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f
E
v
a
lua
t
io
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nd
Resea
rc
h in E
du
ca
t
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n (
I
J
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)
Vo
l.
15
,
No
.
3
,
J
u
n
e
20
26
,
p
p
.
2228
~
2
2
3
8
I
SS
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5
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8
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1
1
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9
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.
v
15
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.
3
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5
2228
J
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:
h
ttp
:
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ere.
ia
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e.
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Preva
lence and
so
cio
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demo
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ra
phic
co
rrelates o
f
a
t
te
ntion
-
deficit
/
hy
pera
ctiv
ity diso
rder am
o
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g
Albania
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nts
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lo
ra
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eqa
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a
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Su
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o
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s,
U
n
i
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e
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si
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f
El
b
a
s
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n
“
A
l
e
k
sa
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r
X
h
u
v
a
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El
b
a
s
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n
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A
l
b
a
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Art
icle
I
nfo
AB
S
T
RAC
T
A
r
ticle
his
to
r
y:
R
ec
eiv
ed
No
v
1
,
2
0
2
5
R
ev
is
ed
Ma
r
2
9
,
2
0
2
6
Acc
ep
ted
Ap
r
2
2
,
2
0
2
6
Atten
ti
o
n
-
d
e
ficit/
h
y
p
e
ra
c
ti
v
it
y
d
i
so
r
d
e
r
(AD
HD
)
m
a
y
sig
n
ifi
c
a
n
t
l
y
in
terfe
re
with
d
a
il
y
fu
n
c
ti
o
n
in
g
,
p
a
rti
c
u
lar
ly
a
m
o
n
g
n
u
rsin
g
stu
d
e
n
ts
wh
o
fa
c
e
h
ig
h
a
c
a
d
e
m
ic
stre
ss
a
n
d
d
e
m
a
n
d
in
g
c
li
n
ica
l
sc
h
e
d
u
les
.
T
h
is
st
u
d
y
a
ime
d
to
a
ss
e
ss
p
re
v
a
len
c
e
o
f
sc
re
e
n
i
n
g
-
p
o
siti
v
e
AD
HD
sy
m
p
to
m
s
a
n
d
a
ss
o
c
iate
d
fa
c
to
rs
a
m
o
n
g
3
7
0
Al
b
a
n
ia
n
n
u
r
sin
g
stu
d
e
n
ts.
A
d
e
sc
rip
ti
v
e
c
ro
s
s
-
se
c
ti
o
n
a
l
stu
d
y
wa
s
c
o
n
d
u
c
ted
u
sin
g
th
e
a
d
u
lt
AD
HD
se
lf
-
re
p
o
r
t
sc
a
le
(ASRS
)
v
1
.
1
.
Da
ta
a
n
a
ly
sis
in
c
lu
d
e
d
d
e
sc
rip
ti
v
e
sta
ti
st
ics
a
n
d
i
n
fe
re
n
ti
a
l
tes
ts
(su
c
h
a
s
χ
²
a
n
d
a
n
a
ly
sis
o
f
v
a
ri
a
n
c
e
(
ANOVA
)
),
with
sig
n
ifi
c
a
n
c
e
se
t
a
t
p
<
0
.
0
5
.
Re
su
lt
s
i
n
d
ica
ted
t
h
a
t
1
1
.
7
%
o
f
stu
d
e
n
ts
wit
h
o
u
t
a
p
ri
o
r
AD
HD
d
iag
n
o
sis
sc
re
e
n
e
d
p
o
si
ti
v
e
f
o
r
h
i
g
h
AD
HD
sy
m
p
t
o
m
lev
e
ls.
Lo
w
to
m
o
d
e
ra
te
sy
m
p
to
m
s
we
re
re
c
o
rd
e
d
b
y
a
p
p
r
o
x
ima
tely
5
9
%
o
f
p
a
rt
icip
a
n
ts
i
n
b
o
t
h
ASR
S
p
a
rt
A
a
n
d
p
a
rt
B,
a
n
d
b
y
6
5
%
b
a
se
d
o
n
th
e
to
tal
sc
o
re
.
No
sig
n
ifi
c
a
n
t
a
ss
o
c
iatio
n
s
we
re
fo
u
n
d
b
e
twe
e
n
AD
HD
sy
m
p
to
m
se
v
e
rit
y
a
n
d
g
e
n
d
e
r,
li
v
in
g
situ
a
ti
o
n
,
re
sid
e
n
c
e
,
o
r
p
e
e
r
in
teg
ra
ti
o
n
(p
>
0
.
