Skip to main content
Download PDF
Download ePub

Elementary school teachers knowledge and attitude towards attention deficit-hyperactivity disorder in Gondar, Ethiopia: a multi-institutional study

Child and Adolescent Psychiatry and Mental Health volume 15, Article number: 16 (2021) Cite this article

Abstract

Background

A child suffering from attention deficit hyperactivity disorder (ADHD) faces many difficulties in social as well as academic performances. School teachers’ knowledge and attitude towards ADHD play a vital role in early detection and referral of the child to treatment centers. Few existing reports, however, indicate the alarming rate at which the problem is highly neglected in sub-Saharan Africa. The present study is designed to determine the knowledge, attitude, and factors that affecting elementary school teachers about ADHD.

Methods

An institutional-based cross-sectional study design was conducted in Gondar town and other towns nearby Gondar from February 24 to March 24, 2020. Data were collected through structured self -administered questionnaires using the Knowledge of Attention Deficit Disorders Scale and ADHD-specific attitudes measurement tools. Then, it was entered into Epi-info version 7 and exported to SPSS version 20 for analysis. Bivariable and multivariate logistic regressions were fitted to identify factors associated with the knowledge and attitude of elementary school teachers. Variables having a p-value < 0.05 at 95% CI were considered statistically significant.

Result

Of 636 respondents, about 44.8% (95% CI 41.2, 48.4) and 84.1% (95% CI 81.0, 86.8) of elementary school teachers had good knowledge and a favorable attitude towards ADHD, respectively. Having a diploma and above (AOR = 3.028, 95% CI 1.630–5.625), reading ADHD leaflets (AOR = 2.035, 95% CI 1.391, 2.950) and search ADHD on the internet (AOR = 1.793, 95% CI 1.090, 2.950) were significantly associated with teachers knowledge to ADHD; whereas, working experience in teaching a child with ADHD (AOR = 1.852, 95% CI 1.195–2.87) and watching ADHD on mass media (AOR = 1.72, 95% CI 1.056–2.8) were positively predicts teachers attitude towards ADHD.

Conclusion

the proportion of teachers’ knowledge towards ADHD was low; in contrast, their attitude was relatively satisfactory. Strengthening teachers’ educational upgrading system, frequent and fair distribution of leaflets written to address ADHD, installation of an internet system to the schools, and continuous ADHD awareness creation programs through mass media are highly recommended.

Background

Attention deficit with or without hyperactivity disorder (ADHD) is one of the most frequently reported neuropsychiatric disorders, especially in school-age children [1]. According to the Fifth Edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), it is characterized by persistent and pervasive problems with inattention and/ or hyperactivity/impulsivity [2]. Commonly, ADHD is diagnosed before the age of 12 years [3]; Likewise, 30–50% of a diagnosed childhood ADHD will be continued until adolescence and adulthood [4]. Even though the exact cause is unknown, genetic, organic, and environmental factors are assumed to be the contributing factors towards the development of ADHD [5].

The global prevalence of ADHD was estimated at 5–7% in children and 2.5% in adults [3, 6]. Even though with this prevalence, teachers knowledge and attitude about ADHD were not satisfactory as evidenced by studies conducted to investigate teachers knowledge such as South Texas (46.49%), Canada (68%), Colombia (48.52%), Pakistan (45.30%), and Egypt (55%), and the attitude in Pakistan(96.2%), and Egypt(55%), respectively [7,8,9,10,11,12,13].

ADHD can have an impact on a student’s academic and social performance due to difficulties in maintaining attention, failure to complete tasks, forgetfulness, and excessive non-goal directed physical activities [14]. Moreover, the problem is not limited to in childhood period, it has also an impact on their mental health condition and social wellbeing in adulthood [15], which could be associated with having few or no friends, exercising antisocial behaviors, manifested depressive symptoms, exposed to stress, unable to stick in specific occupations/work, having poor social relationships, using a substance (like alcohol and smoking), exposing unplanned pregnancy, and experiencing multiple car accidents [16,17,18,19,20,21]. However, since the problem is highly neglected, a majority of children with ADHD remain undiagnosed or do not receive appropriate specialist services in high spite of morbidity [22, 23].

To give timely treatment following early detection, elementary school teachers have been taking the highest place, since most children spend most of their time in schools and interact often with teachers on a daily basis even more than their parents or physicians, suggests that schools play a very important role in the early detection and management of ADHD [3, 24].

Thus, teachers play a central role in early detection and advising parents on managing their children, and implementing classroom and behavioral management strategies [25, 26]. Therefore, it is important for elementary school teachers to have good knowledge and favorable attitudes towards ADHD. However, the evidence in the literature suggests otherwise [26].

Several factors that can affect teachers knowledge and attitude towards ADHD; some of them are, age, sex, marital status, and educational level of the teachers, and searching on the internet about ADHD were factors that affecting the knowledge and attitude of teachers towards ADHD [26,27,28,29,30,31,32,33,34].

