Teachers’ Perceptions of Children With ADHD Label and Stimulant
Medication
Emily VanEyll, M.S.Ed., & Jocelyn Newton, Ph.D., NCSP
School Psychology Program, University of Wisconsin-La Crosse
Introduction
Abstract:
Attention-deficit/hyperactivity disorder (ADHD) is highly prevalent in
today’s schools and a simple label can influence both teachers’
perceptions and reactions. The current study examined how an ADHD
label and use/non-use of stimulant medication impacted teachers’
perceptions of the severity of a child’s behaviors, their emotional and
behavioral reactions to the child, as well as their willingness to aid in
treatment. Implications for school psychology practice as well as
addressing labeling biases in schools are discussed.
Background:
• ADHD affects 4.5 million children ages 3 to 17 and is a rising
concern with diagnoses increasing an average of 3% annually
(Center for Disease Control, 2010).
• With prevalence rates reported as high as 9%, ADHD affects one to
two students in a typical classroom (American Psychiatric
Associations [APA], 2004).
• Preliminary findings regarding labels revealed that participants were
more likely to perceive a child to have more attention problems if
they were labeled with ADHD (Koonce et at., 2004; Stinnett et al.,
2001).
Introduction, cont.
Study purpose:
• Examine whether teacher perceptions are influenced by the
presence of a label of ADHD and/or presence of stimulant
medication.
• Examine teacher years of experience in order to assess if novice or
veteran teachers are more likely to show labeling bias.
• To identify why teachers are more or less willing to help a student
with ADHD and where they feel additional training is needed.
Method
Participants:
• 23 in-service, core Elementary School teachers (1 male, 22
females) from rural and Suburban Midwestern districts
• Mean Age = 46.17, range of 25- 58
• All reported Caucasian ethnicity
Procedure:
• Computer based questionnaire (link sent through email)
• Read 1 of 4 short vignettes* about an elementary boy with behavioral
symptoms meeting DSM-IV criteria for ADHD-Combined Type.
• Vignettes reflected four different conditions:
• A more recent study examined the impact of stimulant medication
and found that labeled children were rated less favorably on
behavior, intelligence, and personality; however those using
stimulant medication were rated more favorably than a child without
medication (Batzle et al., 2010).
• Another recent study found that behaviors of labeled children are
seen as more serious and disruptive, and participants were more
bothered, stressed, and less confident in addressing the behaviors,
yet were more willing to help aid in treatment and interventions
(Ohan et al., 2011).
No Label or Medication
ADHD Label + Stimulant
Medication
Teachers’ Evaluation of
Seriousness of
Social/Behavioral Problems
Emotional Reactions to the
Child
• No main effect for vignette: F(3, 14)= .72, p = .556
• No main effect for Yrs. Teaching: F(1, 14)= .066, p = .800
• No interaction: F(3, 14)= .534, p = .666
Willingness to Aid in Treatment
• No main effect for vignette: F(3, 15)= .134, p = .939
• No main effect for Yrs. Teaching: F(1, 15)= .052, p = .822
• No interaction: F(3, 15)= .221, p = .880
Emotional Reactions to Child
• No main effect for vignette: F(3, 15)= 1.276, p = .318
• No main effect for Yrs. Teaching: F(1, 15)= .244, p = .629
• No interaction: F(3, 15)= .184, p = .905
• No main effect for vignette: F(3, 15)= .755, p = .537
• No interaction: F(3, 15)= .381, p = .768
Results: Qualitative Findings
Please describe what increases your willingness to help a child
with ADHD?
Increase Willingness to Help
1
1
1
Parent Support/Involvement
Administration/Resources
11
2
Early Age of Student
Social Difficulties Observed
Strategy is seen to work
Child Struggles Worsen
3
Disruption to Others
*Vignettes and Questionnaire modified from Ohan et al., 2011
Results: Other Demographics
• Grade level teaching:
Please describe what decreases your willingness to help a child
with ADHD?
Decreases Willingness to Help
K=3; 1st=4; 2nd=1; 3rd=5; 4th=7; 5th=3
• Hrs. of prof. development:
M= 9.56, Range= 0 – 50
• Students taught with ADHD:
M= 44.32, Range= 7 – 180
• Students referred:
M= 11.08, Range= 0 – 60
8
6
6
6
4
3
2
2
Lack of Parent Support
4
14
5
Lack of
Administration/Resouces
Child Isn't Willing to Try
Nothing
Not As Disrupting
5
www.PosterPresentations.com
10
 Yrs. Teaching: F(1, 15)= 3.516, p = .080, indicating that novice
teachers would be more likely to take time and intervene (M=
9.8, SD = .789) than veteran teachers (M= 11.08, SD= 1.071).
