1. SLP Knowledge of ADHD and Medication:
A Nation Wide Survey

2. The University of Louisiana at Lafayette
Jack S. Damico, Ph.D.
Ryan L. Nelson, Ph.D.
Holly Damico, Ph.D.
The University of Louisiana at Lafayette

3. INTRODUCTION
As the prevalence of medicating children diagnosed with Attention Deficit Hyperactivity Disorder (ADHD)/ Attention Deficit Disorder (ADD) increases it is imperative that SLPs dealing with this population learn about the role of medicine in the treatment of ADHD/ADD and alternative treatment measures.

4. The Reauthorization of IDEA and the movement toward various other special accommodations has placed more responsibility than ever on the SLP to provide appropriate and effective services to this population.
This includes working with parents, doctors and school administrators in order to deliver those services.
Being well informed about the use of medication and its effects, especially in populations requiring additional intervention.

5. PURPOSE
This Survey was designed to assess current SLP Knowledge about ADHD, medication, and alternative treatments.

6. Specifically, we investigated:
How well prepared SLPs feel they are for interventions involving clients that are diagnosed as ADD/ADHD.
How much value do SLPs place on medication as an intervention for ADD/ADHD.
Their opinions about the effectiveness of medication as an intervention for ADD/ADHD.
What SLP’s practices are in providing services for clients diagnosed as ADD/ADHD.

7. METHODOLOGY
Using standard survey procedures we constructed a survey instrument and established a schedule of distribution and follow-up that would maximize our response rate

8. Survey Instrument 10 pages in a pamphlet format
Consisted of 79 questions
52 general opinion questions
17 questions pertaining to practice
10 demographic questions
Employed a Likert Scale
Strongly agree Strongly Disagree

9. The general opinion questions were formulated to assess SLP’s opinions about the efficacy and use of medication in the treatment of ADHD.
G-35 There are symptoms of ADD/ADHD that can only be controlled with medication…
The questions concerning practice were formulated in order to assess the actual practices of SLP’s in dealing with the ADHD/ADD Client Population
P-14 Have you ever recommended stopping any medication for ADHD or ADD? …

10. The Participants
The survey was sent to 150 American Speech/Language and Hearing Association (ASHA) certified SLP’s selected randomly from a list of 1000 provided by ASHA.

11. The Schedule
The survey was mailed and a follow-up was sent to non-respondents within a four week (this presentation only contains data from the initial mailing).
Two weeks after the second mailing 10% of non-respondents will be selected and called in order to administer the survey over the telephone in order to account for any biases in the responses.

12. SAMPLE SURVEY

13. RESULTS Preliminary Phase I Response: 42% (63 of 150 surveys returned)
Second phase will be initiated to increase response level.

14. Respondent (SLP) Characteristics
77% work in elementary schools
16% work in middle schools
10% work in high schools
8% work in district centers
5% work in SPED/alternative centers

15. Respondent (SLP) Characteristics
43% with over 10 years work experience
30% with five to ten years experience
26% with less than five years experience

16. DATA ANALYSIS
Data were analyzed to detect opinions regarding literacy service delivery and practices.
Comparisons were made based upon demographic attributes of respondents.
Due to format constraints only the most interesting trends and factors are presented here.

17. Factor Analysis
A factor analysis was run on the 52 questions regarding general opinion in order to ascertain patterns of responses.
Six factors were identified
These factors were labeled based on the types of questions found to load on each factor. However factors two of the factors (5 & 6) did not account for enough variance to warrant explanation, nor could much sense be made of the few questions that did load on these factors.

18. Factor 1: Training and Knowledge
Questions that loaded on this factor show that SLP’s in general do not think that they are well trained to provide services for the ADD/ADHD population.
It also showed that lack of knowledge about ADD/ADHD and medication correlated with positive beliefs about the efficacy of medication in intervention.

19. SLP well trained re: medication 4.23
Question loading on this factor include: G4 .808, G5 .744, G6 .895, G7 .902, G , G G , G
Strongly agree Strongly Disagree
SLP well trained re: medication 4.23
SLP knowledg. re: meds for Rx 3.54
SLP re: how/why meds work 3.70
Meds may be only necessary Rx 3.03

20. 5% of SLPs rank themselves very knowledgeable of ADD/ADHD.
60% of SLPs rank themselves knowledgeable
33% of SLPs rank themselves as having minimal knowledge
67% of SLPs have some experience working directly with ADD/ADHD children
17% of SLPs have much experience
60% of SLPs received primary training in ADD/ADHD from work experience

21. Factor 2: Efficacy & Beliefs Regarding Medication
Questions that loaded on this factor show a positive correlation between beliefs regarding efficacy of medication and practices relating to medication.
Questions loading on this factor include: G , G , G26a .729, G , G , and G

22. Meds address academic problems 3.16 Meds decrease aggression 3.13
Strongly agree Strongly Disagree
Meds address academic problems 3.16
Meds decrease aggression 3.13
Meds decrease neg. social behav. 3.06
Meds increase deportment 3.34
Meds increase academic achiev. 3.32
Meds well-researched in children 2.82
MDs are careful in prescribing 3.27
Effectiveness of Meds verify Dx 2.75

23. Factor 3: Efficacy and Effects of Medication
SLPs observing significant improvements in clients, believe medication is an essential component.
SLPs who believe medication increases attention and decreases hyperactivity and impulsivity agree that medication aids adaptivity.

24. Meds decrease hyperactivity 1.54 Meds decrease impulsivity 1.59
Questions loading on this factor include: G22c .792, G22d .774, G26d .701, G2 .670, G1 .669, G , and G
Strongly agree Strongly Disagree
Meds decrease hyperactivity 1.54
Meds decrease impulsivity 1.59
Meds increase attention
Med. is essential for Rx
Obs. Signif. Improv. since meds. 2.23
Others note similar improv

25. Factor 4: Long term effects of medication and dosage guidelines
Questions here deal with beliefs about long term consequences of medication and appropriate dosage patterns.
Questions loading on this factor include: G , G , G , G , G , G , G

26. Strongly agree Strongly Disagree
Important to provide drug holidays 3.36
Meds should not be long term
Children on meds examined monthly 4.06
Meds may be used with preschoolers 3.03
Positive long term conseq. of meds 2.37
Negative long term conseq. of meds 3.95
Am comfortable w/ use of meds 2.50
Varying ages cooper. Diff. w/ meds 2.33

27. CONCLUSIONS
SLPs perceive that they possess little training or knowledge for dealing with ADD/ADHD medication.
However, they hold positive beliefs regarding these medications and they promote their usage.
Data show that the less their knowledge base, the more positive their evaluation of the medication.

28. SLPs believe that medication reduces the symptoms of ADD/ADHD and increase academic and social performance
However, SLPs hold a number of incorrect assumptions about the value of ADD/ADHD medication:
Medications are well-researched for children
That a positive response confirms a correct diagnosis of ADD/ADHD
That these medications are appropriate for preschoolers
That the medications can be taken for a long period of time

29. IMPLICATIONS
The survey suggests that 84% of SLPs are involved to service delivery to students with ADD/ADHD. If we are expected to provide various types of consultations, collaborations, and interventions, we must be better trained regarding ADD/ADHD medications.
Holding incorrect assumptions and inappropriate expectations are not sufficient.