Assessing Attention Deficit Hyperactivity Disorder in Lebanon: The Adaptation of the Conners’ Teacher Rating Scale for Use with Lebanese Children

Attention Deficit Hyperactivity Disorder (ADHD) is a multifaceted disorder that remains a controversial subject in education. While some practitioners see it as a real issue that blights the lives of children and adolescents, who need dedicated help to overcome it, others dismiss it as an excuse for the failures of parents and teachers. It is a wide spectrum of interpretation. This study started from the viewpoint that ADHD is a serious medical, social and educational issue that has an adverse effect on sufferers, their families, their peers and their teachers, but that these effects can be lessened and controlled by effective educational interventions guided by the principles of the bio-psycho-social approach. Accordingly, the framework for the study was twofold: the bio-psycho-social approach to understanding and treating the disorder; and the mixed-methods research approach to designing, implementing and analyzing the information obtained by this study. One of the reasons for the divergence in professional opinion on ADHD is that the symptoms and associated behaviours make it difficult to assess, especially in younger children. This highlights the need for a reliable and valid assessment tool that can be adapted across languages and cultures, to allow for diagnosis and cross-comparison. In this study, the short form of the Conners’ Teacher Rating Scale Revised (CTRS-R: S) was adapted to make it suitable for use with Lebanese nationals. It was adapted by a team of translators, carefully selected per the ITC guidelines, using the backward-translation design, a small pilot test, structured interviews and a survey. This multilayered approach produced very interesting results regarding prevalence of ADHD in Lebanon, as well as a rating scale with proven reliability and validity. Thus the two research questions posed by this study were answered comprehensively, giving an important insight into the requirements for a successful adaptation and using that adapted assessment tool to deliver new information about ADHD in the Lebanese setting.