TITLE: AWARENESS OF PRIMARY SCHOOL TEACHERS ABOUT
ATTENTION DEFICIT HYPERACTIVITY DISORDER(ADHD)
ABSTRACT
Background:
ADHD is a common neurodevelopmental disorder that is typically manifested in
childhood, but symptoms often continue into adulthood. It is presented by
inattentiveness, hyperactivity, fidgeting, and not being able to sit in one place. Affected
ones are also seen to have a shorter attention span and to get bored by monotonous
tasks.
Teachers play a key role in the early diagnosis of such patients. Furthermore,
previous studies showed that school-based interventions have a great impact in
reducing overall disease burden and could prove helpful in promoting the efficiency of
affected students.
Objective:
The main objective of this study was to access primary school teachers about
general knowledge of ADHD, signs and symptoms of disease, and whether they know
about treatment options available for this condition or not.
Method:
We used a cross-sectional quantitative approach to collect data from 294 primary
school teachers of Islamabad and Rawalpindi from May-September 2025 through
questionnaire based on pretested KADDS (knowledge of attention deficit disorders
scale). Data was analyzed through spss.
Results:
Results are consistent with following findings:
Conclusions:
Based on the above study it can be concluded that:
Keywords
Awareness, primary school , attention deficit hyperactive disorder.
Introduction:
Attention-deficit hyperactivity disorder (ADHD), a neurodevelopmental disorder
that is characterized by symptoms of inattention, hyperactivity, and/or impulsivity, can
affect the functioning of children and adults in various aspects of their lives (American
Psychiatric Association, 2013). Children who get diagnosed with ADHD may continue to
display these patterns into adulthood (American Psychiatric Association, 2013) and may
face undesirable consequences due to the nature of disorder. ADHD symptoms also
influence the individual’s behavior and negatively impact their performance in various
settings like home, school, workplace etc. Data from recent studies suggests that
approximately 5% of children and 2.5% of adults are affected by ADHD (American
Psychiatric Association, 2013).
Symptoms of ADHD can be categorized into three distinct presentations: primarily
inattentive, primarily hyperactive/impulsive, and mixed/combined. (American Psychiatric
Association, 2013). The primarily inattentive type of ADHD (ADHD-PI) manifests as
difficulty focusing, arranging/organizing tasks, and persistence. This ADHD presentation
affects approximately 45% of elementary school children and 75% of adolescents, and it
is considered to be the most common ADHD type (de la Peña et al., 2020).The primarily
hyperactive presentation of ADHD (ADHD-PH) manifests as the individuals being
restless, jittery and may be very talkative. The mixed or combined type of ADHD
(ADHD-C) occurs when the symptoms of both—inattentiveness as well as hyperactivity,
are present and many youth with this presentation also have a diagnosis of Oppositional
Defiant Disorder (American Psychiatric Association, 2013).
Research indicates that ADHD is becoming more common among school-aged children,
resulting in various challenges related to social interactions, behavior, and academics.
According to a systematic review in The Italian Journal of Pediatrics, globally, 7.6% of
kids aged 3–12 have ADHD, and.6% of teens aged 12–18 are affected by ADHD (1)
Reale L, Bonati M. ADHD prevalence estimates in Italian children and adolescents: a
methodological issue. Italian journal of pediatrics. 2018 Sep 5;44(1):108.
The national ADHD rate was about 12.9% (with a 95% Confidence Interval of 11.5% to
14.4%). Counties in the West South Central, East South Central, New England, and
South Atlantic divisions had way higher rates of childhood ADHD - like 55.1%, 53.6%,
49.3%, and 46.2% of counties there had ADHD rates of 16% or more. On the flip side,
counties in the Mountain, Mid Atlantic, West North Central, Pacific, and East North
Central divisions had lower rates - only 2.1%, 4%, 5.8%, 6.9%, and 11.7% of counties
had rates of 16% or higher.(2)
ADHD often goes undiagnosed and untreated in South Asian populations largely
because of social stigmas, taboos, systemic hurdles, and insufficient awareness about
ADHD.
