Psychology
2013. Vol.4, No.12, 963-969
Published Online December 2013 in SciRes (http://www.scirp.org/journal/psych) http://dx.doi.org/10.4236/psych.2013.412139
Open Access 963
Teachers’ Knowledge and Misconceptions of Attention
Deficit/Hyperactivity Disorder
Keetam D. F. Alkahtani
Department of Special Education, College of Education, King Saud University, Riyadh, KSA
Email: kalkahtani@ksu.edu.sa
Received August 21st, 2013; revise d Sep tember 24th, 2013; accepted October 17th, 2013
Copyright © 2013 Keetam D. F. Alkahtani. This is an open access article distributed under the Creative Com-
mons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, pro-
vided the original work is properly cited. In accordance of the Creative Commons Attribution License all Copy-
rights © 2013 are reserved for SCIRP and the owner of the intellectual property Keetam D. F. Alkahtani. All
Copyright © 2013 are guarded by law and by S CIRP as a guardian.
Teachers can play a key role in identifying and supporting students with Attention Deficit/Hyperactivity
Disorder (ADHD). In order to fulfill this important role, it is imperative for teachers to have explicit
knowledge about ADHD. The overall aim of this study is to investigate teachers’ knowledge and miscon-
ceptions of ADHD. Four hundred and twenty-nine (429) teachers participated. The Knowledge of Atten-
tion Deficit Disorder Scale (KADDS) along with a demographic questionnaire was used as the survey in-
struments to collect data. Descriptive statistics and correlation test w ere used to analyze the data. Results
indicated that teachers’ knowledge of ADHD was insufficient. Teachers’ level of knowledge of ADHD
was positively related to their prior training and experience with ADHD (i.e., the number of ADHD
courses taken in college or graduate level, and the number of workshops pertaining to ADHD). Teachers’
level of knowledge of ADHD also correlated positively with their level of confidence in teaching a stu-
dent with ADHD. In spite of a few limitations, the results of this study are valuable for identifying areas
where there is a misperception or lack of knowledge among teachers.
Keywords: Attention Deficit/Hyperactivity Disorder (ADHD); Teachers’ Knowledge; Misconceptions of
ADHD
Introduction
Attention Deficit/Hyperactivity Disorder (ADHD), defined
by the American Psychiatric Association as a disorder is char-
acterized by a persistent pattern of inattention and/or hyperac-
tivity-impulsivity that is more frequently displayed and more
severe than is typically seen in individuals at a comparable
level of development (APA, 2000). ADHD is one of the most
commonly diagnosed psychiatric disorders of childhood. The
American Psychiatric Association, in 2000, estimated the
prevalence rate of ADHD to be 3% - 7% among school-age
children (APA, 2000). Additionally, in 2004, the American
Academy of Pediatrics reported that 6% - 9% of school students
have ADHD (AAP, 2004). Given the rate of children with
ADHD, most researchers estimated that in every mainstream
classroom there will be at least one child with ADHD (Barkley,
2006; DuPaul & Stoner, 2003; DuPaul & Weyandt, 2006;
Goldstein et al., 2011). Children with ADHD have significant
problems with attention, hyperactivity, and impulsivity which
usually cause serious impairments in many areas of functioning
(e.g., interpersonal and social relationships, and academic per-
formance). Children with ADHD are often non-compliant with
commands, disruptive in the classroom, and impulsive in their
behaviors. These children tend to be lagging behind academi-
cally and can require extra time and energy from their teachers.
Because of these problematic behaviors, teaching children with
ADHD can be a hard task for most teachers (Selikowitz, 2004).
Having knowledge of ADHD can increase teachers’ confidence
in teaching and managing children with ADHD (Curtis et al.,
2006; DuPaul & Stoner , 2003 ).
ADHD has intrigued researchers and become the most re-
searched of all the developmental behavioral disorders. Con-
versely, ADHD continues to generate controversy. Cooper and
Ideus (2002) asserted that “unfortunately, to date, some of the
popular debate about [ADHD] has generated far more heat than
light” (p. vii). Over the past decade, most published research
studies in the area of ADHD have focused on etiology, assess-
ment, and treatment of this disorder. There are also researches
concerned with children with ADHD in educational settings.
However, only a small number of studies have been conducted
to examine teachers’ knowledge and misperception of ADHD.
