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    Whānau Māori and their experiences of attention-deficit/hyperactivity disorder : implications for clinical practice : a thesis presented in partial fulfilment of the requirements for the degree of Doctor of Clinical Psychology at Massey University, Manawatū, New Zealand
    (Massey University, 2023-06-30) Tipene, Charlene Mereana
    Health care in New Zealand (NZ) is based on the ideal of universal health coverage for all. However, for many Māori health inequities exist in health outcomes and in access to services which adequately meet the needs of whānau Māori. Researchers have considered explanations (and solutions) for this situation, including whether health services are able to meet the cultural needs of Māori clients through a more holistic approach. Rather than considering this generally for all services, this research considers this specifically in relation to Attention-Deficit Hyperactivity Disorder (ADHD). Alongside core symptoms of hyperactivity, impulsivity, and inattention, for there to be a diagnosis of ADHD there must be associated functional impairment and diffuse impact of behavioural symptoms in multiple domains of a person’s life. This means that ADHD is well suited to the application of holistic understandings of wellbeing, such as those that exist in mātauranga Māori. A lack of research about ADHD among Māori highlights a need for research which explores the experiences of tamariki Māori and their whānau as they navigate ADHD diagnosis and treatment. This research used a Māori-centred framework and throughout, was guided by He Awa Whiria (Gillon & Macfarlane, 2017) which emphasises the importance of drawing together cultural and clinical knowledge. There were three main objectives: to understand the experiences of whānau Māori with a child assessed and treated for ADHD; to describe how whānau understood and accommodated ADHD behaviours before diagnosis; and to identify any barriers or facilitators for whānau Māori in accessing assessment and/or treatment. Semi-structured interviews took place with 10 whānau members, representing 13 young people who had been diagnosed with ADHD. The interview responses were analysed using (codebook) thematic analysis. The main findings revealed firstly that there were different levels of knowledge about ADHD among caregivers and some whānau struggled to know where to begin, to get support; secondly, it was difficult to access the service, and there was a lack of ongoing support available other than medication; and thirdly, while in all cases medication was offered as treatment, whānau found this a difficult decision to make for their child, preferring a more holistic approach. Most whānau were not asked about their cultural background or beliefs during assessment and half of the participants would have accessed a kaupapa Māori service if available. The implications of the findings for clinical practice are discussed with recommendations for how to blend cultural and clinical knowledge to ultimately benefit whānau Māori and achieve the best possible outcomes.
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    Hyperactivity in children : some conceptual issues : a thesis presented in partial fulfilment of the requirements for the degree of Master of Arts in Education at Massey University
    (Massey University, 1973) Soeterik, Victor Frederik Willem
    The literature on hyperactivity in children was reviewed and a theoretical discussion on underlying issues of brain damage, population samples, sociological and contextual variables followed, citing further literature in relevant areas. Some clinic cases were reviewed as instances of the discussion centering on contextual variables. The implications arising from these case histories were discussed.
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    Confirmatory bias in the diagnosis of ADHD : an exploratory study and survey of New Zealand clinicians' protocols & practices in the diagnosis of attention-deficit hyperactivity disorder : a thesis presented in partial fulfilment of the requirements for the degree of Master of Arts in Psychology at Massey University, Palmerston North, New Zealand
    (Massey University, 1999) Mickleson, Julie F
    Attention-deficit hyperactivity disorder (ADHD) is a heterogeneous syndrome of childhood, with primary symptoms of inattention, hyperactivity, and impulsivity. In recent years, numbers of children diagnosed with ADHD have increased. While many factors may be associated with this increase, one possibility is increased false positive diagnoses due to confirmatory bias (CB) in the diagnostician. CB occurs when a clinician pays attention to positive symptoms with disregard of disconfirmatory symptoms. The present study used a quasi-experimental approach to investigate whether CB was present in the diagnosis of ADHD. Diagnostic decision making was examined in three hypothetical case studies where the ratio of positive to negative ADHD symptoms varied. Results demonstrated CB in the diagnosis of ADHD for many participants. Forty-three percent of clinicians gave no indication of considering disconfirmatory symptoms. Additionally, for all symptoms but one, more attention was paid when they were positive rather than negative. Gaining knowledge from psychological literature and completing an internship increased the likelihood of considering disconfirmatory data. CB was related to clinicians' realworld belief of ADHD prevalence, although this was limited to a statistical trend. The majority of clinicians gave a tentative ADHD diagnosis for all case studies. For clear (i.e. not tentative) diagnoses, clinicians who demonstrated CB were significantly more likely to give a positive diagnosis than a negative diagnosis, whether or not this diagnosis was correct. Results suggest possible misdiagnosis of ADHD in some cases, with concerns of this study being support for the potential of overdiagnosis as a function of CB. Some additional hints of underdiagnosis by a few clinicians merit further research, with the phenomenon of a possible disconfirmatory bias raised and discussed. ln addition, clinicians were surveyed regarding ADHD assessment and treatment in actual practice. Clinicians indicated using an average of 7 assessment steps, with school information, parent or family interview, and rating scales being the most popular tools. Clinicians who took disconfirmatory data into account used more assessment steps in actual practice than the CB group. There was a mean of 4 treatment options listed, with the most utilised being medication and behavioural treatment. Findings are limited by the survey-based, correlational nature of the study. The ability to generalise findings to actual practice is considered and discussed.
