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Transcript of The Common Misconceptions on Attention-Deficit Hyperactivity Disorder That Public School Teachers...
THE COMMON MISCONCEPTIONS ON ATTENTION-DEFICIT/ HYPERACTIVITY DISORDER THAT PUBLIC SCHOOL TEACHERS
FROM KRUS NA LIGAS ELEMENTARY SCHOOL HAVE
A SURVEY RESEARCH
SUBMITTED TODR. CATALINA SALAZAR
UNIVERSITY OF THE PHILIPPINESDILIMAN, QUEZON CITY
PHILIPPINES
ONOCTOBER 20, 2006
IN PARTIAL FULFILLMENT OF THE RQUIREMENTS IN EDRE101: EDUCATIONAL RESEARCH AND EVALUATION
BY
JENNY PAGUYO
ACKNOWLEDGEMENTS
Many thanks to
my parents and family for their continued support,
Dr. Catalina Salazar for the guidance and patience,
Prof. Elenita Que for letting us use the computer during the ‘emergency’,
Alma Griño and Gabriel Griño for the inspiration to pursue this research,
Andrew and Victor; if it weren’t for your remarkable traits, I would not have been interested in ADHD,
Krus na Ligas Elementary School teachers, and
Mrs. Clara E. Rabulan, Krus na Ligas Elementary School Principal
ii
Abstract
It has been quite some time since the studies on Attention-Deficit /
Hyperactivity Disorder had begun, but despite the many discoveries about the
disorder and its nature, a lot of people are still confused and unsure of what it
really is. Due to the inadequate dissemination of information, the disorder
acquired a certain kind of stigma.
There are four major points about awareness on Attention-Deficit /
Hyperactivity Disorder that the study covers namely,
1) the common misconceptions about ADHD that teachers have,
2) the level of awareness on ADHD of public school teachers
3) the necessity to reeducate the public school teachers on ADHD
4) the receptivity of public school teachers to the idea of making room for a
child with ADHD in their class.
The following are the researchers’ hypotheses:
1) There is a significant level of misinformation about Attention Deficit /
Hyperactivity Disorder among the elementary public school teachers in
Quezon City thus the teachers hold many misconceptions about the
disorder especially on the nature of the disorder as well as its causes.
2) Public schools nowadays are not updated on the new developments on
the conditions that can affect student learning such as ADHD and most
teachers have very little idea about ADHD.
iii
3) There is a great necessity to reeducate the teachers and promote
advocacy on ADHD as an initial step in eliminating the misconceptions
and providing an appropriate learning environment for children with
ADHD.
4) Most teachers are willing to learn more about ADHD, but they are hesitant
to accept into the regular class a child with ADHD.
The researchers decided to gather information through survey method.
The survey questionnaire includes a true or false test to determine the common
misconceptions that public school teachers have on ADHD and a short essay
type of questions to give the respondents a chance to explain their stand on the
issues raised.
The misconceptions are grouped according to the aspects of ADHD from
which they are related. The groupings were as follows:
I. Definition of ADHD
II. Causes of ADHD
III. Defining characteristics of ADHD
IV. Diagnosis and treatment of ADHD, and
V. Teaching strategies for managing a child with ADHD.
Results are then tabulated and ranked according to the most number of
correct answers and are used to formulate conclusions.
iv
C O N T E N T S
Title i
Acknowledgements ii
Abstract iii
List of Tables vii
Chapter I IntroductionStatement of the Problem ix
Significance of the Study x
Scope and Delimitatons xii
Chapter II Theoretical FrameworkReview of Related Literature
Teachers and Schools xv
Evolution of Attention-Deficit / HyperactivityDisorder xxi
Definition of ADHD xxiv
Causes xxvi
Common Traits of Children With ADHD xxviii
Treatment and Medication xxxi
Hypotheses xxxvi
Chapter III MethodologyRespondents xxxviii
Research Design xxxviii
Method xxxviii
Chapter IV Presentation and Analysis of DataData Presentation and Analysis xl
Chapter V Summary, Implications, Conclusions andRecommendations
Summary of Findings li
Conclusions li
Recommendations lii
v
Bibliography lv
AppendicesA1 First draft of questionnaire lvii
A2 Approved questionnaire lx
A3 Letter asking for permission to conducta survey at Krus na Ligas Elementary School lxiii
A4 Diagnostic Criteria for Attention-Deficit /HyperactivityDisorder in Children (according to DSM-IV) lxiv
A5 Eight Principles on Managing ADD lxv
vi
LIST OF TABLES
Table 1 ADHD Information Source xl
Table 2 Distribution of Answers on Misconceptionson the Definition of ADHD xli
Table 3 Top Three Items Respondents Know to be FalseAbout the Definition of ADHD xlii
Table 4 Top Three Misconceptions Respondents Have About the Definition of ADHD xlii
Table 5 Distribution of Answers on Misconceptionson the Cause of ADHD xliii
Table 6 Top Three Items Respondents Know to be FalseAbout the Cause of ADHD xliii
Table 7 Distribution of Answers on Misconceptionson the Defining Characteristics of Children With ADHD xliv
Table 8 Top Three Items Respondents Know to be FalseAbout the Defining Characteristics of ADHD xlv
Table 9 Distribution of Answers on Misconceptions onthe Diagnosis and Treatment of ADHD xlv
Table 10 Top Three Items Respondents Know to be FalseAbout the Diagnosis and Treatment of ADHD xlvi
Table 11 Distribution of Answers on Misconceptions onTeaching Children ADHD xlvi
Table 12 Top Three Items Respondents Know to be FalseRegarding the Basic Teaching Strategies Used toHandle ADHD xlvii
Table 13 Distribution of Answers on the Teachers’ AttitudesTowards ADHD xlviii
Table 14 Distribution of Answers on Misconceptionson ADHD in General xlviii
vii
Chapter IIntroduction
viii
Statement of the Problem
Once in a fourth year high school class seven years ago, a Health
Education teacher labeled two of her ‘naughty’ students ‘may ADD’. She even
gave out the meaning of the acronym: Attention Deficit Disorder, explaining that
children who are naughty are afflicted with ADHD. Since then, the students held
on to the idea that ADHD indeed is an illness that makes people restless.
Oftentimes, people associate the term with people who demand attention or what
most Filipinos popularly call KSP (Kulang sa Pansin). Others call children who
get into a lot of trouble in school as kids with ADHD. Soon enough, the term is
already being used to signify stupidity, brain damage, retardation and
abnormality.
The most famous definition though is ‘hyperactive’. People with ADHD
are hyperactive, so they say. While this may be true, the term seems to have
become overused without people really knowing what it is all about. Studies
show that labeling can be damaging to children as much as lack of awareness on
conditions that hamper learning. This prompted the researchers to conduct a
survey in one of the public schools in the city to assess how much the public
school teachers know about ADHD. This study aims to determine if teachers are
well-informed on the matter. It also aims to find out the misconceptions most
teachers have about ADHD and if there is a great need for further information
dissemination. It also attempts to gauge the receptivity of the teachers to the
possibility of including a child with ADHD in their class.
ix
Unlike Autism or Hearing Impairment, Attention -Deficit / Hyperactivity
Disorder is quite vague and difficult to understand. Aside from the fact that the
disorder is still in the process of being fully understood, the characteristics that
are often used to describe children with ADHD looks like they are just describing
a typical child who is always on the go. This leads to the most frequently asked
questions on the definition Attention Deficit / Hyperactivity Disorder’ and how
does it affect learning.
The researchers though would like to know are the following:
(1) What are the most common misconceptions that teachers have
about it?
(2) How aware are they about this condition?
(3) Is there a need to educate the teachers on the basic techniques
on handling children with ADHD?
(4) How do most teachers in the public school nowadays feel about
the possibility of having a child with ADHD join their class
through inclusion?
Significance of the Study
A lot of teachers these days, even parents, complain that children these
days are very difficult to discipline and control, too active, too aggressive,
unfocused or lazy. More often than not, the school gives hope up and these
children are all grouped together and are labeled as the ‘slow-learners’,
‘delinquent’ or simply the ‘bad kids’ thus, overlooking their capabilities and
x
potentials that are probably masked or hindered by something else called
Attention Deficit / Hyperactivity Disorder (ADHD).
Due to the lack of awareness of teachers about the disorder, they fail to
provide the students the instruction they need and they are also deprived of the
chance to cultivate their ‘smart’ self. Soon, the students themselves believe that
they are good-for-nothing fellows, feel a dislike for school and eventually drop
out.
