





































Emerging Perspectives 
ep.journalhosting.ucalgary.ca 
 
 

 Teachers’ Knowledge of ADHD: Review and Recommendations 

Laura Flanigan1 & Emma Climie 

University of Calgary 

Attention-Deficit/Hyperactivity Disorder (ADHD) is a highly prevalent and 

concerning disorder in the classroom (Bekle, 2004). Teachers need to provide supports 

for these students, yet it is often the case that they lack sufficient knowledge to do so 

(e.g., Alkahanti, 2013). This paper provides a review of recent literature (2004 to the 

present) regarding teacher knowledge of ADHD in English-speaking countries.  This 

includes a discussion of overall themes, areas of knowledge and misunderstanding, 

with emphasis on the need to ensure that teachers have basic knowledge of the 

etiology, symptoms, and treatments of ADHD. Accurate ADHD knowledge and 

ongoing professional development would likely benefit schools and communities.   

 

Keywords: Attention-Deficit/Hyperactivity Disorder, ADHD, teacher knowledge, 

teacher beliefs, professional development  

 

Flanigan, L. & Climie, E. (2018). Teachers’ knowledge of ADHD: Review and 

recommendations. Emerging Perspectives, 2(1), 1-13. 

 

It is assumed that teachers completing their university programs will enter the classroom 

with the most current and relevant information regarding teaching and learning.  Pre-service 

teachers frequently receive excellent training in many areas of school practice, including 

curriculum development, formative and summative assessment techniques, and classroom 

management (McCrimmon, 2015). However, although novice teachers are generally equipped to 

deal with the learning needs of typically-developing students in their classrooms, they often 

struggle when it comes to working with children with exceptional learning needs.  In today’s 

schools, it is anticipated that most classrooms will have some students with social-emotional, 

learning, or behavioural challenges.  As a poignant example, mental health concerns in children 

are at an all-time high, with up to 20% of Canadian students identified as having mental health 

concerns (Waddell, McEwan, Shepherd, Offord, & Hua, 2005).  Learning disabilities currently 

affect 5-15%, while attentional and behavioural concerns are identified in 5-7% of students 

(American Psychiatric Association [APA], 2013). The wide range of percentages may result from 

differing diagnostic criteria or procedures (Nigg & Barkley, 2014). 

Given the high percentage of children with learning and attentional difficulties in the 

classroom, it is important to ensure that teachers have an adequate understanding of the issues that 
may be impacting their students and how they, as teachers, may be able to best support their 

students. Unfortunately, not all teachers may receive this training, potentially resulting in daily 

frustrations with challenging students and sometimes leading to teacher burnout (Bekle, 2004).  

                                                             
1 lkflanig@ucalgary.ca 



Flanigan & Climie/ Emerging Perspectives (2018)  2 

One population that often experiences challenges in the classroom environment is children with 

Attention-Deficit/Hyperactivity Disorder (ADHD).   

Teachers are an incredibly important resource in the diagnosis and intervention of children 

with ADHD. Sax and Kautz (2003) found that since teachers are generally the first to witness 

children in an academic context, they are often the first to suggest an assessment for ADHD. 

Although children with ADHD are present in most classrooms, teachers report that they often feel 

unprepared as to how to best support these students (Vereb & DiPerna, 2004). Having a strong 

knowledge of the important aspects of ADHD (e.g., symptoms, incidence, evidence-based 

treatments) may help teachers to feel more confident working with students with ADHD (Ohan, 

Cormier, Hepp, Visser, & Strain, 2008). Accurate knowledge of ADHD may also help to reduce 

the perpetuation of common myths and stigmas about ADHD, which may create a more positive 

learning environment for these students (Bell, Long, Garvin, & Bussing, 2011).  

The purpose of this article is to review and critique the current state of teacher knowledge 

regarding children with ADHD. Specifically, following a brief review of the current literature 

surrounding ADHD, the primary emphasis is on exploring what is currently known about teacher 

knowledge of ADHD, highlighting the limited number of published studies that address this issue. 

A detailed analysis of teacher knowledge regarding the etiology, incidence, characteristics, and 

treatment of ADHD will be examined. Finally, recommendations regarding specific areas of 

teacher professional development are provided as a guide for increasing teacher capacity in 

working with students with ADHD. The primary goal of this review is to provide incentive to 

further the education of teachers in the realm of ADHD, and inform areas in which teacher 

education and training can be focused or improved.  

Attention-Deficit/Hyperactivity Disorder 

ADHD is one of the most prevalent childhood disorders, with 5-7% of children under 18 

years affected by the condition (APA, 2013), suggesting that in a typical classroom of 30 students, 

at least one student will have ADHD. Boys are more often impacted by ADHD than girls, with a 

2:1 or 3:1 ratio of males to females and it can affect children in their preschool years through 

childhood and into adulthood (Barkley, 2014), highlighting the lifelong impact that ADHD may 

have on individuals. 