0
5
).
Ho
we
v
e
r,
sy
m
p
to
m
se
v
e
rit
y
wa
s
sig
n
ifi
c
a
n
tl
y
a
ss
o
c
iate
d
wit
h
h
e
lp
-
se
e
k
in
g
b
e
h
a
v
i
o
r
(p
=
0
.
0
0
9
)
a
n
d
d
a
il
y
li
fe
d
iffi
c
u
lt
ies
,
p
a
rti
c
u
larly
e
c
o
n
o
m
ic
c
h
a
ll
e
n
g
e
s
(p
=
0
.
0
2
),
with
h
i
g
h
e
r
sy
m
p
to
m
s
m
o
re
c
o
m
m
o
n
a
m
o
n
g
st
u
d
e
n
ts
re
ly
in
g
o
n
th
e
m
se
lv
e
s
-
c
o
p
in
g
stra
teg
ies
.
Ba
se
d
o
n
t
h
e
se
re
su
lt
s,
targ
e
ted
in
t
e
rv
e
n
ti
o
n
s
su
c
h
a
s
c
o
g
n
i
ti
v
e
-
b
e
h
a
v
io
ra
l
wo
rk
s
h
o
p
s,
a
c
a
d
e
m
ic
c
o
a
c
h
in
g
,
a
n
d
p
sy
c
h
o
e
d
u
c
a
ti
o
n
a
l
p
r
o
g
ra
m
s
c
o
u
ld
h
e
l
p
Alb
a
n
ia
n
n
u
rsin
g
stu
d
e
n
t
s
d
e
v
e
lo
p
o
rg
a
n
iza
ti
o
n
a
l
a
n
d
ti
m
e
-
m
a
n
a
g
e
m
e
n
t
sk
il
ls,
im
p
ro
v
e
e
m
o
ti
o
n
a
l
re
g
u
latio
n
,
a
n
d
e
n
h
a
n
c
e
a
c
a
d
e
m
ic p
e
rfo
rm
a
n
c
e
.
K
ey
w
o
r
d
s
:
ADHD
s
y
m
p
to
m
s
ASR
S v
1
.
1
Pre
v
alen
ce
So
cio
-
d
em
o
g
r
ap
h
ic
f
ac
to
r
s
Un
iv
er
s
ity
s
tu
d
en
ts
T
h
is i
s
a
n
o
p
e
n
a
c
c
e
ss
a
rticle
u
n
d
e
r th
e
CC B
Y
-
SA
li
c
e
n
se
.
C
o
r
r
e
s
p
o
nd
ing
A
uth
o
r
:
Flo
r
a
Z
eq
aj
L
am
çja
Facu
lty
o
f
Me
d
ical
T
ec
h
n
ical
Scien
ce
s
,
Un
iv
er
s
ity
o
f
E
lb
asa
n
“Ale
k
s
an
d
ër
Xh
u
v
an
i”
Petr
it Ga
çe
Stre
et,
3
0
0
1
E
lb
as
an
,
Alb
an
ia
E
m
ail
: Flo
r
a.
L
am
cja@u
n
iel.
ed
u
.
al
1.
I
NT
RO
D
UCT
I
O
N
Atten
tio
n
-
d
ef
icit/h
y
p
e
r
ac
tiv
ity
d
is
o
r
d
er
(
ADHD
)
is
a
p
r
ev
alen
t
n
e
u
r
o
d
e
v
elo
p
m
e
n
tal
d
is
o
r
d
er
ch
ar
ac
ter
ized
b
y
p
er
s
is
ten
t
p
atter
n
s
o
f
in
atten
tio
n
a
n
d
/
o
r
h
y
p
er
ac
tiv
ity
-
im
p
u
ls
iv
ity
th
at
in
ter
f
er
e
with
f
u
n
ctio
n
in
g
o
r
d
ev
elo
p
m
en
t.