Another grave implication of having limited or almost no knowledge about
the disorder is that the disorder goes undiagnosed among these children. The
teacher, having no idea that there exists a disorder that can probably explain the
‘unbelievable’ attitude of a child, cannot make the appropriate recommendations
to the parents. In the end, the teacher, the parent and the child end up
frustrated. If they had known about its existence though, they could have been
saved from a lot of heartache and headache.
In some cases, children with ADHD are not allowed to attend the regular
school system. Teachers and sometimes even the administrators feel that these
children are meant to attend special schools. Because of this, most parents of
children with ADHD especially those who cannot afford sending their children to
a special school hide the fact that their children do have ADHD for they fear that
the school will expel their sons or daughters. These resistances are frequently
due to the misconceptions that school personnel have about the condition.
With this study, though, the different misconceptions will be cleared. It
shall attempt to find a way to make the teachers properly informed. The study
xi
will try to minimize if not totally remove the discrimination that many people have
against ADHD. If teachers are made knowledgeable on this matter, information
dissemination to parents will be a lot easier. This can also encourage parents to
open up to the teachers regarding the conditions of their child in case they were
indeed diagnosed to be having ADHD. If there is a good collaboration between
parents and teachers, handling the student with ADHD will be a lot easier. Aside
from that, the child will be given the appropriate instruction so that he or she can
bring out the best in him or her. The findings may also serve as a guide to the
teachers when they are faced with students who are becoming quite a problem in
class. The study will provide teaching strategies which they can use not only to
motivate and handle students with ADHD but also those who are ‘hyperactive’ in
general. Finally, the study will motivate teachers to gain more knowledge on the
different teaching strategies that will encourage students with or without the
exceptionality.
Scope and Delimitations of the Study
The study focuses on the awareness of city public school teachers on
Attention-Deficit / Hyperactivity Disorder. Its main concern is to determine the
misconceptions that teachers commonly have about what the condition is, its hall
mark characteristics, causes, treatment and medication and appropriate teaching
strategies. It shall also make an effort to quantify the level of awareness of
teachers on ADHD. It is also concerned with the openness of teachers to the
xii
possibility of accepting a child with ADHD in his or her class considering the fact
that most cases of ADHD can be mainstreamed or included in the regular class.
The study also includes the questions that lets the teachers express their
feelings towards ADHD as well as the teaching strategies they have used when
they handled a child with ADHD.
The study is limited only to testing the level of awareness of teachers on
ADHD. It does not cover the effects of the area of concentration of the
respondents as well as the schools from where they graduated. The
investigators also limited the research to the grade school teachers of only one
city public school thus, it is not sufficient to represent the whole public school
teacher population in the city.
It does not seek to include the correlation between the teacher awareness
and the learning outcomes of the students in the school.
xiii
Chapter IITheoretical Framework
xiv
Review of Related Literature
Schools and Teachers
“As a parent, how much can I reasonably expect my child’s teacher to
know about ADHD?” That was one of the many questions posted by a parent in
Dr. Edward Hallowell’s book, Answers to Distraction. In response to that he
wrote:
“The safest assumption is that the teacher knows nothing. You
should not expect the teacher to know anything about ADD1. ADD is not
yet a common knowledge, nor is it knowledge that every teacher will
have… Do not react with shock if you discover the teacher knows less
than you’d like.
“However, you can expect your child’s teacher to be willing to
learn. Almost every teacher is willing to learn if you approach him or her
with respect and trust… Just provide information and work out a plan
that will serve your child through the school year…”2
One should acknowledge the fact that teachers and school play a big role in
the life of a child with ADHD. Though teachers should NEVER take the
responsibility of making the diagnosis, they are the best persons to assess the
child’s behavior and academic performance because they live day in and day out
with the children. And when the child finally gets the professional help he or she
needs, and is diagnosed, it is the teacher, in cooperation with the family and the
child, who prepares and implements (in school) the structuring the child needs.
1 ADD and ADHD will be used interchangeably in this paper. Before APA renamed the disorder as ADHD, it was given an undifferentiated name of ADD where hyperactivity was considered a sub type.2 Hallowell, Edward M. and Ratey, John J., Answers to Distraction. (US: Bantam Books, 1994), p.42
xv
Teachers also play a great role in having the child diagnosed in the first
place. If she is well informed on ADHD, it would be a lot easier for her to notice
the behavioral and learning patterns of the child and she would be able to
suggest assessment for ADHD.
Dr. Hallowell fittingly subtitled the chapter three of his book “Making or
Breaking the Spirit of the Child. Teachers and ADD.” True enough, the manner
teachers would deal with every child, disabled or not, affects the child in more
ways than one could ever imagine. Humiliation has a corrosive effect on the
child’s view of himself. If carelessly handled, unnecessary, indirect emotional
damage may occur. One mistake and it could shatter the child’s respect for
himself, for the teacher, for the school and for learning.
All the same, many teachers have an ‘attitude’ about ADHD. They can be
quite, stubborn and ‘impossible’ to deal with. More often than not, they are quick
to stand on the defensive side when parents try to discuss the matter with them.
Consider the findings of Jenny Corbett (1991) in her study about teacher
reaction to the proposed integration of a special education unit in the regular
school. She cited some common reactions and some of those were as follows:
1. Totally impractical!
2. I disagree with the whole idea!
3. Fine with me!
4. I think a tremendous amount of thought has to be put into any
integration considering the benefits/disadvantages to everyone.
5. I am very unsure about the idea.
xvi
6. We need more integration with normal nursery and primary schools.3
This can also be true in our country as it had been in London where the
study was conducted. In fact, most schools often resist the idea of catering to
students who were diagnosed of having ADHD most of the time, because other
parents make the trouble. All these can be attributed to the lack of knowledge
about the nature of ADHD and the many misconceptions that are fast spreading.
The general mood that schools have on the issues of inclusion and
mainstreaming, such as the aforementioned example, shows “caution reflecting a
mixture of fear, lethargy, and lack of imagination, common resistance to change”4
and hostility.
When Corbett had the opportunity talk to one of the staff, she found out
that they had the wrong idea on ‘special care’. It turns out that it has gained a
reputation of being synonymous to ‘enduring violent and difficult behaviors’.
Clearly, ADHD has a deep social impact because not only does it affect
the child but also everyone else within his or her environment thus, advocacy is
very important. For an individual with ADHD to be understood, the people
around him or her should also know what is going on inside him or her. Dr.
Hallowell (1994) would often say that telling the truth to the child and the school
helps de-stigmatize ADHD and it can also imply that there is no reason to fear or
to be ashamed of.
3 Jenny Corbett, “’Totally Impractical!’ Integrating ‘special care’ within a special school” in Learning For All 1. Curricula for Diversity in Education, ed. Tony Booth, Will Swann, Mary Masterton and Patricia Pots (Routledge, London: Chapman and Hall Inc.,1992), pp. 193-198.4 Jenny Corbett (1991)
xvii
Most children with ADHD are actually smart and physicians hardly
recommend going to a special school. Hallowell (1994) stated that if the teacher
knows the simple techniques in handling a child with ADHD and if the class size
is reasonable, most children with ADHD can be managed in a mainstream
classroom.
Another current trend these days is inclusion where regular teachers and
special education teachers as well as the parents are enjoined to work
cooperatively within the regular classroom to provide instruction to all students,
both non-disabled and disabled.
These placement trends prove to be very effective as well. Here is one
experience of a London school head teacher.
“An adolescent girl arrived from another borough and her notes had
not yet been forwarded. The head teacher placed the girl in the group
which was appropriate for her age. Although she proved to be
sometimes awkward and ill-tempered, the class teacher was able to
cope. After a short period of settling-in, she started to develop rapidly,
showing an interest in many tasks. It was only when her notes arrived
some months later that the head teacher discovered that this girl had
been in a special care unit of her previous school, where she had been
regarded as a behavior problem.”
Later on the head teacher concluded that once children have been labeled
and segregated, the expectations which teachers had of them became
diminished and their behavior was likely to be adversely influenced by other
children with behavior problems in the special class.5
5 Jenny Corbett (1991)
xviii
In the Philippines Title Two, Section 12 of the Magna Carta for Disabled
Persons stated the following provisions regarding access to quality education:
The State shall ensure that disabled persons are provided with adequate
access to quality education and ample opportunities to develop their skills
It will be unlawful for any learning institution to deny a disabled person
admission to any course it offers by reason of handicap or disability.
