INTRODUCTION:

Attention-deficit/hyperactivity disorder (ADHD) is a chronic neurobehavioral disorder with a developmental component that has a genetic basis (Akram et al., 2009). ADHD can manifest in infancy and persist into adulthood. According to the American Academy of Paediatrics (2007), studies suggest that approximately one third to one half of children with ADHD continue to experience symptoms into adulthood. ADHD, which stands for Attention-Deficit/Hyperactivity Disorder, is classified as one of the 18 disorders in the common Axis-I of the DSM-IV-TR. In the ICD-10, ADHD symptoms are referred to as Hyperkinetic Syndrome Disorder. Both the ICD-10 and the DSM-IV-TR agree that typical symptoms of ADHD typically manifest in early childhood. These symptoms include difficulty in staying focused and paying attention, challenges in controlling behaviour, and exhibiting hyperactivity or over activity. ADHD can significantly impact a child's life at home, school, in relationships, at work, and within the community. This condition is reported globally, though statistical differences may arise from cultural views on behaviour. Some of the characteristics of ADHD include having a low tolerance for frustration, experiencing temper outbursts, facing rejection by peers, struggling with academic failure, and dealing with poor self-esteem (APA, 2000; Barkley, 2005, 2006b; Flick, 1998). These features are commonly associated with individuals who have ADHD and can have a significant impact on their daily lives.¹

Students who display symptoms such as difficulty paying attention to details, trouble sustaining attention or organizing tasks, and excessive talking or fidgeting may experience reduced on-task behavior at school. These symptoms can often lead to educational challenges and predict underachievement, as well as increase the risk for delinquent behavior. The most common intervention for students with ADHD is pharmacological treatment aimed at addressing the core symptoms. Combining medication with behavioral therapy, as well as each treatment on its own, has been found to reduce ADHD symptoms. However, the impact on school achievement is somewhat diminished. Since the impairment is particularly noticeable in a school setting, students are frequently assessed and treated after they start school. This underscores the necessity of developing treatments that specifically target the challenges experienced by students in a school environment. An Austrian study investigated the factors influencing the intention of teachers to apply classroom management strategies (CMS). The study involved both in-service teachers and those not regularly working in schools. The findings revealed that behavioral attitude emerged as the most significant variable in explaining the variance in the intention to apply CMS. This suggests that teachers' behavioral attitudes play a crucial role in their adoption of effective classroom management strategies.²

In a study conducted by Geraldine D.J. Cadet and Makella S. Coudray in 2019, the prevalence of ADHD in Tamil Nadu, India was found to be 11.3% among children attending primary school. The study noted that ADHD prevalence was higher among males and in lower socio-economic groups, aligning with trends observed in the United States. Behavioral disorders in India are often perceived as specific to school environments and may not be taken seriously until they start affecting a student's academic performance. The prevailing cultural norms instill certain expectations, which are reinforced by the influence of family and friends. Typically, fathers tend to engage more actively only when a child's behavior reaches a critical level, particularly in a classroom environment. This research sought to explore how a mother's socio-demographic background, attitudes, and understanding of ADHD might be linked to the diagnosis of ADHD in her child. The acceptability of a treatment is influenced by several factors, including the positive outcomes it produces, the time and effort required to undergo the treatment, and its overall effectiveness. ADHD is a common neurodevelopmental disorder that affects people of all ages, but it is particularly prevalent in children. Globally, approximately 7.2% of children are diagnosed with ADHD. In the United States, this figure is slightly higher, with around 8.4% of children being diagnosed with the condition as of 2016.Children with ADHD often exhibit symptoms such as hyperactivity, impulsivity, and difficulty paying attention. These symptoms can significantly interfere with their academic performance, social interactions, and home life. The impact of ADHD on a child's daily functioning underscores the importance of early identification and appropriate support.³

