Thesis (MEdPsych (Educational Psychology)--University of Stellenbosch, 2009. / ENGLISH ABSTRACT: Attention Deficit/Hyperactivity Disorder (AD/HD) is one of the most well-known behaviour disorders in South Africa. Limited studies regarding adolescents’ experience of their own AD/HD are available despite the extensive research on AD/HD. The purpose of this exploratory and descriptive qualitative study was to understand 7 adolescents' experience of their own AD/HD in a special school in order to identify supportive strategies. This study was approached from an interpretive and/or constructivist research paradigm. A collective case study research design was used. Data was collected by means of observation, personal documents as well as semi-structured interviews. The data was transcribed and analised according to the constant comparative method. According to the results it seems as if the adolescents’ experiences of their own AD/HD are unique. However, these unique experiences are influenced by their barriers to learning, the process of diagnosis, development, AD/HD medication and social context. The adolescents seek that others empower them to regulate their own AD/HD by: (1) trying to understand how it feels to live with AD/HD; (2) providing information regarding AD/HD; and (3) focusing on their talents and strengths. The practical implications of the results are individualized intervention, changing roles of educators and support professionals, whole school development, changing attitudes, as well as professional development. Further qualitative research is recommended to investigate adolescents’ experiences of their own ADHD.

The purpose of this study was to explore the use of EEG biofeedback in a school setting to assist students who had attentional challenges. The equipment for implementing biofeedback was relatively inexpensive and was easily integrated into the school setting. Twenty students ranging in age from 7 to 17 were recruited for this study. Data was used from 14 subjects, 12 males (2 Hispanic, 1 African American, and 10 Caucasian) and 2 females (1 Hispanic, 1 Caucasian.) The subject pool was reduced due to non-compliance or the students. moving from the school district. Significant effect size was obtained in the treatment group in areas pertaining to visual perception and motor coordination. However, significant effect sizes in other areas were obtained when the control group scores worsened. The inclusion of student subjects who, perhaps, did not meet stringent criterion of attention deficit may have skewed the results. The small number of students in the study may have hindered accurate measures of statistical significance. Conversely, the information obtained from this study may offer insight to school districts in providing their students an alternate/adjunct to psychopharmacological medication and a non- invasive method of helping students with psycho-social challenges.

Attention deficit/hyperactivity disorder (ADHD) is frequently associated with negative occupational, social and psychological outcomes among community samples of adults; as such, it is expected that college students with ADHD face similar struggles. The research targeting this group of individuals, however, is sparse and tempered by significant limitations. The current study aimed to address methodological limitations in the current literature by including instruments to formally diagnosis ADHD and comorbid disorders, utilizing psychometrically sound instruments and comparing functioning of college students with ADHD across gender and subtype. It was hypothesized that participants with ADHD would report lower GPAs, higher levels of emotional distress and negative relationship characteristics than participants without ADHD. It was also hypothesized that participants with ADHD-combined type (ADHD-C) would report higher levels of substance and alcohol use than participants with ADHD-predominately inattentive type (ADHD-I), and that participants with ADHD-I would report higher levels of anxiety and depression than participants with ADHD-C. Women diagnosed with ADHD were expected to report higher levels of anxiety and depression than men diagnosed with ADHD; whereas, men diagnosed with ADHD were expected to report higher levels of substance and alcohol use than women. MANOVA, ANOVA and Mann-Whitney U tests were conducted to test hypotheses. Results revealed no significant differences between the ADHD and comparison group on GPA and relationship characteristics. Participants diagnosed with ADHD did report significantly higher emotional distress than participants in the comparison group. No differences in GPA or relationship characteristics were found across ADHD subtype or gender. Overall, these findings provide evidence to suggest that college students with ADHD are functioning relatively well compared to their non-ADHD peers.