The State shall take into consideration the special requirements of
disabled persons in the formulation of educational policies and programs.
Auxiliary services that will facilitate the learning process for disabled
persons shall be provided
Section 1 Article IV (School Admission and Organization) of the
Constitution also states that all schools shall admit children and youth with
special needs-preschool, elementary, secondary and tertiary levels. Section 1
Article VI (Organizational Patterns) endorses various settings like integration,
mainstreaming and Inclusion.
Despite all these regulations, most teachers especially those in the regular
schools still seem to be unprepared and skeptical about accomodating these
kinds of students in their classes. It is quite understandable though because
movements to have room for these learner types only came out just recently.
Even specialists from the medical field admit that they have not yet done enough
to clarify the diagnosis and educate parents and teachers.
xix
Needless to say, Philippines has always had budgetary deficits in
education or so most people would claim. Nonetheless, schools should try to
provide an ADHD-friendly environment to ease up dealing with children with the
disorder. “In fact, it is inexpensive to equip a classroom so that it can be ADD-
friendly. The main investment should be in teacher-education”, says Hallowell.
Most schools would shy away from the idea of setting up programs to cater
ADHD because they think that it would cost too much money. What they do not
realize is that the more they delay on acting upon it, the larger the price to pay for
ultimate intervention becomes.
Hallowell and Ratey outlined the basics of setting up an ADD program.
1. Find someone who is knowledgeable on the matter, someone
who has set up this kind of program in another school and seen
it work.
2. Educate the teachers about ADHD. Teach them the simple and
practical means of handling ADHD in a mainstream classroom.
These methods are not disruptive to other children; in fact, they
help other children so everyone benefits.
3. The school may need to invest a little money in special
equipment depending on what the administration and the
consultant agree to use. Then again, Hallowell and Ratey
suggests that the best programs are ‘low-tech, high-personal-
attention’. Human warmth, skill and energy they say are
xx
relatively cheap in education. Use them freely for they are the
best “remedial tools” the school has.
4. Still, some children may have need of more help than what the
mainstream school can provide therefore, in-house programs
might still be necessary though not as much as it was before.
5. Provide budget for ongoing education. The field of ADHD is
rapidly advancing and the school must keep abreast the
developments if they want the program to be effective.
6. Form a staff and have a person in charge of the program to
ensure that it works and meets its purpose.6
Evolution of Attention-Deficit / Hyperactivity Disorder
As Dr. Russell Barkley, Ph.D mentioned in his book Taking Charge of
ADHD. The Complete, Authoritative Guide for Parents (1995), “ADHD is
probably the best studied of all psychological disorders of childhood.” Through
out history, there have been a lot of researches and studies conducted to fully
understand the condition and to find out what really causes the disorder. As
early as 1800s, people have been trying to prove the relationship between
nervous system diseases and ADHD. They observed that children recovering
from nervous system injuries exhibit ADHD-like symptoms.
At the dawn of the 20th century, George Frederic Still, M.D. described “a
group of twenty children who were defiant, excessively emotional, passionate,
6 Hallowell, Edward M. and Ratey, John J., Answers to Distraction. (US: Bantam Books, 1994), pp.79-81
xxi
lawless, and spiteful and had little inhibitory volition.”7 Their troubling behaviors
according to their life story had appeared before the age of eight. What Still
found striking is that these children had been raised with ‘good enough’
parenting. Because of this, he concluded that there must be a biological basis
for the unbounded behaviors that the children exhibited.
In the 1934s, Eugene Kahn and Louis Cohen observed that the outbreak
of encephalitis in 1917-1918 left several children victims with symptoms that are
similar to those of hyperactive children and from this observation they concluded
that hyperactive children are brain damaged.
Later on, further research revealed that these children are not brain
damaged so they changed the label to minimal brain dysfunction (MBD).
In 1957, there was an attempt to establish the diagnostic category called
hyperkinetic reaction or syndrome of childhood. They associated the syndrome
to a dysfunction in a specific anatomical structure of the brain. Maurice Laufer in
Psychosomatic Medicine identified the location to be at the thalamus. However,
this hypothesis was never proven.
During the 1960s, some researches tried to define hyperactivity as an
environmental problem, blaming parents and the community for the development
of ADHD behaviors. These years were humorously called the ‘mommy-bashing’
years.
It wasn’t until 1980 that ADHD became a legitimate neurological disorder
as affirmed by the American Psychological Association (APA). They established
7 Hallowell, Edward M. and Ratey, John J. Driven to Distraction. Recognizing and Coping with ADHD from Childhood to Adulthood. (New York: Touchstone, 1994), 271.
xxii
two diagnoses for the disorder. One was Attention Deficit WITH Hyperactivity
and the other was Attention Deficit WITHOUT Hyperactivity.
In 1987, the Diagnostic and Statistical Manual of Mental Disorders, third
edition, revised (DSM-III-R) was published under which the sub typing of
hyperactivity was eliminated. Instead, undifferentiated Attention Deficit Disorder
(ADD) became the diagnosis for children who displayed marked inattention but
were neither impulsive nor hyperactive.
Later on, the DSM-IV was published and the disorder was divided into
three types-hyperactivity, Inattention and impulsivity. A copy of the diagnostic
criteria for ADHD in children as set forth in the standard psychiatric manual is
provided in the appendix.
Due to the lack of biological evidence, some people contest the existence
of the disorder. Thomas Armstrong (1995) for one, author of The Myth of the
ADHD Child, stated
“(The ADD phenomenon) is a recent historical development that
represents a confluence of parent advocacy groups, legislative
efforts, psychological studies, pharmaceutical advances and
psychiatric endorsements. ADD isn’t an educational virus that’s been
lurking in the brains of our children for centuries waiting for a chance
to spring into action. Instead ADD is a construct that was essentially
invented in the cognitive psychology laboratories of our nation’s (and
Canada’s) universities and given life by the American Psychiatric
Association, the US Department of Education, and the chemical
laboratories of the world’s pharmaceutical corporations.”8
8McEwan, Elaine K. The Principal’s Guide to Attention Deficit Hyperactivity Disorder. (US: Crown Press Inc, 1998), p.3.
xxiii
Another who formulated a hypothesis about the cause of ADHD is Thom
Hartman. He hypothesized that individuals with ADHD were descendants of the
hunters of the ancient times who roamed the wilderness killing prey and warding
off danger. He said that children and adults with ADHD have inherited the fast-
moving and impulsive characteristics of these hunters.
Even in the United States, many teachers and parents were misinformed.
This led Dr. Edward M. Hallowell, M.D. and Dr. John J. Ratey, M.D. to write the
book “Answers to Distraction” in 1994 as a follow up to their previous book
“Driven to Distraction” that same year. Here they compiled the most frequently
asked questions about ADHD. Most of the questions are about the criteria for
diagnosis, treatment and causes as well as strategies on how to handle the
disorder.
Definition of ADHD
Attention-Deficit / Hyperactivity Disorder, as it is now renamed, is defined
by experts in the field as follows:
“Attention-deficit / hyperactivity disorder is a developmental
disorder of self-control. It consists of problems with attention span,
impulse control, and activity level.” – Russell A. Barkley (1995)
Barkley further added that ADHD is exhibited through the
following eight points:
1. It arises early in child development
2. It clearly distinguishes these children from those who do not
have the disorder
xxiv
3. It is relatively pervasive or occurs across many different
situations, though not necessarily all of them
4. It affects the child’s ability to function successfully in meeting
the typical demands placed on children of that age
5. It is relatively persistent over time or development
6. It is not readily accounted for by purely environmental or social
causes
7. It is related to abnormalities in brain functioning and
development
8. It is associated with other biological factors that can affect
brain functioning and development
Dr. Edward Hallowell (1994) would always explain to a child with
ADHD,
“The letters ADD stand for ‘attention deficit disorder.’ Having
attention deficit disorder is like needing to wear glasses. It means
you have trouble seeing life clearly. You have trouble paying
attention. You may like to move around a lot, and this also makes it
hard to pay attention to what is going on. Just as it can be
annoying for people who wear glasses to have to put on their
glasses, it can be annoying to have ADD. But there is nothing
wrong with it. It doesn’t mean you are stupid or dumb. Not at all.