The prevention program for externalizing problem behavior (PEP) for preschool children demonstrated the effectiveness of its parent (PEP-PA) and teacher (PEP-TE) modules in two separate studies under routine care conditions. This secondary analysis investigated the impact of two specific intervention modules on preschool children exhibiting severe symptoms of attention deficit/hyperactivity disorder (ADHD). The study focused on comparing these effects with those observed in children who displayed either no ADHD symptoms or only mild manifestations of the disorder. In the within-subject control group, a comparison was made between the changes in child symptoms and problem behaviors observed in specific situations at home and school during a waiting period and those documented during the subsequent intervention period, which lasted three months for each phase.⁴

OBJECTIVES OF THE STUDY:

1. To assess the pre-test and post-test level of knowledge regarding ADHD among elementary school teachers.

2. To evaluate the effectiveness of an teacher in-service training program on ADHD among elementary school teachers.

3. To associate the knowledge regarding ADHD with socio-demographic variables among elementary school teachers.

HYPOTHESES:

H₁: The teacher in-service training program will be effective on increasing knowledge regarding ADHD among elementary school teachers.

H₂: There will be a significant association pre-level of knowledge regarding ADHD and the socio-demographic variables of elementary school teachers.

METHODOLOGY:

The study employed a quantitative evaluative research design utilising a pre-experimental one-group pre-test post-test methodology to assess the efficacy of an in-service teacher training program on attention-deficit/hyperactivity disorder (ADHD) among elementary school teachers in Cuttack, Odisha. A purposive sample strategy was employed to choose 30 primary school teachers who fulfilled the established inclusion criteria and had no previous exposure to ADHD training.

A structured knowledge questionnaire based on the Knowledge of Attention Deficit Disorders Scale (KADDS) was used to gather data. The instrument consisted of 36 items categorised into three domains: symptoms/diagnosis, treatment, and aetiology. The questionnaire exhibited acceptable reliability (Cronbach’s alpha = 0.69) and confirmed content validity.

The study was carried out at Utkal Mani Sishu Sikshya Mandir, subsequent to a pilot study at Bhatimunda Uchha Prathamika Vidyalaya that confirmed the viability of the methodologies. Before collecting data, we got permission from the ethics board and the administration. The data collection process consisted of a pre-test, a one-hour training session featuring lectures and multimedia materials, and a post-test conducted on the seventh day following the training.

We used IBM SPSS Version 25.0 to look at the data. Descriptive statistics provided a summary of the participants' demographic features, while inferential statistics, such as paired t-tests and chi-square tests, were employed to evaluate the performance of the training program and its correlation with demographic variables.

RESULTS:

The descriptive analysis of the sample’s socio-demographic variables was as follows:

The frequency and proportion of samples by age. Most of the samples, 13(43.3%), were 31–40 years old. For gender-categorised samples, 11(36.7%) were under 30. The 30 study participants were equally male and female, with 15 each (50.0%). Religion-based sampling frequency and percentage. Hindus made up 18(60.0%) of the study's participants, while Muslims made up 7 (23.3%). The samples had 5 Christians, 16.7% of the total. Sample size and percentage dispersion by marital state. 15(50.0%) of the study participants were married and 11(36.7%) were single. Widows and divided people shared #2 (6.7%). Job-specific sampling frequency and percentage. Full-time and part-time jobs were held by 15 samples (50.0%). Sample frequency and percentage vary by education. Most 20(66.7%) of the study participants were post-graduates, and 10 (33.3%) were graduates. In this study, 16(53.3%) lived in cities and 14(46.7%) in rural areas. The analysis results show most study participants. Fourteen (46.7%) were three-to-five-year teachers. Eight (26.7%) survey participants had less than two years of experience. Five (16.7%) teachers have six to ten years of experience. Sample Distribution by Monthly Income: Twelve trial participants (40%) earned Rs 5,000–10,000 per month. Ten samples (33%) earned less than Rs 5,000 each month.

