Knowledge Of Attention Deficit Hyperactivity Disorder Research Articles

Parental ADHD knowledge and medical visit status of school-aged children in Shanghai

IntroductionThe diagnosis and care of children and adolescents with neurodevelopmental disorders presents a public health crisis in China. Attention deficit hyperactivity disorder (ADHD) is one of the most frequent conditions. Many Chinese children and adolescents with ADHD are underdiagnosed and undertreated. This study aimed to evaluate the awareness and attitude parents have about ADHD, and investigated potential factors influencing ADHD medical visit status among school-aged children in Shanghai.MethodsA random cluster sampling method was used, and four primary schools in Shanghai were selected. One class was randomly selected from each grade, including students and their parents. Parents completed the Swanson, Nolan, and Pelham Version IV Questionnaire (SNAP-IV) parent form and questionnaire concerning ADHD awareness, knowledge, attitude and status of ADHD medical visit. Descriptive analysis was conducted on the overall results and logistic regression analysis was performed to explore the influencing factors of ADHD medical visit.ResultsWe received 617 valid questionnaires. There were 313 boys (50.7%) and 304 girls (49.2%), with a median age of 8 years old (p25 = 7, p75 = 9). 42.4% parents believed they had some knowledge about ADHD, and 73.5% of them thought ADHD was a neurologically based disorder or neurological condition by nature. Parental ADHD information came from the following sources: Internet/TV (n = 458, 74.2%), families/friends (n = 267, 43.2%), print publication (n = 208, 33.7%), psychiatrists/pediatricians (n = 192, 31.1%), schools/teachers (n = 186, 30.1%) and other ADHD patients (n = 48, 7.7%). When children had ADHD-like behaviors, most parents (61.5%) educated children to behave themselves, 59.1% parents tried to get help from psychiatrists/pediatricians, 55.5% of them would ask psychologist for help. In terms of the ADHD prevalence, the SNAP-IV positive screen rate was 4.3% (n = 27). Only 33.3% (9/27) of parents went to the hospital for consultation and treatment. Multivariate logistic regression model showed that parental knowledge about ADHD (OR = 13.67, 95%CI: 1.72, 144.39, P = 0.01) was significantly correlated with the medical visit. Parents with sufficient knowledge of ADHD tend to visit hospital for help when they thought their children had ADHD related symptoms.ConclusionsThe majority of parents accepted ADHD as a neurodevelopmental disorder by nature, but some parents still had certain misunderstandings about ADHD. The main source of information for parents to obtain information about ADHD was through the TV/Internet. Parents’ perceptions and knowledge were key to whether children received appropriate treatment for their ADHD. However, medical visits to address ADHD among school-aged children were still lower than expected. Government and healthcare institutes should work to improve ADHD public awareness and to help patients and their families gain access to mental health resources.

The Efficacy of the Current ADHD Training Programs in Saudi General Education Elementary Schools: A Systematic Review

Abstract We conducted a systematic review to estimate the efficacy of current attention-deficit hyperactivity disorder (ADHD) training programs delivered to general education elementary school teachers (GEESTs) in Saudi Arabia and understand how well Saudi GEESTs are prepared to work with students with ADHD. OneSearch@IU and Google Scholar were used to search for relevant studies. The included studies were published in peer-reviewed journals between 2013 and 2023, written in English or Arabic, addressed GEESTs and students with ADHD, and reported on GEESTs’ ADHD knowledge, use of effective strategies for students with ADHD, and/or judgments about the ADHD training programs. Data were extracted and synthesized independently by the two authors based on content analysis and predefined inclusion criteria. Overall, Saudi GEESTs’ knowledge of ADHD was inadequate. Differences in teachers' ADHD knowledge might be attributed to different factors such as age, gender, years of teaching experience, and training related to ADHD. The current ADHD training programs directed toward the Saudi GEESTs increased ADHD knowledge. However, the satisfaction level of GEESTs regarding the ADHD training programs they received was not high. The present ADHD training programs provided to GEESTs in Saudi Arabia did not satisfy teachers and impacted the application of effective strategies to teach students with ADHD. As such, these programs must be improved to better consider teachers’ needs.

