The purpose of the current study was to evaluate the effects of a six-session participatory ADHD training program in improving elementary school teachers’ ADHD knowledge, attitude, and behavior. Despite the busy schedule of teachers in both groups, the response rate was desirable. As expected, in the intervention group teachers and school principals welcomed the program. It can be said that addressing the needs of children with ADHD is one of the educational needs of teachers in Iran.
As predicted, results demonstrate that participants in the intervention group demonstrated a statistically significant increase in ADHD knowledge compared with the control group. This result is supported by numerous previous studies, for example, a similar study in Nigeria showed that brief ADHD training using a standard training package could increase teacher’s ADHD knowledge(14). Likewise, an Australian study revealed that brief professional interventions could be utilized to increase teachers’ ADHD knowledge(18). In addition, the results of a recently published study in Saudi Arabia showed that teachers’ training was effective in promoting teachers’ ADHD knowledge (13).
The results also determined that two mounts after the intervention, compared with the control group, intervention group teachers demonstrated a statistically significant increase in their attitude towards children with ADHD. Consist of our finding, desirable changes in teachers’ attitude toward students with ADHD were reported after teacher training in previous studies (14, 15, 23). Also contrary to the present study, there was no significant difference between pre/post assessments of teachers' attitudes in a similar study in Saudi Arabia (13).
Researchers reported that teachers' attitudes toward affected children with ADHD might be negative (8). Unaware teachers may descript children with ADHD as less favorably and see their behavior as more disruptive to the classroom(12).
In the present study, teachers had the best opportunity to listen, pay attention to others' experiences, and share similar teaching and managing experiences with each other by engaging in-group work. Hence improving teacher’s attitudes towards children with ADHD after educational intervention in this study could be interpreted due to increasing teacher’s knowledge and correcting misconceptions about ADHD.
It is obvious that teachers' ADHD knowledge and attitudes influence their behavior in the classroom while working with ADHD students. As we expected the results revealed that after intervention teachers’ classroom behavioral management in the intervention group was significantly improved rather than those of the control group.
Similar to our study, changing ADHD behavior management strategies into a more positive one after teacher training programs were reported previously(13).
Improving ADHD behavior management strategies could be interpreted because of increasing teachers’ knowledge and self-efficacy. A study in Australia revealed that primary school teachers’ ADHD knowledge and self-efficacy increased following the educational intervention (21).
In the present study, participants were encouraged to contribute their comments and questions during each session. In addition, two trained facilitators encouraged them to explore, discuss, and practice learned behavior-managing strategies. They could modify approaches to their class situations and achieve confirmation and support, for their individual practices to become more confident and effective.
As teachers’ ADHD knowledge increases, their self- efficacy will improve. As a result, they can develop more self-confidence in their abilities in making necessary changes and better control in classrooms; also use less destructive behavior toward children with ADHD. The relationship between ADHD behavior management strategies and teaching self- efficacy await further support by accurate measures in future research.
The educational intervention based on “The Classroom Accommodations for Children with ADHD” is helpful in improving teachers' understanding of school-age children with ADHD and their abilities in addressing attentional and disruptive behavior problems of children affected with ADHD in the classroom.
It is important that the limitations of this study mentioned. First, all outcome measures relied on the self-report questionnaire, because of the limited resources available. In addition, masking was not possible which means that socially appropriate responding could have contributed to the higher scores among the teachers in the intervention group. Future studies should include observational measures of teachers' behavior in addition to self-report.
Second, the participants were aware of whether they were assigned to the control or intervention group. The higher scores in intervention, but not control group teachers may be a function of their expectation that educational intervention worked. Future studies should control the intervention's attention and maintain the blindness by using a psychological placebo such as a support group.
Third, the teachers were assigned to the control or intervention group at the school level rather than as individuals. The latter would have been ideal but would have been impossible because of the time and resource constraints.
Finally, this study examined only short-term outcomes; as a result, the long-term impact of education is uncertain. The intervention’s positive long-lasting effects await further support by long time follow-up measures in future research.