Gender differences in the effects of oppositional behavior on teacher ratings of ADHD symptoms.

Abstract

H. Abikoff, M. Courtney, W. E. Pelham, and H. S. Koplewicz (1993) presented elementary school teachers with a videotape of a 4th-grade male child exhibiting behavior associated with either Attention Deficit Hyperactivity Disorder (ADHD) or Oppositional Defiant Disorder (ODD). Comparisons with ratings generated from a control tape (same child exhibiting unremarkable behavior) suggested that oppositional tendencies inflated teacher ratings of ADHD for boys. The term "halo effect" has been used in the literature to refer to the impact of one class of behavior on the perception of another. This study replicated this procedure using identical scripts with both male and female child models. Oppositional behavior was associated with higher teacher ratings of hyperactivity and inattentiveness. Portrayals of behavior associated with ADHD generated higher teacher ratings of oppositional conduct. This bidirectional effect differed in magnitude as a function of child gender. The boy actor exhibiting oppositional behavior received teacher ratings of hyperactivity and inattention that were roughly half of those elicited by his portrayal of ADHD itself. The girl actor portraying ADHD generated oppositional defiant ratings that were roughly two thirds of those elicited from her performance as a child with ODD. These teacher rating tendencies could contribute to higher diagnostic rates of ADHD among boys and ODD among girls. Available epidemiologic data indicate a much higher rate of ADHD among boys and prevalence differentials for ODD (girls initially lower) that disappear by adolescence. Future research will be required to determine the extent to which these teacher response sets generalize to other evaluators such as parents, physicians and mental health professionals.