In view of the problem and importance of early detection for effective treatment, different studies should be undertaken to show the prevalence and possible factors that affecting teachers’ knowledge and attitude towards ADHD with its possible recommendation. However, there is a paucity of studies in the nation, Ethiopia, therefore, this study aimed to assess the knowledge and attitude of elementary school teachers about ADHD and its associated factors in Gondar town, Northwest Ethiopia. This could be helpful to design new policies to tackle the problem and make a healthy generation.

Methods

Study area, design, and population

An institution-based cross-sectional study design was conducted from February 24 to March 24, 2020, and data were collected from 636 Gondar and nearby town’s public and private elementary school teachers. Gondar town is located in Amhara National Regional State, Ethiopia which is about 727 km Northwest of Addis Ababa (the capital city of Ethiopia). Administratively, Gondar town has a total of 24 kebeles with 13 urban and 11 rural kebeles. Based on reports published by the Central Statistical Agency in 2011, Gondar town has an estimated total population of 254,420 [35]. The town holds several royal castles, including those in Fasil Gebi (the royal enclosure), for which Gondar has been called “Camelot of Africa” [36]. Currently, there are 44 public and 22 private elementary schools in the Gondar and nearby town, which comprise about 3714 elementary school teachers.

Source and study populations

All elementary school teachers working at public and private elementary schools in Gondar and nearby towns were considered as a source population. Elementary school teachers who are working in the selected Gondar and nearby town’s elementary schools were enrolled as a study population.

Inclusion and exclusion criteria

All elementary school teachers working at the selected public and private elementary schools in Gondar and nearby towns who were present at the time of data collection were included in the study. Those participants who had a family member with diagnosed ADHD were excluded from the study, since incorporating those teachers having a family member with ADHD might have affected the true magnitude.

Sample size determination and sampling procedures

The sample size for the first two objectives (knowledge and attitude) was calculated by using single population proportion formula based on the following assumptions 95% confidence level of Z α/2 = 1.96, the margin of error = 5%.

$${\text{n}} = \, \left( {{\text{Z }}\alpha /_{{2}} } \right)\,^{{2}} {\text{p }}\left( {{1} - {\text{p}}} \right)/{\text{d}}^{{2}} ,$$

where n = sample size of the population, Z α/2 critical value of 95% CI = 1.96, p-proportion (0.564) of knowledge taken from similar previous study’s [34], for attitude 50% was used since there is no study in the country, before.

Then n for Knowledge = (1.96)2(0.564) (1–0.564)/0.052 = 378. Thus, by adding 10% for possible non-response rate and 1.5 design effect the total sample size was 624.

n for Attitude = (1.96)2(0.5) (1–0.5)/0. 052 = 385. Thus, by adding 10% for possible non-response rate and 1.5 design effect, the total sample size was 636. As a result, we take the highest number i.e., 636 as a final sample size.

A multistage sampling procedure was used to identify the study participants. All elementary schools (66 schools) in Gondar town and nearby cities (Tseda and Ambagiorgis) were stratified into public and private elementary schools to allocate the proportion. Then, Forty percent (40%) of the entire school were selected to take an adequate number of schools to represent the source populations [37]. When calculating 40% from public and private elementary schools, seventeen from 44 public (Governmental) and 9 from 22 private schools were included in this study using a lottery method. Among these 26 schools, a total of 1027 teachers were actively working. Then, for the sake of representativeness, Proportional allocation using the formula: ni = (n/N) × Ni where; n = total sample size to be selected, N = total population, Ni = total population of each school, and ni = sample size from each school was used to select the number of teachers participated in the study. Using the sampling frame from the teacher’s staff registration book, 636 study participants were recruited by using a simple random sampling technique (Fig. 1).

Fig. 1
figure 1

Schematic presentation of the sampling procedure

Full size image

Data collection tools and procedures

The data was collected through a structured self-administered questionnaire adapted from different kinds of literature. It consists of socio-demographic characteristics, characteristics related to the sources of information, knowledge of ADHD, and ADHD-specific attitude.

Socio-demographic data

It included age, gender, religion, marital status, type of organization (private and public), years of teaching experience, level of education, grade levels one currently teaches, type of education (general or single subject), and subject currently teaching.

Source of information of teachers about ADHD

It included questions such as attend any on-site/off-site training or workshop about ADHD, experience teaching a child who was diagnosed with ADHD, read any books or articles on ADHD, read any leaflet about ADHD, watch any mass media programs about ADHD and searching the internet for getting information about ADHD, with two option response (yes) or (no) format of questions.