Predicting Help-Seeking Behaviors in Caregivers of Children Newly Diagnosed with ADHD

ABSTRACTChildren with attention-deficit/hyperactivity disorder (ADHD) often do not receive the standard of care which includes behavioral and pharmacological treatment. Understanding characteristics associated with treatment-seeking may inform ADHD assessment and treatment practices. This study used the ADHD Help-Seeking Behavior model to explore predictors of behavioral (parent training, classroom behavior management) and pharmacological treatment-seeking following a child’s ADHD diagnosis. Parents (N = 171) seeking an ADHD evaluation for their child (ages 7–12 years) and teachers completed ratings at various time-points. Following feedback, where diagnosis and treatment recommendations were provided, caregivers completed questionnaires regarding treatment-seeking initiation. The majority (91.1%) reported seeking treatment. Most reported seeking pharmacological treatment (MED; 82.9%), with fewer seeking behavioral parent training (BPT; 33.9%) or classroom behavior management (CBM; 70.7%). Treatment-seeking predictors varied by treatment modality. Higher parenting stress, agreement with the ADHD diagnosis, and knowledge of ADHD were significant independent predictors of seeking BPT. Greater child externalizing behaviors were a significant independent predictor of seeking CBM. Higher child ADHD inattention, parenting stress, and the parent not having ADHD were significant independent predictors of MED. These results may inform discussion points in communicating diagnostic feedback and treatment recommendations. Clinicians may improve BPT uptake by providing ADHD psychoeducation, thus promoting knowledge and an understanding of the diagnosis. Likewise, inquiring about parental attitudes and experiences with medication among caregivers diagnosed with ADHD may increase MED uptake for children. These results add to the literature indicating that ADHD treatment-seeking is a complex, nuanced process and set the stage for future studies exploring help-seeking behaviors.

Preparing Teacher Candidates in Classroom Management Prior to Entering the Teaching Profession

The purpose of this quasi-experimental study was to evaluate the promise of a specialized curriculum designed to prepare general education teacher candidates to effectively implement classroom management strategies within a multi-tiered systems of support (MTSS) framework. Participants were 110 teacher candidates enrolled in a student teaching internship course. Fall participants (intervention group; n = 69) received the specialized curriculum that focused on implementation of classroom management strategies for students with emotional and behavioral disorders and attention-deficit/hyperactivity disorder (ADHD), in concert with their internship; spring participants (comparison group; n = 41) did not. All participants completed pre- and postquestionnaires, which included measures assessing knowledge of classroom management principles, knowledge of ADHD, and self-efficacy. Measures of satisfaction with the curriculum were also collected. Fourteen teachers (seven intervention group, seven comparison group) participated in follow-up observations in their first teaching semester. Results demonstrate significant differences in knowledge of classroom management principles and ADHD between groups from pre- to postinternship, and high levels of participant satisfaction with the curriculum. Preliminary observations reveal greater use of evidence-based classroom management strategies in the intervention group. Implications for further program development and educator preparation as well as suggestions for future research are discussed.

What different education professionals know about ADHD and their attitudes towards it

ABSTRACTTeachers and school counsellors play a key role in the detection of symptoms associated with attention-deficit/hyperactivity disorder (ADHD) and in interventions. The present study aimed to analyse differences in knowledge about and attitudes towards ADHD between five different types of educator: infant education teachers, primary education teachers, special education teachers, school counsellors, and secondary education teachers. The participants were 206 professionals from state-funded and independent schools in the north of Spain who completed the Questionnaire for the Evaluation of Teachers’ Knowledge of ADHD (which included four dimensions: general information, symptoms, aetiology and treatment) and the ADHD-Specific Knowledge and Attitudes of Teachers questionnaire (to assess attitudes towards ADHD). Results of univariate analysis of variance showed statistically significant differences between the five different types of educator. School counsellors and special education teachers exhibited greater knowledge and better attitudes towards ADHD. Training programmes for teachers in infant, primary and secondary education, should be provided to improve knowledge and attitudes in relation to ADHD.

Parent attributions and attention deficit/hyperactivity disorder knowledge as predictors of specific help-seeking interests.