Alth
o
u
g
h
h
is
to
r
ically
co
n
c
ep
tu
alize
d
as
a
ch
ild
h
o
o
d
co
n
d
itio
n
,
r
o
b
u
s
t
lo
n
g
itu
d
in
al
ev
id
e
n
ce
d
em
o
n
s
tr
ates th
at
AD
HD
f
r
eq
u
en
tly
p
er
s
is
ts
in
to
ad
u
lth
o
o
d
,
with
s
y
m
p
to
m
s
co
n
tin
u
in
g
to
af
f
ec
t
ac
ad
em
ic,
o
cc
u
p
atio
n
al,
a
n
d
p
s
y
ch
o
s
o
cial
f
u
n
cti
o
n
in
g
[
1
]
.
I
n
h
ig
h
er
ed
u
ca
tio
n
s
ettin
g
s
,
ADHD
s
y
m
p
to
m
s
m
ay
b
ec
o
m
e
p
ar
tic
u
lar
ly
p
r
o
m
in
e
n
t
d
u
e
to
i
n
cr
ea
s
ed
d
em
an
d
s
o
n
e
x
ec
u
tiv
e
f
u
n
ctio
n
in
g
,
i
n
clu
d
in
g
s
u
s
tain
ed
atten
tio
n
,
tim
e
m
an
ag
em
en
t,
p
lan
n
in
g
,
a
n
d
em
o
tio
n
al
r
eg
u
latio
n
[
2
]
.
Hea
lth
ca
r
e
s
tu
d
en
ts
ar
e
esp
ec
ially
v
u
ln
er
ab
le,
as
th
ey
f
ac
e
in
ten
s
iv
e
ac
ad
e
m
ic
wo
r
k
lo
ad
s
,
clin
ical
r
esp
o
n
s
ib
ilit
ies,
an
d
h
ig
h
ex
p
ec
tatio
n
s
f
o
r
s
elf
-
r
e
g
u
latio
n
an
d
p
r
o
f
ess
io
n
al
co
m
p
eten
c
e
[
3
]
,
[
4
]
.
W
h
en
ADHD
r
em
a
in
s
u
n
d
iag
n
o
s
ed
o
r
u
n
tr
ea
ted
,
th
ese
d
em
an
d
s
m
ay
ex
ac
er
b
ate
s
y
m
p
t
o
m
s
an
d
co
n
tr
ib
u
te
to
ac
ad
em
ic
u
n
d
er
p
e
r
f
o
r
m
an
ce
,
em
o
tio
n
al
d
is
tr
ess
,
an
d
r
e
d
u
ce
d
well
-
b
ein
g
[
5
]
.
Evaluation Warning : The document was created with Spire.PDF for Python.
I
n
t
J
E
v
al
&
R
es E
d
u
c
I
SS
N:
2252
-
8
8
2
2
P
r
ev
a
len
ce
a
n
d
s
o
cio
-
d
emo
g
r
a
p
h
ic
co
r
r
ela
tes o
f a
tten
tio
n
-
d
eficit/h
yp
era
ctivity
…
(
F
lo
r
a
Zeq
a
j La
mçja
)
2229
C
o
n
ce
p
tu
ally
,
it
is
es
s
en
tial
to
d
is
tin
g
u
is
h
b
etwe
en
AD
HD
s
y
m
p
to
m
s
,
ADHD
d
iag
n
o
s
is
,
an
d
f
u
n
ctio
n
al
im
p
air
m
e
n
t
[
6
]
,
[
7
]
.
ADHD
s
y
m
p
to
m
s
r
ef
er
to
s
elf
-
r
ep
o
r
ted
o
r
o
b
s
er
v
e
d
b
eh
av
io
r
s
r
elate
d
to
in
atten
tio
n
,
im
p
u
ls
iv
ity
,
o
r
h
y
p
er
ac
tiv
ity
[
8
]
,
[
9
]
.
An
AD
HD
d
iag
n
o
s
is
r
eq
u
ir
es
a
c
o
m
p
r
eh
en
s
iv
e
clin
ical
ev
alu
atio
n
m
ee
tin
g
d
iag
n
o
s
tic
an
d
s
tatis
tical
m
an
u
al
o
f
m
en
tal
d
is
o
r
d
er
s
f
if
th
ed
itio
n
(
DSM
-
5
)
cr
iter
ia
,
in
clu
d
in
g
e
v
id
en
ce
o
f
s
y
m
p
t
o
m
p
er
s
is
ten
ce
,
o
n
s
et
b
ef
o
r
e
ag
e
1
2
,
a
n
d
clin
ically
s
ig
n
if
ican
t
f
u
n
ctio
n
al
im
p
air
m
en
t
ac
r
o
s
s
m
u
ltip
le
s
ettin
g
s
[
1
0
]
.