The Diagnostic and Statistical Manual of Mental Disorders – 5th edition (DSM-5) indicates 

that ADHD is characterized by persistent pattern of inattention and/or hyperactivity-impulsivity 

(APA, 2013). Children and youth with inattentive symptoms have difficulty sustaining attention, 

persisting on tasks, following instructions, and resisting distractions. Parents and teachers often 

note that these children do not listen well, cannot concentrate, and fail to finish assignments 

(Barkley, 2014). In the classroom, these symptoms may appear as making careless mistakes on 

assignments, difficulty organizing materials (e.g., their desk or notebooks), as well as frequently 

losing materials. Hyperactive symptoms often appear as excessive motor activity at inappropriate 

times. Children who demonstrate these symptoms are often described as being “driven by a 

motor,” or always on the go. In the classroom, these symptoms may appear as constant fidgeting, 

leaving their desk when staying seated is expected, inappropriate running or climbing, or excessive 

talking (APA, 2013). Lastly, symptoms of impulsivity involve actions without forethought that 

could potentially harm the child or others. They often stem from a desire for immediate reward or 

difficulty delaying gratification (APA, 2013). These symptoms often include some form of social 

intrusiveness or inappropriate motor action. In the classroom, these behaviours may appear as 



Flanigan & Climie/ Emerging Perspectives (2018)  3 

blurting out answers, intruding into others’ conversations, and playing with or using others’ 

belongings without permission.  

 While the symptoms and characteristics of ADHD have been well-documented and 

outlined in the DSM-5, there are still many misconceptions surrounding ADHD, including those 

related to its actual existence (i.e., “is ADHD a real disorder?”; Strydom & Du Plessis, 2001), 

dietary treatments (Bekle, 2004), use of medication for treatment (Scuitto, 2015), and parenting 

practices (Selekman, 2002), to name a few.  Some individuals propose that the symptoms of 

ADHD are better accounted for by other conditions (e.g., lack of sleep) or learning identifications 

(e.g., giftedness), and that ADHD does not exist as a distinct disorder (Strydom & Du Plessis, 

2001).  As well, others believe that ADHD is caused by ingesting too much sugar or red food dye 

and that simple changes in diet may alleviate problems (Bekle, 2004).  Others deem that the use 

of stimulant medication, an evidence-based treatment for ADHD, leads to “drugging” of a child 

and may be a potential gateway drug for more problematic substances (Scuitto, 2015).  Poor 

parenting techniques are also often thought to be a cause of childhood ADHD, where some 

individuals believe that had parents been more (or less) strict in their child-rearing, the difficulties 

with ADHD could have been avoided (Selekman, 2002).  

Taken together, it is clear that there is still some inconsistency regarding the overall 

knowledge of ADHD. Parents, teachers, and the general public may benefit from an accurate 

awareness of the issues surrounding ADHD and are able to discern fact from fiction so as to ensure 

that individuals with ADHD are better understood.  It may be particularly important for teachers 

to have an accurate understanding of the etiology, behavioural presentation, and effective 

treatment and intervention strategies for children with ADHD, given that there is a high likelihood 

that they encounter these children on a daily basis. 

Teacher Knowledge of ADHD 

 Teachers play a vital role in the early identification, diagnosis, and support of children with 

ADHD.  Teachers may be the first individuals to witness children in a context where there are 

demands that challenge the attentional capabilities of students (i.e., where children are expected to 

remain seated in their desks, etc.).  As such, teachers are often among the first individuals to 

identify atypical levels of attention abilities in a student and suggest that further investigation into 

these issues is warranted (Sax & Kautz, 2003). 

To provide the best support and education to students with ADHD, it would be ideal for 

teachers to have an in-depth knowledge surrounding the incidence, etiology, symptoms, 

interventions, and difficulties associated with the disorder. However, some studies have suggested 

that elementary-school teachers do not possess an adequate or sufficient amount of knowledge of 

the factors related to ADHD (e.g., Alkahtani, 2013; Ghanizadeh, Bahredar, & Moeini, 2005). 

Having limited or incorrect knowledge of ADHD may lead to the ongoing perpetuation of 

misconceptions (Bekle, 2004), gender biases (Jackson & King, 2004), poor use of classroom 

interventions (Blotnicky-Gallant, Martin, McGonnell, & Corkum, 2015), or the use of 

inappropriate punishment techniques (Ghanizadeh et al., 2005). 

 Conversely, when teachers are found to have a greater knowledge of ADHD, a greater 

likelihood of more positive outcomes for these students are reported. For example, Ohan et al. 

(2008) reported that teachers with a higher knowledge of ADHD were more likely to believe that 

students exhibiting ADHD-like symptoms would benefit from an assessment to better understand 

the specific challenges that these students may be facing. Teachers also saw benefits to making 

changes in the home and school environments to improve ADHD symptoms, rather than simply 



Flanigan & Climie/ Emerging Perspectives (2018)  4 

relying on medication to “fix” the concerns (Ohan et al., 2009). Those with greater knowledge of 

ADHD were also more likely to have more positive attitudes towards those with ADHD (Bekle, 

2004), understand the academic and social difficulties that these children may face (Ohan et al., 

2008), and recognize and acknowledge the potential stigma faced by those with ADHD 

(Blotnicky-Gallant et al., 2015). However, knowledgeable teachers may also experience a “label 

bias,” where with higher knowledge of ADHD, they see more impairment and feel more negative 

emotions towards those identified with ADHD (Ohan, Visser, Strain, & Allen, 2011). As well, 

greater teacher knowledge of ADHD is also associated with lower levels of confidence in teaching 

those with ADHD (Ohan et al., 2008), perhaps as a result of teachers having a better understanding 

of their own strengths and limitations in working with this population. 