Many children diagnosed with attention deficit/hyperactivity disorder (ADHD) do not receive appropriate services following diagnosis. Although information about ADHD is widely available and abundant, sometimes conflicting information may impede parent help-seeking. The present study examined parent knowledge of ADHD and attributions of child behavior as predictors of interest in formal and informal help seeking at the point of child evaluation for possible ADHD. Participants (89 caregivers of children ages 5-12) completed a measure of ADHD knowledge, rated attributions of child behavior in response to vignettes depicting ADHD symptoms, and indicated their interest in a range of formal and informal services that could be recommended following the child's evaluation. Parents reported strongest interest in academic services followed by medication, child focused therapy, and informal services (e.g., seeking information about ADHD). Family income, ADHD knowledge and attributions that child behavior will persist over time were associated with all types of help-seeking interest except academic services. Perceptions of child control over behavior predicted greater interest in medication. Findings suggest that increasing parent knowledge of ADHD and exploring parent goals and preferences for treatment may increase service utilization for children following assessment/diagnosis of ADHD.

Knowledge of and attitude toward attention-deficit/ hyperactivity disorder (ADHD) assessed among primary schoolteachers of Makkah City in Saudi Arabia

ABSTRACT Background: One of the most prevalent pediatric medical conditions is attention-deficit/hyperactivity disorder (ADHD). It is characterized by symptoms of hyperactivity, impulsivity, and/or inattention. The first people to notice a child’s ADHD symptoms are typically their teachers, who may then offer data that are typically helpful in its diagnosis. The purpose of this study was to assess teachers’ knowledge of ADHD, its causes and etiology, as well as the key demographic factors that influence said knowledge. Method: The study was conducted among schoolteachers of primary schools located in different regions of Makkah City, Kingdom of Saudi Arabia. We used a stratified random sampling technique to collect our sample, with the inclusion criteria being teachers who were working in a primary school and who were directly involved in teaching students. Data analysis was performed using the IBM SPSS Statistics software version 21. Results: We received 335 responses to our questionnaire. The age of the participants ranged from 18 to 59 years, with the mean age being 40.2 ± 13.8 years. About 66.9% of teachers were women. Most of the teachers in this sample had a bachelor’s degree (73.4%), and only 21.8% had diplomas. Regarding the years of teaching experience, 34.6% had teaching experience exceeding 20 years, whereas 20.6% had less than five years of teaching experience. Regarding general knowledge of the teachers, (5.4%) of the teachers had a good level of knowledge. Only 63.6% of teachers were aware that ADHD students frequently struggled with task and activity organization, and only 7.5% of teachers had good knowledge of ADHD treatment, compared to 40.9% who had a good awareness of symptoms and diagnosis. Only the teachers’ education level was significantly associated with their knowledge level of ADHD: 25% of teachers with a postgraduate degree had an overall good level of knowledge versus 2.7% of those with a diploma (P = 0.006) Conclusion: The findings of this study lead to the conclusion that elementary school instructors have an inadequate understanding of ADHD. Some teachers misunderstand the signs and general facts associated with ADHD, thereby indicating the need for further training in this area.

The Efficacy of Educational Interventions in Improving School Teachers' Knowledge of Attention Deficit Hyperactivity Disorder.

Well-trainedprimary school teachers should be competent in recognizing attention deficit hyperactivity disorder (ADHD) in students and be able to assist in providing care and support. This study intends to assess primary school teachers' knowledge of ADHD and evaluate the effectiveness of a short-term educational intervention. Methods:A quasi-experimental quantitative study was conducted among primary school teachers in Jazan, Saudi Arabia. A two-hour educational intervention was designed and run in six schools using a specific knowledge rating scale before and after the application of the intervention. Results: A total of 150 primary school teachers were included in this study, of which 64% were males, 51.3% were in the age group of 40-49 years, and 28% had teaching experience of more than 20 years. Regarding ADHD knowledge, the pre-intervention knowledge of the general criteria, symptoms and diagnosis, and treatment was considered adequate in 3.3%, 16.7%, and 2.7% of the participants, respectively, which improved post-intervention to 22%, 54.7%, and 19.3%, respectively.There was a significant association between the pre-intervention knowledge of the general criteria and the gender and between the knowledge of symptoms and diagnosis and the attendance of ADHD workshop by the participants. Also, there was a significant association between the participants' age, residence experience, attendance of ADHD workshops, and the general criteria and treatment domains. Most primary school teachers in Jazan have insufficient knowledge of ADHD. Using a knowledge improvement intervention can substantially improve the teachers' knowledge. Therefore, it is necessary to incorporate thoughtful knowledge improvement programs into the educational curricula for teachers.