Fu
n
ctio
n
al
im
p
a
ir
m
en
t
r
ef
lects
th
e
d
eg
r
ee
to
wh
ich
s
y
m
p
to
m
s
in
ter
f
er
e
with
ac
ad
em
ic,
s
o
cial,
o
r
o
cc
u
p
atio
n
al
f
u
n
ctio
n
i
n
g
an
d
is
a
cr
itical
d
eter
m
in
an
t
o
f
clin
ical
r
elev
an
ce
in
ad
u
lt p
o
p
u
latio
n
s
[
1
1
]
.
R
ec
en
t
s
tu
d
ies
co
n
d
u
cted
b
et
wee
n
2
0
1
9
an
d
2
0
2
4
in
d
icate
s
u
b
s
tan
tial
v
ar
iab
ilit
y
in
th
e
p
r
ev
alen
ce
o
f
ADHD
s
y
m
p
to
m
s
am
o
n
g
u
n
iv
e
r
s
ity
s
tu
d
en
ts
ac
r
o
s
s
r
eg
io
n
s
.
Pre
v
ale
n
ce
esti
m
ates
o
f
p
r
o
b
ab
le
ad
u
lt
ADHD
b
ased
o
n
s
cr
ee
n
in
g
in
s
tr
u
m
en
ts
r
an
g
e
f
r
o
m
a
p
p
r
o
x
im
ately
1
0
%
to
o
v
er
2
0
%,
d
ep
en
d
in
g
o
n
th
e
p
o
p
u
latio
n
an
d
m
eth
o
d
o
lo
g
y
[
2
]
.
R
esear
ch
f
r
o
m
E
aster
n
E
u
r
o
p
e
an
d
n
eig
h
b
o
r
i
n
g
r
e
g
io
n
s
s
u
g
g
ests
th
at
ADHD
m
ay
b
e
u
n
d
er
r
ec
o
g
n
i
ze
d
in
y
o
u
n
g
ad
u
lts
d
u
e
to
li
m
ited
m
en
tal
h
ea
lth
liter
ac
y
,
s
tig
m
a,
an
d
r
ed
u
ce
d
ac
ce
s
s
to
d
iag
n
o
s
tic
s
er
v
ices
[
1
2
]
.
T
h
ese
co
n
tex
tu
al
f
ac
to
r
s
ar
e
p
ar
ticu
lar
ly
r
elev
an
t
in
c
o
u
n
tr
ies
u
n
d
e
r
g
o
in
g
tr
an
s
itio
n
s
in
m
en
tal
h
ea
lth
ca
r
e
s
y
s
tem
s
,
s
u
ch
as th
o
s
e
in
th
e
B
alk
an
r
eg
io
n
[
1
3
]
.
Desp
ite
g
r
o
wi
n
g
i
n
t
er
n
a
ti
o
n
al
in
t
er
est
in
a
d
u
lt
A
DHD
am
o
n
g
u
n
iv
e
r
s
it
y
s
t
u
d
e
n
ts
,
n
o
p
r
ev
i
o
u
s
s
t
u
d
y
h
as
in
v
esti
g
at
e
d
t
h
e
p
r
e
v
a
le
n
ce
a
n
d
co
r
r
el
ates
o
f
A
DHD
s
y
m
p
t
o
m
s
s
p
ec
if
ica
ll
y
a
m
o
n
g
n
u
r
s
i
n
g
s
t
u
d
e
n
ts
in
Alb
an
ia
.
T
h
is
r
e
p
r
ese
n
ts
a
cr
i
t
ical
g
a
p
i
n
t
h
e
li
te
r
at
u
r
e
,
g
iv
e
n
t
h
e
c
en
tr
al
r
o
l
e
o
f
n
u
r
s
es
i
n
h
e
alt
h
c
ar
e
d
eli
v
e
r
y
.
Atte
n
ti
o
n
a
l
a
n
d
s
el
f
-
r
e
g
u
l
at
o
r
y
d
i
f
f
ic
u
l
ties
m
a
y
s
i
g
n
if
ic
a
n
tl
y
a
f
f
ec
t
b
o
t
h
a
ca
d
e
m
i
c
t
r
ai
n
i
n
g
a
n
d
f
u
t
u
r
e
p
r
o
f
ess
i
o
n
a
l
p
r
ac
t
ice
.