Knowledge of attention deficit disorders scale (KADDS)

It has 36 items used to assess the knowledge of elementary school teachers. The responses were indicated as ‘true’, ‘false’, and ‘don’t know’ responses. It has contained three subscales: (a) general information of teachers (15 items), (b) symptoms and diagnosis (9 items), and (C) knowledge about treatment (12 items) Accordingly, the passing score of this scale was 50% [29] on each subscale as well as the total scale. The reliability test was performed for KADDS questionnaires using Cronbach’s alpha and initially, the value was 0.79.

ADHD-specific attitudes (SASA)

A 5-point Likert-type SASA scale was used to measure teacher’s attitudes regarding ADHD; it was ranged from ‘strongly disagreed’, ‘disagreed’, ‘neutral’, ‘agreed’, to ‘strongly agreed’. During analysis, several items were again reversing reversed scores to ensure the conscious completion of the questionnaires. The total score was calculated by summing up and converted into a percentage score. Accordingly, teachers’ who scored ≥ 60.0% from the aforementioned attitude questions were considered as having a favorable attitude towards ADHD [38].

Data quality control

To maintain the quality of the data, the tool was carefully adapted from different works of literature in English, then it was translated to Amharic and again translated back to English by language experts working in University of Gondar, language and Literature department with mental health professionals to check its consistency. The content of the questionnaire was reviewed by psychiatrists. One day of training about the objectives, significance, and variables of the study was given to four data collectors and two supervisors by the principal investigator before the actual data collection. A pretest was conducted in about 5% of the samples out of selected schools (Keye Anba, Azezo Teklehaimanot, and Desalegne elementary schools). The data collection process was closely monitored by the principal investigator for the completeness of the data. Each questionnaire was checked regularly for completeness to identify the gaps and act immediately.

Data processing and analysis

After checking the completeness and consistency, the data was entered into Epi-info version 7 and then exported to SPSS version 20 for cleaning, coding, and analysis. Descriptive statistics were carried out and summarized by using texts, tables, charts, and graphs. The prevalence of knowledge and attitude towards ADHD was computed and reported as percentages. To identify the major determinant factors, a binary logistic regression model was employed and Multivariate analysis was used to identify the confounders. All variables were entered into a multivariable logistic regression to identify factors that have a statistically significant association. Thus, variables having a p-value of ≤ 0.05 were considered significant. Adjusted odds ratio (AOR) with a 95% confidence interval was used to show the strength of association. The model’s fitness goodness-of-fit was checked by Hosmer and Lemeshow test [39].

Result

Socio-demographic characteristics

With a response rate of 100%, 636 respondents were enrolled in the study. Among them, more than half (59%) were female participants and about one-third (37.6%) of teachers were between the age of 20–30 years old with a mean of 36.77 (SD ± 10.72). Moreover, a majority (66.7%) of the participants were married, just half (50.9%) had diploma holders, and about half (50.2%) of teachers were teaching grades 5 to 8. Of the participants, below half (44.2%) of teachers had greater than fifteen years of work experience. Likewise, significant proportions (85.1%) of the participants were delivering only one type of subject/course (Table 1).

Table 1 Socio-demographic and academic characteristics of knowledge and attitude towards ADHD among elementary school teachers in Gondar town, Ethiopia, May 2020 (n = 636)
Full size table

Source of information regarding ADHD

Among the respondents, 495 (77.8%) of them did not take any training, workshop, and/or courses regarding ADHD. Nearly two-thirds of the respondents (63.8%) had experience of teaching students with ADHD. About 236 (37.1%), 222 (36.2%), 186 (29.2%), and 87(13.7%) of the respondents were got received information from mass media, books, and articles, reading the pamphlet and searching from the internet, respectively (Table 2).

Table 2 Source of information regarding knowledge and attitude towards ADHD among elementary school teachers’ in Gondar town, Ethiopia, May 2020 (n  =  636)
Full size table

Knowledge of teachers’ towards ADHD (KADDS)

Of the total respondents, below half (44.8% [95% CI 41.2, 48.4]) of them had good knowledge about ADHD. Specifically, among the subscale of knowledge questions, more than half (58.5%) had good knowledge regarding the treatment of ADHD (Fig. 2).

Fig. 2
figure 2

The subscales of knowledge questions used to assess elementary school teachers’ knowledge about ADHD (n = 636)

Full size image

An attitude of elementary school teachers towards ADHD

Regarding the attitude of elementary school teachers about ADHD, 84.1% [95% CI 81.0, 86.8] of the respondents had a favorable attitude towards ADHD.

Factors associated with knowledge of elementary school teachers towards ADHD

The bivariable logistic regression analysis showed that educational status, reading leaflets, watching mass media, and searching on the internet about ADHD were significantly associated with having a good knowledge of ADHD in elementary school teachers. Finally, after running a multivariate analysis among those variables having a p-value of ≤ 0.05 in the bivariable analysis, educational status (diploma, degree, and above), reading ADHD leaflet, and searching on the internet remain significant.

