Children are the greatest gifts of god to humanity and they are mirror of a nation. They are our future and our most precious resources. The quality of tomorrow’s world and perhaps even its survival will be determined by the well-being, safety and the physical and intellectual development of children today [1].

Attention Deficit and Hyperactivity Disorder (ADHD) is one of the most common behavioral disorders of childhood. Its main features are cognitive, behavioral and emotional deficits, with hyperactivity (overactive), impulsivity and difficulty in staying focused [2,3]. The diagnosis is mostly clinical, based on detailed history of a child’s early development and direct observation by parents and teachers. The specific symptoms of ADHD can be distinguished usually at 5 years of age [2,3].

Most of the children with ADHD aged 3–11 years spend their time at home or in classrooms. ADHD is a frequently diagnosed disorder with a high impact affecting multiple facets of social and academic life Getting along with their classmates and peers can be challenging [4,5].

At school, they have trouble with paying attention, managing their behavior and often disrupt classroom activities. Therefore, parents and teachers must be adequately prepared to identify and deal with children suffering from ADHD [6]. ADHD institute report, the mean worldwide prevalence of the disorder, between 5.29-7.1% [7]. 

Identifying affected children early and referring them for treatment is of great importance. Many a time the behaviors associated with ADHD are first observed in the classroom setting and a teacher is the first person to raise concerns about the child. Teachers play an important role in the initial screening for ADHD. Identifying and treating them would reduce the burden of this disorder and may help in better management of the co-morbid conditions in these children [7-9].

Since the classroom is an important context for these students, effective intervention in the classroom setting is essential for the academic progress and emotional wellbeing of children diagnosed with ADHD. The success of children with ADHD in the classroom largely resides in the hands of their teachers [9]. 

Insufficient knowledge and negative attitude towards ADHD and its treatment among teachers result in lack or improper implementation of management recommendations leading to treatment failure. Their knowledge is of direct benefit to students with ADHD and their families. For this reason, in order to find out exactly what level of knowledge teachers have about this problem is crucial [7,8].

Objectives of the Study

• To assess the knowledge of primary school teachers regarding ADHD in Shimla city

• To find the Association of knowledge of primary school teachers with selected demographic variables (Age, Years of teaching experience, Educational qualification, religion, Marital status)

• Research Approach: Descriptive 

• Research Design: Descriptive cross-sectional design 

• Setting of the study: Primary School of Shimla City 

• Study Duration: Between June-July 2018 

• Study Population: Primary school teachers of Shimla city 

• Sample size: 100 Primary school teachers

• Sampling Technique: Randomly Sampling Technique

• Sampling Criteria: 20 Primary school were selected randomly from all primary schools of Shimla city and 5 Primary school teachers who were present on the day of the study were selected randomly after explaining the purpose of the study

• Informed consent/assent was taken from selected primary school teachers and confidentiality of the teachers was also maintained 

• Inclusive Criteria: Teachers available during the period of data collection in study setting and who were willing to participate in the study

• Exclusion Criteria: Teachers who were not willing to participate in the study and who were not present during data collection

• Development of Tool-Knowledge related questionnaires (15) 

• Description of Tool 

• Section A: Socio-demographic characteristics of the Primary school teachers (Age, Gender, Educational status, marital status, religion and Source of information regarding ADHD)

• Sections B: There were Fifteen structured knowledge questionnaire having four options. The teacher has to choose right one. One mark was given for each correct answer and zero for incorrect answer. The maximum score was 15 and minimum score was zero. Scoring was done on the basis of marks as >66%(11-15) = Good, 33%-66%( (5-10) = Average, <33 (0-5) = Poor 

• Validity of Tool: By the experts in this field 

• Permission: Obtained from the concerned head of the schools

• Ethical Consideration: Ethical approval was taken from the Institutional Ethical Committee of Himalayan University for conducting the study. 

• Data Collection: By myself under the guidance of supervisors and Teachers was given 15 minutes’ time to complete that questionnaire and collected at the end of the prescribed time 

• Data Analysis: With appropriate statistical test in terms of frequencies, percentage, mean, standard deviation and Chi-Square test. P value of less than 0.05 was considered to be statistically significant

The Table 1, depicts that for age group, 26% of teacher came between the age group of 26-30 years, 26% participants came in the age group of 31-35 years, 29% came in the age group of 36-40 years while 19% teachers came in the age group of > 40 years. 

Table 1: Socio-Demographic Variables of Primary School Teachers

With respect to gender, 58% of teachers were male and remaining 42% were female, For educational qualification, 2% participants have done teacher training course, 36% have junior basic teachers, 58% have done their B.Ed. and remaining 4% teachers have M.Ed qualification. For years of teaching experience, 10% of teachers have < 5 years’ experience, 20% teachers have 6-10 years’ experience, 29% have 11-15 years’ experience, 20% teachers have 16-20 years’ experience while 21% teachers have total >20 years’ experience. With respect to religion, 95% teaches were from Hindu and 5% teachers were from Muslim religion. For nature of employment, 17% teachers were in temporary job and 83% teachers were permanent job. With respect to Child psychiatry in their curriculum,97% teachers had in the category of yes and 3% teachers had in the category of no. For previous information regarding behavioral problems, 94% teachers had information regarding behavioral problems while 6% had no information regarding behavioral problems.

The mean score of ADHD knowledge was 4.87±1.69. Results revealed that only one third of the primary school teachers (32%) had average knowledge while two third (68%) had Poor knowledge about ADHD. None of the participants had Good knowledge regarding ADHD (Table 2).

Table 2: Knowledge Regarding ADHD Among Primary School Teachers

This Table 3 depicts that there is no association with above listed demographic variables i.e. age groups, genders, educational qualifications, years of teaching experience, religion, nature of employment, child psychiatry in their curriculum and previous information regarding behavioral problems with Knowledge of ADHD among Primary school teachers.

Table 3: Association of Knowledge of ADHD & Socio-Demographic Variables of Primary School Teachers

The mean score of ADHD knowledge was 4.87±1.69. Present study showed that only one third of primary school teachers (32%) had average knowledge about ADHD and around two third (68%) had 15% of them had poor knowledge pertaining to various aspects of ADHD. The results are contrary to the study done by Manju [7] and Alfageer HH et al., [10].

There was no significant association of their age, gender, professional qualification, teaching experience, religion and marital status with their knowledge regarding ADHD. Similar results were reported in the study done by Manju [7].

Study reveals that most of the school teachers have inadequate knowledge regarding ADHD among primary school teachers. Results from this study bring light to the fact that schools should invest in faculty development and arrange structured courses and workshops on children with ADHD and prepare the teachers to deal with special needs of children with ADHD. All teachers need to be educated, trained and supported to further their professional development regarding ADHD because the teachers who are knowledgeable about ADHD are better prepared to be in a position to offer adequate teaching, assistance and support for children with ADHD.

Future Implications 

This study considered the situation in the governmental primary schools only; future studies should be conducted to assess the situation in private schools as well. A comparative study can also be undertaken to assess the knowledge of teachers with patents of ADHD children.

Acknowledgment

The authors acknowledge all the teachers for taking out time from their busy schedule and participating in the study.

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