Teachers are important partners to health professionals in identifying and managing children with attention-deficit hyperactivity disorder (ADHD). However, they may be over-identifying children with possible ADHD diagnoses.
Diagnostic criteria for ADHD require that the symptoms are present both at school and at home. School assessments are generally carried out by rating scales and school reports.
However, these may be unreliable, and a more structured approach should be taken to school assessment, according to a new study.
A recent US study pointed to various school factors that may make teachers more or less likely to report ADHD-like symptoms. The authors of this latest study set out to determine how informative teacher-reported symptoms of ADHD were in the final diagnosis.
A retrospective review was undertaken of referrals for ADHD, or inattention in school, to the Child and Adolescent Mental Health Services (CAMHS) Team for the eastern sector of Tower Hamlets in London.
The diagnostic process and outcome was mapped for all the children. Of those for whom teachers suspected ADHD, an unstructured observation was performed by a CAMHS professional.
Between November 2006 and October 2007, 52 children were referred to CAMHS with ADHD-like symptoms. Enough concern was raised of 14 children to warrant school observation. Of these, only five were diagnosed with ADHD, and one additional child was also diagnosed prior to a school observation being carried out.
The researchers comment that they are unsure why teachers may be over-identifying children with possible ADHD diagnoses.
They suggest that better educational resources need to be made available to teachers to help them accurately identify those children with ADHD, and that CAMHS teams should develop structured school observation tools or telephone interview schedules, so that identified children can be independently and expertly assessed in a classroom setting.
Source: Royal College of Psychiatrists
