The development of a proactive screening system for attention deficit hyperactivity disorder (ADHD) in grade 1 children receiving health services at Khukhan Hospital

Abstract

This study aimed to develop a proactive screening system for Attention Deficit Hyperactivity Disorder (ADHD) among first-grade students receiving health services at Khukhan Hospital. The study employed a Research and Development (R&D) design, divided into three phases. Phase 1 involved a situation analysis of problems and needs, conducted among 323 medical personnel, parents, and teachers using descriptive statistics and the Priority Needs Index (PNI). Phase 2 focused on system development, including a six-step screening process evaluated by 10 experts. Phase 3 involved the implementation and evaluation of the system in a sample of 30 students using the SNAP-IV (Short Form) behavior rating scale. Data were analyzed using descriptive statistics, including frequency, percentage, mean, standard deviation, and PNI analysis. The results showed that the primary issues were the lack of a data linkage system between schools and the hospital, insufficient parental understanding, and inefficient coordination, leading to inconsistent follow-up. The developed proactive screening system consisted of six stages: preparation, initial screening, referral, diagnostic confirmation, follow-up, and network meeting. Expert evaluation indicated that the system’s appropriateness (Mean = 4.23) and feasibility (Mean = 4.41) were both at a high level. After implementation, mean behavioral scores decreased across all categories. The system achieved 100% screening coverage, identified 40% of students as at risk, and successfully referred 83.33% of these cases. All referred cases (100%) received a comprehensive care plan.