India's ADHD prevalence mirrors worldwide estimate overall, yet detection and care
differ by socioeconomic factors. Reported rates span 1.3 % to 28.9 %, showing higher
male representation as compared to females and ethnic-minority groups are
under-identified because of cultural norms and systemic gaps.
Research in Bangladesh confirms ADHD affects many children and often co-occurs with
other disorders. These findings underscore the importance of focused programs to
increase awareness, screening, and treatment for at-risk populations.
Unfortunately, Pakistan lacks precise data on reported or unreported ADHD cases to
evaluate patterns in ADHD among both adults and kids.
As mentioned above, one possible reason for underdiagnosis is the lack of awareness
among key stakeholders — especially teachers, who play a central role in early
identification of behavioral difficulties. As stated in the beginning, school-going children
having ADHD can potentially experience difficulties in academics, social skills, and/or
behaviors. Since the teachers interact with children daily, they are often the first to
observe behavioral patterns such as inattention, impulsivity, or hyperactivity. If teachers
lack sufficient knowledge about ADHD, early detection may not occur, leading to
delayed diagnosis and intervention. Because without adequate knowledge about ADHD,
such behaviors may be misunderstood as disciplinary issues rather than symptoms of a
developmental disorder. Consequently, children with ADHD may remain unidentified,
missing opportunities for early intervention and support.
Bukhari T’s article in the Pakistan Journal of Educational Research revealed that
Pakistani teachers possess limited knowledge of ADHD symptoms and classroom
strategies, reflecting a shortage of specialized training.
Given the scarcity of data on ADHD awareness in Pakistan and the pivotal role of
teachers in identifying behavioral and learning difficulties, assessing their knowledge,
attitudes, and practices regarding ADHD is essential. Understanding these aspects can
help inform training programs and awareness campaigns aimed at improving early
identification and management of ADHD in school settings.
METHODOLOGY
This study employed a cross-sectional quantitative approach to explore
knowledge and awareness of primary school teachers about attention deficit
hyperactive disorder (ADHD).
The survey based on knowledge of attention deficit disorders scale (KADDS) was
circulated in 20 primary schools of twin cities. The sample size calculated through
[Link] was 294. The sampling method chosen was of the purposive type.
Written consent was obtained from the participants who followed inclusion
criteria.
Inclusion criteria were professional educators teaching in private and public
sector schools to students from 5 to 13 years of age and their voluntary participation
while exclusion criteria was no consent from participants.
Data was collected through a questionnaire based on knowledge of attention
deficit disorders scale (KADDS) and it was analyzed through SPSS.
Measures
1-Demographic Questionnaire:
A demographic questionnaire was developed by the researcher to obtain
information regarding participants' age, gender, education level, the region where their
school district is located, and the sector (private or public) in which they are currently
teaching. The demographic questionnaire is included in Appendix A. The sample
group's demographic information can be found in table 1.
2- Knowledge of Attention Deficit Disorders Scale (KADDS):
This study also utilized a survey instrument to assess teachers' knowledge of
ADHD. The Knowledge of Attention Deficit Disorders Scale (KADDS), developed by
Sciutto and colleagues (2000) is a widely accepted instrument that has been used in
many studies to assess teachers' knowledge of ADHD. The KADDS is a 36-item rating
scale that measures three areas of knowledge related to ADHD, including:
1) symptoms/diagnosis (9 items),
2) General Information (i.e. Information regarding the nature, causes, and impact
of ADHD) (15 items)
3) Treatment of ADHD (12 items). Each of the items included in this measure
are statements that use a True (T), False (F), or Do Not Know (DK) format. Correct
responses are given a score of "1" and incorrect responses or do not know responses
are given a score of "0." Scores are calculated by adding the total number of points and
converting them to a percentage for each subscale and a total scale.