493316

research-article2013
JADXXX10.1177/1087054713493316Journal of Attention DisordersSciutto

Current Perspectives
Journal of Attention Disorders

ADHD Knowledge, Misconceptions,

2015, Vol. 19(2) 91­–98
© 2013 SAGE Publications
Reprints and permissions:
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DOI: 10.1177/1087054713493316
jad.sagepub.com

Mark J. Sciutto1

Abstract
Objective:Despite the availability of several effective treatments, many children with ADHD do not receive adequate
services. A variety of factors may influence help-seeking behavior among families of children with ADHD. This study
explores two factors that may influence help-seeking decisions: knowledge and misconceptions of ADHD and treatment
acceptability. Method: A total of 196 participants completed measures of ADHD knowledge and use of information
sources prior to rating the acceptability of two interventions: stimulant medication and sugar elimination diets. Results:
Higher levels of ADHD misconceptions were associated with lower acceptance of medication and higher acceptance of
dietary interventions. However, analysis of individual misconceptions suggests that specific misconceptions are differentially
related to perceptions of individual treatments. Conclusion: It may be important for clinicians to assess and deliberately
target specific misconceptions as part of treatment for ADHD. (J. of Att. Dis. 2015; 19(2) 91-98)

Keywords
ADHD, treatment acceptability, ADHD knowledge and misconceptions

Models of help-seeking behavior for mental disorders
depict four core stages: problem recognition, the decision to
seek help, service selection, and service utilization
(Andersen, 1995; Eiraldi, Mazzuca, Clarke, & Power,
2006). These four help-seeking stages are interrelated, and
families generally transition through them in a linear fash-
ion. This process can be interrupted at any stage and there-
fore many children do not receive adequate care (Power,
Eiraldi, Clarke, Mazzuca, & Krain, 2005). A number of fac-
tors, occurring within and outside the individual, have been
hypothesized to impact the transition through each help-
seeking stage (Cauce et al., 2002; Eiraldi et al., 2006).
Parental cognitions (e.g., knowledge, attitudes toward treat-
ments) are one factor that may predict when (or if) families
enroll in treatment, which types of treatments are consid-
ered, and ultimately whether the treatments are completed
(Hoza, Johnston, Pillow, & Ascough, 2006). The present
study examines the relationship of ADHD knowledge and
misconceptions with perceptions of treatment acceptability
for medication and dietary interventions.
Treatment Acceptability
Kazdin (1980) originally conceptualized treatment accept-
ability as a “judgment of a treatment by nonprofessionals,
lay persons, clients, and other potential consumers of a
treatment” (p. 259). Treatment acceptability can be influ-
enced by a variety of factors including problem severity,
type of treatment, side effects, efficacy, and costs (Reimers,
Wacker, & Koeppl, 1987). Parental cognitions such as
knowledge and beliefs about ADHD and its treatment may
also play a role in the acceptability of a given treatment.
Johnston, Seipp, Hommersen, Hoza, and Fine (2005) found
that parents with more reasonable beliefs about ADHD and
its treatment showed greater acceptance and utilization of
both behavioral and medication treatments for ADHD.
Those with false beliefs about ADHD were more likely to
find alternative interventions (e.g., diet) as more acceptable
(Johnston et al., 2005). Although some research has linked
broader knowledge of ADHD to treatment acceptability
(Bennett, Power, Rostain, & Carr, 1996; Ohan, Cormier,
Hepp, Visser, & Strain, 2008), research on the link between
knowledge and treatment acceptability has been inconsis-
tent (Carter, 2007). It may be that knowledge or misconcep-
tions of specific principles or concepts (e.g., whether
stimulants are addictive), rather than the overall level of
knowledge (i.e., number of correct answers), is a better pre-
dictor of treatment acceptability. It is reasonable to assume
that not all misconceptions are equally important; having
correct or incorrect knowledge of specific content may be
1
Muhlenberg College, Allentown, PA, USA
Corresponding Author:
Mark J. Sciutto, Muhlenberg College, 2400 Chew St., Allentown, PA
18104, USA.
