The Effects of ADHD Teacher Training Programs on Teachers and Pupils: A Systematic Review and Meta-Analysis

Educator Knowledge of Childhood Conduct Problems and Callous-Unemotional Traits

Research evaluating mental health literacy (MHL) of adults who support children with mental health difficulties is relatively scarce. To date, no studies have investigated educator knowledge of conduct problems and callous-unemotional (CU) traits. This is a significant gap in the literature since conduct problems are among the most prevalent childhood mental disorders, while CU traits are associated with poor academic, behavioral, and social outcomes in school settings. In the current study, we assessed educators' knowledge of the characteristics and management of conduct problems and CU traits. Participants were N = 390 preschool and primary/elementary school educators (Mage = 38.62 years, SD = 11.66; 91% woman-identifying; 71% White) who completed a Knowledge Test and survey assessing educator characteristics and various student-educator outcomes. Averaged across items, educators scored 57.1% on the Knowledge Test. We identified gaps in educator knowledge with respect to identifying characteristics associated with distinct domains of externalizing difficulties and evidence-based management strategies. Educators' years of experience and accreditation status were not associated with knowledge. Paraeducators had significantly lower knowledge scores than teachers and leadership. Unexpectedly, greater knowledge was not associated with better student-teacher relationship quality or more positive perceptions of students with conduct problems. Findings support the need for universal MHL programs focused on conduct problems and CU traits, especially among paraeducators, while also suggesting that more intensive interventions may be required to improve educator-student relationship quality.

Assessing adherence and clinical utility of modified goal management training for adolescents with ADHD: A pilot study

Many adolescents with attention-deficit hyperactivity disorder (ADHD) have executive functioning (EF) difficulties that contribute to academic and social-emotional challenges. This pilot explored adherence to and effectiveness of modified Goal Management Training (GMT), an EF intervention, with ADHD youth. Six adolescents with ADHD (14-17 years, 2 female) participated in a 6-session online group. Adherence was tracked via attendance and homework. Reliable change scores gaged pre-post differences on measures before and after training (primary: everyday EF and goal attainment; secondary: EF task performance, functional impairment, emotional adjustment, and self-concept). All youth attended at least 4 sessions, though homework completion was mixed. Four youth achieved their goal, some demonstrated reliable change on outcome measures, and all evidenced a reduction in impairment. Results support the feasibility of modified GMT in adolescents with ADHD and suggest that youth may benefit from this more personalized and holistic approach to EF intervention.

Life Gets Better: Important Resilience Factors When Growing Up With ADHD

OBJECTIVE

To explore emerging adults' descriptions of important resilience factors when growing up with ADHD.

METHOD

Individual interviews with 10 emerging adults (21-24 years) who participated in a 10-year follow-up study, analyzed using thematic analysis.

RESULTS

The main theme was that "life gets better." Resilience factors contributing to this positive development were strategies to regulate ADHD, valuable relationships, acceptance, seeing positive attributes of ADHD, receiving tailored, non-stigmatizing support, and participating in meaningful activities.

CONCLUSION

Growing up with ADHD was associated with both challenges and positives, but the main resilience theme was that life gets better. A variety of resilience factors contributed to this, but relational and environmental factors seemed particularly important. Acceptance, both from society and self-acceptance, were related to all resilience factors in various ways indicating that better knowledge of ADHD might foster better understanding and acceptance of children and adolescents with ADHD.

Pupils' inclusion as a process of narrative interactions: tackling ADHD typification through MADIT methodology

BACKGROUND

ADHD is the most common childhood neurodevelopmental disorder. The symptomatology makes the management of ADHD particularly demanding in school, so teachers' training programs have been widely implemented. Nevertheless, these interventions could lead teachers to concentrate on the dysfunctional elements of these students, exposing them to the risk of stigmatisation. Conceptualising stigma and inclusion as narrative processes, the present study observed how teacher ADHD training texts, endorsed by the Italian government, impact on the inclusion process of students.