These researches were undertaken following the release of the
guidelines for diagnosing children with ADHD (Jerome et al.,
1994; Pelham & Evans, 1992). The Diagnostic and Statistical
Manual of Mental Disorders, Fourth Edition, Text Revised
(DSM-IV-TR) states that symptoms of ADHD must be pre-
sented in two or more settings, such as home and school (APA,
2000). Teachers are valuable sources of information with re-
gard to diagnosis of ADHD because of their daily contact with
children in a variety of settings (Bussing et al., 1998; Pelham &
Evans, 1992). Teachers are frequently involved in the assess-
ment process. According to Carey (1999) more than half of the
primary care pediatricians used school reports to arrive at their
K. D. F. ALKAHTANI
diagnosis of child with ADHD. The goal of diagnosis should
not be the diagnosis itself, rather plan interventions that based
on the information gathered in the assessment phase (Du-Paul
& Stoner, 2003).
Therefore, teachers should have accurate knowledge with
which they can effectively participate in the process of the as-
sessment and treatment decision-making for children with
ADHD. Unfortunately, few studies that have attempted to as-
sess teachers’ knowledge of ADHD suggest that teachers often
lack knowledge of ADHD and they tend to have substantial
misperceptions about the nature, course, causes and outcomes
of ADHD (Barbaresi & Olsen, 1998; Jerome et al., 1994; Sci-
utto et al., 2000; Snider et al., 2003; Vereb & DiPerna, 2004;
West et al., 2005; Weyandt et al., 2009). It was also found that
teachers have received little, if any, training related to ADHD
(Bussing et al., 2002; Jerome et al., 1994; Sciutto et al., 2000;
Kos et al., 2004). This is alarmingly considered that teachers
are primarily responsible for referring children with ADHD for
assessment, and their frequent involvement in the treatment
process (Barkley, 2006; Bussing et al., 2002). This research
attempts to further previous studies that investigated teachers’
knowledge of ADHD. Specifically, this research investigated
three questions. The questions are:
What is the teachers’ level of knowledge of ADHD?
Is there relationship between teachers’ level of knowledge
of ADHD and their prior training and experience with
ADHD (the number of ADHD courses taken in college or
graduate level, and the number of workshops pertaining to
ADHD)?
Is there relationship between teachers’ level of knowledge
of ADHD and their level of confidence in teaching a stu-
dent with ADHD?
Method
This is a descriptive research using self-reported question-
naire method. Survey research provide a broad overview of
information collected from representative sample of a large
population so that inferences can be made about their knowl-
edge, attitudes, characteristics, or behaviors (Cresswell, 2008).
This type of research is quantitative in nature and often
grounded upon existing practice which allows “making careful
descriptions of educational phenomena” (Gall et al., 2007: p.
300). Previous researchers considered survey design as an effi-
cient method in collecting original data to measure teachers’
knowledge about ADHD (Bekle, 2004; Brooka et al., 2000;
Canu & Mancil, 2012; Ghanizadeh, et al., 2006; Kos et al.,
2004; Jerome et al., 1994; Ohan et al., 2008; Sciutto et al., 2000;
Snider et al., 2003; Vereb & DiPerna, 2004; West et al., 2005;
White et al., 2011). Self-reported questionnaire method has
been chosen, as it is the best available method to achieve the
aim of this research.
Procedure
The The Knowledge of Attention Deficit Disorders Scale
(KADDS) was obtained from Professor Mark Sciutto, who
granted permission for the use of KADDS in this research.
Permission to conduct this research was obtained from the re-
search department at the middle region. The participants were
recruited from thirty-seven (37) randomly selected schools in
the middle region. A total of two thousand (2000) question-
naires were administered to preschool through ninth grade
school teachers. A letter was attached to each questionnaire.
The letter explains the purpose of the study and thanking teach-
ers for their cooperation. It was emphasized in the letter that
taking part in this study is voluntary, and teachers are not re-
quired to identify themselves or their schools on the question-
naire. No incentive was provided for participation. Of the two
thousand (2000) questionnaires distributed, four hundred and
thirty-one (431) were returned. Two questionnaires were not
usable due to substantial missing data. The total number of
usable questionnaires for data analysis was four hundred and
twenty-nine (429); a usable response rate of more than twenty
one percent (21.45%).
Data Collection
The Knowledge of Attention Deficit Disorders Scale
(KADDS) and a demographic questionnaire were used to col-
lect data from four hundred and twenty-nine (429) teachers.
