The Common Misconceptions on Attention-Deficit Hyperactivity Disorder That Public School Teachers From Krus Na Ligas Elementary School Have

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

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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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