METHODS

The research analysed a corpus of N = 31,261 text occurrences and focused on three areas: (1) ADHD as a clinical condition; (2) the impact of ADHD characteristics in the scholastic setting; (3) interventions to manage ADHD criticalities in school settings. To observe the interactive processes fostered by the narratives under scrutiny, we used Dialogic Science and MADIT methodology, since they allow us to measure the language use modalities through an index: the Dialogical Weight (dW). The value of dW ranges between 0.1 (min) and 0.9 (max) and is linked to the potential outcomes of inclusion for students with ADHD. A low dW accounts for narratives entrenched in personal beliefs presented as absolute truths, undermining inclusion of students with ADHD. In contrast, high dW signals language interaction relying on sharable elements, able to foster social unity and diminish stigma.

RESULTS

The results yielded a critical discursive configuration, both in general and for the three distinct areas. We measured an overall Dialogical Weight of 0.4dW and, for the three areas (1) = 0.3dW; (2) = 0.3dW; (3) = 0.4dW. The analysed text does not maximise the triggering of inclusive interactions, as they rely on individual references and present one's narrative as the sole plausible perspective: reinforcing already existing positions and exposing to the risk of stereotyping of the pupils.

CONCLUSIONS

The study highlighted how the ADHD training materials analysed, focusing on a purely informational and clinical approach, lose in effectiveness with respect to generating inclusive school settings. Finally, to promote the inclusion of these pupils, elements are offered for outlining an approach based on fostering active participation by all roles involved.

Use of School-Based Interventions for ADHD, Professional Support, and Burnout Symptoms among Teachers in Iceland

OBJECTIVE

Effective school-based interventions for youth with ADHD are critical to their success. We examined whether teacher application of such interventions and perceptions of professional support related to greater well-being, including fewer burnout symptoms.

METHOD

Teachers in primary schools in Iceland were invited to participate in an online survey, including questions about professional support and the Maslach Burnout Inventory (MBI). The sample comprised N = 592 (88.5% female) participants.

RESULTS

Regression analyses indicated that use of recommended ADHD interventions was positively associated with MBI-Personal Achievement (PA). Greater satisfaction with professional support related to lower MBI-Emotional Exhaustion and MBI-Depersonalization, and higher MBI-PA. Level of professional support was positively associated with use of recommended interventions.

CONCLUSION

Effective interventions and support for students with ADHD may enhance teacher well-being. Icelandic teachers require further training and professional support in best practices for ADHD, to help promote teacher and student success.

Collaboration Between Occupational Therapy Practitioners and Elementary School Educators to Support Students with Attention Deficit Hyperactivity Disorder

AIMS

This study compares experiences of occupational therapy practitioners (OTPs) and other elementary school educators when supporting students with attention deficit hyperactivity disorder (ADHD). The aim is to establish collaborative methods for OTPs and other educators to support students with ADHD. Recommendations to overcome barriers to supporting students with ADHD are made based on study findings and current research.

METHODS

An online survey of OTPs and other educators was conducted. The survey asked about the barriers to supporting elementary students with ADHD, and the training resources that would improve the ability to support students with ADHD.

RESULTS

Responses from 147 OTPs and 35 other educators were compared using two-sample proportion tests. The groups shared common barriers and preferences for training resources, however, statistically significant (p < 0.05) differences were found in; 1) the barrier of limited knowledge and training about ADHD, with other educators being more limited by this barrier; and, 2) the preference for video formatted training, with other educators identifying a higher preference for this option.

CONCLUSIONS

The data suggest that there is an opportunity for OTPs and other educators to collaboratively develop ADHD training videos for all educators to foster the success of elementary students with ADHD.

The Efficacy of Educational Interventions in Improving School Teachers' Knowledge of Attention Deficit Hyperactivity Disorder

BACKGROUND

Well-trained primary school teachers should be competent in recognizing attention deficit hyperactivity disorder (ADHD) in students and be able to assist in providing care and support.

