Prevalence and Correlates of Teacher-Reported Attention-Deficit/Hyperactivity Disorder Symptoms among Primary School Children in Government Schools of Tamil Nadu: A School-Based Cross-Sectional Study

Resumen

Background: Attention-Deficit/Hyperactivity Disorder (ADHD) is a prevalent neurodevelopmental condition affecting academic functioning, social behaviour, and long-term psychosocial outcomes in children. Evidence from India remains limited, particularly regarding subtype patterns and school-based comorbidity profiles.

Objectives: To estimate the prevalence and subtype distribution of ADHD through screening  among primary school children and to identify associated developmental, behavioural, and academic correlates.

Methods: A school-based cross-sectional analytical study was conducted among 190 children aged 6–11 years enrolled in government schools in Chengalpattu district, Tamil Nadu (January–June 2025). ADHD screening was performed using the Vanderbilt Teacher Rating Scale, supported by parent-reported developmental and behavioural details. Comorbidities were assessed using selected domains of the Child Behaviour Checklist (CBCL). Data were analysed using Chi-square and Fisher’s exact tests with p<0.05 considered statistically significant.

Results: The prevalence of screen-positive ADHD  was 12.6% (95% CI: 7.9–17.4). The inattentive subtype was most common (45.8%), followed by combined (41.7%) and hyperactive-impulsive type (12.5%). ADHD was significantly associated with male sex (p<0.01), lower socioeconomic status (p<0.01), developmental delay (p=0.01), NICU admission history (p=0.02), and prolonged screen exposure (p=0.03). Academic impairment and behavioural comorbidities were frequent among ADHD-positive children, with 62.5% exhibiting ≥2 CBCL-defined comorbidity domains.

Conclusion: ADHD is a substantive and under-recognized classroom burden with predominant inattentive subtype and high behavioural comorbidity. Early school-based screening, developmental risk assessment, parent education on screen-time moderation, and teacher-clinician collaboration may improve early identification and functional outcomes.