teachers’ knowledge, beliefs, and values about children with adhd judy a. liesveld august 16, 2007
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Teachers’ Knowledge, Beliefs, and Values about
Children with ADHD
Judy A. Liesveld
August 16, 2007
Background for the Study
ADHD is a complex disorder with neurological and genetic factors comprising a sound but still unproven explanation for the cause (Anastopoulos & Shelton, 2001; Biederman & Faraone, 2005).
ADHD has profound effects at the individual, family, school, and societal levels (Chan et al., 2002; Kendall, 1998; Kendall et al., 2003; Leibson et al., 2001).
Why Teachers are Important
Most elementary school classrooms have at least one child with ADHD (Barkley, 1998).
ADHD viewed as a medicalized phenomenon (Conrad, 1992).
“Medical gaze” (Foucault, 1976) partially transferred to teachers
Why Teachers are Important (Continued)
A high percentage of children referred for ADHD evaluations are first identified by teachers (Pilling, 2000).
Teachers are asked to complete rating scales or questionnaires regarding symptoms.Teachers are asked to carry out recommended treatment regimens or to monitor effectiveness of treatment (Tannock & Martinussen, 2001).
The Albuquerque JournalMarch 22, 2007, Page A1
Purpose of the Study
The purpose of the study was to sequentially determine elementary teachers’ knowledge regarding ADHD and to then explore teachers’ beliefs and values vis-à-vis knowledge regarding children with ADHD and treatment practices.
Quantitative Research Questions
What do teachers know about ADHD?
How do teachers rate their knowledge about ADHD?
How does age, gender, ethnicity, number of teaching years, past ADHD training, and number of children taught with ADHD affect teachers’ knowledge about ADHD?
Qualitative Research QuestionsWhat are elementary school teachers’ beliefs and values regarding children with ADHD?How do school environments influence teachers’ knowledge, beliefs, and values regarding children with ADHD?What are their beliefs and values regarding treatment practices for children with ADHD? How do teachers think that their cultural beliefs and values influence their actions taken in working with children with ADHD?
Combining Quantitative and Qualitative Data
Does knowledge about ADHD influence teachers’ beliefs and values about ADHD and if so, how?
Methodology
quantitative: KADDS, visual analog,demographic information
qualitative: group interviews, field notes
Qualitative: Individual interviews, participant observations, documentary evidence, field notes
concurrentsequential
Study Design
Ethnographic Paradigm
The upper/lower case notations of “q” indicate the majorand minor methods of data collection and analysis in thestudy design sequence (Morse, 2003).
Data Collection Strategies
The Knowledge of Attention Deficit Disorders Scale (KADDS)—criterion based tool (reliability .82 to .90).
Demographic Questionnaire
Visual Analog Tool
Group Interviews and Individual Interviews
Field Notes
Setting for the Study
Gallup McKinley County School District
(2nd largest geographical school district in US in the 3rd poorest county in the US)
Nine elementary schools participated.
Demographics of the Sample133 teachers completed the KADDS, demographic questions and VAS; 4 group interviews with 28 teachers; 5 high KADDS and 3 low KADDS individual interviews80% Female. Ages ranged from 22 to 72 (M = 44.00, SD = 12.43).80% White, 8% American Indian, 7% Hispanic, 2% Asian, 1% African American, 2% Unreported.Years taught: 1 to 39 (M = 12.50, SD = 9.47)Standard Licensure (82%), Alternative (13%), and (5%) unreported.
Experience with ADHD
Percentages for Categorical Variables Measuring Experiences with ADHD (N = 133)
Currently Teaching Child with ADHD
40n = 53
58n = 77
2
Any Type of Past Training about ADHD
78 n = 104
20n = 26
2
Past College Courses about ADHD
26 n = 34
73n = 97
1
Workshops about ADHD 34 n = 45
64 n = 85
2
Journals Read about ADHD 69 n = 92
29 n = 38
2
Variable Yes (%) No (%) Missing Data (%)
Have Relative/ Friend with ADHD
45 n = 59
53 n = 71
2
Experience with ADHD (cont.)Means, Standard Deviations, and Ranges for Variables Measuring Experiences with ADHD
Variable M SD Range
Number of Past Taught Children with ADHD
10.1 13.6 0 - 76
Number of Children Currently Taught with ADHD
1.08 2.40 0 - 20
Number of College Courses about ADHD
.30 .627 0 - 3
Number of Workshops/ Conferences about ADHD
.65 1.26 0 – 8
Number of Years Past Taught
12.49 9.47 1 – 38
KADDS ResultsKR-20 Results and Descriptive Statistics for the Knowledge of Attention
Deficit Disorders Scale (N=133)
Scale No. Items M (%) SD KR-20
KADDS
Total 36 59.23 % 17.36 .84
General Information 15 53.13 % 19.42 .70
Symptoms/ Diagnosis 9 68.69 % 17.36 .53
Treatment 12 59.91 % 20.31 .66
General Descriptions and Thoughts about ADHD
‘Hyper’ as catch-all descriptor
Negative descriptors
Gender issues and ADHD
‘Challenging’ for the child’
Negative and positive beliefs about ADHD
Difficulty Recognizing ADHD Symptoms
ADHD or ADD?