Sammanfattning Syfte: Syftet med studien var att beskriva arbetsterapeuters kliniska resonemang samt erfarenheter av interventioner för att främja delaktighet i aktivitet hos barn med ADHD. Metod: Studien var baserad på en kvalitativ ansats med semistrukturerade intervjuer för att undersöka arbetsterapeuternas kliniska resonemang och erfarenheter. Sex arbetsterapeuter från olika regioner i Sverige deltog i studien. En kvalitativ innehållsanalys användes för att undersöka erfarenheter av interventioner vilka därefter analyserades deduktivt för att identifiera kliniska resonmang. Resultat: Resultatet redovisades i ett övergripande tema; Att möta barnet och familjen i den aktuella situationen med tre kategorier; Hela familjen som klient, Kartläggning av aktivitetsutförande för en lyckad intervention och Resonemang kring yrkesetiska aspekter. Resultatet visade att klientcentrering var kärnan i deltagarnas kliniska resonemang där empati, samarbete och kommunikation var viktiga aspekter att resonera kring. Deltagarnas erfarenhet var att det mest betydelsefulla för att främja delaktighet i aktivitet hos barn med ADHD var inlärning av strategier för att hantera barnets begränsningar i vardagen. Utöver det var olika former av kognitivt stöd vanligt förekommande interventioner. Slutsats: Studien har bidragit till ökad insikt i arbetsterapeuters erfarenhet av interventioner i arbetet med barn med ADHD samt en ökad förståelse för arbetsterapeuters kliniska resonemang.

Attention Deficit-Hyperactivity Disorder diagnoses have been rising steadily since the early 1990s. Today, about 10 percent of the school-aged population has been diagnosed with the disorder, and prevalence is increasing steadily among preschool children and adults. Most of the individuals diagnosed with the disorder use stimulant medications to treat the symptoms. Both the rapidly rising number of diagnoses and the substantial variation in prevalence and treatment utilization -- across states, regions, gender, race, ethnicity, and socioeconomic status -- have attracted attention and raised concerns about under and over recognition and treatment. The implicit justification for the increasing awareness and recognition of the disorder is that it is a valid clinical object that matches medically-proven treatments with those reliably expected to benefit from them. From this perspective, the uptake in prevalence results from changes in environmental determinants or scientific advances in neurology, psychiatry, diagnostic protocols, or pharmaceutical research. But a widespread argument among teachers, parents, policy makers, the general public, and academic researchers -- including sociologists -- is that the development and success of the disorder results from a medicalization process. Medicalization encompasses a social construction critique that contradicts the environmental/scientific advance claims, but medicalization research also emphasizes macro-level actors that forcibly advance the medical label and treatment. Traditionally, medicalization studies focused on the disproportionate power of the medical profession vis-a-vis patients, but more recently they have begun to emphasize a broader range of actors pursuing a medical label -- pharmaceutical companies and even consumers influenced by new forms of advertising. Those arguments assume that educational institutions act in concert with those pushing the medical label. The goal of this dissertation is to provide an account of diagnostic prevalence and treatment utilization (and their uneven distribution) that debunks explanations based solely in science but that also demonstrates the insufficiency of the medicalization account. Together, the chapters show that there is no correlation in timing between the surge in diagnoses and the processes implied by either medicalization or scientific progress arguments, there is little support in the micro-level data for a strictly medicalization account, and there is substantial evidence that macro-level educational institutions and the school context play a significant role in reshaping the category. The chapters emphasize that the success of the category lies in the confluence of technoscientific innovation, social control of troublesome behaviors, the increased activism of parents along with direct-to-consumer pharmaceutical advertising, encroachments of the law into student discipline and into the health care industry, the institutional needs of schools, a cultural emphasis on high academic achievement, and the influence of parallel and predecessor classifications, among other factors. The category -- a result of multiple institutions working to recraft expertise – is a school-specific medical disorder that includes a heterogeneous symptom complex, one that is understood differently within school and medical milieu. Although the chapters do not disprove medicalization, they suggest that the medicalization framework overstates the importance of medical professionals and medicine broadly defined for the success of the category.