Measuring Teacher Knowledge 

 There are numerous assessment tools that may be used to measure knowledge of ADHD, 

such as the Knowledge of Attention Deficit Disorder Scale (KADDS; Sciutto, Terjesen, & Frank 

2000), the Attention-Deficit/Hyperactivity Disorder Knowledge and Opinion Survey (AKOS; 

Bennett, Power, Rostain, & Carr, 1996), the ADHD Knowledge Scale (Jerome, Gordon, & Hustler, 

1994), the Knowledge of ADHD Rating Evaluation (KARE; Vereb & DiPerna, 2004), and the 

Knowledge About ADHD Questionnaire (KADD-Q; West, Taylor, Houghton, & Hudyma, 2005).  

 The KADDS (Sciutto et al., 2000) is a commonly-used ADHD knowledge scale.  It is a 

36-item true/false and “don’t know” scale that is divided into three subscales: symptoms/diagnosis 

of ADHD, general information (nature, causes, impact of ADHD), and treatment.  This scale 

includes 18 positive and 18 negative items. For example, one negative item states 

“Electroconvulsive therapy (i.e., shock treatment) has been found to be an effective treatment for 

severe causes of ADHD.”  The KADDS has been found to have adequate reliability and validity 

for both the overall scale and each of the subscales.  

 The AKOS (Bennett et al., 1996) is unique in that it measures the rater’s opinions of 

concepts related to ADHD (e.g., medication use), in addition to their objective knowledge. The 

knowledge section includes 17 true/false items regarding the symptoms, diagnosis, treatments, 

causes, and prevalence of ADHD (e.g., “Medication often reduces a child’s tendency to be 

aggressive with others at school”).  The opinion section includes twenty-five 6-point Likert items 

(strongly disagree – strongly agree) with items related to medication acceptability, counselling 

acceptability, and counselling feasibility, such as “I believe that medication could help my child 

with ADHD.” 

 The ADHD Knowledge Scale (Jerome et al., 1994) is believed to be the first scale 

developed to measure the knowledge of elementary school teachers regarding ADHD. Many of 

the other measurement tools mentioned in this review were developed from this scale. This scale 

includes 20 items in true/false format and can be divided into subscales regarding the biological 

and non-volitional factors of ADHD, family influences, causation, and medical and educational 

interventions; for example, “ADHD often results from a chaotic, dysfunctional family life.”  

 The KARE (Vereb & DiPerna, 2004) includes items regarding the knowledge of ADHD 

and the acceptance of medication and behavioural treatments. The knowledge section includes 43-

items in two subscales: knowledge of etiology, symptoms, and prognosis, and knowledge about 

treatments used for ADHD. The acceptance section includes 10 items in two subscales: level of 

acceptance of medication use, and level of acceptance of behavioural intervention. The knowledge 

section uses a true/false/don’t know format and the opinion section uses a 4-point Likert format 

(not at all likely – very likely). Sample items include “To be diagnosed with ADHD, a child must 



Flanigan & Climie/ Emerging Perspectives (2018)  5 

exhibit relevant symptoms in two or more settings (e.g., home, school)” from the knowledge 

section, and “How necessary are behaviour management techniques for treating students with 

ADHD?” from the opinion scale.  

 Finally, the KADD-Q (West et al., 2005) was developed in Australia and is an extended 

version of the KADDS (Scuitto et al., 2000). It includes 67 items in a true/false/don’t know format, 

measuring three areas of knowledge: causes, characteristics, and treatment of ADHD.  

 The scales described above are all psychometrically sound and used frequently within the 

ADHD knowledge literature (Soroa, Gorostiaga, & Balluerka, 2013). The KADDS (Sciutto et al., 

2000) is possibly the most accessible and useful to teachers, as it is frequently used in the literature, 

is relatively short, includes solely knowledge (rather than opinion) items, and includes a “don’t 

know” response option. Other scales, such as the AKOS (Bennett et al., 1996) and the KARE 

(Vereb & DiPerna, 2004) may be particularly useful when looking to assess both knowledge and 

opinions about ADHD. The KADD-Q (West et al., 2005) may be useful when looking for a very 

in-depth assessment of teachers’ knowledge, as it is quite long (67 items).  

Review Parameters 

The authors obtained empirical studies using the PsycINFO database, as well as Google 

Scholar to ensure that no relevant papers were overlooked. The key search terms entered into 

PsycINFO included “ADHD”, “ADHD and teachers”, “knowledge and ADHD”, and “teachers 

and knowledge and ADHD.” The authors included studies that assessed in-service elementary 

school teachers’ knowledge of ADHD only and were based in English-language countries.  Studies 

that solely examined pre-service teachers or undergraduate populations were excluded.  The search 

of peer-reviewed articles was limited to the last ten years (2004 to the present) to provide the most 

up-to-date information regarding teacher knowledge. Previously published review articles of 

ADHD knowledge that may incorporate teachers were not included in the current review, although 

these articles were examined to ensure that no papers were missed.  The authors reviewed reference 

lists of all appropriate articles to ensure no studies were overlooked.   