The KADDS is a 36-item rating scale developed by Sciutto and
colleagues (Sciutto et al., 2000) to measure teachers’ knowl-
edge and misperceptions of Attention-Deficit/Hyperactivity
Disorder. Items in the KADDS questionnaire phrased as state-
ments about ADHD with three option response format: true (T),
false (F) or don’t know (DK). These items divided into three
specific areas: symptoms/diagnosis of ADHD (9 items), the
treatment of ADHD (12 items), and general knowledge about
the nature, causes and outcome of ADHD (15 items). The
KADDS format allows for the differentiation between what
teachers do not know from their misperception of ADHD (Sci-
utto et al., 2000; Soroa et al., 2013). The KADDS is considered
to be “one of the most widely used instruments to assess the
level of knowledge of teachers regarding ADHD, and is the
first instrument whose indices of reliability and validity were
published in this field” (Soroa et al., 2013: p. 156). Internal
consistency of the KADDS total score, in previous studies, has
ranged from 0.82 to 0.89 (Herbert et al., 2004; Sciutto et al.,
2000; Soroa et al., 2013). Cronbach’s alpha value for the current
study was 0.76 which indicate an adequate internal consistency.
Results and Discussion
Data gathered from the demographic questionnaire and
KADDS were analyzed using a computer statistical software
program, Statistical Package for the Social Sciences (SPSS).
Descriptive statistics were used to describe characteristics of
the study participants. The mean age of the participants was
34.18 (range, 23 - 59 years), with a standard deviation of 7.61.
Participants reported an average of 10.48 years of teaching
experience (standard deviation = 7.45; range, 1 - 39 years). As
shown on Table 1, forty four and a half percent (44.5%, n =
191) of the participants were male, and fifty five and a half
percent (55.5%, n = 238) were female. In terms of participants’
education, the vast majority had a bachelor’s degree (96.5%, n
= 414); while less than four percent (3.3%, n = 14) were hold-
ing a master degree. Of the 429 participants, 389 (90.7%) were
general education teachers, and 40 (9.3%) were special educa-
tion teachers. The number of respondents from urban areas was
379 (88.3), while 35 (8.2%) from suburban, and 15 (3.5%) from
schools located in rural areas.
Teachers’ overall percentage score of correct responses
(items answered correctly) was 17.2% which reflect poor
knowledge of ADHD. Incorrect responses (items answered
incorrectly) percentage was 23% which indicate misperceptions
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K. D. F. ALKAHTANI
Table 1.
The demographic characteristics of the parti cipants (N = 429).
Variable Frequency (n) Percentage (%)
Gender
Male 191 44.5
Female 238 55.5
Educational Level
Bachelor degree. 414 96.5
Master degree. 14 3.3
Doctoral de gree. 0 0
Educational Role
General education teacher. 389 90.7
Special education teacher. 40 9.3
School Loc ation
Rural. 15 3.5
Suburban. 35 8.2
Urban. 379 88.3
of ADHD. Don’t know responses (items that teachers admitted
they just don’t know) percentage was 59.8% which point to a
lack of knowledge of ADHD among teachers. Teachers’ overall
percentage score of the correct, incorrect, and don’t know re-
sponses are presented graphically in Figure 1.
In order to examine teachers’ knowledge within each of the
KADDS subscales, their responses were grouped to represent
the three subscales of KADDS. Table 2 presents teachers’ re-
sponses on the first subscale which include 15 items assessing
general knowledge about the nature, causes and outcome of
ADHD. Nearly seventeen (16.8%) of the teachers responded
correctly, while (26.2%) responded incorrectly, and (57%) re-
sponded “don’t know” to these items. The highest proportion of
correct responses (30%, n = 129) and also the lowest incorrect
responses (4%, n = 17) were on item 32, “The majority of
ADHD children evidence some degree of poor school per-
formance in the elementary school years”, which signify that
only less than the third of the teachers knew that most children
with ADHD have difficulty with academic performance. The
lowest proportion of correct responses (3.5%, n = 15) and also
the highest incorrect responses (68.1%, n = 292) were on item
22, “If an ADHD child is able to demonstrate sustained atten-
tion to video games or TV for over an hour, that child is also
able to sustain attention for at least an hour of class or home-
work”, which indicate that the majority of teachers have mis-
conceptions about the change of ADHD symptoms across tasks
and settings. The majority of teachers (76.7%, n = 329) selected
“don’t know” option to answer item 28, “There are specific
physical features which can be identified by medical doctors
(e.g. pediatrician) in making a definitive diagnosis of ADHD”,
which point out that more than two-third of the teachers showed
lack of knowledge about the fact that there is no medical ex-
amination to confirm the diagnosis of ADHD.