Email: sciutto@muhlenberg.edu
92
more important than overall levels of knowledge when it
comes to predicting perceptions of treatments. Specific
misconceptions about dietary interventions, ADHD etiol-
ogy, and medication treatment have been well documented
in studies of parents and teachers (Akram, Thomson,
Boyter, & McLarty, 2009; Bussing et al., 2012; dosReis
et al., 2003; Sciutto, Terjesen, & Bender Frank, 2000). The
present study examines how specific misconceptions and
the strength with which they are held are related to the per-
ceptions of interventions that are either “directly” (e.g.,
misconceptions about stimulants predict acceptability of
stimulants) or “indirectly” (e.g., misconceptions about
stimulants predict acceptability of alternatives like diet)
related to the content of the misconception. For instance, a
parent who believes that stimulant medication leads to later
substance abuse is likely to find stimulant medications as
less acceptable in the treatment of ADHD. However, there
may also be a “collateral” effect. In other words, does that
misconception also make alternatives like diet seem more
acceptable?
Measuring ADHD Knowledge and
Misconceptions
Many studies examining knowledge of ADHD have used
dichotomous scoring (true/false or correct/incorrect) to esti-
mate knowledge. Using this method, an incorrect answer on
a true/false item may be the result of a strongly held mis-
conception, a weakly held belief, or simply a consequence
of guessing. Therefore, this method does not directly iden-
tify misconceptions and gives little information about the
strength of people’s confidence in the accuracy of their
knowledge. The strength of beliefs may be clinically impor-
tant to the study of help seeking because strongly held, but
incorrect, beliefs are harder to change and may adversely
affect the interpretation of new information (Anderson,
Watt, Noble, & Shanley, 2012; Dole & Sinatra, 1998; Taylor
& Kowalski, 2004). Thus, a strong belief in inaccurate
knowledge may serve as a barrier to seeking help or pursu-
ing a specific form of treatment for ADHD. For example,
parents who hold strong misconceptions about the use of
stimulant medication for ADHD (e.g., that they lead to
greater substance abuse) may be reluctant to consider this
treatment option for their child or they may delay seeking
help in the first place if medication is perceived to be the
first-line intervention. Those parents, in turn, may find less
established treatments more acceptable. Other parents may
hold the same misconception but not as strongly. These par-
ents may be more receptive to new information and may be
open to changing their cognitions over time. Changes in
parental cognitions may play an important role in the
improvement and maintenance of progress over the course
of treatment (Hoza et al., 2006). In this study, ADHD
knowledge was measured using the Strength of Belief in
Journal of Attention Disorders 19(2)
ADHD Knowledge Scale (SBAKS), which has been
designed to (a) distinguish guessing from misconceptions
and (b) reflect the strength of participants’ belief in the
accuracy of their knowledge.
Sources of Information and ADHD
Knowledge
Relatively little is known about the sources that contribute
to people’s knowledge of ADHD. Some studies have exam-
ined the types of sources that parents have used or prefer
for information about ADHD (Bussing, Gary, Mills, &
Wilson Garvan, 2007; Bussing et al., 2012). In general,
parents of children with ADHD tend to seek information
from a variety of sources, including healthcare profession-
als, school personnel, social networks, the Internet, and
other media sources. While some studies have linked infor-
mation sources to stigma experiences (dosReis, Barksdale,
Sherman, Maloney, & Charach, 2010), it is less clear how
the use of specific sources of information is related to mis-
conceptions or perceptions of treatment alternatives. One
particularly important source may be the Internet because
many individuals use the Internet as a source of informa-
tion about ADHD (Akram et al., 2009; Bussing et al.,
2012). Although there are many credible, informative sites,
the Internet may also be a source of misinformation about
ADHD and other health-related conditions (Akram,
Thomson, Boyter, & Morton, 2008; Kisely, Ong, & Takyar,
2003; Reavley & Jorm, 2011). This study will examine the
relationships among information sources, ADHD knowledge/
misconceptions, and treatment acceptability.
Method
Participants
In this study, 196 participants (21% male, 75% female, 4%
other/no response) with an average age of 25.97 (SD =
10.52) years completed an online survey measuring ADHD
knowledge and the acceptability of interventions for ADHD.
Participants were recruited from two different sources.
Seventy-two (37%) participants were college students from
an introductory psychology class who participated for
course credit. The remaining 63% (n = 124) accessed the
study through an Internet site that posts online psychologi-
cal experiments (http://psych.hanover.edu/research/expon-
net.html). The majority (85%) of the sample self-identified
as White/Caucasian, with the next largest racial group being
Black/African American (4%). With regard to participants’
highest level of education, 27% of those who responded had
a college degree (bachelor’s or above) and 17% had not
completed any college work. Forty-seven (24%) of the par-
ticipants were parents and 75 (38%) indicated that they
worked regularly with children or adolescents. The majority
Sciutto
Table 1. Descriptive Statistics for Measures of ADHD Knowledge, Misconceptions, and Treatment Acceptability.