Teacher Knowledge: Etiology  

 Empirical studies have shown mixed information in terms of teachers’ knowledge and 

understanding of the etiology (causes), of ADHD. However, typically teachers perform relatively 

well on these questions, with accuracy scores often falling with the range of 50-92% correct 

(Blotnicky-Gallant et al., 2015; Ohan et al., 2008; West, et al., 2005). This wide range may be a 

result of differing scales used to measure knowledge of ADHD etiology.  Specifically, teachers 

correctly identified questions related to the biological nature of ADHD and the lack of relationship 

to ineffective parenting. Interestingly, West et al. (2005) noted that teachers were generally aware 

that ADHD was not caused by a lack of motivation to control behaviour, indicating a more positive 

attitude towards the disorder than those who simply attributed poor behaviour to poor choice. 

Teachers were also more confident in their answers on questions related to etiology, as this 

category had the lowest number of “Don’t Know” responses compared to the other subscales.  

Bekle (2004) noted that teachers had strong and appropriate knowledge of the etiology of 

ADHD. Specifically, it was found that teachers correctly believed that ADHD has a biological 

basis, and that this disorder was not caused by a lack of behavioural volition, familial 

environments, or racial background.  Similarly, Ohan et al. (2008), also using the ADHD 

Knowledge Scale, found high levels of knowledge regarding the causes of ADHD and provided a 

breakdown of the number of correct responses for each item. They indicated that in their sample, 



Flanigan & Climie/ Emerging Perspectives (2018)  6 

teachers knew that ADHD was not related to poor parenting practices (78.8%) or a chaotic/ 

dysfunctional family life (85.5%), that children with ADHD were born with biological 

vulnerabilities towards inattention and poor self-control (79.5%), and that the disorder could be 

inherited (62%). Teachers from this sample also knew that ADHD was not caused by a lack of 

desire to follow rules or complete assignments (92%), lack of willingness to try (91.2%), nor a 

consequence of defiance or oppositionality (78.5%). Few teachers, however, were able to identify 

that ADHD was not caused by sugar or food additives (27%).  

Anderson, Watt, and Noble (2012), using the KADD-Q (West et al., 2005), found that 

teachers answered 65.5% of the causation-related questions correctly, while Blotnicky-Gallant et 

al. (2015), using the KADDS (Scuitto et al., 2000), indicated that teachers knew that ADHD was 

not a result of ineffective parenting, but did not mention teachers’ responses regarding the 

biological nature of ADHD.  

These findings suggest that teachers generally have an adequate knowledge of some 

aspects of the etiology of ADHD, and are particularly aware of the biological and familial 

influences on the disorder.  However, some aspects, particularly around food-related influences, 

appear to have lower accuracy, although this result may be due to individual differences within 

each paper (i.e., each of these studies used different assessment measures). It may be that teachers 

do have a sufficient knowledge of the etiology of ADHD, but an extended and in-depth 

measurement may be warranted to properly assess this dimension of knowledge. Ensuring that 

teachers have an understanding of the etiology of ADHD—mainly, that it is biologically-based and 

not driven by motivation or parenting practices, may help reduce teachers’ negative views, thus 

creating a more understanding and supportive school environment. 

Teacher Knowledge: Prevalence and Incidence  

There is little empirical research on teachers’ knowledge of the prevalence and incidence 

of ADHD, as this information is usually included as a single item in a general knowledge of ADHD 

subscale. For example, the KADDS stated “Most estimates suggest that ADHD occurs in 

approximately 15% of school age children” (Scuitto et al., 2000). Results from these types of scales 

have shown that information in this area is also not common knowledge for teachers. Among the 

questions on the scale, the single question asked regarding the incidence of ADHD in West et al. 

(2005) provided the highest “Don’t Know” responses from teachers. Similarly, in Kos, Richdale, 

and Jackson (2004), only 35% of teachers were correctly able to identify that ADHD occurs in 

about 5% of school-aged children, while Bekle (2004) noted that many teachers (55%) did not 

know that in most classrooms, there is at the minimum one child with ADHD.  

Kos et al. (2004) did, however, show that their sample had significant knowledge of the 

sex differences in the prevalence of ADHD, indicating that teachers were aware that ADHD, 

although more common in males (81.7% of teachers correctly responded), impacts both males and 

females (95.8%). Bekle (2004) also found that teachers had sufficient knowledge of the sex 

differences in ADHD. Further, all teachers surveyed were aware that ADHD does not occur more 

frequently in minority groups than in Caucasians (Bekle, 2004).  

It may be important for teachers to have an understanding of the prevalence of ADHD, so 

they are able to accurately estimate the number of students with ADHD they may have in their 

classrooms. Additionally, teachers who do not know actual prevalence rates may be more at-risk 

of over-identification of students (Ohan et al., 2011). As many of the reviewed studies did not 

examine teachers’ knowledge of prevalence rates, it is difficult to pinpoint where teachers stand, 

even though an understanding of the incidence of ADHD may be incredibly important to the 



Flanigan & Climie/ Emerging Perspectives (2018)  7 

success and education of students with ADHD. A more accurate understanding of incidence rates 

of ADHD may help to mitigate or prevent these negative effects. 