Studiens syfte har varit att undersöka upplevelsen och betydelsen av att få en ADHD-diagnos hos unga kvinnor. Studien har haft en kvalitativ ansats och består av intervjuer med tre kvinnor i åldrarna 24 till 30 år som alla har fått sin diagnos efter tjugo års ålder. Utskrifterna från dessa intervjuer har meningskoncentrerats och har analyserats utifrån känsla av sammanhang, diagnossociologiska tankeströmningar och medikaliseringsbegreppet. De två forskningsfrågor som studien har ämnat besvara har varit dels hur de intervjuade kvinnorna har upplevt att få en ADHD-diagnos och dels vilken betydelse ADHD-diagnosen har haft för de intervjuade kvinnorna. Resultatet visar att kvinnorna i studien upplevde det som mestadels positivt att få en ADHD-diagnos och att diagnosen har ökat deras känsla av sammanhang avseende framför allt begriplighet och hanterbarhet men även avseende meningsfullhet. Att få en diagnos har enligt mina informanter inneburit att de förstår sig själva bättre och att de också har fått en större förståelse från andra. Diagnosen har också fungerat som en förklaringsmodell för ens eget beteende. Förutom att egna beteenden har omdefinierats till att förstås utifrån en medicinsk förklaringsmodell har diagnosen även inneburit att kvinnorna fått tillgång till hjälp och hjälpmedel som exempelvis receptbelagda läkemedel. Det har också underlättat utvecklingen av strategier för att klara av vardagen genom att antingen ”ADHD-säkra” eller använda diagnosen som en felsökningsmanual. Slutligen visar studien, som dess titel skvallrar om, på en alternativ bild av att ha en ADHD-diagnos än den som vanligtvis förmedlas i samhället, där kvinnorna ser på ADHD mer som en uppsättning personlighetsdrag som förvisso kan innebära vissa svårigheter i vardagen men som också för många goda saker med sig så som kreativitet, initiativrikedom och en förmåga att se möjligheter där andra ser problem. / The purpose of this study was to examine the experience and the meaning of being diagnosed with ADHD in young women. The study had a qualitative approach and consists of interviews with three women aged 24 to 30 whom all received their diagnosis after the age of 20. The transcripts from the interviews have been processed through meaning condensation and then content analysis, focusing on sense of coherence, sociology of diagnosis and medicalization. The study aims to answer two questions – how the interviewed women experienced being diagnosed with ADHD and what meaning the diagnosis had for the interviewed women. The results shows that the women in this study mainly had positive experiences of being diagnosed with ADHD and that the diagnosis increased their sense of coherence mainly in regards of comprehensibility and manageability but also regarding meaningfulness. Getting an ADHD-diagnosis has, according to the interviewed women, led to a greater understanding of themselves and also to a more understanding approach from others. The diagnosis has also been used as an explanation model for their own behavior. In addition to own behaviors being redefined to be understood in a medicinal explanation model, the diagnosis has also meant that the women has gained access to help and aids like, for instance, prescription drugs. It has also facilitated the development of strategies for managing everyday life through either “ADHD-securing” and using the diagnosis as a manual for troubleshooting.  Finally, this study shows an alternative picture of having an ADHD-diagnosis that differs from the picture that is usually conveyed in society, where the women in this study perceive ADHD more as a set of personality traits that indeed may cause difficulties in their everyday life but also brings a lot of good things with it, such as creativity, an ability to take initiatives and an ability to see possibilities where others see problems.

This study was designed to assess teachers' and counsellors' knowledge and experiences related to ADHD and the use of stimulant medication. The sample population was comprised of elementary, middle school, and high school teachers and counsellors from two school districts in southwestern Canada. A descriptive, cross-sectional design using a self-administered questionnaire was used to obtain information. Results revealed that the teachers and counsellors responding to the questionnaire have limited knowledge about ADHD and the use of stimulant medication, although a large majority of them have experience with students with ADHD and are involved in the diagnosing and assessment process of ADHD. These results suggest that there is a need for in-service training regarding the diagnosis and characteristics of ADHD, different intervention strategies, and assessment of the effectiveness of these strategies. Teachers and counsellors need to become more familiar with empirical research and to base their practice on it, rather than on popular opinion. Finally, further collaboration is needed between teachers and counsellors and allied professionals, such as physicians and psychologists. / x, 77 leaves ; 29 cm.

The purpose of this study was to explore the nature of the relationship between a continuous performance test (CPT) and teachers' ratings of behavior. Assessment data were archival in nature. One hundred-one children from one rural, middle-class, predominately Caucasian school district in a Midwestern state were selected who had taken the Test of Variables of Attention (TOVA) and whose teachers had completed the Attention Deficit Disorders Evaluation ScaleSchool Version (ADDES) and the Child Behavior ChecklistTeacher Report Form (TRF). Of this group 46 had been referred for Attention-Deficit/Hyperactivity Disorder (ADHD) and/or learning difficulties and 55 had participated in a local norming project for the TOVA.Descriptive statistics were found for CPT variables and teachers' ratings of behavior for all participants, boys and girls separately, and referred and nonreferred separately. The research question was investigated using a matrix of partial correlations controlled for age. TOVA variables included Omissions, Commissions, Response Time, Response Time Variability, Anticipatory Responses, and Multiple Responses. Teacher's rating scale variables included the ADDES Total and subscales Inattention, Impulsive, and Hyperactive as well as the TRF Attention Problems, and Aggressive Behavior.Research provided support that TOVA Omissions and Commissions are valid indicators of ADHD as measured by teachers' ratings of behavior. Response Time Variability and Multiple Responses may be valid indicators of generalized behavior dysfunction as measured by teachers' ratings of behavior. Anticipatory Responses and Response Time may aid in distinguishing ADHD with and without hyperactivity but further research is recommended. / Department of Educational Psychology