The odds of having good knowledge was 3.0 times higher among elementary school teachers who had diploma (AOR = 3.028, 95% CI 1.630, 5.625) and 3.1 times higher among elementary school teachers who had a degree and above educational status (AOR = 3.134, 95% CI 1.664, 5.900) as compared with elementary school teachers who had a certificate.

The odds of having good knowledge was about two times higher among elementary school teachers having experience of reading leaflet as compared to their counterparts (AOR = 2.035, 95% CI 1.391, 2.950). The likelihood of having good knowledge was 1.79 times higher among elementary school teachers having experience of internet searching as compared to their counterparts (AOR = 1.793, 95% CI 1.090, 2.950) (Table 3).

Table 3 Factors associated with knowledge towards ADHD among elementary school teachers’ in Gondar town, Ethiopia, May 2020 (n = 636)
Full size table

Factors associated with an attitude of elementary school teachers towards ADHD

The multivariate logistic regression analysis, having teaching experience of students with ADHD, and watching mass media were significantly associated with the attitude of elementary school teachers.

The odds of having a favorable attitude were nearly 1.85 times higher among elementary school teachers having teaching experience to a child with ADHD as compared to their counterparts (AOR = 1.852, 95% CI 1.195, 2. 87). The likelihood of having a favorable attitude was 1.7times higher among elementary school teachers watching any mass media than their counterparts (AOR = 1.72, 95% CI 1.056, 2.8) (Table 4).

Table 4 Factors associated with an attitude towards ADHD among elementary school teachers’ in Gondar town, Ethiopia, May 2020. (n = 636)
Full size table

Discussion

This study was conducted aimed to ascertain the knowledge, attitude, and associated factors towards ADHD among elementary school teachers in Gondar and nearby towns, Ethiopia. In the current study, the proportion of having knowledge bout ADHD among elementary school teachers was 44.8% [95% CI 41.2, 48.4], which indicated that there is a knowledge gap in this population about the problem, therefore, a comprehensive and well-designed strategy will be mandatory for making a timely solution to minimize the possibility of delayed diagnosis of ADHD and classroom mistreatment [40,41,42].

This study finding was in line with a study conducted in Cape Town (South Africa) [43]. Nonetheless, the finding was far higher and higher than the studies done in Saudi Arabia at 11%, Thailand at 19.4%, Egypt at 23.9%, Nepal city (Asia) 24.2%, and India 40% [13, 29, 44, 45]. Even if, the studies were used a cross-sectional design the same as our study, the observed discrepancy might be due to the study design such as sample size and sampling method (random and convenient sampling technique was used in Saudi Arabia and Egypt study’s [13, 46]) as well as the difference in cultural characteristics too [13, 29, 44, 45].

On the other hand, the current finding was lower than studies conducted in Canada 68%, Colombia 48.52%, Saudi Arabia 58.9%, another Saudi Arabia study 72%, India 49%, and South Africa 78%, [8, 9, 12, 27, 28, 33, 34, 46]. The discrepancy could be attributed to educational curricula that were used to teach teachers and the highest educational level attained was observed [8, 9, 12, 27, 28, 33, 34, 46].

In the current study, having good knowledge about ADHD was significantly associated with participants’ educational level of diploma and degree than those having a certificate. The same has been reported by others [28, 32]. It is likely that the participants’ highest educational level attained the capacity of acquiring knowledge towards different issues including ADHD will be increased [47]. Therefore, to increase the understanding of ADHD and the implementation of behavioral strategies, teachers holding lower educational qualifications could be encouraged to seek training regarding ADHD.

This study came up with having good knowledge was statistically significant with teachers reading ADHD leaflets. This might be due to the content of leaflets is minimal with a brief description of the information and easy to handle [48, 49]. Hence, reading leaflets is one of the effective ways of promoting and educating people about health.

The study evidenced that the higher odds of having Good knowledge were observed among participants of the internet user. The same has been reported [34]. This might be due to the fact that using the internet is a good way of acquiring knowledge and new ways of learning environment for most teachers since it is rapid, cost-effective, get reliable information and publications which enhance knowledge [50,51,52,53]. However, in Ethiopia, only 17.8% of the population had internet accesses [54]; moreover, this study also evidenced that more than three-fourth (86.3%) of respondents did not use the internet to read about ADHD which indicates that internet accesses is a commonly faced problem among elementary school teachers.

An important finding observed in this study is participant’s attitudes about ADHD, the study revealed that 84.1% of elementary school teachers were detected to have a favorable attitude, which indicated that the existing attitude towards ADHD is good. Even though, to address the issues at large for covering the rest of the participants having an unfavorable attitude, a well-designed strategy and policy still needed. The current finding was higher than a study done in Iran, South Africa, Egypt, and Nigeria [12, 13, 46, 55]. The discrepancy might be due to the difference in sample size (n-120, 360, and 250) and sampling method (random sampling technique) was used in Iran, Egypt, and Nigeria studies and the difference in cultural characteristics too [12, 13, 46, 55]. Nonetheless, the result of this study was lower than a study conducted in Pakistan (92.2%) [10]. The observed discrepancy might be due to the tool difference that measures ADHD which is Conner’s teacher’s rating scale [10].