Teacher Knowledge: Symptoms and Diagnosis 

 Overall, research has found that teachers tend to have a sufficient knowledge of the 

characteristics, symptoms, and diagnostic process associated with ADHD. Kos et al. (2004) found 

that most teachers were able to correctly identify that inattentiveness in the absence of 

hyperactivity is sufficient for a diagnosis of ADHD (77.5% of the sample of teachers), that there 

are subtypes of ADHD (75% of the sample), and that children from any walk of life can have this 

disorder (96.7% of the sample). They also understood that the ability to focus in some situations 

(e.g., playing video games) does not rule out a diagnosis of this disorder (77.5%). However, they 

did lack an understanding that adherence to set rules is difficult for children with ADHD (22.5%).  

 Bekle (2004) as well as Ohan et al. (2008) both found promising results regarding teachers’ 

knowledge of the symptoms and diagnosis of ADHD using the ADHD Knowledge Scale. Both 

groups indicated that they knew that a child can be diagnosed with ADHD (97% of sample 

responded correctly), but not necessarily be overactive (79.8%), that these children are often quite 

variable in their day-to-day school performance (100% and 93.6%, respectively), and that they 

often have good focus for things such as video games (100% and 88.1%, respectively). There were 

some discrepancies between these two studies regarding teacher knowledge surrounding the fact 

that children with ADHD do not outgrow their disorder and become symptom-free as adults (70% 

and 57.3%, respectively), and are at high risk of becoming delinquent as teenagers (73% and 

50.4%, respectively). Ohan et al. (2008) suggested that these discrepancies may be due to the 

limited sample size of the Bekle (2004) study (30 teachers), compared to their own (140 teachers).  

 West et al. (2005), using the KADD-Q, found that teachers from their sample only had 

59% accuracy regarding the characteristics of ADHD. Teachers had specifically limited 

knowledge that children with ADHD often talk excessively in class (48%) and tend to be verbally 

aggressive (39%), but do not have poor body posture (38%). They were, however, aware that 

children with ADHD often have poor concentration (95%), are often inattentive (93%), and can 

act impulsively (86%). Anderson et al. (2012), who also used the KADD-Q, found that teachers 

from their sample had a 73% accuracy on this subscale. The discrepancy between these studies 

may be due to sample differences, as West et al. used an Australian sample whereas Anderson et 

al. (2012) used an American sample. There may be a difference in the training received by teachers 

in these samples.  

 Finally, 80% of teachers in Blotnicky-Gallant et al. (2015) correctly answered items on the 

symptoms and diagnosis subscale of the KADDS (Scuitto et al., 2000). Of note, 95.6% of their 

sample were aware that a child with ADHD can have sustained attention to a video game or TV 

while still having difficulty sustaining attention to class or homework. This sample was also aware 

that the majority of children with ADHD will experience some form of poor school performance 

in elementary school (82.5% correctly answered).  

 Based on these studies, it appears as though teachers have a sufficient basic knowledge 

regarding the symptoms and behavioural presentation associated with ADHD. Across studies, the 

majority of teachers knew that the ability to focus on enjoyable and stimulating activities such as 

video games and television does not discount the difficulties focusing in class or on homework. 

They were also correctly aware that ADHD can have multiple presentations that include 

hyperactivity, inattention, impulsivity, or any combination of the three. There was some 

inconsistency regarding the day-to-day presentation of the disorder, such as verbal aggression and 



Flanigan & Climie/ Emerging Perspectives (2018)  8 

talking excessively, as well the future consequences, such as risks for later teenage delinquency. 

Education focused on increasing these areas of knowledge could aid in faster identification of 

ADHD, potentially preventing some of these negative consequences.  

Teacher Knowledge: Treatments  

 For almost all papers included in this review, teacher knowledge of treatments for ADHD 

was lower than any other knowledge-related domain.  As well, this area demonstrated the largest 

number of myths or misconceptions related to ADHD, with accuracy scores ranging from 42% 

(Anderson et al., 2012) to 68.8% correct (Blotnicky-Gallant et al., 2015).  Some papers examined 

in this review provided only overall correct scores, while others broke down their results into 

categories (e.g., medication or diet-related treatments).   

Overall, teacher knowledge regarding medication use was limited.  West et al. (2005) found 

that teachers’ knowledge of ADHD treatment was below chance, with scores of only 47.8% 

accuracy on this subscale. However, they found that most teachers were aware that stimulant 

medication is effective to reduce symptoms of inattention (93%), and a combination of medication 

and behavioural management is ideal (89%). West et al. (2005) also noted a lack of knowledge 

related to the side effects of stimulant medication, including anxiety (38% correct). Kos et al. 

(2004) also examined knowledge regarding treatment of ADHD. Teachers knew that medication 

was not a cure for ADHD (84%), and that educational interventions are beneficial even with 

medication use (75%). All other questions, however, demonstrated a significant deficit in 

knowledge related to treatment. For example, the questions “if a child responds to stimulant 

medication then they probably had ADHD” and “children with ADHD always need a quiet 

environment to concentrate” were endorsed by almost 50% of respondents (47.5% and 50.8%, 

respectively). In addition, approximately one in four (21.7%) believed that prolonged use of 

stimulant medication may lead to increased addiction in adulthood. 

