properly evaluated. Municipalities with ADHD classes also exhibit ambivalence towards these classes. The emergence, prevalence and functioning of the ADHD classes are discussed in light of the notion of inclusive education.     

What knowledge and conceptions do Irish primary schoolteachers hold on attention deficit hyperactivity disorder?

Attention deficit hyperactivity disorder (ADHD) diagnosis rates have increased significantly in recent times. A teacher's role is crucial in determining if a child will be referred for an ADHD assessment. Teachers' opinions and observations are also required for and play a huge role in the actual assessment process. For this reason, their knowledge of ADHD is also an important part of this process. This research has measured, on a small scale, Irish primary schoolteacher's knowledge and conceptions about ADHD using the Knowledge of Attention Deficit Disorders Scale (KADDS) questionnaire. Ninety teachers participated in the research from 11 primary schools in County Clare. A quantitative method was utilised enabling the research to be comparable with other pieces of research using the same questionnaire. Data in relation to the teachers' professional background were also gathered in order to analyse significant differences based on a variety of factors. The results were analysed as prescribed in KADDS test manual using the statistical software package SPSS. This research shows that Irish primary schoolteachers are more knowledgeable in regards to ADHD symptoms and diagnosis than they are in the areas of associated features or treatments. It also shows that knowledge levels of Irish primary schoolteachers are higher than teachers in earlier research using the same questionnaire.     

Knowledge about Attention‐Deficit/Hyperactivity Disorder: A comparison of in‐service and preservice teachers

Attention‐Deficit/Hyperactivity Disorder (ADHD) is a common childhood disorder, yet relatively little research has assessed teachers' knowledge of this disorder or how teacher characteristics affect such knowledge. There also is a dearth of research comparing in‐service and preservice teachers' knowledge about ADHD. The aims of this study were (a) to investigate the relationships between various teacher characteristics and teachers' knowledge about ADHD, and (b) to compare perceived and actual ADHD knowledge across in‐service and preservice primary‐school teachers. Participants included 120 primary‐school teachers and 45 final‐year education undergraduates who were asked to complete a questionnaire. Two of the five hypotheses were supported: (a) that knowledge would be significantly correlated with experience in teaching a child with ADHD and (b) that in‐service teachers would obtain higher scores than preservice teachers on the actual knowledge (about ADHD) questionnaire. Implications stemming from this research include ensuring that teachers receive more training about ADHD and greater exposure to students with ADHD in the classroom. Overall, this study highlighted that deficits in teachers' knowledge about ADHD are common for both in‐service and preservice teachers. © 2004 Wiley Periodicals, Inc. Psychol Schs 41: 517–526, 2004.     

The term comorbidity is of questionable value in reference to developmental disorders: data and theory

Over the last decade, there has been an enormous increase in the number of studies evaluating the overlap of developmental syndromes or disorders in both children and adults. This overlap of symptoms is often referred to as comorbidity, a term we criticize in this article because of its unsubstantiated presumption of independent etiologies. The premise of this article is that discrete categories do not exist in real life, and that it is misleading to refer to overlapping categories or symptoms as "comorbidities." We illustrate our point by presenting data from 179 school-age children evaluated with rigorous research criteria for seven disorders: reading disability (RD), attention-deficit/hyperactivity disorder (ADHD), developmental coordination disorder (DCD), oppositional defiant disorder (ODD), conduct disorder (CD), depression, and anxiety. Fully 50% of this sample met the criteria for at least two diagnoses. The children with ADHD were at higher risk of having at least a second disorder compared to the children with RD. Overall, the high rates of overlap of these behavioral, emotional, and educational deficits in this broadly ascertained sample support the idea that the concept of comorbidity is inadequate. We discuss the concept of atypical brain development as an explanatory idea to interpret the high rate of overlap of developmental disorders.     

A Design Thinking Model Based on Quantitative Electroencephalography in Social Emotional Learning for Attention Deficit Hyperactivity Disorder

To design a social and emotional learning (SEL) skills training program for children with attention deficit hyperactivity disorder (ADHD). Quantitative electroencephalography was analyzed, focusing on the strengths and weaknesses in the brain mapping performance (BMP) of children. A total of 305 participants with and without ADHD were recruited. Theta relative power was analyzed using stepwise multiple regression. Twelve brain locations were further predicted using a design thinking model to develop a reasonable prototype via crossover methods. Both strengths and weaknesses were found at the T5 and F7 brain regions in the ADHD group. The Fz region was a well‐defined predictor in both groups. The co‐predictors of both groups were F3 and F4. No comparison was suggested to enhance positive performance in either group of children. The SEL program could be designed based on a good‐fit model of the BMP of these subcomponents of primary brain functions.     

The internal restlessness scale: performance of college students with and without ADHD

Attention-deficit/hyperactivity disorder (ADHD) was previously believed to be a disorder of childhood, with symptoms attenuating at the onset of puberty. Follow-up studies, however, suggest that the majority of children with ADHD continue to manifest symptoms into adulthood. Although the inattention components associated with ADHD persist into adulthood, the nature of the hyperactivity component is less well understood. For example, according to criteria established by the Diagnostic and Statistical Manual of Mental Disorders, fourth edition, hyperactivity in adolescents and adults may be limited to subjective feelings of restlessness. Recent studies with adults with ADHD have also reported that mental restlessness is commonly reported by individuals with the disorder. To better understand this characteristic of ADHD, the Internal Restlessness Scale (IRS) was developed. The results of the IRS suggest that (a) college students with ADHD report significantly higher ratings of internal restlessness than college students without ADHD, and (b) the IRS appears to have adequate test-retest reliability and a four-factor structure. Implications and suggestions for future research are discussed.     

