This study examined urban educators' attitudes toward commonly recommended interventions for students with Attention Deficit Hyperactivity Disorder (ADHD). Participants included 358 pupil personnel services (PPS) professionals-school psychologists, social workers, and counselors-and 70 classroom teachers from urban elementary schools. On average, PPS professionals and classroom teachers expressed little confidence in the effectiveness of commonly used classroom, mental health, and pharmacological treatments for ADHD. For PPS professionals, a moderately positive correlation was found between self-confidence and effectiveness ratings for classroom interventions and mental health interventions, and a small positive association was found between know/edge of ADHD and effectiveness ratings for medication. Teacher self-confidence was positively associated with effectiveness ratings for classroom interventions. Knowledge of ADHD was negatively correlated with teacher perceptions of the effectiveness of classroom and mental health interventions. Neither child gender nor ADHD subtype influenced effectiveness ratings. Results are discussed in regard to the urgent need for urban educators to experience greater success in their efforts to implement interventions for students with ADHD and for research focused on the unique needs of children residing in urban, low-income communities.
Children with Attention Deficit Hyperactivity Disorder (ADHD) often face their greatest challenges in school. They are three to seven times more likely than their peers to be retained, suspended or expelled, or to require special education (LeFever, Villers, Morrow, & Vaughn, 2002). Over one-third of students with ADHD will not complete high school (Pfiffner & Barkley, 1990). Problems faced by children with ADHD are most likely exacerbated in urban low-income communities due to a shortage of community mental health providers for children and adolescents, the subsequent low rates of mental health service usage among residents of these communities, and the low quality of care received (U.S. Department of Health and Human Services, 1999).
Nationally, there is increasing awareness that schools are, de facto, the major providers of mental health services for children and youth (Burns et al., 1995). It is estimated that schools provide 70% to 80% of mental health care to children (Rones & Hoagwood, 2000), and these figures may prove to be conservative estimates for children with mental health needs who reside within disadvantaged urban communities. Of particular importance to this study, therefore, were two groups of urban educators who play pivotal roles in promoting the success of children with ADHD: pupil personnel services (PPS) professionals (i.e., school psychologists, social workers, counselors) and teachers.
There have been several investigations of teachers' knowledge about ADHD. However, to our knowledge, no study has assessed the knowledge and beliefs about ADHD held by PPS professional groups. This is unfortunate because PPS professionals have mandated roles under section 504 of the Rehabilitation Act of 1973; the Individuals with Disabilities Act (IDEA; 1990, 1997); and IDEA'S predecessor, Public Law 94-142 (PL 94-142; the Education of All Handicapped Children Act of 1975), which involve the identification, evaluation, and formulation of intervention plans such as Individual Education Plans (IEPs) for children with ADHD and other handicapping conditions. As a result, PPS professionals are often described as "gatekeepers" for specialized services. For students with ADHD, PPS professionals also often provide direct services (e.g., social skills training) and consultation to teachers and families. Thus, PPS professionals play a critical role in the identification and provision of support to students with ADHD. A greater understanding of their attitudes toward interventions for children with ADHD represents an important initial step toward enhancing the types of services provided to students with ADHD in urban schools. …