Measure of Caregiver Attention-Deficit/Hyperactivity Disorder Knowledge Is Responsive to Decision Aid on Treatment for Attention-Deficit/Hyperactivity Disorder

ObjectiveAdapt and test a measure of knowledge for caregivers of children with attention-deficit/hyperactivity disorder (ADHD) and evaluate the impact of the information component of a decision aid (DA) on participant knowledge. MethodsA set of seven knowledge items were created based on prior knowledge measures and clinical guidelines. As part of a larger cross-sectional survey study of caregivers of children diagnosed with ADHD, caregivers were randomized to one of two arms: 1) a DA arm, where participants reviewed the information component of the Cincinnati Children’s Hospital’s DA, and 2) a control arm, where participants were not shown a DA. All participants completed the seven knowledge items. Knowledge items were assessed for difficulty, quality of distractors, acceptability, and redundancy. Total knowledge scores (0–100) for the DA and control arm were compared. ResultsCaregivers were assigned to the DA arm (n = 243) or the control arm (n = 260). All 7 knowledge items were retained as no items were too difficult or too easy, all response options were used, there were little missing data, and no items were redundant. The overall knowledge score was normally distributed, and almost covered the full range of scores (5–100). Those who received the DA component had higher knowledge scores (M=68, SD=23) than those who did not receive the DA component (M=60, SD=19, P < .01, d=0.4). ConclusionsThe Caregiver ADHD Knowledge (CAKe) measure was acceptable and demonstrated construct validity as those who were assigned to review the DA component demonstrated greater knowledge than those who were not assigned to review the DA component.

Training and specialisation of psychiatrists in ADHD.

To identify the level of training of Australian psychiatrists in Attention Deficit Hyperactivity Disorder (ADHD), and to compare the number of psychiatrists specialising in ADHD versus other psychiatric conditions on the basis of the prevalence of conditions, by interrogating the RANZCP 'Find a Psychiatrist' database. Fewer psychiatrists listed in the RANZCP database specialise in ADHD than in many other psychiatric conditions. Given that 5% of the Australian population suffers from ADHD, the condition can have significant adverse outcomes and is a common comorbidity with other psychiatric conditions, the RANZCP Training Program would be improved by requiring an in-depth knowledge of ADHD. Further training in ADHD would assist many practising psychiatrists.

Factors Affecting Knowledge of Attention-Deficit Hyperactivity Disorder Among Female Primary Schoolteachers in Taif City, Saudi Arabia.

Background Attention-deficit hyperactivity disorder (ADHD) is a public health challenge because it may contribute to academic and psychological difficulties among school children.Though ADHD is a common problem, Taif teachers' knowledge of the disease has never been assessed. Therefore, this study aimed to determine factors that influence ADHD knowledge among female primary schoolteachers in Taif City, Saudi Arabia. Methods This cross-sectional study was conducted on 359 female schoolteachers recruited by stratified random sampling. Participants self-reported demographic and personal data and completed the validated Arabic version of the knowledge of ADHD scale and teacher's attitude toward ADHD questionnaires. Results In Taif, it was determined that 96.4% of female primary schoolteachers had insufficient knowledge of ADHD, notably with nature, causes, consequences, and treatment knowledge. In contrast, 40% had adequate knowledge of the condition's symptoms and diagnosis, and 97.5% exhibited a favorable attitude. There is significantly higher knowledge among private schoolteachers, those who freshly graduated, specialize in learning difficulties, who attended any course/training about ADHD, and whoever taught ADHD children. There was a significant positive weak correlation between teachers' knowledge of ADHD and their attitude. Regression analysis revealed that female schoolteachers specialized in learning difficulties show significantly higher knowledge scores, teachers who never taught an ADHD child had a reduction of 94.6 % in ADHD knowledge, and any increase in the number of ADHD children teachers teaches has significantly increased teachers' knowledge (Overall Model: Chi-Square X2= 69.514, p < 0.000**). Conclusions Our study showed that there was a serious knowledge gap on ADHD among Taif female primary schoolteachers. Therefore, it is strongly recommended to boost teachers' knowledge of ADHD, especially at government schools, through conducting training courses, distributing leaflets intended to address ADHD, and launching awareness campaigns through the media, including social media,television,and radio.It is also recommended that education faculty curricula should include moreinformation on ADHD.

