ADHD in Schools: Examining the Role of Gender and Symptom Presentation in Teacher-Initiated Referrals

For years, Attention-Deficit/Hyperactivity Disorder (ADHD) was believed to be a phenomenon disproportionately impacting boys and men. However, in light of recent upticks in initial diagnosis and treatment for girls and women with ADHD, prevalence estimates appear to be more comparable across genders than previously believed. With increased visibility and identification, research has illuminated differential patterns of symptom presentation when comparing males and females with ADHD. Specifically, hyperactive and impulsive symptom patterns are more commonly observed in males, while inattentive symptoms are more characteristic of females with ADHD, though less likely to be identified and perceived to cause less impairment. As initial symptoms often emerge in school, teachers occupy a critical role in both identifying the presence of symptoms and making referrals for students who require specialized services to promote their behavioral, emotional, and academic success. The current study aimed to add to the existing literature by surveying teachers (N = 50) to learn more about their perceptions and knowledge of ADHD and to investigate the impact of teacher and student-specific characteristics on educators' perceptions of students' degree of referral need. Findings did not reflect statistically significant differences in participants' perceived degree of student need for specialist referral based on student gender and symptom presentations. A simple linear regression was used to test if student (i.e., gender and ADHD presentation) and teacher characteristics (i.e., years of teaching experience and knowledge of ADHD) predicted differences in perceived referral need and the overall model was not statistically significant. However, teachers with fewer than five years of experience perceived students as demonstrating a lesser degree of referral need than did more experienced teachers. Implications for educators and other stakeholders in school-based mental health are discussed.