Middle School Teacher Acceptance of Interventions for ADHD

94 Pages·2015·2.92 MB·English

Philadelphia College of Osteopathic Medicine
DigitalCommons@PCOM
PCOM Psychology Dissertations Student Dissertations, Theses and Papers
2008
Middle School Teacher Acceptance of
Interventions for ADHD
Linda Latsko Castenova
Philadelphia College of Osteopathic Medicine, [email protected]
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Castenova, Linda Latsko, "Middle School Teacher Acceptance of Interventions for ADHD" (2008).PCOM Psychology Dissertations.
Paper 25.
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Philadelphia College of Osteopathic Medicine
Department of Psychology
MIDDLE SCHOOL TEACHER ACCEPTANCE OF INTERVENTIONS FOR ADHD
By Linda Latsko Castenova
Submitted in Partial Fulfillment of the Requirements of the Degree of
Doctor of Psychology
August 2008
PHILADELPHIA COLLEGE OF OSTEOPATHIC MEDICINE
DEPARTMENT OF PSYCHOLOGY
Dissertation Approval
This is to certify that the thesis presented to us by _u:L~1r J-=-=-o--.:.r-\~_t-'"""'----Ptn-...SLll-,--,=,-t?---,U",---""O,-"tI~ft
on the l1- day of_--..:...)~lJ=--rV--=-G_ __, 20 Og, in partial fulfillment of the
requirements for the degree of Doctor of Psychology, has been examined and is
acceptable in both scholarship and literary quality.
Committee Members' Signatures:

James Brad Hale, Ph.D., Chairperson

Ray Christner, Psy.D.

George DuPaul, Ph.D.