Assessing Knowledge, Attitude, and Practice Regarding Attention-deficit Hyperactivity Disorder Children among Dentists in Gujarat - An Electronic Cross-sectional Survey

Introduction: Attention-deficit hyperactivity disorder (ADHD) is a complex neurobiological disorder that affects children and is characterized by lack of attention, impulsive behavior, and hyperactivity. Through this study, we measured the level of perception of dentists to ADHD. Methodology: A survey questionnaire was sent to 380 IDA members in the Gujarat branch as part of a cross-sectional study. The first part of the survey includes demographic data about the participants, then questions about ADHD knowledge and management. The data were uploaded into a computer and evaluated with SPSS software. The level of significance was set at P = 0.05, and any value below or equal to 0.05 was deemed statistically significant. Results: The participants had a good knowledge of ADHD; however, dental practitioners need to be more aware of dealing with such patients. The majority of participants lacked the necessary expertise to treat them, but they were still ready to provide dental treatment to people with ADHD as part of their dental practice. There was a significant correlation between work experience and years of practice. Conclusion: Appropriate training should be provided to dentists so they can treat patients with ADHD. To raise dentists’ understanding of ADHD, well-planned programs and explicit policies should be developed using the current findings.

Assessment and Management of Attention-Deficit/Hyperactivity Disorder: Pediatric Resident Perspectives on Training and Practice.

Attention-deficit/hyperactivity disorder (ADHD) is a common presenting concern in primary care. This study examined the relationship between pediatric residency training program characteristics and residents' ADHD knowledge, attitudes, and comfort in providing ADHD services. Given the familiarity that pediatric chief residents have with the training and experiences within their residency programs, a 30-item survey was mailed to pediatric chief residents. A total of 100 residents returned their surveys (response rate 49.5%) and were included in the descriptive quantitative and thematic qualitative analyses. The majority of participants rated their ADHD knowledge as at least average. However, approximately half of the participants were comfortable with screening, and less than half were comfortable with managing stimulant medication or behavioral treatments. Participants emphasized the importance of interprofessional collaboration, clinical experiences, and integrated ADHD education throughout training. These results emphasize the importance of improved training in screening, diagnosing, and managing ADHD to increase resident comfort regarding these practices.

What different education professionals know about ADHD and their attitudes towards it

ABSTRACT Teachers and school counsellors play a key role in the detection of symptoms associated with attention-deficit/hyperactivity disorder (ADHD) and in interventions. The present study aimed to analyse differences in knowledge about and attitudes towards ADHD between five different types of educator: infant education teachers, primary education teachers, special education teachers, school counsellors, and secondary education teachers. The participants were 206 professionals from state-funded and independent schools in the north of Spain who completed the Questionnaire for the Evaluation of Teachers’ Knowledge of ADHD (which included four dimensions: general information, symptoms, aetiology and treatment) and the ADHD-Specific Knowledge and Attitudes of Teachers questionnaire (to assess attitudes towards ADHD). Results of univariate analysis of variance showed statistically significant differences between the five different types of educator. School counsellors and special education teachers exhibited greater knowledge and better attitudes towards ADHD. Training programs for teachers in infant, primary and secondary education, should be provided to improve knowledge and attitudes in relation to ADHD.