Regarding factors associated with the participant's attitude towards ADHD; The odds of having a favorable attitude was higher among elementary school teachers who had a teaching experience of a child with ADHD. This supported finding is in line with a study conducted in Saudi Arabia [28]. This could be explained by Having experience might be the most common source of knowing the problem to some extent and knowledge is found upon the accumulation of information through either experience or education [47, 56].

Finally, this study found that the likelihood of having a favorable attitude was higher among elementary school teachers watching any mass media programs. This might be due to the mass media may play an important role in sharing health information and increasing awareness about health since media not only spread awareness but also report new knowledge, scientific information, and research findings to the public which has ultimately helped in the change of attitude of the audience for achieving better health [57, 58].

Doing the study in this overlooked area of mental health (ADHD) especially in the country with a paucity of researches was the good looks of the study and the findings could alarm the responsible body’s pleasing to the eye on Childhood mental health. Nonetheless, the fact that the study was a cross-sectional survey, it is difficult to derive causal relation. Likewise, it would have been more novel if it was conducting a training and re-administer the survey to teachers to see if attitudes/knowledge of ADHD has changed. Moreover, it would have been more soundable if it incorporates the socio-economic status of the teachers as this may possibly also have an impact on the knowledge and attitudes of ADHD.

Conclusion

The proportion of elementary school teachers who had good knowledge of ADHD was low, whereas, the proportion of teachers who had a favorable attitude towards ADHD was relatively satisfactory. Educational status, reading the leaflet, and searching on the internet were variables significantly associated with the knowledge of teachers about ADHD. On the other hand, the experience of teaching children with ADHD and watching mass media were significantly associated with the attitude of elementary school teachers regarding ADHD. Therefore, to enhance teachers’ understanding of ADHD and implementation of behavioral strategies in the classroom, teachers with lower educational status like certificates could be encouraged to seek training regarding ADHD. Moreover, policymakers should consider the incorporation of ADHD and other childhood mental health issues in primary school teachers’ curriculum. Likewise, Frequent and fair distribution of leaflets that are talking about ADHD, installation of the internet to the schools considering easy accessibility, and continuous ADHD awareness creation through mass media are highly recommended.

Availability of data and materials

All relevant data are available within the manuscript.

Abbreviations

ADHD:

Attention deficit-hyperactivity disorder

AOR:

Adjusted odds ratio

DSM:

Diagnostic and statistical manual

KADDS:

Knowledge of Attention Deficit Disorders Scale

SASA:

ADHD-specific attitudes

SPSS:

Statistical package for social science

References

  1. Mathee K, Cickovski T, Deoraj A, Stollstorff M, Narasimhan G. The gut microbiome and neuropsychiatric disorders: implications for attention deficit hyperactivity disorder (ADHD). J Med Microbiol. 2020;69(1):14–24.

    Article  CAS  PubMed  Google Scholar 

  2. Sharma N, Mishra R, Mishra D. The fifth edition of diagnostic and statistical manual of mental disorders (DSM-5): what is new for the pediatrician. Indian Pediatr. 2015;52(2):141–3.

    Article  PubMed  Google Scholar 

  3. Association AP. Diagnostic and statistical manual of mental disorders (DSM-5®): American Psychiatric Pub; 2013.

  4. Sánchez-Mora C, Ramos-Quiroga JA, Bosch R, Corrales M, Garcia-Martinez I, Nogueira M, et al. Case–control genome-wide association study of persistent attention-deficit hyperactivity disorder identifies FBXO33 as a novel susceptibility gene for the disorder. Neuropsychopharmacology. 2015;40(4):915–26.

    Article  PubMed  CAS  Google Scholar 

  5. Thapar A, Cooper M, Jefferies R, Stergiakouli E. What causes attention deficit hyperactivity disorder? Arch Dis Child. 2012;97(3):260–5.

    Article  PubMed  Google Scholar 

  6. Ohan JL, Visser TA, Strain MC, Allen L. Teachers’ and education students’ perceptions of and reactions to children with and without the diagnostic label “ADHD.” J Sch Psychol. 2011;49(1):81–105.

    Article  PubMed  Google Scholar 

  7. Guerra FR Jr, Brown MS. Teacher knowledge of attention deficit hyperactivity disorder among middle school students in South Texas. RMLE Online. 2012;36(3):1–7.

    Article  Google Scholar 

  8. Blotnicky-Gallant P, Martin C, McGonnell M, Corkum P. Nova Scotia teachers’ ADHD knowledge, beliefs, and classroom management practices. Can J Sch Psychol. 2015;30(1):3–21.