Robert A. DiTomasso, Ph.D., ABPP, Chair, Department of Psychology
111
Acknowledgments
I would like to express my deepest gratitude and sincere appreciation to the
esteemed members of my dissertation committee. Dr. Brad Hale, my dissertation chair, I
want to express sincere thanks for his endless hours at his computer and his dogged
persistence, "Come on, let's get this done!" I thank you for your confidence in me and
encouragement to continue when I faced personal setbacks. Dr. Ray Christner, I thank
you for your calm and positive attitude that kept me moving forward toward my goal. Dr.
George DuPaul, I thank you for keeping the committee focused and grounded working
towards the completion of my research. I could not have asked for a better group of
psychologists and mentors in their commitment and quest for the best interventions in
helping students with ADHD.
I would like to thank my special friends, Jeremiah and Michelle O'Leary, for their
friendship and support in printing, collating, counting, and boxing my 200 surveys to be
distributed. Slainte to the future Dr. O'Leary!
I would like to express my heartfelt appreciation and acknowledgment to my
family for their efforts and support in my academic pursuits. I want to thank my husband,
Cordell, for his love, patience, encouragement, and belief in me and in what I can
accomplish. It was never a matter of "if," but "when." I want to thank my parents, John
and Mary Latsko, for instilling the value of education and fostering my strong work ethic.
Thanks, Beets and Pappo, for allowing me to be myself and to pursue my career in
psychology.
iv
Abstract
The study explored the relationship between middle school teacher knowledge of
Attention-Deficit/Hyperactivity Disorder (ADHD), their knowledge of common
interventions for ADHD, and their perception of treatment acceptability. The study also
investigated teacher characteristics and their relationship to teacher knowledge of ADHD
and their ratings of acceptability of interventions. Fifty-eight general education middle
school teachers completed a survey containing demographic infonnation, an ADHD
knowledge scale, and a survey on interventions for students with ADHD. Results
indicated that teachers scored an average of 58% correct on the Knowledge of Attention
Deficit Disorders Scale (KADDS), scoring significantly higher on the
Symptoms/Diagnosis sub scale compared to the General Information and Treatment
subscales. Most teacher characteristics were unrelated to teachers' knowledge of ADHD
and their ratings of acceptability of interventions. However, teacher training was
significantly related to higher knowledge scores. In terms of interventions, teachers
preferred behavioral interventions (self-management and daily report) over medication
monitoring for interventions for the vignette of an ADHD student without comorbid
conditions. However, in more severe cases when comorbid externalizing problems were
present, all interventions were considered to be equally important according to treatment
acceptability ratings. Overall, fewer significant relationships were observed than
predicted, suggesting that knowledge level may not be a critical variable for teachers to
consider in accepting a particular treatment plan. Limitations of the study and directions
for future research are discussed.
v
TABLE OF CONTENTS
ACI(NOWLEDGMENTS .................................................................. .iii
LIST OF TABLES ........................................................................... viii
CHAPTER 1
Introduction ............................................................................ 1
Statement of the Problem ............................................................ 1
Purpose of the Study .................................................................. 3
CHAPTER 2
Review of Literature .................................................................. 5
Introduction ........................................................................... 5
Diagnostic Background .............................................................. 6
Etiological Considerations ........................................................... 7
Adolescent ADHD .................................................................... 9
Sociocultural Factors and Epidemiology ......................................... 11
Treatment of ADHD ................................................................ 12
Treatment Acceptability ............................................................ 16
Teacher Training in ADHD ......................................................... 18
Analogue Methodology ............................................................. 20
Teacher Acceptability and ADHD ................................................. 21
Research Questions .................................................................. 23
Specific Hypotheses ..................................................................2 4
vi
CHAPTER 3
Method ..................................................................................2 5
Participants - Demographic Characteristics ........................................ 25
Materials ...............................................................................2 8
ADHD analogue vignettes .................................................. 28
Instrumentation ........................................................................ 29
Knowledge of Attention Deficits Disorder Scale (KADDS) ........... 29
Intervention Rating Profile-IS .............................................. 30
Procedure ............................................................................... 31
Anal yses ................................................................................ 33
CHAPTER 4
Results .................................................... '" ........................... 35
KADDS Assessment of ADHD Knowledge ...................................... 36
I<ADDS Cronbach's Alpha ......................................................... 37
Most Common Correct Responses ofTeachers ................................... 38
Teacher Misperceptions About ADHD ............................................ 39
Teacher Lack of Knowledge About ADHD ....................................... .40
Correlational Data ....................................................................4 1
Teacher Acceptance of Treatments ............................................... .44
CHAPTERS
Discussion .............................................................................4 8
Introduction ..... " .................................................................... 48
Teacher Knowledge of ADHD ..................................................... 49
vii
Education and Training in ADHD ................................................. 53
Acceptability of Treatments for ADHD .......................................... 56
Limitations of Study ................................................................. 60
Future Directions ..................................................................... 62
Conclusion ............................................................................ 63
REFERENCES ................................................................................ 66
APPENDIX A ................................................................................. 77
Survey Packet. ........................................................................ 77
APPEl\fDIX B ................................................................................. 88
Two Week Reminder Letter to Teachers ......................................... 88
V111
LIST OF TABLES
Table 1: Sample Demographic Characteristics ........................................... 26
Table 2: Source of Teacher ADHD Knowledge .......................................... 36
Table 3: Teacher Scores on the Knowledge of Attention Deficit Disorder
Scale (KADDS) ................................................................... 37
Table 4: Most Common Correct Responses on the Knowledge of Attention
Deficit Scale (KADDS) .......................................................... 38
Table 5: Teacher Incorrect Scores (Errors) on the Knowledge of Attention
Deficit Disorder Scale (KADDS) ............................................... 39
Table 6: Most Common Incorrect Responses on the Knowledge of Attention
Deficit Disorder Scale (KADDS) .............................................. .40
Table 7: Teacher "Don't Know" Scores on the Knowledge of Attention Deficit
Disorder Scale (KADDS) ....................................................... .41
Table 8: Most Common "Don't Know" Responses on the Knowledge of
Attention Deficit Disorder Scale (KADDS) .................................. .42
Table 9: Significant Correlations for Teacher Characteristics ....................... .44
Table 10: Means, Standard Deviations, and Total N for Treatment as a
Function of Vignette ........................................................... .46
Teacher Acceptance
Chapter 1
Introduction
Statement of the Problem
Attention-Deficit/Hyperactivity Disorder (ADHD) is characterized by clinical
impairment in attention, activity level, and impulse control that manifests in early
childhood and can cause social, behavioral, and academic problems in school (American
Psychiatric Association, 2000; Barkley, 2006; DuPaul & Stoner, 2003). It has been
estimated that the ADHD prevalence rate is 3% to 10% of school-age population and 1%
to 6% of adults in the United States (Daley, 2004). More frequently observed in boys
than girls, ADHD is often comorbid with other psychiatric disorders that cause additional
learning and psychosocial problems (Barldey, 2004; Hall & Gushee, 2000). ADHD
behavior puts children at risk for educational failure, developing substance use disorders,
poor vocational experience, peer rejection, oppositional behavior, and delinquency
(DuPaul & Eckert, 1997). Most children with ADHD have high percent affected rates of
behavior and learning problems, regardless oftheir subtype classification (Hale, How,
DeWitt, & Coury, 2001). A number of children with ADHD perform below grade level
and have specific learning disabilities, with percent affected rates as high as 80%
(Schwiebert, Sealander, & Bradshaw, 1998). Consequently, since ADHD may be only
one of the presenting problems, the other problems will need to be addressed as well,
requiring multiple interventions as a result (Hall & Gushee, 2000).
This developmental disorder may be identified in childhood, but the persistence of
symptoms through adolescence and into the adult years represents a major mental health
problem, with as many as 1 to 2 million adult Americans affected by the disorder