OBJECTIVES

This study intends to assess primary school teachers' knowledge of ADHD and evaluate the effectiveness of a short-term educational intervention.  Methods: A quasi-experimental quantitative study was conducted among primary school teachers in Jazan, Saudi Arabia. A two-hour educational intervention was designed and run in six schools using a specific knowledge rating scale before and after the application of the intervention.  Results: A total of 150 primary school teachers were included in this study, of which 64% were males, 51.3% were in the age group of 40-49 years, and 28% had teaching experience of more than 20 years. Regarding ADHD knowledge, the pre-intervention knowledge of the general criteria, symptoms and diagnosis, and treatment was considered adequate in 3.3%, 16.7%, and 2.7% of the participants, respectively, which improved post-intervention to 22%, 54.7%, and 19.3%, respectively. There was a significant association between the pre-intervention knowledge of the general criteria and the gender and between the knowledge of symptoms and diagnosis and the attendance of ADHD workshop by the participants. Also, there was a significant association between the participants' age, residence experience, attendance of ADHD workshops, and the general criteria and treatment domains.

CONCLUSIONS

 Most primary school teachers in Jazan have insufficient knowledge of ADHD. Using a knowledge improvement intervention can substantially improve the teachers' knowledge. Therefore, it is necessary to incorporate thoughtful knowledge improvement programs into the educational curricula for teachers.

Exploring Teachers' Knowledge and Attitudes Toward Attention Deficit Hyperactivity Disorder and Its Treatment in a District of Turkey

Background Teachers are pivotal in integrating children with attention deficit hyperactivity disorder (ADHD) into academic and social contexts. Their comprehension of and attitudes toward ADHD significantly influence the inclusion of these children. This study was conducted to assess teachers' knowledge, attitudes, and perceptions about ADHD and its treatment within a representative sample from Turkey. Methods An online self-administered questionnaire was formulated to gauge teachers' knowledge, attitudes, and perceptions related to ADHD and its treatment. Results Of the respondents, 57.7% accurately identified that ADHD is more commonly present in boys. Furthermore, a majority of teachers (60.8%) correctly answered the question related to the comorbidity of ADHD and learning disabilities. However, 20.3% of teachers believed that ADHD medications were addictive, with 9.7% expressing reluctance to use such treatment for their children if needed. Conclusion The results highlight the need for revising the current training curricula for novice teachers and providing additional training for experienced teachers. Such initiatives should aim to rectify any negative perceptions and attitudes toward ADHD held by teachers.

Interventions for ADHD in childhood and adolescence: A systematic umbrella review and meta-meta-analysis

There are several meta-analyses of treatment effects for children and adolescents with attention deficit hyperactivity disorder (ADHD). The conclusions of these meta-analyses vary considerably. Our aim was to synthesize the latest evidence of the effectiveness of psychological, pharmacological treatment options and their combination in a systematic overview and meta-meta-analyses. A systematic literature search until July 2022 to identify meta-analyses investigating effects of treatments for children and adolescents with ADHD and ADHD symptom severity as primary outcome (parent and teacher rated) yielded 16 meta-analyses for quantitative analyses. Meta-meta-analyses of pre-post data showed significant effects for pharmacological treatment options for parent (SMD = 0.67, 95% CI 0.60 to 0.74) and teacher ADHD symptom ratings (SMD = 0.68, 95% CI 0.54 to 0.82) as well as for psychological interventions for parent (SMD = 0.42, 95% CI 0.33 to 0.51) and teacher rated symptoms (SMD = 0.25, 95% CI 0.12 to 0.38). We were unable to calculate effect sizes for combined treatments due to the lack of meta-analyses. Our analyses revealed that there is a lack of research on combined treatments and for therapy options for adolescents. Finally, future research efforts should adhere to scientific standards as this allows comparison of effects across meta-analyses.