Normal development
Co morbidities/Look Alikes
Home versus School Symptoms
Beliefs about Causes of ADHD
ADHD as a biological condition
Parenting style and lack of discipline
Nutrition affecting Behavior
Technology/Fast Society
Beliefs about the Diagnosis
Label of ADHD
Easy label
Over diagnosis
Questioning the diagnosis
Diagnosis as a relief
ADHD as a new phenomenon
ADHD behaviors as a continuum
Teachers’ Values about ADHD
Valuing children
Valuing individuality
Valuing knowledge, education, and research about ADHD
Steps to Help a Child with ADHD
Teachers as gatekeepers (Intentional or unintentional)
Broaching the subject about ADHD with parents
The School Environment and ADHD
A Recipe for DisasterProcess
1. Start with one healthy child.2. Add a heightened sense of test anxiety.3. Trim new schools of excess fat (a.k.a.
recess).4. Whip into a test frenzy.5. Add one scoop of Ritalin.6. Mash a dash of hyper-parenting.7. Pour in a heaping spoonful of NCLB.8. Bring competitive National Test
Scoring to a boil.9. Reduce exercise and joyful emotionally
nourishing play.10. Let simmer until good intensions go
away.11. Let sit perfectly still for 6-5 hours a
day.
Treatment Strategies and ADHDThemes and Sub-themes of Teachers’ Beliefs About ADHD and Treatment Practices
Treatment as Medication Alternative Strategies (“It’s not just the pill.”)
Ritalin not seen as ‘cure all’ Instructional
The amazing Ritalin Environmental
A day without Ritalin Punitive
Concerns with Ritalin Use of coffee
Teachers’ Cultural Beliefs about ADHD
Hyperactivity is normal
Then and Now
Environment and Culture
Teachers Characteristics
The Influence of Knowledge on Beliefs and Values about ADHD
Teachers with higher knowledge seemed to have more positive general beliefs about children with ADHD, had more confidence in the diagnosis, and supported a multimodal approach. They also had more willingness to support the use of stimulant medication in children with ADHD and had flexibility in using various teaching strategies.
Experience Ties Knowledge, Beliefs, and Values Together
Teachers with higher ADHD knowledge were influenced by experiences with ADHD through teaching children with ADHD, through workshops/journals/books, through friends or relatives.Interest and experience fueled the value of acquiring more education and knowledge.Experience and knowledge had an additive quality: Experience promoted knowledge and + beliefs, and in turn, more knowledge stimulated the quest for more experience in teaching children with ADHD.
Creating Niche Valance
The Importance of Partnerships
Child with ADHD: distinct patterns, movements, rhythms, and spatial awareness.
+/-Proxi mal
Processes
Teacher with or without high knowledge and positive beliefs regarding ADHD.
Macrosystem +/- providing support for teachers and multiple ways of learning
=
Stabl e (microsystem) advantaged environment
Enriched classroom/ honoring diversity/ novelty
Low classroom size and time for teacher preparation.
Niche valance +/-
expanding informational capacity of ADHD child
experiencing (+) academic success and school peer relationship.
Fusing Theories/ Ideas (Newman, Brofenbrenner, Agar)
Child/Teacher/Environment Model
Area where reframing and discourse occurs if differences or hidden agendas are present.
Strengths and Limitations of the Research
Emic/Etic views
Mixed Methods: pros and cons
Theory-driven approach: pros and cons
Reliability issues with KADDS subscales
Sampling issues
Timing of the research
Lack of thick description about cultural beliefs
Implications for Future ResearchCreate opportunity for teachers’ experience with children with ADHD.Participatory Action Research: Collaboration, shared ownership, community actionUse of KADDS and demographic tool with larger diversified samples, in other geographic locationsStructural equation modeling to measure relationships between theoretical constructs with models of emergent themes and subthemesMore stories to hear and observations to be made
Questions
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