Transcript Teachers’ Knowledge, Beliefs, and

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