Scale Possible range
Strength of Knowledge 0-27
Strength of Misconceptions 0-27
AARP—Stimulants 8-40
AARP—Dietary Interventions 8-40
Note. AARP = Abbreviated Acceptability Rating Profile.
(84%) of participants indicated that they knew someone
who had been diagnosed with ADHD.
Measures and Procedure
Strength of Belief in ADHD Knowledge Scale. The SBAKS is a
9-item scale designed to measure participants’ knowledge
and misconceptions of interventions for ADHD. Items were
derived from the content of existing measures (Power, Hess,
& Bennett, 1995; Sciutto et al., 2000) and modified based on
feedback from five experts in the field of ADHD and qualita-
tive feedback from a sample of 20 parents who were seeking
treatment for their child with ADHD. Based on the assump-
tion that not all misconceptions are held with equal convic-
tion, the SBAKS is constructed to reflect the strength of
confidence in a person’s knowledge or misconceptions rather
than a sum of correct or incorrect responses. For each item,
the participant indicates (a) whether he or she believes the
statement is true or false and (b) his or her level of confidence
in that response on a 4-point scale (0 = just a guess; 3 = I am
certain). The SBAKS generates two total scores: strength of
misconceptions and strength of knowledge. When measuring
knowledge, correct true/false responses are coded as 1 and
incorrect answers as 0. Alternatively, when measuring mis-
conceptions, incorrect responses are coded as 1. For each
item, the strength of belief was computed by multiplying the
true/false score by the confidence level. A guess (i.e., a con-
fidence level of 0) does not contribute to the knowledge or
misconceptions score. For instance, an incorrect answer to a
question for which the person was very confident would get
a 3 toward the strength of misconceptions score and a 0
toward the strength of knowledge score. Scores on each of
the items are summed to compute total scores ranging from 0
to 27. Descriptive statistics and reliability estimates for the
SBAKS are presented in Table 1.
Treatment acceptability. The Abbreviated Acceptability Rat-
ing Profile (AARP; Tarnowski & Simonian, 1992) is
designed to provide a brief measure of the acceptability of
interventions. In this study, participants read a brief vignette
designed to meet the Diagnostic and Statistical Manual of
Mental Disorders (4th ed.; DSM-IV; American Psychiatric
Association, 1994) criteria for ADHD Combined Type
(adapted from Pisecco, Huzinec, & Curtis, 2001). After
93
Items M SD Alpha
9 10.57 5.71 .80
9 3.05 3.13 .60
8 27.29 7.49 .92
8 28.12 6.89 .89
reading the vignette, participants read a brief description of
two interventions for ADHD: dietary restrictions and stimu-
lant medications. These two interventions were chosen for
analysis in this study because they have been well docu-
mented as areas of misconception and concern among par-
ents of children with ADHD (Bussing et al., 2007, 2012).
The order of the treatment descriptions was counterbal-
anced and randomly assigned to participants. Below are the
descriptions of each treatment:
Stimulant medications are commonly used to treat the symptoms
of attention-deficit/hyperactivity disorder (ADHD) in children
and adolescents. Ritalin is one of the most commonly used
stimulants. These medications have been found to improve
symptoms in the majority of children who have the condition by
stimulating chemicals in the brain that help a person inhibit or
restrain behaviors. Side effects may include loss of appetite,
nervousness, tics or twitches, and problems sleeping. These side
effects usually decrease after a few weeks on the medication, or
the dosage can be lowered to offset them. Children should be
closely monitored after they start medications to assess whether
they are receiving the correct dose.
Dietary restrictions are commonly used to treat the symptoms
of attention-deficit/hyperactivity disorder (ADHD) in children
and adolescents. Eliminating sugar is the most commonly used
method. Parents have reported that this strategy leads to a
reduction in hyperactive behavior. Although there are generally
no physical side effects, children should be closely monitored
after they start dieting to assess whether they are receiving
adequate nutrition. Parents also report that these changes in
diet are often time consuming. Changes should be made
gradually in order to test whether the change helped or not.
After reading these descriptions, participants completed
each of the eight AARP items using a 6-point scale. Scores
on the eight items were summed to provide a total accept-
ability score for each intervention. The total scores could
range from 8 to 48 with higher scores reflecting a greater
level of acceptability for that intervention (see Table 1 for
descriptive statistics)
Background characteristics. In addition to providing informa-
tion about demographic characteristics, participants com-
pleted a brief survey about their background related to
ADHD. Specifically, participants provided information about
94
Table 2. Differences in Correlations Between the Strength of Specific Misconceptions and Treatment Acceptability.