    Article  Google Scholar 

  9. Padilla AM, Cuartas DB, Henao LFD, Arroyo EAB, Flórez JES. Knowledge of ADHD among primary school teachers in public schools in Sabaneta, Antioquia. Colombia Rev Colombiana de Psiquiatría (English ed). 2018;47(3):165–9.

    Article  Google Scholar 

  10. Mirza N, Nisar N, Ikram Z. Knowledge, attitude & practices towards attention deficit hyperactivity disorder among private elementary school teachers of Karachi, Pakistan. J Dow Univ Health Sci (JDUHS). 2017;11(1):11–7.

    Google Scholar 

  11. Khademi M, Rajeziesfahani S, Noorbakhsh S, Panaghi L, Davari-Ashtiani R, Razjouyan K, et al. Knowledge and attitude of primary school teachers in Tehran/Iran towards ADHD and SLD. Global J Health Sci. 2016;8(12):141–9.

    Article  Google Scholar 

  12. Hosseinnia M, Mazaheri MA, Heidari Z. Knowledge, attitude, and behavior of elementary teachers regarding attention deficit hyperactivity disorder. J Educ Health Promotion. 2020;9(1):120.

    Article  Google Scholar 

  13. Aly SE, Mohammed F, Ahmed Z. Teachers’ perception and attitudes toward attention deficit hyperactivity disorder in primary schools at Assiut City. AAMJ. 2015;13(4):165–73.

    Google Scholar 

  14. Rief SF. How to reach and teach children and teens with ADD/ADHD: Wiley; 2016.

  15. Mpango RS, Kinyanda E, Rukundo GZ, Levin J, Gadow KD, Patel V. Prevalence and correlates for ADHD and relation with social and academic functioning among children and adolescents with HIV/AIDS in Uganda. BMC Psychiatry. 2017;17(1):336.

    Article  PubMed  PubMed Central  Google Scholar 

  16. Grazioli VS, Gmel G, Rougemont-Bücking A, Baggio S, Daeppen J-B, Studer J. Attention deficit hyperactivity disorder and future alcohol outcomes: examining the roles of coping and enhancement drinking motives among young men. PLoS ONE. 2019;14(6):e0218469.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  17. Owens EB, Hinshaw SP. Adolescent mediators of unplanned pregnancy among women with and without childhood ADHD. J Clin Child Adolesc Psychol. 2020;49(2):229–38.

    Article  PubMed  Google Scholar 

  18. Curry AE, Yerys BE, Metzger KB, Carey ME, Power TJ. Traffic crashes, violations, and suspensions among young drivers with ADHD. Pediatrics. 2019;143(6):e20182305.

    Article  PubMed  PubMed Central  Google Scholar 

  19. Merrill BM, Molina BS, Coxe S, Gnagy EM, Altszuler AR, Macphee FL, et al. Functional outcomes of young adults with childhood adhd: a latent profile analysis. J Clin Child Adolesc Psychol. 2020;49(2):215–28.

    Article  PubMed  Google Scholar 

  20. Yoshimasu K, Barbaresi WJ, Colligan RC, Voigt RG, Killian JM, Weaver AL, et al. Childhood ADHD is strongly associated with a broad range of psychiatric disorders during adolescence: a population-based birth cohort study. J Child Psychol Psychiatry. 2012;53(10):1036–43.

    Article  PubMed  PubMed Central  Google Scholar 

  21. Nabors L. Attention-deficit hyperactivity disorder and anxiety in children. In: Anxiety management in children with mental and physical health problems. Cham: Springer; 2020. p. 101–15.

    Chapter  Google Scholar 

  22. Melegari M, Bruni O, Sacco R, Barni D, Sette S, Donfrancesco R. Comorbidity of attention deficit hyperactivity disorder and generalized anxiety disorder in children and adolescents. Psychiatry Res. 2018;270:780–5.

    Article  CAS  PubMed  Google Scholar 

  23. Gul N, Tiryaki A, Kultur SEC, Topbas M, Ak I. Prevalence of attention deficit hyperactivity disorder and comorbid disruptive behavior disorders among school age children in Trabzon. Klinik Psikofarmakoloji Bülteni Bull Clin Psychopharmacol. 2010;20(1):50–6.

    Article  Google Scholar 

  24. Arnett AB, MacDonald B, Pennington BF. Cognitive and behavioral indicators of ADHD symptoms prior to school age. J Child Psychol Psychiatry. 2013;54(12):1284–94.

    Article  PubMed  Google Scholar 

  25. Ewe LP. ADHD symptoms and the teacher–student relationship: a systematic literature review. Emot Behav Diffic. 2019;24(2):136–55.

    Article  Google Scholar 

  26. Anderson DL, Watt SE, Noble W, Shanley DC. Knowledge of attention deficit hyperactivity disorder (ADHD) and attitudes toward teaching children with ADHD: the role of teaching experience. Psychol Sch. 2012;49(6):511–25.