The purpose of this study was to determine school psychologists' current level of knowledge about Attention-deficit/hyperactivity disorder (ADHD), their training and comfort level with that training, their roles and practices in assessing, diagnosing, and treating children and adolescents with ADHD, and their attitudes toward the disorder and those with it. An original survey (see Appendix B) developed for this purpose was distributed to 700 systematically selected members of the National Association of School Psychology (NASP) who were currently practicing in the public schools. A total of 406 usable surveys were returned for a final response rate of 58%.Overall school psychologists are confident in their abilities to deliver services (consultation, assessment, and intervention) to students with ADHD. Respondents underestimated the rate of comorbidity of ADHD with other psychiatric disorders but overestimated the percentage of students with ADHD who also have a learning disability. Respondents most often mentioned diagnosis or identification of the disorder as their goal for assessment of possible ADHD. However, in their rankings of specific goals, respondents ranked the development of appropriate interventions as more important than the diagnosis of the disorder. The most often used standardized tests for ADHD referrals are questionnaires (for parents, teachers, and students) and drawings. Most (57%) school psychologists agreed that they do not determine the diagnosis of ADHD, but rather refer to a medical doctor. A Specific Learning Disability is the most often used special education category for students with ADHD who qualify, followed somewhat closely by Other Health Impaired, then by Emotionally Handicapped. Only 14 percent of the school psychologists surveyed stated that every student with ADHD who did not qualify for special education was considered for accommodations under Section 504. More respondents (83%) agreed that teachers often press to have their problem students diagnosed with ADHD than agreed that parents often press (55%). The majority of respondents (74%) agreed that ADHD is overdiagnosed. However, there was disagreement as to whether stimulant medications were used more often than necessary to treat ADHD. Implications of these findings for school psychologists and for future research are discussed. / Department of Educational Psychology

The past decade has witnessed students with disabilities attending university in everincreasing numbers. In particular, many countries, including Australia, now report that students with so-called 'invisible disabilities' comprise the vast majority of those seeking support from Student Disability Services at university. Despite this increase, relatively few researchers have investigated the processes involved in the university education of students with disabilities, particularly during their crucial first year, when the highest rate of student attrition occurs across the board. The substantial body of research which has investigated the 'first year experience' for university students in Australia and the United States of America has ignored the issues unique to students with disabilities during this critical period. At the same time, some researchers, predominantly in the United States of America and the United Kingdom, have studied the tertiary education of students with disabilities. However, the subject has received less attention in Australia. Also, certain categories of university students with disabilities have been overlooked. In particular, university students diagnosed with Attention Deficit/Hyperactivity Disorder (AD/HD) appear to be one of the groups that have attracted little attention worldwide, despite the vast body of research that exists on children and, increasingly, on adults with the diagnosis. These students constituted the focus of the study reported in this thesis. The aim of this study was to develop substantive theory about how university students who are diagnosed with Attention-Deficit/Hyperactivity Disorder (AD/HD) deal with their first year. The study is conceptualised within the social theory of symbolic interactionism. A central research question and a series of related guiding questions were used as the starting point for data collection. Data collection was conducted largely through in-depth, individual, face-to-face semistructured interviews, and participant observation consistent with the interpretivist qualitative research tradition. In addition, informal interviews, telephone interviews and documents provided supplementary data for the study. Data analysis, which occurred concurrently with data collection, employed the open coding method consistent with the grounded theory model and the development and testing of propositions. The central proposition of the substantive theory generated from this study is that students diagnosed with AD/HD experience a sense of developing empowerment as they progress through three stages in their first year at university. The first stage in the theory of developing empowerment is entitled the development of empowerment through realising a dream. The second stage is entitled the development of empowerment through becoming proactive. The final stage is entitled the development of empowerment through the feeling of belonging. The theory of developing empowerment provides a new perspective on how university students with a diagnosis of AD/HD deal with their first year of study. A number of implications for further theory development, policy and practice are drawn from it. There are also several recommendations for further research.