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Project Code

01-333-2552

Research team

Researchers

Kakanang Tosanguan, BSPs.(Pharmaceutical Science)

Co - Researcher

-

Project Details

Project Status

Completed - 100%

Viewer: 2188

Publish date1 December 2011 18:43

Project Summary

Attention Deficit and Hyperactivity Disorder (ADHD) is one of the health problems that affect learning, behavior, child development and sociability of school children. If ADHD is detected early and the correct treatment is provided, a patient can recover from the disease and live a normal life. ADHD screening measures currently used have diversity in the operational process. In case a screening result is positive, several actions can be taken, such as education for special children and referral to a specialist. The objective of this study is to look for an appropriate ADHD screening system and the operational processes after screening in the context of Thailand.  
Abstract/Policy brief: School-Based Screening for Attention Deficit and Hyperactivity Disorder (ADHD) and Learning Disorders (LD) is very important according to the high prevalence rate. These diseases affect the learning ability of students and can lead to social problems in the future. This study aims to estimate the ADHD and LD prevalence and review the situations, limitations and obstacles of ADHD and LD screening in primary schools under the Office of the Basic Education Commission (OBEC). The results of this study may be used to identify appropriate screening and treatment options and to conduct on economic evaluation of ADHD and LD in a forthcoming project.   Two methods were employed in this study. First, the ADHD and LD screening databases of OBEC were analyzed by using descriptive statistics to get the estimated prevalence rate. Second, two focus groups among teachers and doctors were set up separately to obtain the information situations on limitations and obstacles.   From the KUS-SI screening form, the average prevalences of ADHD, LD-Reading, LD-Written Expression, LD-Mathematics were 4.1, 7.1, 6.8 and 6.6, respectively. These results are in line with previous epidemiological studies.  When analyzing in detail, there was a variety of prevalence rates in each school. Only one third of samples were categorized into acceptable range of ADHD and LD prevalence. The results showed that there are some problems in ADHD and LD screening.   From the focus groups, teachers who used KUS-SI form informed that there were many different ways to implement screening. Therefore, the prevalence rate of each school was varied. This is because the variety of knowledge, skills and experience of each teacher using KUS-SI. Moreover, the students who were found positive ADHD and LD from the KUS-SI forms had not been diagnosed and treated appropriately. The recommendations from this study are as follows: 1) To develop a novel effective screening system because the ongoing system depends on the class teachers who may have less knowledge, fewer skills and no positive attitude regarding ADHD issues. In addition, we should evaluate this ongoing screening system in terms of effectiveness and appropriateness. Inevitably, these properties of the novel screening system must meet the needs of teachers and guardians based on country-specific contexts. After the screening process, a referral system should be coordinated with a higher number of health service centers for confirmation and monitoring. 2) To enhance the awareness among health managers and the public about the necessity of ADHD in primary school level in order to obtain a fair cooperation from children’s guardians for diagnosis acceptance, care and treatment. 3) The Royal College of Pediatricians of Thailand (RCPT) should specify a clear policy and guidelines regarding a responsibility frame and the clinical practice guidelines for general pediatricians and/or pediatric specialists. Moreover, the RCPT should promote the growth of academic knowledge in Thailand. 4) The Universal Coverage Scheme (UC) should consider the feasibility and appropriateness of motivating all health care levels to develop a diagnosis, treatment and monitoring system of ADHD. Furthermore, the UC should also closely coordinate with the Ministry of Education (MOE) at local, regional and national level on this issue.   In conclusion, there should be an additional systematic research on screening and a referral system with the relevant stakeholders, including the MOE, the MOPH, the health centers, RCPT and other related organizations. This pivotal research will act as an explicit evidence for pushing this policy to be clear, systematic and suitable in real world practice of all related sectors

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