京都大学 / 新制・課程博士 / 博士(生命科学) / 甲第24756号 / 生博第497号 / 新制||生||66(附属図書館) / 京都大学大学院生命科学研究科高次生命科学専攻 / (主査)教授 北島 智也, 教授 見学 美根子, 教授 今吉 格 / 学位規則第4条第1項該当 / Doctor of Philosophy in Life Sciences / Kyoto University / DGAM

Teachers report that there are an increased number of students engaging in persistent antisocial behaviour in their classrooms. Teachers need to identify these students early because if there is early identification then there is the potential for early intervention, which in turn may prevent negative long-term outcomes for these students as well as long-term costs to society. The aims of this study were (1) develop a psychometrically sound, cost effective, three-step multiple gating behaviour screening procedure that teachers could use in their kindergarten/classroom so that they could identify those students at-risk of antisocial development, (2) examine if the third gate of this procedure was necessary for the accurate identification of these students, and (3) could such a screening procedure be adapted for classroom teacher use in New Zealand kindergartens and schools. Forty eight teachers from three kindergartens and 10 primary/intermediate schools volunteered for the study, of which 34 teachers completed all three gates of the screening procedure. Results indicate the three gate screening procedure was easily adapted for kindergarten and classroom use with, at Gate 3, teachers’ self-recording 30 direct observations of a nominated and control student during their normal teaching lesson with good accuracy. All three gates were effective in identifying those students at-risk of antisocial development but Gates 1 and 2 were the most effective in terms of accuracy, time and resourcing. The teachers found the three gate procedure manageable, required very little training and did not interrupt classroom routine or schedules. The implications of these findings are discussed.

Attention-deficit/hyperactivity disorder (ADHD) is one of the most common behavioural disturbances in school children. The aims of this thesis were to explore the association of ADHD with recurrent health complaints and bullying behaviour in children in grade four, and to evaluate whether it is possible to predict ADHD in grade four by screening before or at school entry. Cohort study in a population of 577 fourth graders (10-year-olds) in Sigtuna, a municipality in Stockholm County. All children were screened for attention and behaviour problems by parents and teachers in fourth grade. In a second step children with high scores underwent further clinical and cognitive assessments. Information about health complaints and bullying was collected from the children themselves in a classroom questionnaire. Hypotheses were tested in multivariate analyses with adjustment for sex and parental education. Screening with developmental indicators and Conners scale from routine child health services was performed. Sensitivity, specificity and positive predictive value for being diagnosed with ADHD in fourth grade was calculated. Recurrent abdominal pain, sleeping problems, and tiredness were associated with ADHD (adjusted relative risks: 2.2 [1.4-3.4], 1.7 [1.1-2.7], and 2.7 [1.7-4.1] respectively). ADHD was associated with bullying others students (adjusted odds ratios; 3.8 [95% C.I.: 2.0-7.2]) as well as being bullied (often 10.8 [4.0-29.0] and sometimes 2.9 [1.5-5.7]). The predictive value of developmental deviations for ADHD was no more than 20% and 50% when combining a Conner score of at least 10 from both parents and teachers. This thesis demonstrates a connection between ADHD in one as well as two settings (home and school), health complaints, and bullying in school children. Treatment strategies for ADHD need to include an effective evaluation and treatment of health complaints and effective interventions for bullying. Evaluation of ADHD should be considered in children with recurrent health complaints and in children involved in bullying. Screening does not identify children who are diagnosed with ADHD in grade four with a high degree of selectivity. It may be more important for schools to have an effective strategy for identifying and dealing with children who develop ADHD when these problems evolve, rather than before school entry.