Greek early childhood educators’ knowledge of attention-deficit/hyperactivity disorder

As more children enter preschool programs, there is an increasing need for early education professionals to recognize and understand Attention-Deficit/Hyperactivity Disorder (ADHD). This study examined 120 Greek early childhood educators’ knowledge of ADHD using a Greek self-report ADHD Knowledge Questionnaire (ADHD-KQ). All participants worked in infant/child centers operated by municipalities in Greece. Results point out early childhood educators’ lack of fundamental knowledge about the causes, symptoms/diagnosis, cognitive deficits, and interventions regarding ADHD. Among the personal and professional variables (years of teaching experience, age, and educational level) studied as predictors of overall knowledge about ADHD age was found as the only significant. Older participants seemed to have better knowledge regarding the basic aspects of ADHD. Results suggest greater efforts must be made to provide training specifically in the management of children with ADHD.

Effectiveness of a training programme on the knowledge and perception of Attention-Deficit Hyperactivity Disorder among primary school teachers in Kano, Nigeria

This study assessed the effect of Attention-Deficit Hyperactivity Disorder (ADHD) training on teachers’ knowledge and perception of the condition in Kano, Nigeria. It was a controlled trial of 200 primary schoolteachers from two Local Government Areas (LGAs). One LGA was randomly assigned to the intervention group and the other to a waitlist control (100 teachers per group). The intervention group received two training sessions on ADHD one week apart. The training was based on the Mental Health Gap Action Programme – Intervention Guide (mhGAP-IG). Participants completed the ADHD Knowledge Questionnaire, ADHD Attitude Scale, and Knowledge of Behavioral Intervention Questionnaire at baseline and one-week post-intervention. The participants ranged from 17 to 58 years (Mean = 34.1 years; SD = 8.7), comprising 112 females and 85 males. The intervention and control groups were broadly similar at baseline. Controlling for baseline scores and other differences (age, gender, duration of teaching experience, and if schools employed staff dedicated to helping children with mental health difficulties such as ADHD), the intervention group had significantly higher scores on Knowledge of ADHD and Knowledge of Behavioral Management of the condition, with effect sizes of 0.7 and 0.3, respectively. This intervention led to statistically significant improvements in the teachers’ knowledge of ADHD and behavioral intervention for ADHD. This provides further evidence of the feasibility and effectiveness of specific ADHD-training interventions for primary school teachers in Nigeria.

Assessment of Knowledge Regarding Attention Deficit Hyperactivity Disorder among Teachers in Selected Government Schools: A Cross-sectional Study

INTRODUCTION: Attention deficit hyperactivity disorder (ADHD) is a neuro-developmental disorder that typically first manifest early in childhood and often persist into adulthood which can affect the academic achievement, well-being and social interactions of children. The objective of this study was to assess knowledge about ADHD among the government school teacher and to find the association between ADHD knowledge with their demographic variables. MATERIALS AND METHODS: A cross section descriptive research design was adopted. A total of 112 numbers of samples were selected from government schools of Janakpurdham, Nepal by use of purposive sampling. The information was collected through the use of the Knowledge Attention Deficit Disorder Scale (KADDS) tool, and subsequently, data were analyzed using Statistical Package for Social Sciences (SPSS). RESULTS: The result revealed that 43.8% demonstrated insufficient knowledge, while only 56.2% possessed adequate knowledge. There was significant association of gender and the ADHD knowledge among the government school teachers (p = 0.016). CONCLUSIONS: Insufficient knowledge about ADHD was noted among school teachers, indicating a need for the government to provide targeted training and in-service education in this field.

Screening of ADHD symptoms in primary school students and investigation of parental awareness of ADHD and its influencing factors: A cross-sectional study.