U
n
d
e
r
s
tan
d
i
n
g
AD
HD
s
y
m
p
t
o
m
p
atte
r
n
s
wi
th
in
th
is
p
o
p
u
la
ti
o
n
is
ess
e
n
ti
al
f
o
r
in
f
o
r
m
i
n
g
t
ar
g
ete
d
s
c
r
ee
n
in
g
,
p
r
e
v
e
n
ti
o
n
,
a
n
d
s
u
p
p
o
r
t
s
t
r
a
te
g
ies
in
Al
b
an
ia
n
h
i
g
h
e
r
e
d
u
ca
t
i
o
n
i
n
s
t
it
u
ti
o
n
s
[
1
4
]
.
T
o
f
ac
ilit
ate
ef
f
icien
t
id
en
tific
atio
n
o
f
ad
u
lts
at
r
is
k
f
o
r
ADHD
,
th
e
W
o
r
ld
Hea
lth
O
r
g
an
izatio
n
(
W
HO)
d
ev
elo
p
ed
t
h
e
a
d
u
lt
ADHD
s
elf
-
r
ep
o
r
t
s
ca
l
e
(
ASR
S)
v
1
.
1
,
a
b
r
ief
an
d
wid
ely
v
alid
ated
s
cr
ee
n
in
g
in
s
tr
u
m
en
t
alig
n
ed
with
DS
M
-
5
cr
iter
ia
[
1
5
]
.
T
h
e
ASR
S
h
as
d
em
o
n
s
tr
ated
g
o
o
d
p
s
y
c
h
o
m
etr
ic
p
r
o
p
er
ties
ac
r
o
s
s
d
iv
er
s
e
cu
ltu
r
al
co
n
te
x
ts
an
d
is
co
m
m
o
n
l
y
u
s
ed
i
n
u
n
iv
er
s
ity
-
b
ased
r
esear
ch
t
o
esti
m
ate
ADHD
s
y
m
p
to
m
b
u
r
d
en
an
d
ass
o
ciate
d
f
u
n
ctio
n
al
d
if
f
icu
lties
[
1
6
]
.
T
h
is
s
tu
d
y
aim
ed
to
d
eter
m
in
e
th
e
p
r
ev
alen
ce
an
d
s
ev
er
ity
o
f
s
cr
ee
n
in
g
-
p
o
s
itiv
e
ADHD
s
y
m
p
to
m
s
an
d
to
ex
am
in
e
th
eir
ass
o
ciatio
n
s
with
d
em
o
g
r
a
p
h
ic
ch
ar
ac
ter
is
tics
,
h
elp
-
s
ee
k
in
g
b
eh
av
io
r
,
an
d
d
aily
life
d
if
f
icu
lties
am
o
n
g
u
n
d
e
r
g
r
ad
u
ate
n
u
r
s
in
g
s
tu
d
en
ts
in
Alb
an
ia
b
etwe
en
J
an
u
ar
y
an
d
Dec
em
b
er
2
0
2
4
.
I
t
was
h
y
p
o
th
esized
th
at
f
in
an
cial
s
tr
ess
,
liv
in
g
awa
y
f
r
o
m
f
am
ily
,
an
d
lim
ited
s
o
cial
s
u
p
p
o
r
t w
o
u
l
d
b
e
s
ig
n
if
ica
n
tly
ass
o
ciate
d
with
h
ig
h
e
r
lev
els o
f
ADHD
s
y
m
p
to
m
s
.
2.
M
E
T
H
O
D
2
.
1
.
Study
des
ig
n a
nd
s
et
t
ing
T
h
is
was
a
d
escr
ip
tiv
e
cr
o
s
s
-
s
ec
tio
n
al
o
b
s
er
v
atio
n
al
s
tu
d
y
co
n
d
u
cted
b
etwe
en
J
an
u
ar
y
2
0
2
4
an
d
Dec
em
b
er
2
0
2
4
at
th
e
Facu
lty
o
f
Me
d
ical
T
ec
h
n
ical
Scien
ce
s
in
“Ale
k
s
an
d
ër
Xh
u
v
an
i”
Un
iv
er
s
ity
,
E
lb
asan
,
an
d
“I
s
m
ail
Qem
ali”
Un
iv
er
s
ity
,
Vlo
r
ë,
Alb
an
ia.