Misconception
Special diets like the Feingold diet improve ADHD symptoms in
most children
Reducing sugar intake is effective in reducing ADHD symptoms
Stimulant medications are less effective than behavior therapy at
improving attention and reducing hyperactivity
Stimulant medications are of little benefit in adolescence or
adulthood
Taking stimulant medications leads to recreational drug abuse in the
teenage years
whether they knew someone personally (including self) who
had been diagnosed with ADHD (yes or no) and the extent to
which they believed ADHD is overdiagnosed (1 = strongly
disagree; 5 = strongly agree). Participants also indicated any
sources from which they had obtained information about
ADHD and the source they considered to be their primary
source of information. The possible sources were the Inter-
net, professionals (e.g., medical/healthcare), social networks
(e.g., family, friends, coworkers), media (e.g., TV, newspa-
per, radio), professional literature (e.g., research articles), and
formal education (e.g., learned about it in a class).
Results
All statistical analyses were evaluated using an alpha level
of .05.
Sample and Order Effects
I conducted a series of analyses to examine whether the col-
lege sample differed from the online sample on any of the
primary measures. Fisher’s z transformations were used to
compare the strength of the relationships between knowl-
edge and acceptability measures across samples. The mag-
nitude of these correlations did not differ significantly
across samples (p > .05). However, the two samples did dif-
fer significantly on some background characteristics. The
online sample (M = 30.43, SD = 11.08) was significantly
older than the college sample (M = 18.45, SD = 0.65),
t(120.38) = 11.80, p < .001, η2 = .54. Age, however, was not
significantly related to any of the measures of knowledge/
misconceptions or treatment acceptability (p > .05). Not
surprisingly given the age difference, a higher percentage of
participants from the online sample (48%) had worked reg-
ularly with children and adolescents than those in the col-
lege sample (24%), χ2(1, N = 191) = 11.13, p = .001. With
regard to gender, the college sample had a higher proportion
of male participants, χ2(1, N = 194) = 4.65, p = .031.
However, males and females differed only on one of the
Journal of Attention Disorders 19(2)
Treatment acceptability
n Stimulant medication Dietary interventions z p
195 −.11 .24 3.48 <.001
196 −.08 .33 4.16 <.001
195 −.43 .12 5.69 <.001
195 −.34 .08 4.25 <.001
196 −.31 .15 4.63 <.001
primary measures; females had higher acceptability scores
than males for dietary interventions, t(187) = 2.16, p = .032,
η2 = .02. The two samples did not differ significantly with
regard to personally knowing someone with ADHD, χ2(1,
N = 192) = 0.14, p = .708, or in their belief that ADHD is
overdiagnosed, t(178.17) = 0.49, p = .626, η2 = .001.
There were no significant effects of the order of the treat-
ment descriptions (i.e., stimulants or diet first) on any mea-
sures or acceptability or belief that ADHD is overdiagnosed
(p > .05). There were also no order effects for strength of
knowledge scores, but there was a tendency for those who
read dietary modifications first to report stronger miscon-
ceptions, t(183.63) = 2.26, p = .025, η2 = .03. However, the
knowledge/misconceptions measure preceded the informa-
tion on interventions. Therefore, this is not likely an effect
of the order of presentation, but a random variation.
Relationship of Overall Knowledge and
Misconceptions With Treatment Acceptability
In general, knowledge and misconceptions were stronger
predictors of acceptability of medication than dietary inter-
ventions. Higher strength of knowledge about ADHD was
associated with more positive levels of acceptability for
medication, r(194) = .45, p < .001, but was not significantly
related to views of dietary interventions (p > .05).
Conversely, stronger misconceptions about ADHD were
associated with more positive attitudes toward dietary inter-
ventions, r(194) = .23, p = .001, and more negative attitudes
toward stimulant medications, r(194) = −.33, p < .001.
Relationship of Specific Misconceptions With
Treatment Acceptability
Although the total strength of knowledge/misconceptions
scores from the SBAKS were related to acceptability, it
may be clinically useful to identify specific misconceptions
that predict acceptability. Table 2 presents correlations of
specific items on the SBAKS that differentially predicted
Sciutto
the acceptability of medication compared with dietary
interventions. Fisher’s z transformations were used to com-
pare the magnitude of each item’s correlation with the
acceptability of medication to its correlation with the
acceptability of dietary interventions. In general, miscon-
ceptions about dietary interventions were significantly
related to the treatment acceptability of dietary interven-
tions but not to the acceptability of stimulant medications.