In fact lots of really smart kids have ADD, just as lots of really smart
kids wear glasses.”9
9 Hallowell, Edward M. and Ratey, John J., Answers to Distraction. (US: Bantam Books, 1994), p.53
xxv
George J. DuPaul, Ph.D. (1994) stated that ADHD is not a disturbance in
attention but instead it is a delay in the development of response inhibition which
leads to the inefficiency in the neuropsychological dysfunction that inhibits
responding. He further adds that ADHD is a “disorder in performance, not in skill;
one of dysregulation, not of deficit; one of not doing what you know rather than of
not knowing what to do.”10
Causes
There are several theories on the causes of ADHD. One of the reasons
looked at is heredity. Although it has not yet been proven, there is sufficient
evidence that ADHD runs in the family.
Doctors also look at the possibility of brain injury at birth as another
reason for ADHD conditions. The words ‘at birth’ were highlighted because one
factor that psychologists rule out when diagnosing ADHD is the fact that the
hyperactivity should not be a secondary manifestation of another disorder or
injury acquired due to accidents.
In 1970 C. Kornetsky proposed that ADD is caused by an underproduction
or underutilization of neurotransmitters as a result of his observations on the
effect of Catecholamines on people with ADHD. This led to the conclusion that
ADHD is caused by chemical imbalances in the brain. Like most theories
though, there was not enough evidence on the effect of the compounds to the
alteration of neurotransmitters in the brain.
10 DuPaul, George J. Ph.D. and Stoner, Gary, Ph.D. ADHD in the Schools: Assessment and Intervention Strategies. USA: The Guilford Press, 1994.
xxvi
In 1990, Alan Zametkin and his colleagues at the National Institutes of
Mental Health attempted to demonstrate the biochemical process in the brain.
He examined the activity of the brain in adults with and without ADHD by
watching how the brain utilizes glucose during a continuous performing task.
The tasks used were tests that have been designed to measure ones attention to
stimuli. In his study, subjects are to indicate when they heard a particular set of
tones using a push button apparatus that is hooked to a computer. The test was
administered to twenty-five adults who were diagnosed to be having ADHD since
childhood and were then biological parents of children with ADHD. The control
group consists of adults who do not have ADHD but who shared the same
demographic characteristics as themselves.
PET, or positron emission tomography, was used to measure the rate of
glucose consumption of the brains during the test. He found out in his study that
there is a deficit in glucose uptake in the brains of the subjects with ADHD than
of those who do not have ADHD. On an average, the ADHD group metabolized
glucose at rates 8 percent lower than the control group. He also found out that
reduced brain metabolism rate was more evident in the portion of the brain that is
important for attention, handwriting, motor control and inhibition of responses.
The PET scans indicating depressed frontal lobes are consistent with the claims
of other researchers called functional neuroanatomy of ADHD.
With these evidences, all environmental factors and psychological
disorders are ruled out to be the cause of ADH.
xxvii
Common Traits of Children with ADHD
Most clinical professionals-physicians, psychologists, psychiatrists and
others believe that there are three primary problems arising from ADHD. First
are the difficulties in sustained attentions, another is impulse control and third is
excessive activity. Others like Barkley included difficulties in following rules and
instructions and excessive variability in their responses to situations especially
those involved at work.
Difficulty in sustaining attention refers to problems with paying attention
and concentration. Evidences of this characteristic are daydreaming, constant
losing and misplacing things, failure to finish tasks, lost sense of direction,
disorganization and confusion. They have trouble sticking to a task for as long
as the others. Staying on activities that are repetitious and longer than usual is a
constant struggle for them. Examples of these activities are lengthy household
chores, uninteresting assignments such as those that involve research and a lot
of writing, long lectures, lengthy reading assignments on topics that are not so
interesting for them and finishing extended projects.
Usually, children are able to bear a low stimulating task as they grow
older. However, this is not the case with children with ADHD. According to
Barkley (1995), children with ADHD will lag behind in this ability by as much as
30% or more. For example, a 10-year old boy with ADHD can have an attention
span of a seven-year old. Many conflicts arise because of this delay in
development.
xxviii
Studies though show that these children do not have problems with
filtering information nor were they distractible. The only problem is their ability to
sustain attention. They tend to look away from tasks more frequently than others
and they are more readily drawn to activities that are more rewarding. This
should not be confused with distractibility. Controlled experiments actually show
that distractions do not seem to draw the children from their work. What really
happens when they drop an activity unfinished is that they easily get bored with
or lose interest in their work much faster than the others.
Children with ADHD also have difficulty in controlling impulses. They find
it very difficult to wait for their turn or line up. When an anticipated activity is
postponed they badger up the adults and the act can seem to be very self-
centered and demanding but actually, those behaviors surface because they
have problems with holding back their initial response a situation. Another
classic example is when they blurt out answers or hit other playmates
unintentionally thus given the character of being rude. They may act on
something else in the middle of doing another activity. They begin answering
tests or exercises without reading the directions first. They are also loud talkers
and without them noticing it, they can monopolize a conversation.
Dr. Hallowell illustrated it this way.
“… The ability to behave properly in our everyday lifr depends in
part upon our ability to inhibit certain impulses. During the course of an
average day we all have the impulse now and then to lash out at
someone, either physically or verbally. Most people are able to inhibit that
impulse. Their brains give them a millisecond of reflection before putting
the impulse into action. If during that time to reflect the brain decides, “No,
xxix
I had better not punch out this policeman who is giving me a ticket,” then
the average brain will inhibit the impulse to punch. However, ADD often
wipes out that millisecond of time to reflect. As the policeman reaches
into his pocket to get his pad of tickets, the ADD fist hits his nose, and
what had been a quiet day in Mudville becomes a catastrophe in the life of
at least one of its citizens.”11
One more remarkable manifestation of their impulsivity is their love for
shortcuts. Children with ADHD are notorious for taking shortcuts in whatever
they do. They always want to do less interesting tasks with the least effort with
the shortest possible amount of time.
Their impulsivity also shows up in greater risk taking thus exposing them
to greater danger. It is not that they don’t care about what could happen instead,
they fail to consider the consequences of a certain action.
Lastly, they have a problem with too much behavior. They are often
‘squirmy, fidgety, restless’ and all the other synonymous adjectives one can ever
think of. They do a lot of ‘unnecessary’ movements such as tapping of feet,
drumming of fingers, pacing around or playing wit anything their hands could get
hold of.
Drs. Linda Porrino, Judith Rapoport, and their colleagues at the National
Institute of Mental Health at Bethesda, Maryland conducted a study that
measured the level of activity of these children and they found out that there is a
significant difference in activity levels between boys with ADHD and those who
do not even during sleep.
11 Hallowell, Edward M. and Ratey, John J., Answers to Distraction. (US: Bantam Books, 1994), p.31
xxx
Barkley, however, corrects the use of terms in this case. He stated that
the term ‘hyperactive’ fails to explain the cause of the behavior. He said that
these children don’t simply just move around, instead they behave too much
meaning they tend to be more responsive to their environment than their non-
ADHD peers. He used the term hyperresponsive to describe them. Both
impulsivity and the hyperactivity are now seen as part of an underlying problem-
their being hyperresponsive or inability to inhibit behavior or response to the
environment.
Treatment and Medication
One of the most publicized and hotly debated issues these days is the
medication for ADHD. Numerous studies positively indicate that stimulant,
antidepressants and Clonidine can be of great help to people with ADHD.
Understandably, there is great reluctance to try medication at the initial stage of
treatment. Several factors cause the hesitation. For parents, they do not want to
‘drug’ their child. Adults on the other hand feel that they can get through the
disorder without medical aid. Sometimes they feel embarrassed because they
feel that they are sort of admitting a weakness once they try medication.
Whatever the reason may be, one thing has to be kept in mind: one should
never take any medication until he or she feels that he or she has learned
all he or she needs to know about it and he or she feels comfortable with
the course of treatment. (Hallowell)
In the first place, one is never obliged to take medication especially when
one does not fully understand the benefits and the risks involved. What too often
xxxi
happens though is that one decides against medication on the basis of hearsay,
superstition, or gut feeling and not on scientific basis. For example, there have
been rumors going around about the use of Ritalin saying that the drug makes
the individual addicted and eventually crazy. The fact is, when used properly,
Ritalin and all the other drugs are safe and effective.
Barkley with George J. DuPaul, Ph.D, and Anthony Costello, M.D. stated
five myths about the medication of ADHD and refute each of them.