Teachers from both Bekle (2004) and Ohan et al. (2008) were also aware that educational 

interventions are beneficial to support the use of medication (83% and 91%, respectively), that 

medication is not the only effective treatment for ADHD (73% and 76%, respectively), and that 

these children typically behave better in one-to-one interactions than groups (93% and 85%, 

respectively). There was some discrepancy regarding whether ADHD children require a quiet, 

sterile environment in order to concentrate, with Bekle (2004) reporting 93% accuracy and Ohan 

et al. (2008) only reporting 76%. Finally, Vereb and DiPerna (2004) reported an average of 54.4% 

correctly-answered items regarding treatments, including questions like, “Behaviour management 

techniques can improve a child’s ability to pay attention in class” and “Medication will help a child 

with ADHD achieve better grades in school.” 

Teachers also overwhelmingly supported the idea that changes in food intake and/or sugar 

reduction is an effective treatment for ADHD.  Specifically, teachers indicated a strongly-held 

sugar/food additives belief, where 66% believed that diet changes were an appropriate treatment, 

and many believed that homeopathic remedies (67%), fish oil supplements (66%), and biofeedback 

(86%) were effective treatments (West et al., 2005). In Kos et al. (2004), 86% of this sample 

indicated that they believed that special diets were helpful in treating children with ADHD, 

perpetuating long-held misconceptions. However, in a single-item analysis, Blotnicky-Gallant et 

al. (2015) found that 41% of their teacher sample disagreed with the statement regarding the 

reduction of sugar and food additives to reduce symptoms of ADHD. Participants in Bekle (2004) 

and Ohan et al. (2008) also upheld the myth that diets can be helpful in treating ADHD, with 23% 

and 13% accuracy, respectively. 



Flanigan & Climie/ Emerging Perspectives (2018)  9 

In comparing the above studies, it seems that more recent studies (e.g., Blotnicky-Gallant 

et al., 2015) report more accurate treatment knowledge than older studies (e.g., West et al., 2005). 

This may speak highly of the updated training and professional development that teachers are 

currently receiving. It is also important to note that teachers are not responsible for treating ADHD, 

and thus are not required to have in-depth knowledge of the different treatments available. 

However, as Anderson et al. (2012) noted, teachers are often responsible for implementing certain 

behavioural interventions and observing the effectiveness of medication throughout the school 

day. Equipping teachers with the appropriate knowledge regarding medical, behavioural, and 

educational management strategies for ADHD could help to improve their confidence in teaching 

these students. This has the potential to make these interventions more successful and create a 

more effective learning environment for their students with ADHD. 

Summary 

Teachers from these various studies showed a varied but adequate knowledge of ADHD in 

a number of areas. Promisingly, their most knowledgeable areas were of the etiology and 

characteristics/symptoms of ADHD. This finding may be critical, as having a good understanding 

of the etiology of ADHD may prevent inappropriate judgment of the parent or child. Similarly, 

having a good understanding of the appearance of ADHD will allow teachers to appropriately 

identify children with attentional concerns and may enable them to acquire further supports for 

this child. 

 Teachers also demonstrated relatively limited knowledge regarding effective treatments 

for children with ADHD. Some teachers were aware that medication and behavioural management 

together would be an ideal treatment, but a majority either disagreed with or were unsure of the 

accuracy of this statement. However, teachers surveyed in more recent studies had more accurate 

treatment knowledge than older studies, suggesting that teacher training and professional 

development may be dispelling some older myths and misconceptions. Ensuring that teachers have 

appropriate and correct knowledge of evidence-based ADHD treatments may allow them to better 

support and manage students with ADHD.  

Limitations in Current Research 

There were some limitations to the studies included in this review. First, there was little 

empirical research regarding teachers’ knowledge of the prevalence of ADHD. Few teachers knew 

the incidence rate of ADHD in the school-aged population. As knowledge of incidence rates made 

up such a small part of the overall knowledge assessment (often only one question), it is difficult 

to determine whether this finding is an accurate representation of teacher knowledge. As an 

understanding of the incidence of ADHD may help to prevent an over-identification of children 

with ADHD, future studies on teacher knowledge of ADHD may wish to provide a greater focus 

in this domain. 

A second limitation of this article is the focus on English-speaking countries only.  

Although this review purposefully focused on understanding teacher knowledge of ADHD in 

English-language countries, it is also important to understand the broader cultural perspective on 

this disorder.  There are studies examining teachers’ knowledge of ADHD in other countries, such 

as Saudi Arabia (e.g., Alkahtani, 2013).  However, accurate ADHD knowledge in these countries 

was significantly more varied than that of English-language countries.  For example, Alkahtani 

(2013) reported that teachers in their Saudi Arabian sample answered only 19% of the ADHD 

knowledge questions correctly.  There may be a variety of explanations for the differences in 



Flanigan & Climie/ Emerging Perspectives (2018)  10 

ADHD knowledge throughout the world, but these findings lend support to the idea that it is 

necessary to also consider the background of teachers when exploring knowledge of ADHD, as 

the impact of culture may play a significant role in the acceptance and understanding of the 

disorder.   