For instance, participants who more strongly believed that
sugar elimination diets or other restrictive diets (e.g.,
Feingold diet) were effective for most children with ADHD
were more likely to find dietary interventions acceptable.
However, these beliefs were not significantly related to
their perceptions of the acceptability of stimulant medica-
tions. Likewise, more strongly held misconceptions about
serious side effects or the effects of stimulants on later
abuse were associated with lower treatment acceptability
of medication but not consistently with more favorable
views toward dietary interventions.
Source of Information, Knowledge, and
Acceptability
Although Internet sources were used by most participants
(58%), relatively few people cited it as a primary source of
information about ADHD (14%). Overall, the most com-
mon primary sources of information for this sample about
ADHD were social networks (30%) followed by medical/
healthcare professionals (29%). A series of independent
samples t tests were conducted to evaluate whether knowl-
edge and acceptability measures differed for participants
who used a given primary source (e.g., Internet) compared
with those who relied on other primary sources (e.g., not the
Internet). Participants whose primary source was the
Internet or social networks were not significantly different
in their acceptability toward stimulants or dietary interven-
tions (p > .05). However, participants whose primary source
was healthcare professionals had significantly higher
acceptability scores (compared with those whose primary
source was not a healthcare professional) for stimulants,
t(186) = 3.25, p = .001, η2 = .05, but they did not differ for
dietary interventions, t(186) = 0.29, p = .776, η2 = .001.
With regard to ADHD knowledge, participants whose pri-
mary source was healthcare professionals had significantly
higher strength of knowledge scores than those who used
other primary sources, t(186) = 4.42, p < .001, η2 = .10.
Participants whose primary source was social networks had
significantly lower strength of knowledge scores, t(173.58)
= 4.62, p < .001, η2 = .11, than those who used other sources.
Participants whose primary source was the Internet were
not significantly different in their knowledge (p >.05).
Strength of misconception scores were not significantly
related to the participants’ primary source of information
about ADHD (p > .05).
95
Background Characteristics
Participants who knew someone with ADHD scored signifi-
cantly higher on the strength of knowledge scale than par-
ticipants who did not know anyone with ADHD, t(189) =
4.07, p < .001, η2 = .08, but did not differ on measures of
acceptability or strength of misconceptions (p > .05).
Surprisingly, those participants who worked regularly with
children or adolescents scored significantly higher on the
strength of misconceptions scale, t(188) = 2.17, p = .031, η2
= .02, but did not differ on measures of acceptability or
strength of knowledge (p > .05). Participants who believed
that ADHD was overdiagnosed found medication less
acceptable, r(189) = −.26, p < .01. Perceptions of overdiag-
nosis were not related to the acceptability of dietary inter-
ventions, r(189) = −.003, p = .968.
Discussion
In this study, the overall strength of knowledge and strength
of misconceptions were moderately related to perceptions
of treatment acceptability. In general, more positive atti-
tudes toward stimulants were associated with higher levels
of knowledge and lower levels of misconceptions. However,
examination of specific misconceptions suggests that the
acceptability of a given treatment is likely related primarily
to misconceptions about that treatment only. There was not
a corollary relationship between misconceptions about
stimulants and perceptions of alternative treatments like
diet. For example, believing that stimulant medications
were likely to lead to future substance abuse predicted a
more negative response toward stimulants as a treatment for
ADHD, but it did not appear to cast dietary interventions in
a more positive light. This finding has implications for the
service-selection stage of help-seeking models for ADHD
(Eiraldi et al., 2006). Addressing misconceptions about
dietary interventions, for example, may not be sufficient to
have parents consider more empirically supported interven-
tions. Prior research has found that these misconceptions
are prominent among parents who are reluctant to consider
medication use and that this reluctance may account for
racial or ethnic disparities in help-seeking attitudes and
behavior (Bussing et al., 2012).