Myth 1: Stimulant Drugs Are Dangerous and Should Not Be Taken by
Any Child. Inaccurate media propaganda campaign against the use of
stimulants, particularly Ritalin (methylphenidate) during the 1980s caused a
decline in the prescribing of this medication. However since 1990, the trends
were reversed despite the controversy. Since then, physicians require the
parents to sign a consent form not because the drug is dangerous but because
they feel the need to protect themselves from threats of malpractice lawsuits.
The consent form contains up-to-date information on the possible side effects of
the drug. As parents or individual seeking medication, it is your responsibility to
read the information thoroughly and clarify matters that may seem confusing.
Myth 2: Stimulants Just Cover Up “the Real Problem” and Do Not
Deal Directly with the Root Cause of the Child’s ADHD. This is simply false.
Stimulants deal directly with the underactive part of the brain, stimulates it thus,
minimizing the behavioral symptoms of ADHD namely inattentiveness, impulsivity
and restlessness.
xxxii
Myth 3: Stimulants Make Children “High” as Other Drugs Do and Are
Addictive. While this may be true to adults, this is rare in children. So far, there
has not been any report of drug dependence and an increased risk of abusing
the drug when the children become teenagers.
Myth 4: Stimulant Medication s Stunt Children’s Growth, and Their
Use is Strictly Limited by Age. Studies in the early 70s suggest that stimulants
can affect their growth adversely but recent studies show that weight and height
loss are very minimal during the early years of treatment. Any loss in weight and
height are compensated during the later years of treatment.
Myth 5: Stimulants Can be Used Only by Young Children. On the
contrary, stimulants can be used until adulthood. The theory that stimulants are
no longer effective during puberty is a fallacy and was never backed up by
sufficient study.12
Why stimulants are effective can be explained in a single sentence: The
areas of the brain that these stimulants activate are the areas responsible for
inhibiting behavior and maintaining effort or attention to things. As Barkley puts
it, “they increase the braking power of the brain over behavior.”
Target symptoms or behaviors are inability to stay focused at work,
impulsivity, difficulty in maintaining attention in a conversation, poor frustration
tolerance, angry outbursts, mood swings, disorganization, tendency to worry than
act, inner feeling of chaos, hopping from topic to topic and difficulty in prioritizing.
12 Barkley, Russell Ph. D. Taking Charge of ADHD. The Complete and Authoritative Guide for Parents. (New York: The Guilford Press, 1995.) p.252-253.
xxxiii
When medication is effective, it helps the individual to become more
focused and the negative behaviors are kept under control. This can bring about
secondary effects like increased confidence and self-esteem.
The three most common prescribed stimulants are Dexedrine (d-
ampethamine), Ritalin (methylphenidate) and Cylert (pemoline).
Definitely, there can be side effects upon using these drugs but through
the course of study of many physicians, these occur minimally. Should any of
the side effects become bothersome, they will likely go away when medication
stops. Some of the common side effects are Decrease in appetite, increased
heart rate and blood pressure, increased brain electrical activity, insomnia and
nervous tics.
Antidepressants are also used in some cases. The common medicines
prescribed are Norpramin or Pertofrane (desipramine), Tofranil (imipramine),
Elavil (amitriptyline) and Prozac (fluoxentine). These drugs are prescribed
primarily to treat children with ADHD when they have not shown a good response
to stimulants or has depression or anxiety with ADHD.
Common side effects of antidepressants include slower heart rate and
sometimes seizures or convulsions particularly to those children who have
history of experiencing seizures or have had a serious head injury or some other
neurological disorder. Minor physical effects such as drying of mouth,
constipation and blurred vision can be manifested. Drying of mouth can be
addressed by giving the child some sugar-free gum to chew. Adjusting the diet
to fiber-rich foods can avoid constipation.
xxxiv
Another type used to medicate ADHD is Clonidine, a drug used to treat
high blood pressure in adults. When used with ADHD, it appears to minimize
hyperactivity and impulsivity. However, most children using this medicine were
seen to feel sedated and experience a feeling of tiredness or sleepiness. This
usually lasts till the fourth week of the treatment. There can also be a mild drop
in the child’s blood pressure. Some cases show that children experience
nausea, headaches, stomachaches and even vomiting. Doctors warn that the
medicine should not be stopped abruptly if any of these side effects occur
because the child may experience sudden elevation of blood pressure, agitation
and rapid and irregular heartbeat.
A guideline for the facts that one should know before they agree to a
certain kind of medication is stated below.
xxxv
Figure 1
What to Ask the Physician about Medication
1. What are the effects, and side effects, both short-term and long-term, of this particular medication?
2. What doses shall be used, and by what schedule should they be given?3. How often should you see my child for reevaluation while he or she is taking
this medication?4. When should the medicine be stopped briefly to see if it is still required for
treatment of ADHD?5. Are there foods, beverages, or other substances that my child should not
consume while taking this medication because they will interfere with its effects in the body?
6. Will you be in contact with the school periodically to determine how my child is responding to the medication in that environment, or am I expected to do that?
7. If the child accidentally takes an overdose of the medication, what procedures should I follow?
8. Do you have a fact sheet about the medication that I can have to read?
Note: the questions were stated assuming that the parent is the one asking
Reference: Barkley, Russell Ph. D. Taking Charge of ADHD. The Complete and Authoritative Guide for Parents. p.250
The related literature and studies included in this research were selected
on the basis of their significance as grounds to refute the misconceptions that
teachers have about ADHD nowadays. These will also serve as the framework
of the recommendations that will be cited.
Also, the concepts on sufficient information dissemination and teacher
awareness as reflected in the works of Hallowell and Ratey and Corbett revealed
insights that are related to the present researchers’ study.
Hypotheses
The researchers have the following hypotheses:
1. There is a significant level of misinformation and misconception
about Attention Deficit / Hyperactivity Disorder among the
elementary public school teachers in Quezon City especially on the
nature of the disorder as well as its causes.
2. Public schools nowadays are not updated on the new
developments on the conditions that can affect student learning
such as ADHD.
3. There is a great necessity to reeducate the teachers and promote
advocacy on ADHD in order to clear up the misconceptions and be
able to provide an appropriate environment for children with ADHD.
4. Most teachers welcome the idea of learning more about ADHD
although they are quite reluctant when possibility of mainstreaming
or including children with ADHD in their classes is brought up.
xxxvi
Chapter IIIMethodology
xxxvii
Respondents
The respondents of the study were the elementary teachers of Krus na
Ligas Elementary School in Quezon City. There were fifty (50) regular teachers
employed this year in the school.
Research Design
The research is conducted to test the level of awareness of public school
teachers about ADHD. It is also designed to determine the misconceptions that
teachers have nowadays as well as their willingness to accept a child with ADHD
in their class and to learn more about ADHD.
Method
Survey was used to gather data. A list of misconceptions clustered
according to the different aspects of ADHD such as definition, causes, defining
character traits, diagnosis and treatment and teaching strategies was given to the
respondents of which they shall classify whether true or false. Six questions to
be answered subjectively were also included. These will determine the teachers’
attitude towards ADHD.
xxxviii
Chapter IVPresentation, Analysis and Interpretation of
Data
xxxix
Data Presentation and Analysis
The following are the results of the conducted survey. All in all, there were
24 teachers out of the 50 employed ones answered the questionnaire.
Table 1 shows the different media from which one may have heard a thing
or two about ADHD. The respondents were allowed to mark all items that apply
to them thus, the total responses does not amount to 24.
ADHD INFORMATION SOURCE
Table 1
SourceTotal
ResponsesSource
Totalresponses
Television 13 College classroom discussion 6
Personal experience 13 Radio 5
Magazines 8 Books 5
Friends 8 Doctor 4
Seminar 6 Others (observation) 1
The media is already arranged in order from the most frequently used to
the least used source. Based on the data, television and experience contributes
the most to the conceptualization of ADHD among the teachers. College
classroom discussion and books, items of which are most credible sources of
information on this matter belong to the lower half of the list.
The succeeding tables will tackle the different misconceptions that
teachers may have about ADHD. The statements all through out the survey are
false, therefore, the more ‘false’ answers, the more aware are the teachers of
xl
ADHD. The mean and median for every cluster of misconceptions are already
calculated.
Table 2 presents the first group of misconceptions. The items on this
cluster focus on how most people who are misinformed about the disorder may
define ADHD.
Distribution of Answers on Misconceptionson the Definition of ADHD
Table 2
Statement True False No Answer
1. ADHD is an illness that has a life-long
implications17 5 2
2. ADHD does not exist in adults. 3 19 2
3. ADHD makes children incapable of paying
attention that is why
it is called attention deficit disorder..
