Teachers' Preferences for Interventions for Ethnically Diverse Learners with Attention-Deficit Hyperactivity Disorder
Wood, Jamie C., Heiskell, Kelly D., Delay, Dawn M., Jongeling, Jody Ann S., Perry, Darrick, Adolescence
Attention-Deficit Hyperactivity Disorder is one of the most common childhood disorders. Approximately 3 to 7% of school-age children are diagnosed with ADHD (Pastor & Reuben, 2002). About 50% of these students take psychotropic medication to treat their ADHD, while 12 to 34% receive other interventions such as special education and mental health services (Pastor & Reuben, 2002). The core symptoms of ADHD include impulsivity, inattention, and overactivity. The disorder is further divided into subtypes including combined type (ADHD-CT), predominantly inattentive type (ADHD-IA), and predominantly hyperactive-impulsive type (ADHD-HI) (American Psychiatric Association, 1994). Due to these primary difficulties, children with ADHD often experience significant problems in school settings (see DuPaul & Stoner, 2003, pp. 72-106, for a review of associated academic concerns). While the core symptoms noticed by teachers and others are often consistent, other variables may help explain important differences in the rates at which the disorder is diagnosed and in preferences for certain intervention strategies over others.
One important variable which interacts with the prevalence of diagnosis of ADHD is gender. Many more males than females are diagnosed with ADHD, and the ratio has varied depending on the source of the research. Referrals in clinics approximate a 6:1 ratio while referrals in community settings approximate a 3:1 ratio (Pastor & Reuben, 2002). Another somewhat understudied variable is the ethnicity of the child. Some studies have found significant differences between Caucasians and African American students (e.g., DuPaul et al., 1997; Epstein, March, Connets, & Jackson, 1998; Reid, DuPaul, Power, Anastopoulos, & Riccio, 1998). Not surprisingly, concern has been expressed regarding the accuracy of current assessment methodology with ethnic minority students (Bauermeister, Berrios, Jimenez, Acevedos, & Gordon, 1990). Just as a multitude of factors seem to affect the prevalence of ADHD diagnosis, intervention selection may also be influenced by ethnic/gender variables. Prior to addressing these possibilities, the current researchers reviewed the general literature on intervention for ADHD and the impact of teacher variables on the success of intervention.
Several studies have provided support for both behavioral and pharmacological interventions. It is clear that medication treatment provides at the very least short-term benefits academically, behaviorally, and socially (see DuPaul, Barkley, & Connor, 1998, for a review). Long-term studies seem to have suggested that the intervention method and success of the approach may hinge on whether the student has other comorbid conditions along with ADHD (Jensen, Martin, & Cantwell, 1997). As the previous report attests, students who have other behavioral and/or psychological concerns, may find that other treatments such as behavior modification or counseling are beneficial. Modification of instruction, curriculum, and the physical environment of the classroom may also prove efficacious (see DuPaul & Stoner, 2003, pp. 139-189), for suggestions).
The impact of teacher effort on an intervention's success would seem to be omnipotent. For example, when teachers disagree with an intervention, they may choose to refuse to implement it, implement it improperly, of fail to finish the treatment (Eckert & Hintze, 2000; Wilson & Jennings, 1996). Logically, it follows that the degree to which teachers "believe in" the possible success of a given intervention may play a major role in the intervention outcome. Undoubtedly, numerous factors affect teachers' perceptions about their preference for certain interventions over others. The amount of effort involved, duration of effort, resources, and support are factors teachers are likely to ponder in considering their intervention preferences. One investigation found that plans for teacher support were crucial to the success of interventions (Horner, Albin, & O'Neill, 1991). …