The present study aimed to compare the differences in positive screening rates of attention deficit hyperactivity disorder (ADHD) symptoms between parents and teachers in the same sample of primary school students. Concurrently, parental awareness and information sources of ADHD were investigated, and possible relevant factors affecting parental awareness and their influence on positive screening rate of ADHD were analyzed. A cross-sectional study was conducted in Changchun, China, between September 2020 and January 2021. Parents of 1,118 primary school students and 24 head teachers were recruited in the survey. Data were collected through a structured self-administered questionnaire. It consisted of socio-demographic characteristics, ADHD symptom screening questionnaire, parental awareness, and information sources of ADHD. Among the 1,118 primary school students, 30 (2.7%) and 60 (5.4%) students were positive for Swanson, Nolan, and Pelham Rating Scale (SNAP-IV) screening in the parent version and teacher version, respectively. Parents had lower positive screening rates for ADHD symptoms than teachers. Relationship with children (mother, OR = 1.552, 95% CI = 1.104-2.180), bachelor degree or above of parents (OR = 1.526, 95% CI = 1.054-2.210), children's sex (girl, OR = 1.442, 95% CI = 1.093-1.904), and age (OR = 1.344, 95% CI = 1.030-1.754), children's grade (grade 2, OR = 0.522, 95% CI = 0.310-0.878; grade 3, OR = 0.388, 95% CI = 0.185-0.782), information sources of ADHD (medical staff, OR = 1.494, 95% CI = 1.108-2.015; family/relative/friend, OR = 1.547, 95% CI = 1.148-2.083; TV/Internet, OR = 3.200, 95% CI = 2.270-4.510) were the factors related to the parental awareness of ADHD. Parents and teachers of primary school students recognize ADHD symptoms differently. The positive screening rate of ADHD among teachers was significantly higher than that of parents. Relationship with children, educational level of parents, children's sex, age, and grade, and information sources of ADHD are the relevant factors affecting parental awareness of ADHD. More efforts should be made to disseminate ADHD knowledge through mass media, and medical staff. Fathers, parents with low educational level, and parents of grade 2 and 3 pupils should be encouraged to acquire more knowledge on ADHD to improve the early recognition rate of ADHD symptoms. [http://www.chictr.org.cn/showproj.aspx?proj=54 072], identifier [ChiCTR2000033388].

Referring Attention-Deficit/Hyperactivity Disorder: Gaining Perspective From Advanced Practice Providers in Primary Care.

The objective of the current study is to identify provider, patient, and family characteristics associated with pediatric advanced practice provider (APP) decisions to refer to a subspecialist for diagnosis and management of attention-deficit/hyperactivity disorder (ADHD). We conducted a cross-sectional electronic survey of pediatric primary care APPs using member lists of professional organizations. T tests and chi-square analysis were conducted to identify group differences. Most respondents rated themselves as comfortable diagnosing and managing ADHD. We found no significant difference between groups based on comfort level or likelihood to refer. APPs working in suburban settings report significantly lower levels of comfort. Self-designation as the practice's primary provider for behavioral/mental health concerns had significantly higher levels of comfort and were less likely to refer. In a limited sample, most APPs reported comfort diagnosing and managing ADHD. Activities to identify and ameliorate gaps in ADHD knowledge and care need to consider this growing part of the workforce.

Clinical Change Mechanisms in the Treatment of College Students With ADHD: Trajectories and Associations With Outcomes

The purpose of this study was to evaluate trajectories of response for the three theorized mechanisms of clinical change (knowledge, behavioral strategies, and adaptive thinking) associated with the Accessing Campus Connections and Empowering Student Success (ACCESS) intervention for college students with attention-deficit/hyperactivity disorder (ADHD) and their association with treatment outcomes. Participants included 250 college students comprehensively diagnosed with ADHD randomly assigned to ACCESS or to a delayed-treatment control who completed ratings at baseline, end of active treatment, and end of the maintenance phase of treatment (after two semesters). Growth mixture models (GMMs) were used to evaluate trajectories. Participants in ACCESS made significant gains in the use of behavioral strategies and trajectories were associated with large effect size improvements in measures of symptoms and functioning. Participants also made improvements in ADHD knowledge. However, only the knowledge trajectory with rapid improvement displayed significantly better outcomes. Only one trajectory group showed improvement in adaptive thinking with most ACCESS participants remaining stable across time. However, adaptive thinking trajectories were strongly related to both symptom and functional outcomes. ACCESS is associated with large gains in two of the three theorized clinical mechanisms of change, behavioral strategies and ADHD knowledge. Rapid improvement in behavioral strategies was associated with robust improvement in symptoms and functioning. Although improvements in the third mechanism, adaptive thinking, were small, they were strongly associated with outcomes demonstrating the importance of a cognitive-behavioral approach in treating college students with ADHD.