Table 1: Mean and Standard Deviation of Knowledge Scores of the Samples in Pre-test and Post-Test Concerning Knowledge Level About ADHD (n = 30)

Knowledge Aspects	Pre-Test Level of Knowledge		Post-Test Level of Knowledge
Knowledge Aspects	Mean	SD	Mean	SD
General Knowledge ADHD	4.87	2.161	12.13	1.907
Symptoms and Diagnosis ADHD	3.00	1.287	7.37	1.066
Treatment ADHD	2.90	1.517	9.87	1.224
Overall ADHD Knowledge Score	10.77	4.256	29.40	3.568

Table 1: depicts the Mean and Standard Deviation of Knowledge Scores of the Samples in Pre-test and Post-Test Concerning Knowledge Level About ADHD.

The average and standard deviation scores for general knowledge about ADHD were 4.87±2.161 on the pre-test and 12.13±1.907 on the post-test. The average and standard deviation scores for synopsis and diagnosis of ADHD were 3.00±1.287 on the pre-test and 7.37±1.066 on the post-test. The average and standard deviation scores for treatment of ADHD were 2.90±1.517 on the pre-test and 9.87±1.224 on the post-test. The average and standard deviation scores for overall knowledge about ADHD were 10.77±4.256 on the pre-test and 29.40±3.568 on the post-test.

Figure 1: Percentage Distribution of Samples According to Pre-Test and Post-Test Level of Knowledge

Figure 1: presents the frequency and percentage distribution of samples based on their level of knowledge regarding ADHD.

In the pre-test, a majority of the samples, 24(80.0%), exhibited low knowledge levels. Six samples, representing 20.0%, exhibited a moderate level of knowledge. In the post-test assessment, a significant majority of the samples, 27(90.0%), demonstrated a high level of knowledge. Individuals with a moderate level of knowledge constituted 3 participants, representing 10.0% of the total.

Table 2: Mean, Mean Difference, Standard Deviation and Paired ‘t’ test value of Samples Level of Knowledge (n = 30)

Test

Mean

Mean Difference

Standard Deviation

Paired t-test

p-value

Pre-Test

10.77

18.63

4.25

24.70

(df=29)

0.001***

Post-Test

29.40

3.56

*** Highly Significant at p-value < 0.001

Table 2 presents the mean, mean difference, standard deviation, and paired ‘t’ test values of samples according to their level of knowledge regarding knowledge on ADHD AMONG elementary school teachers. The mean score of the pre-test knowledge assessment was 10.77, with a standard deviation of 4.25. In comparison, the post-test mean knowledge score was 29.40, accompanied by a standard deviation of 3.56. The mean difference observed was 18.63. The paired ‘t’ test yielded a score of 24.70, based on a degree of freedom of 59. The results were statistically significant, with a p-value of less than 0.001.

Regarding level of association, we could find that the religion (ꭓ2 = 8.17, df = 2, p-value 0.01) and educational qualification (ꭓ2 = 3.75, df = 1, p<0.05) of the study participants had a statistically significant association with the pre-test level of knowledge regarding ADHD.

DISCUSSION:

Concerns concerning primary school teachers' ability to detect and treat children's ADHD symptoms, especially in classrooms where these actions are widespread, prompted the study. This study used a teacher's in-service training program to teach elementary school instructors about concerns and how to detect and manage ADHD symptoms. Primary school teachers' knowledge was assessed before and after in-service training using pre- and post-intervention exams. The data was statistically analysed to see if the program changed knowledge levels.

Educational research continues to examine the usefulness of brief in-service training for teachers on evidence-based ADHD evaluation and treatment. Neurodevelopmental disorder ADHD affects children's academic performance and classroom behaviour (American Psychiatric Association, 2013).⁵Teacher in-service training is a typical way to educate school workers about unique issues, but its efficacy for ADHD management is unclear.⁶

Previous research shows that instructors are critical in recognising and supporting ADHD kids (DuPaul & Stoner, 2014).⁷ However, many teachers feel unable to handle ADHD-related classroom behaviours (Martinussen et al., 2011).⁸ This teacher preparation gap suggests focused in-service training initiatives.