17 6 1
4. ADHD is classified as a learning disability. 20 3 1
5. Having ADHD means being a slow learner or
retarded.8 14 2
6. ADHD is a curable disease. 17 5 2
7. ADHD is contagious. 1 21 2
8. ADHD is a form of insanity* 5 15 3
TOTAL 88 88 15
*one of the respondents marked both true and false boxes in this item
Mean = 11Median = 10
From the above data, it is evident that the teachers are considerably
misinformed about the nature of ADHD. It shows that only 46% of the total
respondents (based on the calculated mean) possess a relatively accurate
knowledge about what ADHD is.
A look at Table 3 below shows the top three items that the respondents
know most to be false about ADHD.
xli
Top Three Items Respondents Know to be FalseAbout the Definition of ADHD
Table 3
Rank Statement Correct Answers
1 ADHD is contagious. 21
2 ADHD does not exist in adults. 19
3 ADHD is a form of insanity 15
Mean = 18.33
It appears from the above results that about 75% of the teachers are
aware of the fact that ADHD is not a disease or a psychiatric disorder that only
children can have. However, there is still a considerable number of respondents
who have misconceptions as shown in the table below.
Top Three Misconceptions Respondents Have About the Definition of ADHD
Table 4
Rank Statement Total Answers
1 ADHD is classified as a learning disability 20
2
ADHD is an illness that have life-long implications
17ADHD makes children incapable of paying attention that is why it is called attention deficit disorder.ADHD is a curable disease
3 Having ADHD means being a slow learner or retarded.
8
Mean = 15.8
From the above information, it shows that an average of 16 out of 24
teachers or 66% of the total respondents have incorrect ideas about ADHD.
Table 5 presents the misconceptions most people have regarding the
cause of ADHD.
xlii
Distribution of Answers on Misconceptions on the Cause of ADHDTable 5
Statement True False No Answer
9. Poor parenting causes ADHD 16 8 0
10. Family stress cause ADHD 16 7 1
11. ADHD is caused by poor instruction. 13 10 1
12. High sugar, food coloring, additives etc. intake
and elevated lead levels can cause ADHD.12 11 1
13. Brain injury causes ADHD. 14 6 4
14. ADHD is not hereditary. 15 7 2
15. Sociological problems can bring about ADHD 19 4 1
16. Psychological problems trigger ADHD 19 4 1
17. Smoking during pregnancy causes ADHD 18 5 1
18. Drinking alcoholic beverages during pregnancy
can cause ADHD19 4 1
TOTAL 161 66 13
Mean = 6.6Median = 6.5
The results shown in the table indicates that only 27.5% are considerably
well informed on what and what does NOT cause ADHD. It is also evident that
the respondents place the blame on substance abuse and environmental factors.
79% of respondents also believe that ADHD is caused by psychological
problems.
Table 6 below will exhibit the top three items that teachers know best to be
false.
Top Three Items Respondents Know to be FalseAbout the Cause of ADHD
Table 6
Rank Statement Correct Answers
1High sugar, food coloring, additives etc. intake and elevated
lead levels can cause ADHD.11
2 ADHD is caused by poor instruction. 10
xliii
3 Poor parenting causes ADHD 8
Mean = 9.667
The results show that only 40.25% of the respondents know that food
intake as well as external factors like teaching methods and parenting hardly
causes ADHD.
The next set of misconceptions shown in Table 7 covers the differing
ideas on the characteristics of children with ADHD.
Distribution of Answers on Misconceptionson the Defining Characteristics of Children With ADHD
Table 7Statement True False No Answer
19. All children with ADHD are hyperactive 10 13 1
20. Someone with ADHD is hostile all the time 9 13 2
21. Children with ADHD can never excel
academically8 15 1
22. People with ADHD are unreliable 11 12 1
23. Children with ADHD are cry babies 5 17 2
24. Children with ADHD are naturally hard-headed 14 9 1
25. Students with ADHD are lazy 11 12 1
26. People with ADHD cannot distinguish reality from
fiction8 14 2
TOTAL 76 105 11
Mean = 13.125Median = 13
Based on the data presented above, it can be concluded that 55% of the
respondents are conscious of the different characteristics that define a child with
ADHD. Notice also that most teachers associate hard headedness with ADHD.
The top three correctly answered items are shown in Table 8.
xliv
Top Three Items Respondents Know to be FalseAbout the Defining Characteristics of ADHD
Table 8
Rank Statement Correct Answers
1 Children with ADHD are cry babies 17
2 Children with ADHD can never excel academically 15
3 People with ADHD cannot distinguish reality from fiction 14
Mean = 15.333
It appears therefore that teachers understand the fact that children with
ADHD are very much like their non-ADHD peers and are able to excel
academically under certain conditions.
A look at Table 9 shows that teachers have a fair understanding on the
diagnosis and treatment of ADHD.
Distribution of Answers on Misconceptions on the Diagnosis and Treatment of ADHDTable 9
Statement True False No Answer
27. Teachers can diagnose ADHD 18 5 1
28. Children showing traits indicative of ADHD does not need to be assessed and diagnosed
0 23 1
29. Psychiatrists are the only ones to diagnose an
individual9 14 1
30. Children with ADHD should take medicines** 8 9 6
31. There is no need for a second opinion regarding the diagnosis of the first examining doctor.
3 20 1
TOTAL 38 71 10
**one respondent answered ‘it depends’
Mean = 14.2Median = 14
Notice respondents recognize the necessity of assessment and proper
diagnosis as shown by their responses on items 28 and 31. Also, they prove to
xlv
be misinformed about who should do the diagnosis. Like most people think, they
majority of the sample feel that teachers are qualified to diagnose ADHD.
Table 10 will show the top three correctly answered items.
Top Three Items Respondents Know to be FalseAbout the Diagnosis and Treatment of ADHD
Table 10Rank Statement Correct
Answers
1Children showing traits indicative of ADHD does not need to
be assessed and diagnosed23
2There is no need for a second opinion regarding the
diagnosis of the first examining doctor.20
3 Psychiatrists are the only ones to diagnose an individual 14
Mean = 19
The next table, Table 11 will give an overview on how aware teachers are
on the teaching techniques that work with students who have ADHD.
Distribution of Answers on Misconceptions on Teaching Children ADHDTable 11
Statement True False No Answer
32. Behavior modification schemes hardly work well
in managing children with ADHD.9 11 4
33. It is not fair to give a child with ADHD more timein answering tests.
6 15 3
34. Children with ADHD should always attend a
special school9 12 3
35. Inclusion should be practiced for students with
ADHD15 6 3
36. Teachers should not be informed if the child has
ADHD.3 20 1
37. Children with ADHD should not be accepted in
public schools6 16 2
38. Students with ADHD should always be
mainstreamed8 12 4
39. Detention and suspension are the proper punishments
1 20 3
xlvi
for children with ADHD.
TOTAL 57 112 23
Mean = 14Median = 13.5Based on the details above, it is very evident that the teachers are not well
equipped with information regarding the different ways to handle students with
ADHD. The group was also divided between whether to adopt inclusion or
mainstreaming programs to accommodate students with ADHD.
Table 12 below summarizes the result to the top three correctly answered
items.
Top Three Items Respondents Know to be False Regardingthe Basic Teaching Strategies Used to Handle ADHD
Table 12Rank Statement Correct
Answers
1
Teachers should not be informed if the child has ADHD.
20Detention and suspension are the proper punishments for
children with ADHD.
2 Children with ADHD should not be accepted in public schools 16
3 It is not fair to give a child with ADHD more time in answering
tests.15
Mean = 17
The data shows that teachers acknowledge their need to be informed. It
is also clear that they understand the ineffectiveness of traditional punishments in
teaching children with ADHD.
The last part of the survey includes an essay type of test where the
respondents are given the chance to elaborate on their answers as well as
express how they really feel about the topic.
Table 13 below summarizes the responsiveness of the teachers on the
issues concerning ADHD.
xlvii
Distribution of Answers on the Teachers’ Attitudes Towards ADHDTable 13
Question Yes No No Answer
40. Have you ever experienced teaching a child with
ADHD?***6 12 5
41. If no, would you accept a child with ADHD in your class?
6 3 1
42. Would you rather be informed or not by the parent if the has ADHD?
16 0 2
43. Do you think that public school teachers are well-informed and fully aware on ADHD?
14 0 3
***a respondent answered ‘uncertain’
Total of positive answers: 36****Mean = 12Median = 14**** item number 40 not included
The table above shows that very few of the respondents have had the
opportunity to experience teaching a child with ADHD. Also, note that a number
of respondents did not answer this part of the survey. On the other hand, 14 out
of 24 respondents admitted that public school teachers are not well informed
about ADHD. Some of them even wrote comments on the survey form that
seminars and workshops should be conducted to keep them updated on these
issues on education.