Recommendations 

 This review of teacher knowledge of ADHD has confirmed some of the areas of need when 

addressing gaps in understanding or, indeed, misunderstanding of ADHD. Specifically, it is 

necessary to ensure that all teachers, both novice and experienced, have an adequate understanding 

of ADHD so they are better able to identify, support, and manage students with ADHD. As such, 

the following recommendations are a guide for building capacity in teachers to support students 

with ADHD, highlighting needs for both pre-service and in-service teachers, and noting the 

importance of ongoing professional development.   

Pre-service Educators 

 It may be imperative to ensure that university training programs address issues of 

exceptional learners in their education degree programs.  Inclusion of relevant courses allows pre-

service teachers access to a broad range of information on students with a variety of learning needs, 

including those with ADHD.  It may be particularly important for pre-service teachers to have 

specific instruction on disorders such as ADHD, given the relatively high prevalence in school-

aged children. It is likely that teachers will encounter a student with ADHD in their classrooms on 

their first day of teaching, emphasizing the need for teachers to be prepared before walking into 

the classroom.  Teachers who are armed with accurate knowledge and understanding of ADHD, 

including its etiology and treatment, may be more likely to recognize the needs of these students 

and work collaboratively to find ways to support them. Providing tools for these teachers in 

advance may ensure that their first year in the classroom runs more smoothly. 

Ongoing Professional Development 

 There is also a need to ensure that teachers continue to receive ongoing professional 

development (PD).  The requirement for PD is not unusual in the teaching world but is often 

focused on curriculum updates or changes, broad school-wide issues (e.g., bullying, truancy), or 

supporting struggling learners (e.g., specific instructional programs; Lumpe, 2007).  Rarely is the 

emphasis on expanding knowledge or capacity in a specific population, such as children with 

ADHD, yet the importance of understanding and supporting these learners should not be 

overlooked (Lumpe, 2007). 

 Additionally, it may be beneficial to target new and experienced teachers separately in PD 

sessions related to ADHD.  The focus of sessions for new teachers may focus on understanding 

what ADHD is, its symptoms and behaviours, classroom presentation and challenges, and general 

treatment approaches.  An expanded focus on identifying areas of academic, social-emotional, and 

behavioural supports may also be useful for inexperienced staff. For more experienced teachers 

and staff, it may be more beneficial to provide an opportunity to understand what these teachers 

know or believe about ADHD and explore the accuracy of this information.  Given that some 

studies have indicated that years of teaching is not necessarily correlated with ADHD knowledge 

(e.g., Vereb & DiPerna, 2004), it may be useful to ensure that experienced teachers have access to 
information on the current understanding of ADHD.  The idea of “dispelling myths” may be 



Flanigan & Climie/ Emerging Perspectives (2018)  11 

beneficial so as to allow teachers to explore their own accurate and inaccurate beliefs and how 

these beliefs may be impacting their work. 

 In addition, for teachers who are particularly interested in furthering their understanding of 

children with ADHD, it may be beneficial to turn to university or professional development 

programs that specifically focus on providing further education in this area.  In particular, there is 

a need to ensure that teachers are able to support children with ADHD across a number of areas, 

including an understanding of mental health, classroom management, and learning.  Education 

faculties at accredited post-secondary institutions may provide graduate-level courses that allow 

interested teachers to not only further their education, but to do so in an area of particular interest 

for them. 

Finally, it may also be useful to connect schools and local organizations that support 

children with ADHD and their families.  These organizations may be able to organization PD 

sessions for teachers or parents to allow greater access to information on how to support these 

students at home and at school.  Increasing the connection between home, school, and community 

provides a stronger support for parents and teachers who may be struggling to support the needs 

of children with ADHD. 

Conclusion 

 This paper has provided a comprehensive review of the most current understanding of 

teacher knowledge of ADHD in English-speaking countries and the suggested areas of support for 

pre-service, novice, and experienced teachers.  Through the enhancement of knowledge and 

understanding of ADHD, teachers may be better prepared to support children impacted by the 

disorder. Thus, in their classrooms, they can help to ensure that all children have the opportunity 

to thrive. 

 This article may be useful to teachers, school psychologists, and researchers. Teachers may 

use this information to examine and increase their own knowledge of ADHD, and to encourage 

their school divisions to provide supports and resources about ADHD. School psychologists and 

professionals may wish to use this article to develop professional development opportunities for 

their school districts, focusing on the identified areas of strengths and weaknesses in ADHD 

knowledge while incorporating some of the above recommendations. Lastly, researchers are 

encouraged to continue to examine teachers’ (and other school professionals’) knowledge of 

ADHD, particularly as the understanding of ADHD grows and changes in the literature. 

Researchers may also wish to develop teacher-focused ADHD knowledge scales, which address 

the information teachers need to bring into their classrooms. 

References 

Alkahtani, K.D.F. (2013). Teachers’ knowledge and misconceptions of Attention Deficit 

Hyperactivity Disorder. Psychology, 4(12), 963–969.  