    Article  Google Scholar 

  27. Alfageer HH, Aldawodi MD, Al Queflie SA, Masud N, Al Harthy NA, Alogayyel N, et al. Knowledge and attitude of male primary school teachers about attention deficit and hyperactivity disorder in Riyadh, Saudi Arabia. J Natural Sci Biol Med. 2018;9(2):257.

    Article  Google Scholar 

  28. Munshi AMA. Knowledge and misperceptions towards diagnosis and management of attention deficit hyperactivity disorder (ADHD) among primary school and kindergarten female teachers in Al-Rusaifah district, Makkah city, Saudi Arabia. Intern J Med Sci Public Health. 2014;3(4):444–51.

    Article  Google Scholar 

  29. Muanprasart P, Traivaree C, Arunyanart W, Teeranate C. Knowledge of attention deficit hyperactivity disorder and its associated factors among teachers in 3 large primary schools in Phra Nakorn Sri Ayutthaya Province, Thailand. J Med Assoc Thai. 2014;2014:97.

    Google Scholar 

  30. Sankar CS. Attitude of primary school teachers towards children with attention deficit and hyperactivity disorder (ADHD). Am J Educ Res. 2017;5(9):977–83.

    Google Scholar 

  31. Stampoltzis A, Antonopoulou K. Knowledge and misconceptions about attention deficit hyperactivity disorder (ADHD): a comparison of Greek general and special education teachers. Int J Sch Educ Psychol. 2013;1(2):122–30.

    Article  Google Scholar 

  32. Safaan NA, El-Nagar SA, Saleh AG. Teachers’ knowledge about attention deficit hyperactivity disorder among primary school children. Am J Nurs Res. 2017;5(2):42–52.

    Google Scholar 

  33. Shroff HP, Hardikar-Sawant S, Prabhudesai AD. Knowledge and misperceptions about attention deficit hyperactivity disorder (ADHD) among school teachers in Mumbai, India. Int J Disabil Dev Educ. 2017;64(5):514–25.

    Article  Google Scholar 

  34. Thanasekaran P, Upashe SP, Chala D. Primary school teacher’s knowledge towards attention deficit/hyperactivity disorder (ADHD) and its associated factors in Nekemte Town, Oromiya Region, Western Ethiopia. Sci Technol Arts Res J. 2016;5(1):76–9.

    Article  Google Scholar 

  35. Ababa A. Central Statistical Agency. 2011.

  36. Weldesenbet EG, Kasahun HS, Woreta SL. The Gonderian period bridges of Ethiopia: status and prospects for tourism. 2017.

  37. Sambo L, Chatora R, Goosen E. Tools for assessing the operationality of district health systems. Brazzaville: World Health Organization, Regional Office for Africa; 2003.

    Google Scholar 

  38. Mulholland S. ADHD-specific knowledge and attitudes of teachers (ASKAT): development and validation of a new research instrument. Int J Educ Res. 2016;77:109–16.

    Article  Google Scholar 

  39. Hosmer DW Jr, Lemeshow S, Sturdivant RX. Applied logistic regression. USA: Wiley; 2013.

    Book  Google Scholar 

  40. Munshi A. Knowledge of diagnosis and management of ADHD among female teachers in Saudi Arabia. Med Sci Publi Health. 2014;3:434–5.

    Google Scholar 

  41. Esra’a Yahya Al-Moghamsi A. Elementary school teachers’ knowledge of attention deficit/hyperactivity disorder. J Family Med Primary Care. 2018;7(5):907.

    Article  Google Scholar 

  42. Kos JM, Richdale AL, Jackson MS. Knowledge about attention-deficit/hyperactivity disorder: a comparison of in-service and preservice teachers. Psychol Sch. 2004;41(5):517–26.

    Article  Google Scholar 

  43. Perold H, Louw C, Kleynhans S. Primary school teachers’ knowledge and misperceptions of attention deficit hyperactivity disorder (ADHD). South Afr J Educ. 2010;30(3):457–73.

    Article  Google Scholar 

  44. Srignanasoundari E, Vijayalakshmi S, Kokilavani N. A study to assess the knowledge on attention deficit hyperactivity disorder among primary school teachers at selected schools of kancheepuram district. Tamilnadu Intern J Nurs Educ. 2016;8(4):66–70.

    Article  Google Scholar 

  45. Bhattarai L, Sharma M. Knowledge regarding attention deficit hyperactivity disorder of children among school teachers at Lalitpur. J Chitwan Med Coll. 2019;9(4):64–8.

    Article  Google Scholar 

  46. Yarde-Leavett C. Teachers’ knowledge of and attitudes towards ADHD in the Western Cape. South Africa: University of Cape Town; 2018.