Table 14 summarizes the results of the study.
Distribution of Answers on Misconceptionson ADHD in General
Table 14
Sectiion True False No Answer
I. Definition of ADHD 88 88 15
II. Causes of ADHD 161 66 13
III. Defining characteristics of ADHD 76 105 11
IV. Diagnosis and treatment of ADHD 38 71 10
xlviii
V. Teaching strategies for managing ADHD 57 112 23
TOTAL 420 442 72
Percent rate compared to the perfect score 44.87% 47.22% 7.69%
*****note that there were two answers that were not in the choices given
From the above data, it can be concluded that teachers are relatively at
the borderline between being aware and unaware of the different aspects of
ADHD however. Teachers consider 44.87% of the stated misconceptions to be
true.
xlix
Chapter VSummary, Implications, Conclusions and
Recommendations
l
Summary of Findings
Based on the survey, the respondents believe 44.87% of the statements
cited to be true. When the questions were segmented, it turns out that most of
the misconceptions are about the causes of ADHD. Only 27.5 % of the
statements were believed to be false. Most of the respondents believe that
substance abuse and sociological factors cause ADHD. On the other hand, two
sections of the survey have the highest means of 14.2 and 14- teaching
strategies and diagnosis and treatment, respectively.
A significant percentage of (58%) the respondents acknowledge their lack
of information about the disorder and they themselves suggested that seminars
and workshops should be conducted. However, only 6 out of the 24 respondents
expressed the willingness to include a child with ADHD in the regular class while
6 others did not answer the last part of the survey.
Conclusions
The results of the survey conducted at Krus na Ligas Elementary School
shows that public school teachers have a lot of misconceptions about Attention-
Deficit / Hyperactivity Disorder because more than half of the sample believe that
most of the statements that were presented to them are true for ADHD. Most of
them believe that ADHD is a curable illness that can be managed with proper
li
medication. A number of teachers still consider external factors to be causes of
ADHD.
The average respondents who are considered aware of the fallacy of the
presented statements in every section of the survey are low and almost always in
the middle-significant enough to conclude that majority of the sample are still
unaware or misinformed about ADHD.
Considering the fact that there is a significant level of misinformation
among the teachers, reeducation is very necessary to provide teachers a clear
view of what ADHD really is all about. Acquisition of accurate and up to date
knowledge on ADHD is the only way to straighten up the wrong ideas that the
teachers believe in.
Recommendations
Based on the results of the study, the researchers propose the following:
1) Inform and educate the teachers and the rest of the school about ADHD.
It is understandable that many teachers are not yet familiar with the
disorder but this should be addressed accordingly sooner or later. There
is greater risk in the school and teaching personnel not knowing what
ADHD is. Only when everyone is aware of it can they participate in
providing quality education to children both with or without ADHD.
Educating the teachers may include conduction of seminars and
workshops for the faculty and staff of the school. It is a good idea to
coordinate with parent groups and professionals who advocate ADHD.
lii
2) Books are also the best sources of reliable information. Take time to
read. Television and all the other ‘modern’ media indeed make it easy
for individuals to gain access to a myriad of information but one should
also be careful about what one sees and hears. Be critical of the
sources of the information you receive. Believe only those that are
scientifically proven and those that are supported by research
3) Establish an ADHD program in the school. It may cost the school quite a
sum of money to make a school ADHD-friendly but compared to the
damages that disregarding the disorder can create as well as the
remediation costs when remediation becomes necessary, it is
surprisingly inexpensive. It will also save the people concerned (i.e.
teachers and parents) a lot a agony and frustration.
4) Educate the parents. Problems arise when one party does not
cooperate. It is essential to educate the parents so that the measures
implemented in school can be implemented at home as well thus
reinforcing whatever the school tries to teach the child. Consistency is
important.
5) Educate the students. Take time to explain what the disorder is so that
when the need to accommodate a child with ADHD in the class comes,
liii
everyone is psychologically prepared consequently minimizing the
probability of trouble occurrence.
6) Advocate, Do NOT Discriminate. Teaching in a public school can be
very stressful and sometimes teachers do flare up easily when
confronted with ‘naughty’ students. Instead of lashing out at them, try to
devise a way to calm yourself down.
7) Conduct studies on the advantages and disadvantages of having an
ADHD Program in your school once the program is set up. Research
also on the new developments on ADHD and the adaptation of new
trends in education into your school program.
liv
Bibliography
Barkley, Russell, PhD. Taking Charge of ADHD. The Complete, Authoritative Guide For Parents. New York: The Guilford Press, 1995.
Booth, Tony, ed. Learning For All 1. Curricula for Diversity in Education. Routledge,
London: Chapman and Hall Inc.,1992.
Boyles, Nancy, M.Ed., and Contadino, Darlene, M.S.W. Parenting a Child With ADHD. USA: 1999.
DuPaul, George J. Ph.D., and Stoner, Gary, Ph.D. ADHD in the Schools: Assessment and Intervention Strategies. USA: The Guilford Press, 1994.
Guyer, Barbara P., ed. ADHD Achieving Success in School and in Life. USA: Allyn and Beacon, A Pearson Education Company, 2000.
Hallowell, Edward M., MD and Ratey, John J., MD. Driven to Distraction. Recognizing and Coping with ADHD from Childhood to Adulthood. New York: Touchstone, 1994.
Hallowell, Edward M., MD and Ratey, John J., MD. Answers to Distraction. USA: Bantam Books, 1994.
McEwan, Elaine K. The Principal’s Guide to Attention Deficit Hyperactivity Disorder. US: Crown Press Inc, 1998.
National Council for the Welfare of Disabled Persons. Magna Carta for Disabled Persons and its Implementing Rules and Regulations (Republic Act No. 7277). An Act Providing for the Rehabilitation, Self-Development and Self-Reliance of Disabled Persons and Their Integration into the Mainstream of Society and for Other Purposes. Quezon City: Regan Printers, 1995.
EDSP 101 Course Notes
lv
Appendices
lvi
A1 First Draft of Questionnaire
Good day! There is a great movement in our current education system these days and one of the most popular changes that we are having is the immersion and acceptance of children with developmental delays both in the private and public schools. Because of this, I, a student taking up EDRE 101 (Educational Research and Evaluation) would like to know how informed are the teachers in the public school on the developmental delays particularly on Attention Deficit with or without Hyperactivity Disorder (ADHD).
Kindly answer the questions as honestly as possible. I assure you that this will be held confidential. Thank you very much for your cooperation.
--------------------------------------------------------------------------------------------------------------------------------------- Name (optional): _______________________________________________________
Number of years in the teaching profession: _______
Undergraduate course: ________________________
Graduate Studies (if any): ______________________
______________________
Subject/s handled this school year:
___________________________________________________
How did you come to know about ADHD? Please mark the ones that apply to you.
____ Television ____ Radio ____ Magazines
____ Books ____ Doctor ____ College classroom discussion
____ Seminar ____ Personal Experience ____ Friends
____ Others (pls. specify)
___________________________________________________________
Check the box under your answer
Statement True False
1. Poor parenting and family stress cause ADHD
2. Behavior modification schemes work well in managingchildren with ADHD.
3. Anyone with ADHD is hyperactive.
4. Teachers play a crucial role in handling children with ADHDbecause they can either build the child’s confidence upor ruin it.
5. ADHD is an illness.
6. ADHD does not exist in adults.
7. Children with ADHD are not capable of paying attention
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that is why it is called ‘attention deficit disorder’.