American Psychiatric Association (2013). Diagnostic and statistical manual of mental disorders, 

fifth edition (DSM-V). Washington, DC: Author. 

Anderson, D.L., Watt, S.E., & Noble, W. (2012). Knowledge of Attention Deficit/Hyperactivity 

Disorder (ADHD) and attitudes towards teaching children with ADHD: The role of 

teaching experience. Psychology in the Schools, 49(6), 511–525.  

Barkley, R. A. (Ed.). (2014). Attention-deficit hyperactivity disorder: A handbook for diagnosis 

and treatment. Guilford Publications.  



Flanigan & Climie/ Emerging Perspectives (2018)  12 

Bekle, B. (2004). Knowledge and attitudes about Attention-Deficit Hyperactivity Disorder 

(ADHD): A comparison between practicing teachers and undergraduate education 

students. Journal of Attention Disorders, 7(3), 151–161.  

Bell, L., Long, S., Garavan, C., & Bussing, R. (2011). The impact of teacher credentials on ADHD 

stigma perceptions. Psychology in the Schools, 48(2), 184–197.  

Bennett, D. S., Power, T. J., Rostain, A. L., & Carr, D. E. (1996). Parent acceptability and 

feasibility of ADHD interventions: Assessment, correlates, and predictive validity. Journal 

of Pediatric Psychology, 21, 643–657. 

Blotnicky-Gallant, P., Martin, C., McGonnell, M., & Corkum, P. (2015). Nova Scotia teachers’ 

ADHD knowledge, beliefs, and classroom management practices. Canadian Journal of 

School Psychology, 30(1), 3–21. 

Ghanizadeh, A., Bahredar, M.J., & Moeini, S.R. (2005). Knowledge and attitudes towards 

Attention Deficit Hyperactivity Disorder among elementary school teachers. Patient 

Education and Counselling, 63(1), 84–88.  

Jerome, L., Gordon, M., & Hustler, P. (1994). A comparison of American and Canadian teachers' 

knowledge and attitudes towards Attention Deficit Hyperactivity Disorder (ADHD). The 

Canadian Journal of Psychiatry, 39(9), 563–567.  

Kos, J.M., Richdale, A.L., & Jackson, M.S. (2004). Knowledge of Attention Deficit Hyperactivity 

Disorder: A comparison of in-service and pre-service teachers. Psychology in the Schools, 

41(5), 517–526.  

Liviatan, S.A. (2015). Knowledge about ADHD among teachers in the educational system (the 

state and state religious sectors) in Israel. Higher Studies Israel, 36, 443–463.  

Lumpe, A.T. (2007). Research-based professional development: Teachers engaged in professional 

learning communities. Journal of Science Teacher Education, 18(1), 125–128. 

Nigg, J.T. & Barkley, R.A. (2014). Attention-Deficit/Hyperactivity Disorder. In E.J. Mash & R.A. 

Barkley (Eds.), Child Psychopathology (pp. 75–144). New York: The Guildford Press. 

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 behaviours and 

perceptions? School Psychology Quarterly, 23(3), 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(1), 81–105.  

Sax, L., & Kautz, K.J. (2003). Who first suggests the diagnosis of Attention Deficit Hyperactivity 

Disorder? Annals of Family Medicine, 1(3), 171–174. doi: 10.1370/afm.3 

Sciutto, M. J. (2015). ADHD Knowledge, misconceptions, and treatment acceptability. Journal of 

Attention Disorders, 19 (2) 91–98.  

Sciutto, M. J., Terjesen, M. D., & Frank, A. S. B. (2000). Teachers' knowledge and misperceptions 

of attention‐deficit/hyperactivity disorder. Psychology in the Schools, 37(2), 115–122 

Selekman, J. (2002). 100 years of attention deficit hyperactivity disorder: Debunking the myths. 

Pediatric Nursing, 28(1), 79. 

Soroa, M., Gorostiaga, A., & Balluerka, N. (2013). Review of tools used for assessing teachers’ 

level of knowledge with regards attention deficit hyperactivity disorder (ADHD). In S. 

Banerjee (Ed.), Attention Deficit Hyperactivity Disorder in Children and Adolescents (pp. 

151–177). Rijeka: InTech. 

Strydom, J., & Du Plessis, S. (2001). The Myth of ADHD and other Learning Disabilities: 

Parenting without Ritalin. Huntington House. 



Flanigan & Climie/ Emerging Perspectives (2018)  13 

Vereb, R. L., & DiPerna, J. C. (2004). Teachers' knowledge of ADHD, treatments for ADHD, and 

treatment acceptability: An initial investigation. School Psychology Review, 33(3), 421. 

Waddell, C., McEwan, K., Shepherd, C.A., Offord, D.R., & Hua, J.M. (2005).  A public health 

strategy to improve the mental health of Canadian children.  Canadian Journal of 

Psychiatry, 50 (4), 226–233. 

West, J., Taylor, M., Houghton, S., & Hudyma, S. (2005). A comparison of teachers’ and parents’ 

knowledge and beliefs about Attention Deficit Hyperactivity Disorder (ADHD). School 

Psychology International, 26(2), 192–208.  

 

 