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    Current diagnosis and treatment practices for attention-deficit hyperactivity disorder with children : a thesis presented in partial fulfilment of the requirements for the degree of Master of Arts in Psychology at Massey University
    (Massey University, 2000) Kingi, Denise A.
    Attention-Deficit Hyperactivity Disorder (ADHD) is a condition that affects many children and their families. Given the severity and pervasiveness of ADHD, diagnosis requires a thorough and comprehensive evaluation procedure along with multimodal treatment strategies tailored to the specific needs of the individual child. The present study aimed to identify the current diagnostic and treatment practices for ADHD with children to ascertain their consistency with current scientific research and recommendations. Additionally, the study aimed to highlight cultural issues surrounding the diagnosis of ADHD with Maori and Pacific Islands children. The research was conducted in two stages consisting of two separate samples. First, data were collected from parents/guardians of 47 children currently diagnosed with ADHD via survey based questionnaires. Second, information was elicited, also via questionnaires, from practitioners who provided data for 19 of the children participating in the stage one of the study. Overall, findings from the present study reveal inconsistent application of the recommended diagnostic procedures as well as discrepancies between parent and practitioner reports. In addition, results clearly identified stimulant medication as the main treatment prescribed for children with ADHD. However, the establishment of appropriate ongoing monitoring for treatment effectiveness and possible side effects was lacking. The underuse of systematic behavioural treatments evident from the findings is of concern given that empirically-based literature emphasises the importance of multimodal therapy. Cultural differences identified in the study are discussed and limitations of the research are noted, along with suggestions for future research.
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    New Zealand primary school teachers' knowledge and perceptions of attention-deficit/hyperactivity disorder (ADHD) : a thesis presented in partial fulfilment of the requirements for the degree of Master in Educational Psychology at Massey University, Albany, New Zealand
    (Massey University, 2013) Dilaimi, Alia
    Attention-deficit/hyperactivity disorder (ADHD) is one of the most common, unremitting, and controversial childhood disorders, which affects between 1% and 7% of New Zealand children. It leads to impairments in the individual’s key life activities, including social relations, academic, family, and vocational functioning, self sufficiency, as well as adherence to social regulations, norms, and laws. Teachers play a central role in the referral, diagnosis, treatment, and monitoring of students with ADHD. Research examining teachers’ knowledge of ADHD however, has led to some uncertainty as to whether teachers have the level of knowledge about the disorder needed to support ADHD learners. The present study had two main objectives. It examined the knowledge and perceptions of attention-deficit/hyperactivity disorder held by primary school teachers in New Zealand and sought to determine whether teacher characteristics, such as demographic variables and experiences of students with ADHD, are associated with teachers’ knowledge of ADHD. Eighty-four primary school teachers completed a postal survey containing demographic information and the Knowledge Of Attention Deficit Disorders Scale (KADDS). Results indicated that teachers answered an average of 35% of questions correctly on the KADDS. Teachers’ scored significantly higher on the Symptoms/Diagnosis subscale compared to the Associated Features and Treatment subscales. All teachers in the present study reported that they believed ADHD impacts on the educational experiences of students diagnosed with the disorder. Most teachers had received no pre-service or in-service training about ADHD, and 90% of teachers wanted more training on ADHD. The majority of teacher characteristics examined were unrelated or only weakly related to teachers' knowledge of ADHD. However, the number of students with ADHD teachers’ had taught, participation in an individual behaviour plan (IBP), and participation in an individual education plan (IEP), were significantly and moderately related to higher KADDS total and Symptoms/Diagnosis scores. The results of this study suggest that New Zealand primary school teachers do not in fact have the level of knowledge about the disorder required to effectively participate in the referral, diagnosis, treatment, or monitoring of students with ADHD. Implications for educational psychology practice and directions for future research are discussed. Strengths and limitations of the study are also considered.