Prevalence of behavioral disorders and attention deficit/hyperactive disorder among school going children in Southwestern Uganda

Abstract

Background Disruptive Behavioral Disorders (DBDs) and Attention Deficit/Hyperactivity Disorder (ADHD) are chronic, impairing, and costly child and adolescent mental health challenges which, when untreated, can result in disruptions in school performance, friendships and family relations. Yet, there is dearth of prevalence data on child and adolescent behavioral challenges within sub-Saharan Africa, including Uganda. This study aims to estimate the prevalence rate of behavioral challenges and ADHD among young school going children and early adolescents (ages 8–13 at study enrollment), utilizing a school-based sample in southwest Uganda. Methods We present screening results from a 5-year scale-up study titled SMART Africa-Uganda (2016–2021), set across 30 public primary schools located in the greater Masaka region in Uganda, a region heavily impacted by poverty and HIV/AIDS. Specifically, we draw on screening data from caregivers of 2434 children that used well-established standardized measures that had been pre-tested in the region. These were: 1) oppositional defiant disorder (ODD) and conduct disorder (CD) subscales of the Disruptive Behavior Disorders (DBD) scale; and 2) the Iowa Connors and Impairment scales. Slightly over half of the children in the sample were female (52%), with a mean age of 10.27 years. Results Of the 2434 participants screened for disruptive behaviors: 1) 6% ( n = 136) scored positive on ODD and 2% ( n = 42) scored positive on CD subscales of the DBD scale; 2) 9.61% ( n = 234), and 2.67% ( n = 65) were reported to have elevated symptoms of ODD and ADHD on the Iowa Connors caregiver report scale respectively. Twenty-five percent ( n = 586) of children were described by their caregivers as having experienced some form of impairment in at least four domains of the Impairment scale. Conclusion The results indicate the presence of behavioral challenges and ADHD among school going children, aged 8–13 years, in Uganda. Given the negative outcomes associated with behavioral challenges as children transition to adolescence and adulthood, detecting these emerging behavioral challenges early is critical in developing appropriate interventions. School settings could be considered as one of the contextually-relevant, culturally-appropriate, and non-stigmatizing venues to implement screening procedures and to detect emerging behavioral challenges and to make necessary referrals.

Parent and Teacher Training Increases Medication Adherence for Primary School Children With Attention-Deficit/Hyperactivity Disorder

“…Thus, in China many children with ADHD do not receive proper treatment (25). Parent and teacher training is necessary and urgent because the most significant determinant of medication initiation is parent belief about ADHD and attitudes toward treatment (26). For instance, some parents who believe that the child's difficulties are a medical disorder that requires a biological intervention will accept using medication and encourage long-term use (27).…”

The longitudinal impact of an evidence‐based multiple family group intervention (Amaka Amasanyufu) on oppositional defiant disorder and impaired functioning among children in Uganda: analysis of a cluster randomized trial from the SMART Africa‐Uganda scale‐up study (2016–2022)

“…The Impairment Rating Scale (IRS) comprises 6 items and evaluated impaired functioning across different key domains known to be impaired in children with attention deficit hyperactive disorder (relationship with peers; relationship with siblings; relationship with parents, academic progress, self‐esteem, influence on family functioning, and overall impairment) (Fabiano et al., 2006) (α = .81). For each domain, caregivers rated their child’s problems on a 6‐point scale from 1 indicating “no problem (definitely does not need treatment/special services)” to 6 indicating “extreme problem (definitely needs treatment/special services).” In this analysis, the 5 items of the Iowa Conners were summed and the total score was treated as a continuous variable (Kivumbi et al., 2019). Similarly, for the IRS, each of the 6 domains were summed and treated as a continuous variable (Kivumbi et al., 2019).…”

“…In this analysis, the 5 items of the Iowa Conners were summed and the total score was treated as a continuous variable (Kivumbi et al, 2019). Similarly, for the IRS, each of the 6 domains were summed and treated as a continuous variable (Kivumbi et al, 2019). The DBD Rating Scale was only used at screening.…”

Usefulness of Homoeopathic Medicine in Oppositional Defiant Disorder(ODD):A Case Report

“…Disruptive behaviors may also lead to maternal stress, which may result in poor parenting, further contributing to children's emotional difficulties. 20 The Disruptive Behaviour Disorder Rating Scale (DBDRS) is a screening tool designed to aid in the diagnostic process for a number of child psychopathologies, particularly externalizing disorders. The DBD rating scale consists of 45 items related to symptoms of Conduct disorder (16 items), ODD (8 items), ADHD-Inattention (9 items), ADHD-hyperactivity/ Impulsivity (9 items).…”