There is a critical need for sustained, effective school based interventions for students with Attention Deficit Hyperactivity Disorder (ADHD) in urban schools, as ADHD incidence is higher, but treatment rates are lower (NHIS, 2004). Students with ADHD frequently exhibit deficits in school achievement and performance due to significant impairments in learning, behavior, or social functioning, which place them at greater risk for school failure. Research based interventions for ADHD are underused in schools and often perceived as ineffective by teachers (NIMH, 2001). An increased presence of ADHD in urban schools poses additional challenges for classroom teachers who struggle to balance the needs of students with ADHD with the group needs of others. There is a dearth of research regarding urban teachers' knowledge, beliefs or practices for students with ADHD or the availability of sustained teacher supports.

This study explored the interrelationships between urban elementary teachers' frequency of use and effectiveness ratings of research based interventions for ADHD, their factual and perceived knowledge of ADHD, background characteristics, and the teacher supports available to them in their schools. Participants were 119 teachers from three large elementary schools in an urban district. Surveys consisted of the Knowledge of Attention Deficit Disorder Scales (KADDS) developed by Mark J. Sciutto, Mark D. Terjesen, and Allison Bender-Frank (2000), a background questionnaire, and rating scales for Environmental, Instructional, and Behavior Interventions, Mental Health Services, and Teacher Support Services. Physician Feedback, Medication Treatment and Unsupported Practices were also rated.

Major study findings indicated Teacher Support Services was significantly and positively related to teachers' use of every research based ADHD intervention. Teachers' Perceived knowledge of ADHD was positively related to their use of several school based interventions, ADHD related academic education, workshops, and experiences. Factual knowledge of ADHD was positively related only to students' use of Medication and ADHD related academic education. Implications for practice include teacher/consultant collaboration, co-facilitated professional development, organizational structure analysis and system outreach. Teacher preparation programs should include experiences, coursework in ADHD and childhood mental health issues. Further research is needed to examine availability of sustained teacher support services and ADHD intervention in urban schools.