ADHD in Indian schools : a study of students with ADHD and their teachers in twenty primary schools in New Delhi and Bangalore

Abstract

Attention Deficit/Hyperactivity Disorder (ADHD) has been identified as a worldwide problem. However, questions remain regarding its expression, recognition and management in different cultures. In India, ADHD is a very under-researched topic. Only four studies could be found in the research literature, two of which reported high prevalence rates. This thesis presents two studies, a broad pilot study and an investigation focussed on teachers and their experience with ADHD in their classes. The pilot study was conducted to gain initial insights into the awareness, recognition, diagnosis and management of ADHD in India. Key people in the child's ecological system (teachers, principals, parents, mental health professionals and school counselors) were chosen to be interviewed for this purpose. These "stakeholders" commented on a wide range of issues, based on their involvement with children with ADHD and their ability to influence the children's outcomes, either directly or indirectly. The findings indicated that in many cases, ADHD was probably left unrecognized. In addition, the impression was gained that many schools were not supporting these children adequately because of limited teacher knowledge, lack of well, developed referral and intervention systems and limited resources. The second study was conducted to investigate more systematically a number of issues related to ADHD, this time with a narrower focus on children and their teachers. One hundred and ten teachers reported on 110 children with ADHD symptoms in their classrooms as well as 110 comparison children whom they regarded as "average" children. Teacher identified children with ADHD symptoms displayed significantly more inattentive, hyperactive and/or behaviour problems than "average" children in the same classrooms. However, in spite of being significantly more symptomatic, fewer than one fourth had received a diagnosis of ADHD and only 7.2% were on medication. In addition, only 10% of children had Individual Education Plans. This extended impressions gained in the pilot study that this may be an underserviced population in India. An analysis of the demandingness of these children, teacher stress, burnout and efficacy was conducted. Not only were these children more demanding, but they also stressed teachers more than comparison average children. The sheer frequency of inattention, hyperactivity/impulsivity and/or behaviour problems played a major role in stressing teachers. However, stress associated with children with teacher identified ADHD was not found to be uniquely predictive of teacher burnout or lowered self-efficacy. Investigation of the supports for teachers in the schools revealed that teachers in Indian schools wanted more support with children with ADHD, including professional development and the school's support and understanding. This research brings into focus and highlights the needs of children with ADHD and their teachers. These children need to be adequately diagnosed and managed in schools, which does not appear to be the case at the moment. The current processes of recognition and intervention in schools have the potential to leave many children undiagnosed and/or not supported. This research also brings into focus the perspectives of teachers and the need to support them. Lastly, the results make a case for professionals and school personnel to invest in children with ADHD to ensure that Indian schools will be truly inclusive. Show more