Statement True False
8. Learning disabilities is also ADHD.
9. It is only fair to give a child with ADHD more timein answering tests.
10. Children with ADHD should take proper medication.
11. A developmental pediatrician should diagnose ADHD.
12. Children with ADHD should all attend the special school.
13. Mainstreaming and inclusion should be practicedin public schools.
14. Children with ADHD are aggressive and hostile.
15. ADHD is caused by poor instruction.
16. Children with ADHD should not be allowed in public schools.
17. Having ADHD means one is a slow-learner or retarded.
18. Public school teachers need more training in handlingchildren with ADHD.
19. High sugar, food coloring, additives etc. intake andelevated lead levels can cause ADHD.
20. Teachers should be informed if the child has ADHD.
21. Brain injury and heredity causes ADHD.
22. The Department of Education provides guidelinesfor the accommodation of children with ADHDin the public schools.
23. Sociological / psychological problems canbring about ADHD.
24. Smoking and alcohol consumption during pregnancycause ADHD.
25. ADHD is a curable disease.
26. Children with ADHD can excel academically.
27. ADHD can be contagious.
28. Children with ADHD are often creative.
29. Children with ADHD has a relative lack of inhibition.
30. Detention and suspension are the proper punishmentsfor children with ADHD.
Have you ever experienced teaching a child with ADHD? _____
If no, would you accept a child with ADHD in your class? Why or why not?_____________________________________________________________________________________________________________________________________________________________________________________________________________________
How did you manage a child with ADHD in the class? (use the back page if necessary)
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______________________________________________________________________________________________________________________________________________
Would you rather be informed or not by the parent if the child has ADHD? Why or why not?_____________________________________________________________________________________________________________________________________________________________________________________________________________________
Do you think that public school teachers are well-informed and fully aware on ADHD? Why or why not?______________________________________________________________________________________________________________________________________________
Suggestions or comments____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
---------------------------------------------------------------------------------------------------------------------------------Thank you very much for the time!
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A2 Approved questionnaire
Good day! There is a great movement in our current education system these days and one of the most popular changes that we are having is the immersion and acceptance of children with developmental delays both in the private and public schools. Because of this we, student taking up EDRE 101 (Educational Research and Evaluation), would like to know how informed are the teachers in the public school on the developmental delays particularly on Attention Deficit with or without Hyperactivity Disorder (ADHD).
Kindly answer the questions as honestly as possible. We assure you that this will be held confidential. Thank you very much for your cooperation.
--------------------------------------------------------------------------------------------------------------------------------------- Name (optional): _______________________________________________________
Number of years in the teaching profession: _______
Undergraduate course: ________________________
Graduate Studies (if any): ______________________
______________________
Subject/s handled this school year:
___________________________________________________
How did you come to know about ADHD? Please mark the ones that apply to you.
____ Television ____ Radio ____ Magazines
____ Books ____ Doctor ____ College classroom discussion
____ Seminar ____ Personal Experience ____ Friends
____ Others (pls. specify) ________________________________________________________
Check the box under your answer
Statement True False
1. ADHD is an illness that has a life-long implications
2. ADHD does not exist in adults.
3. ADHD makes children incapable of paying attention that is why
it is called attention deficit disorder..
4. ADHD is classified as a learning disability.
5. Having ADHD means being a slow learner or retarded.
6. ADHD is a curable disease.
7. ADHD is contagious.
8. ADHD is a form of insanity
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9. Poor parenting causes ADHD
10. Family stress cause ADHD
11. ADHD is caused by poor instruction.
12. High sugar, food coloring, additives etc. intake andelevated lead levels can cause ADHD.
13. Brain injury causes ADHD.
14. ADHD is not hereditary.
15. Sociological problems can bring about ADHD
16. Psychological problems trigger ADHD
17. Smoking during pregnancy causes ADHD
18. Drinking alcoholic beverages during pregnancy can cause ADHD
19. All children with ADHD are hyperactive
20. Someone with ADHD is hostile all the time
21. Children with ADHD can never excel academically
22. People with ADHD are unreliable
23. Children with ADHD are cry babies
24. Children with ADHD are naturally hard-headed
25. Students with ADHD are lazy
26. People with ADHD cannot distinguish reality from fiction
27. Teachers can diagnose ADHD
28. Children showing traits indicative of ADHD does not need to be assessed and diagnosed
29. Psychiatrists are the only ones to diagnose an individual
30. Children with ADHD should take medicines
31. There is no need for a second opinion regarding the diagnosis of the first examining doctor.
32. Behavior modification schemes hardly work well in managingchildren with ADHD.
33. It is not fair to give a child with ADHD more timein answering tests.
34. Children with ADHD should always attend a special school.
35. Inclusion should be practiced for students with ADHD
36. Teachers should not be informed if the child has ADHD.
37. Children with ADHD should not be accepted in public schools
38. Students with ADHD should always be mainstreamed
39. Detention and suspension are the proper punishmentsfor children with ADHD.
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Have you ever experienced teaching a child with ADHD? ___ yes ___ no
If no, would you accept a child with ADHD in your class? Why or why not?___________________________________________________________________________________________________________________________________________________________________________________________________________________
If yes, how did you manage a child with ADHD in the class? (use the back page if necessary)______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
Would you rather be informed or not by the parent if the child has ADHD? Why or why not?_____________________________________________________________________________________________________________________________________________________________________________________________________________________
Do you think that public school teachers are well-informed and fully aware on ADHD? Why or why not?______________________________________________________________________________________________________________________________________________
Suggestions or comments or questions about____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
---------------------------------------------------------------------------------------------------------------------------------Thank you very much for the time!
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A3 Letter asking for permission to conduct a survey at Krus na
Ligas Elementary School
October 10, 2006
To: Principal Guitnang Bayan Elementary School Sta. Ana, San Mateo, Rizal
Dear ma’am;
This is to introduce Ms. Jenny C. Paguyo, a student of EDRE 101: Educational Research
and Evaluation at the University of the Philippines, Diliman. In partial fulfillment of the
requirements of the subject, she is tasked to conduct a research related to herr area of
concentration. In connection with this, she would like to ask your permission to carry out a survey
in your school.
I assure you that all personal information will be held confidential and a copy of the output
will be given upon request.
Hoping for your kind consideration on this matter.
Sincerely yours,
Dr. Catalina SalazarProfessor
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A4
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DIAGNOSTIC CRITERIA FOR ATTENTION-DEFICIT / HYPERACTIVITY DISORDER IN CHILDREN
(according to DSM IV)
NOTE: Consider a criterion met only if the behavior is considerably more frequent than that of most people of the same mental age.
A. Either (1) o2r (2)
(1) six (or more) of the following symptoms of inattention have persisted for at least 6 months to a degree that is maladaptive and inconsistent with developmental level
Inattention:(a) often fails to give close attention to details or makes careless mistakes in
schoolwork, work, or other activities(b) often has difficulty sustaining attention in tasks or play activities(c) often does not seem to listen when spoken to directly(d) often does not follow through on instructions and fails to finish schoolwork,
chores and duties in the workplace (not due to oppositional behavior or failure to understand instructions)
(e) often has difficulty organizing tasks and activities(f) often avoids, dislikes, or is reluctant to engage in tasks that require sustained
mental effort (such as schoolwork or homework)(g) often loses things necessary for tasks or activities (e.g. toys, school
assignments, pencils, books or tools)(h) is often distracted by extraneous stimuli(i) is often forgetful in daily activities
(2) six (or more) of the following symptoms of hyperactivity-impulsivity have persisted for at least 6 months to a degree that is maladaptive and inconsistent with developmental level
Hyperactivity:(a) often fidgets with hands or feet or squirms in seat(b) often leaves seat in classroom or in other situations in which remaining seated
is expectedB. often runs about and climbs excessively I situations in which it is inappropriate (in
adolescents or adults, may be limited to subjected feelings of restlessness)(d) often has difficulty playing or engaging in leisure activities quietly(e) is often “on the go” or often acts as if “driven by a motor”( f) often talks excessively
Impulsivity(g) often blurts out answers before questions have been completed(h) often has difficulty awaiting turn( i) often interrupts or intrudes on others (e.g. butts into conversations or games
B. Some hyperactive-impulsive or inattentive symptoms that caused impairment were present before age 7 years
C. Some impairment from the symptoms is present in two or more settings (e.g. at school [or work] and at home).
A5 Eight Principles on Managing ADD
Russell Barkley, Ph.D., Professor at the University of Massachusetts Medical School in Worcester (proposed the following ‘Principles’)
1. Use more immediate consequences.
2. Use a greater frequency of consequences.
3. Employ more salient consequences
4. Start incentives before punishments.
5. Strive for consistency.
6. Plan for problem situations and transitions.
7. Keep a daily perspective.
8. Practice forgiveness.
Of principle number 8, Dr. Barkley writes, “This is the most important but
often the most difficult guideline to implement consistently in daily life.”13
13 Hallowell, Edward M. and Ratey, John J., Answers to Distraction. (US: Bantam Books, 1994), pp.50-51
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