The results of this study suggest that assessing and target-
ing specific misconceptions may be a desirable strategy to
consider as clinicians integrate educational components into
treatment for ADHD. How to address misconceptions is
complicated. Research on psychoeducational approaches in
clinical practice may provide little insight. Although there
does appear to be generally positive results, psychoeduca-
tion is a poorly defined treatment component (Montoya,
Colom, & Ferrin, 2011). What is called “psychoeducation”
may vary considerably from intervention to intervention or
study to study. There is little systematic evidence related to
96
the specific strategies for psychoeducation. Further compli-
cating the matter is the fact that some misconceptions may
influence the stages of help seeking that come before the
clinician has an opportunity to intervene. However, even
after parents make the decision to seek help, little is known
about how providers address misconceptions in the context
of treatment. Simply providing information that a form of
treatment has not been supported by research may not be
sufficient. In this regard, clinicians can benefit from the edu-
cational psychology literature on addressing misconcep-
tions. Simple didactic interventions or textbook style
readings are unlikely to be effective. Refutational texts have
been researched extensively in education and may provide a
helpful framework to address misconceptions in clinical set-
tings. Refutational texts directly identify a misconception
and provide scientific evidence that disputes it (Guzzetti,
2000). These texts are believed to create cognitive conflict in
the reader that facilitates conceptual change. Research on
refutational texts in education settings suggests that they are
particularly effective when followed by discussion with an
informed guide (Guzzetti, 2000).
The results of the current study also suggest a need for a
deeper investigation about the sources of information that
contribute to knowledge and misconceptions of ADHD.
Past studies have pointed to clients’ preference to gather
information from the Internet (Bussing et al., 2012). Even
though participants in the current study did not report that
the Internet was their primary source of information, a
majority did report using it as a source of information about
ADHD. It also appears that people whose primary source of
information is a healthcare professional have higher levels
of ADHD knowledge. Strength of misconceptions, how-
ever, was not related to participants’ primary source of
information. It is possible that firmly held misconceptions
are reinforced or diffused across multiple sources or that
these misconceptions, once formed, serve as a filter for new
information regardless of the source. One issue not
addressed in the current study is how people process infor-
mation available from a given source, especially Internet-
based resources. Future research should examine how
people respond to conflicting information about a given
treatment. For instance, a simple search of “ADHD and
sugar” quickly turns up several reputable sites that dispute
the sugar-hyperactivity myth. However, paid ads alongside
the search provide links to dietary interventions for ADHD.
More research is needed on how people respond to this kind
of conflicting information and how it influences their per-
ceptions of treatment options. As access to health informa-
tion on the Internet becomes more abundant, it will become
particularly important for providers and researchers to iden-
tify credible information resources that are accessible to
parents.
Finally, the current study is limited in several ways.
The present study used a nonclinical, analogue population
Journal of Attention Disorders 19(2)
that may be different from the population of parents seek-
ing treatment for a child with ADHD. Gage and Wilson
(2000) found that there were differences between potential
and actual consumers; that parents of children with ADHD
differed in acceptability ratings from parents of children
without ADHD. However, in other areas of healthcare
research, findings based on analogue populations have
been reliable and valid predictors of key elements in the
help-seeking process (e.g., perceptions of patient–provider
interactions; Blanch-Hartigan, Hall, Krupat, & Irish, 2013;
van Vliet et al., 2012). Analogue methodologies, such as
the one used in this study, may provide unique and impor-
tant information about decision-making processes
(Huebner, 1991), and may suggest hypotheses to be tested
with clinical populations. Because of the apparent link
between misconceptions and perceptions of acceptability
in the present study, future research may need to examine
the efficacy of specific strategies for refuting misconcep-
tions. These strategies are likely to be evaluated using
experimental methodologies, which may be prohibitive
with clinical populations for practical and ethical reasons.
Consequently, the use of analogue methodologies can
play an important role in understanding the help-seeking
process.
In addition, the current study only examined two spe-
cific intervention options, sugar elimination diets and
stimulant medications. It is not clear whether these results
are generalizable to other ADHD interventions. Of partic-
ular importance is how people’s knowledge and miscon-
ceptions relate to their perceptions of school-based
interventions. Bussing and colleagues (2007) found that
parents’ knowledge and awareness of school-based inter-
ventions were particularly low. Finally, the information
about treatment options presented in this study was lim-
ited in scope. It is not clear whether the pattern of results
in this study will generalize to situations in which parents
encounter more extensive information on each of the treat-
ment options.
Acknowledgments
The author would like to thank Thomas J. Power for his feedback
during the development of the ADHD knowledge scale and
Florencia Allegretti, Evelina Eyzerovich, Melanie Franklin, and
Eric Hamilton for their assistance in the early stages of setting up
the survey materials.
Declaration of Conflicting Interests
The author(s) declared no potential conflicts of interest with
respect to the research, authorship, and/or publication of this
article.
Funding
The author(s) received no financial support for the research,
authorship, and/or publication of this article.
Sciutto
References
Akram, G., Thomson, A. H., Boyter, A. C., & McLarty, M.