**p is <.10, had there been more participants
significance at the more traditional p <.05 may have been
obtained.
• Personal experience w/ ADHD: Yes-10, No-13
TEMPLATE DESIGN © 2007
11
Child is Willing to Try
Behaviors Towards the Child
Qualitatively:
• Parent support emerged as the number one reason why a
teacher would be more or less likely to help a child with ADHD.
• The second highest influence in both responses discussed the
amount of administration support and in-school resources.
 This implies that if we strengthen either or both of these top
variables, we can help support our teachers more effectively to
work with this population of children with ADHD.
• When asked about specific training, the following data was
obtained:
12
Behavior Towards Child
2
Willingness to Aid in
Treatment
• With respect to the quantitative results, it is hypothesized that
had there been more participants, significance may have been
found especially in the IV of behavior towards child.
 This shows that ‘labeling bias’ can still be occurring in schools.
Area Teachers’ Requested More Training
4
•
 More research is needed to see how labeling bias is occurring in the
schools within the increasing ADHD population and increased use
of medication as a treatment.
No Label + Stimulant
Medication
Discussion
• Four separate 4 (vignette condition) x 2 (yrs. teaching) Analysis of
Variance (ANOVA) analyses were conducted.
• A median split formed 2 groups (novice vs. veteran teachers)
based on the number of years they’ve been teaching
• 20 years or less = 9
• 21 years or more = 13
Evaluations of Social/Behavioral Problems
• Then completed an 11-item questionnaire* assessing the four main
outcome areas of:
• This difference in perception due to the presence or absence of a
label is referred to as labeling bias (Stinnett et al., 2001).
 Given the rise in incidence of this diagnosis and potential impact in
the classroom, it is crucial for school professionals, particularly
school psychologists, to understand how a mere label of “ADHD”
will influence teachers’ perceptions.
ADHD Label + No Medication
Results: Analysis of Variance
0
Workshops to
Increase General
Knowledge/Education
Bx Mgnt. Training
Classroom
Intervention
Resources
More Communication
with Parents and
Teams
 These results suggest that school psychologists can positively
impact children with ADHD by consulting with their teachers on
the following topics: sharing knowledge regarding the basic
characteristics of this disorder; promoting basic behavior
management skills and effective classroom interventions; and
encouraging home-school communication.
References
• APA- American Psychiatric Association (2000).
• APA- American Psychiatric Association (2004).
• Batzle, C. S., Weyandt, L. L., Janusis, G. M., & DeVietti, T. L. (2010). Potential impact of ADHD with
stimulant medication label on teacher expectations. Journal of Attention Disorders, 14, 157-166.
• CDC- Center for Disease Control. (2010). ADHD from http://www.cdc.gov/ncbddd/adhd/
• Ghanizadeh, A. (2008). Distribution of symptoms of attention deficit-hyperactivity disorder in
schoolchildren of Shiraz, south of Iran. Arch Iran Med, 11, 618-624.
• Koonce, D.A., Cruce, M.K., Aldridge, J.O., Langford, C.A., Sporer, A.K., & Stinnett, T.A. (2004). The
ADHD label, analogue methodology, and participants’ geographical location on judgments of social and
attentional skills. Psychology in the Schools, 41, 221-234
• Ohan, J. L., Cormier, N., Hepp, S. L., Visser, T. A. W., & Strain, M. C. (2008). Does knowledge about
attention-deficit/hyperactivity disorder impact teachers’ reported behaviors and perceptions? School
Psychology Quarterly, 23, 436-449.
• Ohan, J.L., Visser, T. A. W., Strain, M. C., & Allen, L. (2011). Teachers’ and education students’
perceptions of and reactions to children with and without the diagnostic label “ADHD”. Journal of School
Psychology, 49, 81-105.
• Stinnett, T.A., Bull, K.S., Koonce, D. A., & Aldridge, J.O. (2001). Effects of diagnostic label, race, gender,
educational placement, and definitional information on prognostic outlook for children with behavioral
problems. Psychology in the Schools, 36, 51-59