Table 3 presents teachers’ responses on the second subscale
of KADDS which include 9 items assessing symptoms/dia-
gnosis of ADHD. Eighteen and one-tenth percent (18.1%) of
the teachers responded correctly, while (22.8%) responded
incorrectly, and (59.1%) responded “don’t know” to these items.
The highest proportion of correct responses (38.9%, n = 167)
was on item 9, “ADHD children often fidget or squirm in their
seats”, which indicate that less than half of the teachers were
Figure 1.
Teachers’ overall percentage score of the correct, incorrect, and don’t
know responses on the KADDS.
aware of one of the hallmark symptoms of ADHD. The lowest
proportion of correct responses (13.3%, n = 57) and also the
highest incorrect responses (19.6%, n = 84) were on item 11,
“It is common for ADHD children to have an inflated sense of
self-esteem or grandiosity”, which show that less than one-
fourth of the teachers thought mistakenly that children with
ADHD have an inflated self-esteem. The majority of teachers
(77.9%, n = 334) selected “don’t know” option to answer item
16, “Current wisdom about ADHD suggests two clusters of
symptoms: One of inattention and another consisting of hyper-
activity/impulsivity”, which point out that more than two-third
of the teachers showed lack of knowledge about the subtypes of
ADHD.
Table 4 presents teachers’ responses on the third subscale of
KADDS which include 12 items assessing the treatment of
ADHD. Sixteen and six-tenth percent (16.6%) of the teachers
responded correctly, while (20.4%) responded incorrectly, and
(63%) responded “don’t know” to these items. The highest
proportion of correct responses (26.3%, n = 113) was on item
10, “Parent and teacher training in managing an ADHD child
are generally effective when combined with medication treat-
ment”, which indicate that only about the fourth of the teachers
knew that an effective treatment of ADHD should be multifac-
eted and comprehensive. The highest proportion of incorrect
responses (26.8%, n = 115) was on item 23, “Reducing dietary
intake of sugar or food additives is generally effective in re-
ducing the symptoms of ADHD”, which show that more than
one-fourth of the teachers hold a misperception about the effec-
tiveness of the diet on the symptoms of ADHD as they thought
mistakenly that the symptoms of ADHD will reduce with the
reduction of sugar and or food additives in the diet of children
with ADHD. The lowest proportion of both correct responses
(7%, n = 30) and incorrect responses (4.4%, n = 19) were on
item 35, “Electroconvulsive Therapy (i.e. shock treatment) has
been found to be an effective treatment for severe cases of
ADHD”. Responses on this item revealed that although less
than five percent of the teachers have a misperception, only
seven percent were aware that there is no evidence of the effec-
tiveness of this type of treatment for children with ADHD. Item
35 also has the highest percentage (88.3%, n = 379) for don’t
know responses, pointing to lack of knowledge among the ma-
jority of the teache rs.
Percentage of teachers’ score of the correct, incorrect, and
don’t know responses on the KADDS subscales are presented
graphically in Figure 2.
Two-tailed Pearson correlation analysis was computed to in-
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K. D. F. ALKAHTANI
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966
Table 2.
Participants’ responses on the first subscale of KADDS which include 15 items pertain to general knowledge about the nature, causes and outcome of
ADHD (N = 429).
Number of responses
Items CACorrect Incorrect Don’t Know
1. Most estimates suggest that ADHD occurs in approximately 15% of school age children. F 62
(14.5%) 50
(11.7%) 318
(73.7%)
4. ADHD children are typically more compliant with their fathers than with their mothers. T 69
(16.1%) 53
(12.4%) 303
(70.6)
6. ADHD is more common in the 1st degree biological relatives (i.e. mother, father) of children with
ADHD than in the general population. T 81
(18.9%) 49
(11.4%) 296
(69.7%)
13. It is possible for an adult to be diagnosed with ADHD. T 57
(13.3%) 60
(14.1%) 309
(72.1%)
17. Symptoms of depression are found more frequently in ADHD children than in non-ADHD children. T 47
(11 %) 62
(14.5%) 318
(74.5%)
19. Most ADHD children “outgrow” their symptoms by the onset of puberty and subsequently function
normally in adulthood. F 29
(6.8%) 78
(18.2%) 320
(74.6%)
22. If an ADHD child is able to demonstrate sustained attention to video games or TV for over an hour,
that child is also able to sustain attention for at least an hour of class or homework. F 15
(3.5%) 292
(68.1%) 121
(28.2%)
24. A diagnosis of ADHD by itself makes a child eligible for placement in special education. F 30
(7.0%) 104
(24.2%) 292
(68.1%)
27. ADHD children generally experience more problems in novel situations than in familiar situa tions. F 50
(11.7%) 54
(12.6%) 323
(75.3%)
28. There are specific physical features which can be identified by medical doctors (e.g. pediatrician) in
making a definitive diagnosis of ADHD. F 23
(5.4%) 73
(17%) 329
(76.7%)
29. In school age children, the prevalence of ADHD in males and females is equivalent. F 28
(6.5%) 78
(18.2%) 320
(74.6%)