(2009). ADHD and the role of medication: Knowledge and
perceptions of qualified and student teachers. European
Journal of Special Needs Education, 24, 423-436.
doi:10.1080/08856250903223088
Akram, G., Thomson, A. H., Boyter, A. C., & Morton, M. J. S.
(2008). Characterisation and evaluation of UK websites on
attention deficit hyperactivity disorder. Archives of Disease in
Childhood, 93, 695-700. doi:10.1136/adc.2007.130708
American Psychiatric Association. (1994). Diagnostic and statis-
tical manual of mental disorders (4th ed.). Washington, DC:
Author.
Andersen, R. M. (1995). Revisiting the behavioral model and
access to medical care: Does it matter? Journal of Health &
Social Behavior, 36, 1-10.
Anderson, D. L., Watt, S. E., Noble, W., & Shanley, D. C.
(2012). Knowledge of attention deficit hyperactivity disorder
(ADHD) and attitudes toward teaching children with ADHD:
The role of teaching experience. Psychology in the Schools,
49, 511-525. doi:10.1002/pits.21617
Bennett, D. S., Power, T. J., Rostain, A. L., & Carr, D. E. (1996).
Parent acceptability and feasibility of ADHD interventions:
Assessment, correlates, and predictive validity. Journal of
Pediatric Psychology, 21, 643-657. doi:10.1093/jpepsy/21.5.643
Blanch-Hartigan, D., Hall, J. A., Krupat, E., & Irish, J. T. (2013). Can
naive viewers put themselves in the patients’ shoes? Medical
Care, 51, e16-e21. doi:10.1097/MLR.0b013e31822945cc
Bussing, R., Gary, F. A., Mills, T. L., & Wilson Garvan, C. (2007).
Cultural variations in parental health beliefs, knowledge, and
information sources related to attention-deficit/hyperactivity
disorder. Journal of Family Issues, 28, 291-318. doi:10.1177/
0192513X06296117
Bussing, R., Zima, B. T., Mason, D. M., Meyer, J. M., White, K.,
& Garvan, C. W. (2012). ADHD knowledge, perceptions, and
information sources: Perspectives from a community sam-
ple of adolescents and their parents. Journal of Adolescent
Health, 51, 593-600. doi:10.1016/j.jadohealth.2012.03.004
Carter, S. L. (2007). Review of recent treatment acceptabil-
ity research. Education and Training in Developmental
Disabilities, 42, 301-316.
Cauce, A. M., Paradise, M., Domenech-Rodriguez, M., Cochran,
B. N., Shea, J. M., Srebnik, D., & Baydar, N. (2002). Cultural
and contextual influences in mental health help seeking: A
focus on ethnic minority youth. Journal of Consulting &
Clinical Psychology, 70, 44-55.
Dole, J. A., & Sinatra, G. M. (1998). Reconceptualizing change in the
cognitive construction of knowledge. Educational Psychologist,
33(2-3), 109-128. doi:10.1207/s15326985ep3302&3_5
dosReis, S., Barksdale, C. L., Sherman, A., Maloney, K., &
Charach, A. (2010). Stigmatizing experiences of parents of
children with a new diagnosis of ADHD. Psychiatric Services,
61, 811-816. doi:10.1176/appi.ps.61.8.811
dosReis, S., Zito, J. M., Safer, D. J., Soeken, K. L., Mitchell, J.
W., & Ellwood, L. C. (2003). Parental perceptions and satis-
faction with stimulant medication for attention-deficit hyper-
activity disorder. Journal of Developmental & Behavioral
Pediatrics, 24, 155-162.
97
Eiraldi, R. B., Mazzuca, L. B., Clarke, A. T., & Power, T. J. (2006).
Service utilization among ethnic minority children with
ADHD: A model of help-seeking behavior. Administration
and Policy in Mental Health and Mental Health Services
Research, 33, 607-622. doi:10.1007/s10488-006-0063-1
Gage, J. D., & Wilson, L. J. (2000). Acceptability of attention-
deficit/hyperactivity disorder interventions: A compari-
son of parents. Journal of Attention Disorders, 4, 174-182.
doi:10.1177/108705470000400304
Guzzetti, B. J. (2000). Learning counter-intuitive science con-
cepts: What have we learned from over a decade of research?
Reading & Writing Quarterly: Overcoming Learning
Difficulties, 16, 89-98. doi:10.1080/105735600277971
Hoza, B., Johnston, C., Pillow, D. R., & Ascough, J. C. (2006).