    Google Scholar 

  47. Singh J. Role of education in knowledge based society.

  48. Sustersic M, Gauchet A, Foote A, Bosson JL. How best to use and evaluate patient information leaflets given during a consultation: a systematic review of literature reviews. Health Expect. 2017;20(4):531–42.

    Article  PubMed  Google Scholar 

  49. Garner M, Ning Z, Francis J. A framework for the evaluation of patient information leaflets. Health Expect. 2012;15(3):283–94.

    Article  PubMed  Google Scholar 

  50. Fu H, Wang M, Li P, Jiang S, Hu W, Guo X, et al. Tracing knowledge development trajectories of the internet of things domain: a main path analysis. IEEE Trans Industr Inf. 2019;15(12):6531–40.

    Article  Google Scholar 

  51. Felt U. Sociotechnical imaginaries of “the internet”, digital health information and the making of citizen-patients. In: Science and democracy: making knowledge and making power in the biosciences and beyond. New York: Routledge; 2015. p. 176–97.

    Google Scholar 

  52. Conrad P, Bergey MR. The impending globalization of ADHD: notes on the expansion and growth of a medicalized disorder. Soc Sci Med. 2014;122:31–43.

    Article  PubMed  Google Scholar 

  53. Ponnou S, Gonon F. How French media have portrayed ADHD to the lay public and to social workers. Int J Qual Stud Health Well Being. 2017;12(sup1):1298244.

    Article  PubMed  PubMed Central  Google Scholar 

  54. Group MM. World internet usage and population statistics. Internet World Stats. 2017.

  55. Jimoh M. Knowledge and attitudes towards attention deficit hyperactivity disorder among primary school teachers in Lagos State, Nigeria. Adv Life Sci Technol. 2014;23(9).

  56. Peruffo E, Marchegiani L, Vicentini F. Experience as a source of knowledge in divestiture decisions: emerging issues and knowledge management implications. J Knowl Manage. 2018;22:344–61.

    Article  Google Scholar 

  57. Mashreky SR, Rahman F, Rahman A, Talab A, Rahman Z. Role of mass media in increasing knowledge and practices of mothers on IYCF: findings from a community trial in rural Bangladesh. South East Asia J Public Health. 2015;5(1):18–24.

    Article  Google Scholar 

  58. Colley B. ADHD, science and the common man. Emot Behav Diffic. 2010;15(2):83–94.

    Article  Google Scholar 

Download references

Acknowledgements

The authors appreciate the data collectors and study participants. Likewise, our gratitude also goes to Gondar town educational office for giving us the information that we need to conduct this study.

Funding

University of Gondar.

Author information

Authors and Affiliations

  1. Department of Nursing, Blue Nile Health Science College, Gondar, Ethiopia

    Mekdes Dessie

  2. Department of Pediatrics and Child Health Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia

    Masresha Asmare Techane

  3. Department of Psychiatry, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia

    Bizuneh Tesfaye

  4. Community Health Nursing Unit, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia

    Daniel Ayelegne Gebeyehu

Authors
  1. Mekdes Dessie
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Masresha Asmare Techane
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Bizuneh Tesfaye
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Daniel Ayelegne Gebeyehu
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

MD conceived the idea and wrote the proposal, participated in the data collection process, analyze data, and draft the paper. DAG designed the study. MAT, BT and DAG approved the proposal with some revisions, participated in data analysis, and reviewed the manuscript. All authors approved the final draft of the manuscript.

Corresponding author

Correspondence to Daniel Ayelegne Gebeyehu.

Ethics declarations

Ethical approval and consent to participate

Ethical clearance was obtained from the Research Ethical Committee of the School of Nursing (Ref. no. S/N/C/H/N/U/07/06/11) and the Gondar Town Educational bureau. In addition, written informed consent was obtained from each study participant. Ahead of the data collection, participants were briefed about the objectives, benefits, and possible risks of the study and participation is voluntary. Initially, they were informed about their right to withdraw from the study at any time of the interview process. When they were informed about their right to withdraw they agreed to leave the study whenever they are not feeling comfortable. Confidentiality was maintained by avoiding the name and other identifiers of the participants.

Consent for publication

Not applicable.

Competing interests

The authors have declared that they have no competing interests.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

Reprints and Permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Dessie, M., Techane, M., Tesfaye, B. et al. Elementary school teachers knowledge and attitude towards attention deficit-hyperactivity disorder in Gondar, Ethiopia: a multi-institutional study. Child Adolesc Psychiatry Ment Health 15, 16 (2021). https://doi.org/10.1186/s13034-021-00371-9

Download citation

  • Received:

  • Accepted:

  • Published:

  • DOI: https://doi.org/10.1186/s13034-021-00371-9

Keywords

  • Knowledge
  • Attitude
  • ADHD
  • Elementary school teacher

Child and Adolescent Psychiatry and Mental Health

ISSN: 1753-2000