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<p>Teacher reports are one of the most valued methods when conducting school-based screening, identification, and treatment planning for attention-deficit/hyperactivity disorder (ADHD). Yet,&#xa0;wide cross-national variations in the administrative diagnosis of ADHD have raised concerns about the potential impact of cultural bias on teachers’ assessments. This scoping review synthesized research exploring how teachers in diverse cultural contexts evaluate ADHD symptoms and related behaviors to better understand the variables that affect assessment outcomes. Twenty-five peer-reviewed articles were identified through iterative searches of the Cochrane Library, ERIC, PsycINFO, Scopus, and Teacher Reference Center, along with forward-and-back citation screening. Relevant data were extracted and narratively analyzed in relation to Hofstede’s cultural dimensions. The cross-cultural equivalence of included studies were assessed using a novel checklist, which we designed to determine the reliability and validity of cross-country comparisons.&#xa0;Most studies reported significant cross-cultural differences, with teachers in collectivist, high power-distance, and long-term oriented societies more likely to report students as exhibiting ADHD symptoms and refer them for medical care. Student and teacher demographic characteristics, as well as differences in classroom and educational contexts, further contributed to these disparities. Results highlight the importance of considering sociocultural factors when interpreting teachers’ rating scale data and referral decisions. In addition, this review supports calls for international standards of rating instruments used within child psychiatry research as well as educational and clinical settings. Efforts to improve the cross-cultural validity of school-based screening and identification of ADHD will translate to increased reliability of diagnosis and treatment outcomes for children globally.</p>

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Cross-cultural disparities in teachers’ reports of ADHD symptoms and behavior: a scoping review

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年6月29日

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  • Tyler-Shea L. Diener,
  • Mervyn Jackson,
  • Mark A. Lee,
  • Christine Grové,
  • Vinh Nguyen

摘要

Teacher reports are one of the most valued methods when conducting school-based screening, identification, and treatment planning for attention-deficit/hyperactivity disorder (ADHD). Yet, wide cross-national variations in the administrative diagnosis of ADHD have raised concerns about the potential impact of cultural bias on teachers’ assessments. This scoping review synthesized research exploring how teachers in diverse cultural contexts evaluate ADHD symptoms and related behaviors to better understand the variables that affect assessment outcomes. Twenty-five peer-reviewed articles were identified through iterative searches of the Cochrane Library, ERIC, PsycINFO, Scopus, and Teacher Reference Center, along with forward-and-back citation screening. Relevant data were extracted and narratively analyzed in relation to Hofstede’s cultural dimensions. The cross-cultural equivalence of included studies were assessed using a novel checklist, which we designed to determine the reliability and validity of cross-country comparisons. Most studies reported significant cross-cultural differences, with teachers in collectivist, high power-distance, and long-term oriented societies more likely to report students as exhibiting ADHD symptoms and refer them for medical care. Student and teacher demographic characteristics, as well as differences in classroom and educational contexts, further contributed to these disparities. Results highlight the importance of considering sociocultural factors when interpreting teachers’ rating scale data and referral decisions. In addition, this review supports calls for international standards of rating instruments used within child psychiatry research as well as educational and clinical settings. Efforts to improve the cross-cultural validity of school-based screening and identification of ADHD will translate to increased reliability of diagnosis and treatment outcomes for children globally.