Predicting treatment response for childhood attention-
deficit/hyperactivity disorder: Introduction of a heuristic
model to guide research. Applied & Preventive Psychology, 11,
215-229. doi:10.1016/j.appsy.2005.11.001
Huebner, E. S. (1991). Bias in special education decisions:
The contribution of analogue research. School Psychology
Quarterly, 6, 50-65. doi:10.1037/h0088240
Johnston, C., Seipp, C., Hommersen, P., Hoza, B., & Fine, S.
(2005). Treatment choices and experiences in attention defi-
cit and hyperactivity disorder: Relations to parents’ beliefs
and attributions. Child: Care, Health and Development, 31,
669-677. doi:10.1111/j.1365-2214.2005.00555.x
Kazdin, A. E. (1980). Acceptability of alternative treatments for
deviant child behavior. Journal of Applied Behavior Analysis,
13, 259-273. doi:10.1901/jaba.1980.13-259
Kisely, S., Ong, G., & Takyar, A. (2003). A survey of the quality
of web based information on the treatment of schizophrenia
and attention feficit hyperactivity disorder. Australian and
New Zealand Journal of Psychiatry, 37, 85-91. doi:10.1046/
j.1440-1614.2003.01107.x
Montoya, A., Colom, F., & Ferrin, M. (2011). Is psychoedu-
cation for parents and teachers of children and adoles-
cents with ADHD efficacious? A systematic literature
review. European Psychiatry, 26, 166-175. doi:10.1016/
j.eurpsy.2010.10.005
Ohan, J. L., Cormier, N., Hepp, S. L., Visser, T. A. W., & Strain,
M. C. (2008). Does knowledge about attention-deficit/hyper-
activity disorder impact teachers’ reported behaviors and
perceptions? School Psychology Quarterly, 23, 436-449.
doi:10.1037/1045-3830.23.3.436
Pisecco, S., Huzinec, C., & Curtis, D. (2001). The effect of child
characteristics on teachers’ acceptability of classroom-based
behavioral strategies and psychostimulant medication for the
treatment of ADHD. Journal of Clinical Child Psychology,
30, 413-421. doi:10.1207/S15374424JCCP3003_12
Power, T. J., Eiraldi, R. B., Clarke, A. T., Mazzuca, L. B., & Krain,
A. L. (2005). Improving mental health service utilization for
children and adolescents. School Psychology Quarterly, 20,
187-205. doi:10.1521/scpq.20.2.187.66510
Power, T. J., Hess, L. E., & Bennett, D. S. (1995). The accept-
ability of interventions for attention-deficit hyperactivity dis-
order among elementary and middle school teachers. Journal
of Developmental and Behavioral Pediatrics, 16, 238-243.
doi:10.1097/00004703-199508000-00005
98
Reavley, N. J., & Jorm, A. F. (2011). The quality of mental dis-
order information websites: A review. Patient Education and
Counseling, 85, e16-e25. doi:10.1016/j.pec.2010.10.015
Reimers, T. M., Wacker, D. P., & Koeppl, G. (1987). Acceptability
of behavioral interventions: A review of the literature. School
Psychology Review, 16, 212-227.
Sciutto, M. J., Terjesen, M. D., & Bender Frank, A. S. (2000).
Teachers’ knowledge and misperceptions of attention-deficit/
hyperactivity disorder. Psychology in the Schools, 37,
115-122. doi:10.1002/(SICI)1520-6807(200003)37:2<115::
AID-PITS3>3.0.CO;2-5
Tarnowski, K. J., & Simonian, S. J. (1992). Assessing treatment
acceptance: The Abbreviated Acceptability Rating Profile.
Journal of Behavior Therapy and Experimental Psychiatry,
23, 101-106. doi:10.1016/0005-7916(92)90007-6
Journal of Attention Disorders 19(2)
Taylor, A. K., & Kowalski, P. (2004). Naïve psychological
science: The prevalence, strength, and sources of misconcep-
tions. Psychological Record, 54(1), 15-25.
Van Vliet, L. M., van der Wall, E., Albada, A., Spreeuwenberg, P. M.
M., Verheul, W., & Bensing, J. M. (2012). The validity of using
analogue patients in practitioner–patient communication research:
Systematic review and meta-analysis. Journal of General Internal
Medicine, 27, 1528-1543. doi:10.1007/s11606-012-2111-8
Author Biography
Mark J. Sciutto, PhD, is a professor of psychology at Muhlenberg
College. His research interests include mental health stigma,
Asperger’s syndrome, and factors affecting the assessment and
diagnosis of ADHD.