The study distributed samples by sociodemographic factors: Most samples, 13 (43.3%), were 31–40 years old. Eleven (36.7%) samples were under 30. The 30 study participants were 15 male and 15 female (50.0%). The survey included 18(60.0%) Hindus and 7(23.3%) Muslims. The samples had 5 Christians (16.7%). 15 (50.0%) were married and 11(36.7%) single. Widows and splits shared #2(6.7%). 15 samples (50.0%) worked full- and part-time. Most 20(66.7%) were post-grads, 10 (33.3%) graduates. This survey had 16 (53.3%) urban and 14(46.7%) rural residents. The analysis shows most study participants. Three-to-five-year teachers numbered fourteen (46.7%). Eight respondents (26.7%) had less than two years of experience. Five (16.7%) teachers have 6-10 years of experience. Twelve experimental participants (40%) earned Rs 5,000–10,000/month. Ten samples (33%) earned less than Rs 5,000 monthly.

In a similar study, M. Mohammed et al. (2023) examined how ADHD training affected teachers' understanding and impression of the disease in Kano, Nigeria. The participants included 112 (56.9%) women and 85 (43.1%) men. Their ages ranged from 17 to 58 years (Mean ¼ 34.1; SD ¼ 8.7).⁹

T. Melhem (2020) The study examined how well a training program improves teachers' ADHD knowledge in Eastern Saudi Arabia. The study population includes 450 public education teachers from the Eastern Province of Saudi Arabia who attended King Faisal University's 2018-2019 summer training programs. The experimental instructors' ADHD understanding improved dramatically after the training. Moreover, teaching experience did not significantly improve ADHD understanding among experimental group teachers. ADHD knowledge is consistent among experimental teachers regardless of experience. The training programme improved ADHD understanding among experimental teachers.¹⁰

The findings of the present study are supported by Sharma S. and Kaur D. (2023), who evaluated the effectiveness of a planned teaching program on attention deficit hyperactivity disorder (ADHD) among school teachers in selected primary schools in Mohali, Punjab. The findings demonstrate the frequency and percentage distribution of pre-test knowledge regarding ADHD among primary school teachers.¹¹ In the pre-test, a majority of participants, 48(80%) primary school teachers, exhibited inadequate knowledge, while 12 (20%) displayed moderate knowledge, with no participants demonstrating adequate knowledge. In the post-test, the distribution of knowledge changed: 22 (36.7%) teachers exhibited moderate knowledge, while 38(63.3%) demonstrated adequate knowledge, with no teachers classified in the inadequate knowledge category.

In a study analogous to this one, Derakhshanpour F et al. (2021) aimed to examine instructors' knowledge, attitudes, and roles concerning attention-deficit/ hyperactivity disorder (ADHD), as well as assess the effectiveness of curriculum development. A notable difference was observed in the mean knowledge levels of teachers who sourced information about attention-deficit/hyperactivity disorder (ADHD) from the media (F = 7.07; df [1,140]; P = 0.009) and their close network (F = 4.05; df [1, 140]; P = 0.05) compared to those who acquired information from alternative sources. The mean values of positive attitudes among teachers informed by academic education (F = 5.82; df [1,140]; P = 0.02) and scientific references (F = 5.48; df [1,140]; P = 0.02) were significantly different.¹²

CONCLUSION:

This Study was carried out to evaluate the effectiveness of a teachers in-service training programme aimed at increasing elememtary school teachers' knowledge about attention deficit hyperactivity disorder (ADHD). The findings revealed a significant improvement in knowledge scores after the program, indicating that the post-test scores were notably higher than those from the pre-test. The findings indicate that the in-service training program for teachers serves as a valuable and effective resource for deepening their knowledge and comprehension of ADHD. Through this initiative, teachers are equipped with essential strategies and insights that enhance their ability to support students with attention deficit hyperactivity disorder, ultimately leading to improved learning outcomes.

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Received on 28.10.2025 Revised on 06.12.2025

Accepted on 11.01.2026 Published on 30.07.2026

Available online from August 05, 2026

Int. J. Nursing Education and Research. 2026;14(3):235-239.

DOI: 10.52711/2454-2660.2026.00047

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