30. In very young children (less than 4 years old ), the problem behaviors of ADHD children (e.g.
hyperactivity, inattention) are distinctly different from age-appropriate behaviors of non-ADHD children.F 38
(8.9%) 79
(18.4%) 309
(72%)
31. Children with ADHD are more distinguishable from normal children in a classroom setting than in a
free play situation. T 64
(14.9%) 42
(9.8%) 322
(75.1%)
32. The majority of ADHD children evidence some degree of poor school performance in the elementary
school years. T 129
(30%) 17
(4%) 283
(66%)
33. Symptoms of ADHD are often seen in non-ADHD children who come from inadequate and chaotic
home environ ments. T 68
(15.9%) 40
(9.3%) 320
(74.6%)
CA = Correct Answer; T = True; F = False.
Table 3.
Participants’ responses on the second subscale of KADDS which include 9 items pertain to symptoms/diagnosis of ADHD (N = 429).
Number of responses
Items CACorrect Incorrect Don’t Know
3. ADHD children are frequently distracted by extraneous stimuli. T 109
(25.4%) 47
(11.2 %) 272 (63.4%)
5. In order to be diagnosed with ADHD, the child's symptoms must have been
present before age 7. T 68
(15.9%) 49
(11.4%) 296
(71.3%)
7. One symptom of ADHD children is that they have been physically cruel to other people. F 59
(13.8%) 75
(17.5%) 291
(68.5%)
9. ADHD children often fidget or squirm in their seats. T 167
(38.9%) 36
(8.4%) 225
(52.4%)
11. It is common for ADHD children to have an inflated sense of self-esteem or grandiosity. F 57
(13.3%) 84
(19.6%) 287
(66.9%)
14. ADHD children often have a history of stealing or destroying other people’s things. F 72
(16.8%) 42
(9.8%) 314
(73.4%)
16. Current wisdom about ADHD suggests two clusters of symptoms: One of inattention and anothe r
consisting of hyperactivity/impulsivity. T 65
(15.2%) 27
(6.3%) 334
(77.9%)
21. In order to be diagnosed as ADHD, a child must exhibit relevant symptoms in two or more settings
(e.g., home, school). T 68
(15.9%) 45
(10.5%) 311
(72.5%)
26. ADHD children often have difficulties organizing tasks and activities. T
111
(25.9%) 26
(6.1%) 289
(67.4%)
CA = Correct Answer; T = True; F = False.
K. D. F. ALKAHTANI
Table 4.
Participants’ responses on the third subscale o f KADDS which include 12 items pertain to the treatment of ADHD (N = 429).