(Un)becoming dysfunctional: ADHD and how matter comes to matter

Various neuropsychiatric disorders are a common feature today, not least in educational contexts where Attention Deficit Hyperactivity Disorder (ADHD) is a common diagnosis. The dominant perspective regarding ADHD is biomedical. This perspective has been questioned and challenged in various ways. The aim of this article is to think ADHD through quantum physicist and philosopher Karen Barad’s [Barad, K. 2007. Meeting the Universe Halfway: Quantum Physics and the Entanglement of Matter and Meaning. Durham, NC: Duke University Press.] theory of agential realism. According to Barad, what we perceive as singular entities do not exist in advance. Barad pays attention to the world’s entanglements, and what we perceive as singular objects and subjects are effects of specific and various material-discursive practices acting as agential cuts. The theory of agential realism assigns performativity to matter, which highlights that ADHD is something that continuously comes into being together with human and non-human bodies. The material dimension has not previously been emphasised as a causal factor in studies on ADHD. In this article, the focus is on the agency of the book. As a conclusion, the importance of taking responsibility for every material-discursive practice with which we are always entangled is emphasised.     

An analysis of the discourses on attention deficit hyperactivity disorder (ADHD) in US special education textbooks,with implications for inclusive education

The purpose of this paper is to examine the discourses on attention deficit hyperactivity disorder (ADHD) found in textbooks used in pre-service special education programmes in the USA. Five textbooks are examined with the intent of discovering how ADHD is portrayed to future teachers. A discourse analysis framework is utilised, revealing five categories that structure the discourses of textbooks: definition, causes, symptoms, characteristics, and treatment. Examples of each are provided, followed by a critical analysis of the underlying meanings and assumptions. The analysis reveals an overwhelmingly medicalised narrative in which children diagnosed with ADHD are presented as inherently dysfunctional and devoid of positive characteristics. Two implications of this analysis are suggested: (1) teachers are likely to limit their pedagogical responses to these children in favour of relying upon medical knowledge and (2) teachers are apt to construct policy that is inconsistent with the goal of inclusive education to embrace diversity in the classroom. Lastly, the importance of exposing pre-service teachers to an alternative discourse on ADHD is discussed.     

Attention‐Deficit/Hyperactivity Disorder (ADHD): A national survey of training and current assessment practices in the schools

The primary purpose of this research was to survey school psychologists to investigate their training and current assessment practices for attention‐deficit/hyperactivity disorder (ADHD) in the schools. The survey consisted of 38 questions regarding participant characteristics and three main areas relevant to ADHD: (a) training, (b) caseloads/referral patterns, and (c) assessment. The respondents reported receiving adequate training in the assessment of ADHD, with doctorate‐level psychologists self‐reporting being better trained than nondoctorate psychologists. Results confirmed a substantial caseload of ADHD referrals. In the assessment of ADHD, the results indicated school psychologists are using multiple informants, methods, and settings for the assessment of ADHD with rating scales, observations, and interviews the most common methods identified. Limitations of current practices will be discussed. © 2003 Wiley Periodicals, Inc. Psychol Schs 40: 583–597, 2003.     

Comparison of Quebec and British teachers' beliefs about,training in and experience with attention deficit hyperactivity disorder

Abstract

This study compares belief patterns of teachers from Quebec and Britain about attention deficit hyperactivity disorder (ADHD). It also compares teacher training in ADHD in both countries, as well as their experience with students who have this disorder. The results indicate that: (1) teacher belief patterns about ADHD in Quebec and Britain are different, although teachers from both countries have predominant beliefs about ADHD that are of an allopathic medical nature; (2) British teachers have received less information on ADHD in their initial training than Quebec teachers; and (3) British teachers are contacted more often than Quebec teachers by doctors when they have a youngster using medication to treat ADHD in their classroom. Results are discussed from a sociological and an educational perspective.     

Using a collaborative working group model to develop an ADHD resource for school staff

Inclusive education for children with attention deficit hyperactivity disorder (ADHD) presents challenges for school staff and professional development is lacking. Training is not always available when needed, strategies suggested by external experts can be impractical and staff lack autonomy in choosing the best way of being resourced. Additionally, the experience and knowledge of the range of school staff is not utilised. A collaborative working group of school staff and a researcher explored an alternative method of ADHD resourcing. Co-construction of knowledge defines how the group discursively identified actionable knowledge from the different perspectives and knowledge brought by individual group members. A systemic framework was used to critically reflect on the collaboration. The framework enabled reflection on four areas to understand how and why the collaboration led to a published web-based school staff ADHD resource. Firstly, starting conditions and assumptions were considered to identify and articulate the rationale for the resource. Secondly, the context and system dynamics enabled consideration of the socio-cultural and political landscape of the project and the impact of COVID-19. Thirdly, the different voices of participants and power dynamics were reflected on. Finally, emergence was a frame in which to elucidate knowledge production and changes in practice. The collaborative working group addressed the research–practice gap and the need for diversity of voices to be heard across the school. Knowledge co-construction positions staff as knowledge bearers and, together with different forms of knowledge, they can be empowered to create new, contextualised evidence-based knowledge.     

A contemporary review of the assessment,diagnosis and treatment of ADHD

Attention-deficit/hyperactivity disorder (ADHD) is a neuro-behavioural disorder that presents frequently in paediatric and mental health settings. Children with ADHD present with symptoms of hyperactivity, inattention, distractibility and impulsivity. The purpose of this paper is to provide clinicians with a summary of contemporary issues relevant to their clinical understanding, assessment, diagnosis and treatment of the disorder. Issues discussed include the primary and secondary symptoms of the disorder, developmental course, underlying causes, recognition in a clinical setting, diagnosis and treatment.