The Negative Halo Effect of Oppositional Defiant Behaviors on Teacher Ratings of ADHD: Impact of Child Gender

This study explored one potential reason for differences in diagnostic rates of attention-deficit hyperactivity disorder (ADHD) between genders: teacher-based rating bias. Abikoff, Courtney and Pelham (1993) showed elementary teachers two tapes of a male child in a fourth grade classroom, then had the teachers complete ADHD and ODD rating scales. One tape depicted a normal child; another depicted a child exhibiting either ADHD or ODD behaviors. Rating comparisons from the ADHD v. ODD tapes showed biases: the ADHD tape was rated higher than the ODD tape on ADHD rating scales and lower on ODD rating scales; while the ODD tape was rated higher than the ADHD tape on ODD rating scales but equal on ADHD rating scales. It was hypothesized that ODD behaviors exerted a halo effect on ADHD ratings. The present study replicated and extended Abikoff et. al\u27s study with new tapes including female actresses, hypothesizing that bias existed with the male, but not the female tapes. Following the procedures of Abikoff et al., this study showed new tapes to 80, rural Midwestern teachers. Though the tapes followed Abikoff\u27s scripts, objective behavioral rating scales found crucial differences between his tapes and the present study tapes. ADHD v. ODD tape comparisons showed no bias. Yet, comparisons of ADHD/ODD vs. normal tape ratings showed a bidirectional bias: ADHD behaviors inflated ODD ratings, with females rated significantly higher on ODD behaviors than males, and ODD behaviors inflated ADHD ratings, with males rated significantly higher than females on ADHD behaviors. Results indicate that teachers may not differentiate between ADHD and ODD behaviors on rating scales, and that gender of the child exhibiting disruptive behaviors influences teacher ratings. Since diagnosticians and prevalence rate studies rely upon teacher ratings, these findings imply: (a) compared to females, the male prevalence rate for ADHD may be artificially inflated by the presence of ODD behaviors; (b) compared to males, the female prevalence rate for ODD may be artificially inflated by the presence ADHD behaviors; and (c) the comorbidity rate between ADHD and ODD may be artificially inflated by teacher failure to differentiate between ADHD and ODD behaviors