Number of responses
Items CACorrect Incorrect Don’t Know
2. Current research suggests that ADHD is largely the result of ineffective parenting skills. F 51 (11.9%) 66 (15.4%) 312 (72.7%)
8. Antidepressant drugs have been effective in reducing symptoms for many ADHD children. T 54
(12.6%) 56
(15.2%) 309
(72.2%)
10. Parent and teacher training in managing an ADHD child are generally effective when
combined with medication treatment. T 113
(26.3%) 37
(8.6%) 279
(65.1%)
12. When treatment of an ADHD child is terminated, it is rare for the child's symptoms to return. F 58
(13.5%) 78
(18.2%) 292
(68.1%)
15. Side effects of stimulant drugs used for treatment of ADHD may include mild insomnia and
appetite reduction. T 69
(16.1%) 32
(7.5%) 328
(76.5%)
18. Individual psychotherapy is usually sufficient for the treatment of most ADHD children. F 55
(12.8%) 60
(14%) 312
(73.1%)
20. In severe cases of ADHD, medication is often used before other behavior modification
techniques are attempted. T 64
(14.9%) 34
(7.9%) 330
(76.9%)
23. Reducing dietary intake of sugar or food additives is generally effective in reducing the
symptoms of ADHD. F 37
(8.6%) 115
(26.8%) 272
(63.4%)
25. Stimulant drugs are the most common type of drug used to treat children with ADHD. T 34
(7.9%) 65
(15.2%) 327
(76.2%)
34. Behavioral/Psychological interventions for children with ADHD focus primarily on the child’s
problems wit h inattention . F 36
(8.4%) 90
(21%) 303
(70.6%)
35. Electroconvulsive Therapy (i.e. shock treatment) has been found to be an effective treatment
for severe cases of ADHD. F 30
(7%) 19
(4.4%) 379
(88.3%)
36. Treatments for ADHD which focus primarily on punishment have been found to be the most
effective in reducing the symptoms of ADHD. F 78
(18.2%) 39
(9.1%) 311
(72.5%)
CA = Correct Answer; T = True; F = False.
Figure 2.
Percentage of teachers’ score of the correct, incorrect, and don’t know
responses on the KADD S subscales.
vestigate the relationship between teachers’ level of knowledge
of ADHD and their prior training and experience with ADHD
(i.e., the number of ADHD courses taken in college or graduate
level, and the number of workshops pertaining to ADHD ). The
result of the correlational analysis was statistically significant (r
= 0.311, p < 0.01). This result shows a strong positive correla-
tion between teachers’ level of knowledge of ADHD and their
prior training and experience with ADHD.
Two-tailed Pearson correlation analysis was also carried out
to examine the relationship between teachers’ level of knowl-
edge of ADHD and their level of confidence in teaching a stu-
dent with ADHD. The result of the correlational analysis was
statistically significant (r = 0.631, p < 0.01). This result shows
that teachers’ level of knowledge of ADHD correlated posi-
tively with their level of confidence in teaching a student with
ADHD.
Conclusion
Teachers have a major role in the identification and assess-
ment of students with ADHD. This study was intended to ex-
amine teachers’ knowledge and misperceptions of ADHD.
Three major study findings emerged. First, teachers’ scores on
KADDS were fairly low, pointing to a significant lack of
knowledge about ADHD. Second, teachers’ level of knowledge
of ADHD was positively related to their prior training and ex-
perience with ADHD. Third, teachers’ level of knowledge of
ADHD correlated positively with their level of confidence in
teaching a student with ADHD. Results from this study concur
with the findings of previous studies (Bekle, 2004; Brooka et
al., 2000; Canu & Mancil, 2012; Ghanizadeh et al., 2006; Kos
et al., 2004; Jerome et al., 1994; Ohan et al., 2008; Sciutto et al.,
2000; Snider et al., 2003; Vereb & DiPerna, 2004; West et al.,
2005) showing that teachers lack adequate knowledge. Results
from this study also bring light to the fact that teachers need to
be educated and supported to further their professional devel-
opment regarding ADHD through in-service training. 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 (Goldstein et al., 2011; Lerner et al.,
1995).
The limitations of this study that deserve consideration in
future investigations include the instrumentation used to collect
data. Sciutto and colleagues provide cited references for each
item of KADDS. However, the existing research on ADHD is
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K. D. F. ALKAHTANI
conflicting (Barkley, 2006; Cooper & Ideus, 2002; Richard,
2000; Weiss & Hechtman, 1993). Thus, using scientific litera-
ture to construct and support the KADDS is problematic. In
addition, the KADDS, being a self-reported measure, is possi-
bly subjective in nature. This research is also limited by the use
of correlation analysis. This type of statistical analysis provides
understanding the nature of relationships between variables, but
it does not indicate what causes the relationship which limits
drawing conclusions about outcomes and causes. Although the
sample size was large (n = 429), there were a large number of
unreturned questionnaires (78.55%). The generalizability of the
results is limited by low response rate (21.45%) and the fact
that only one geographical region was included in this study. In
spite of these limitations, the results of this study are valuable
for identifying areas where there is a misperception or lack of
knowledge among teachers.
Acknowledgements
I would like to thank Professor Mark Sciutto who kindly
gave his permission for the use of KADDS in this research. I
also gratefully acknowledge that this research project was sup-
ported by a grant from the Research Center for the Humanities,
Deanship of Scientific Research, King Saud University.
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