Effective but Not Feasible—What Support Staff in All-Day Primary Schools Think of Pedagogical Interventions with Regard to Children with ADHD

Children with attention deficit/hyperactivity disorder (ADHD) are faced with multiple challenges both in the classroom and in the homework situation. While there are many studies on pedagogical interventions by teachers in the classroom, this is hardly the case when it comes to support staff in after-school homework supervision. In this study, 196 support staff with different qualifications were asked not only about their knowledge of ADHD, their subjective level of stress, and whether they felt trained enough to work with children with ADHD, but also to assess the effectiveness and feasibility of 25 interventions in homework supervision. Overall, the respondents rated effectiveness higher than feasibility. Higher qualifications, greater knowledge, and better preparation went hand in hand with higher ratings of effectiveness. The more stressed the support staff feel themselves to be, the less feasible they rate the measures. The results underline the necessity of employing well-trained pedagogical staff to supervise children with ADHD. A number of interventions can be identified that the support staff deem to be both effective and feasible, and that promise a high level of implementation in practice. At the same time, more attention should be given to potential obstacles to using recommended measures in training and further education.

Effectiveness of Specific Techniques in Behavioral Teacher Training for Childhood ADHD Behaviors: Secondary Analyses of a Randomized Controlled Microtrial

Behavioral teacher training is an effective intervention for children with attention-deficit/hyperactivity disorder (ADHD). Intervention effectiveness may be enhanced by including intervention components that carry the strongest evidence for their effectiveness. A previous article of this group showed that both antecedent- (i.e., stimulus-control) and consequent-based (i.e., contingency management) techniques were highly effective in reducing daily teacher-rated, individually selected problem behaviors in a specific situation of the child. Effects were observed up to three months post intervention. Here, we tested whether effects were also present in teacher-rated and masked DSM-based assessments that comprise the full range of ADHD and oppositional defiant disorder (ODD) symptoms, as well as on teacher-rated impairment. Teachers of 90 children with (subthreshold) ADHD (6–12 years) were randomly assigned to one of three conditions: a short (two sessions), individualized intervention consisting of either a) antecedent-based techniques or b) consequent-based techniques; or c) waitlist. Multilevel analyses showed that both sets of techniques were effective in reducing teacher-rated ADHD symptoms and impairment immediately after the intervention and up to three months later, as compared to waitlist. Masked observations of ADHD behavior were in line with teacher ratings, with effects being most pronounced for inattention. No effects on teacher-rated or masked ODD behavior were found. This study showed that antecedent- and consequent-based techniques were effective in improving classroom ADHD symptoms and impairment. Long-term changes in teacher-rated ADHD are promising. These results extend previous findings and show the potential of short individually tailored interventions in classroom settings as treatment of ADHD symptoms.

Facilitators and Barriers of Teachers’ Use of Effective Classroom Management Strategies for Students with ADHD: A Model Analysis Based on Teachers’ Perspectives

Students with attention-deficit/hyperactivity disorder (ADHD) often experience school-related difficulties. Although evidence-based classroom management strategies (CMS) are known to alleviate such problems, they are rarely implemented. The current study examined whether a path model including variables influencing the use of effective CMS developed by top-down methods can be replicated utilizing an open science method. An extended model including class size and experience with children with ADHD was also calculated. We further explored prominent implementation barriers. N = 336 in-service teachers completed an online survey. Perceived effectiveness, training on ADHD, perceived disruption, and affiliation with primary/special educational needs schools were important variables associated with the use of CMS. While class size was not correlated with the use of CMS, experience mediated by training revealed an indirect association with it. Class size, lack of time, and many students with disabilities were the most frequently reported implementation barriers. The implementation of effective CMS could thus be mainly enhanced by improving how effectiveness is perceived and by engaging teachers in ADHD-specialized training. Preparing teachers in how to cope with potential barriers should also be considered.