T
h
e
s
tu
d
y
in
clu
d
ed
o
n
ly
n
u
r
s
in
g
s
tu
d
en
ts
,
ex
clu
d
in
g
s
tu
d
en
ts
f
r
o
m
o
th
er
p
r
o
g
r
am
s
.
Nu
r
s
in
g
s
tu
d
en
ts
wer
e
s
elec
ted
b
ec
au
s
e
th
eir
c
u
r
r
icu
l
u
m
co
m
b
in
es
in
ten
s
iv
e
th
eo
r
etica
l
co
u
r
s
ewo
r
k
with
ea
r
ly
an
d
co
n
tin
u
o
u
s
clin
ical
tr
ain
in
g
.
T
h
is
d
u
al
ac
ad
em
i
c
-
clin
ical
s
tr
u
ctu
r
e
d
em
an
d
s
s
u
s
tain
ed
atten
tio
n
,
s
tr
o
n
g
ex
ec
u
tiv
e
f
u
n
ctio
n
in
g
,
m
u
ltit
ask
in
g
,
an
d
r
ap
i
d
ad
a
p
tatio
n
to
c
o
m
p
lex
clin
ical
en
v
ir
o
n
m
en
ts
,
m
ak
i
n
g
atten
tio
n
-
r
elate
d
d
if
f
icu
l
ties
m
o
r
e
o
b
s
er
v
ab
le
th
an
in
o
th
er
s
tu
d
en
t
p
o
p
u
latio
n
s
.
Nu
r
s
in
g
p
r
o
g
r
am
s
also
in
v
o
lv
e
h
ig
h
s
tr
ess
,
s
h
if
t
-
b
ased
clin
ical
s
ch
ed
u
les,
an
d
elev
ated
ac
ad
em
ic
ex
p
ec
tatio
n
s
,
f
ac
to
r
s
th
at
m
ay
ex
ac
er
b
ate
ADHD
s
y
m
p
to
m
s
[
1
7
]
.
Alth
o
u
g
h
d
ata
wer
e
c
o
llected
ac
r
o
s
s
an
en
tire
ac
a
d
em
ic
y
ea
r
,
ea
ch
s
tu
d
e
n
t
co
m
p
leted
t
h
e
s
u
r
v
ey
o
n
ly
o
n
ce
,
p
r
o
v
id
in
g
a
s
n
ap
s
h
o
t
o
f
th
eir
s
y
m
p
to
m
lev
el
s
at
th
at
m
o
m
en
t.
B
ec
au
s
e
r
esp
o
n
s
es
wer
e
n
o
t
an
aly
ze
d
b
y
s
em
ester
o
r
ex
am
in
atio
n
p
e
r
io
d
,
p
o
s
s
ib
le
s
ea
s
o
n
al
o
r
tim
e
-
r
elate
d
in
f
l
u
en
ce
s
o
n
s
y
m
p
to
m
r
ep
o
r
tin
g
ca
n
n
o
t
b
e
r
u
led
o
u
t
an
d
ar
e
ac
k
n
o
wled
g
ed
as
a
l
im
itatio
n
o
f
th
e
s
tu
d
y
.
T
h
is
s
tu
d
y
ad
h
er
e
d
t
o
th
e
s
tr
en
g
th
en
in
g
th
e
r
e
p
o
r
tin
g
o
f
o
b
s
er
v
atio
n
al
s
tu
d
ies
in
ep
id
em
io
lo
g
y
(
STROB
E
)
g
u
id
elin
es
f
o
r
cr
o
s
s
-
s
ec
tio
n
al
s
tu
d
ies [
1
8
]
.
2
.
2
.
Sa
m
pli
ng
m
et
ho
d
All
b
ac
h
elo
r
n
u
r
s
in
g
s
tu
d
en
t
s
f
r
o
m
t
h
e
two
u
n
iv
e
r
s
ities
wh
o
p
r
o
v
id
e
d
in
f
o
r
m
e
d
co
n
s
en
t
wer
e
en
r
o
lled
u
s
in
g
a
ce
n
s
u
s
a
p
p
r
o
ac
h
,
tar
g
etin
g
all
elig
ib
le
s
tu
d
en
ts
.
Ou
t
o
f
4
2
0
in
v
ited
s
tu
d
e
n
ts
,
3
7
0
co
m
p
leted
th
e
s
u
r
v
ey
,
y
ield
i
n
g
a
r
esp
o
n
s
e
r
ate
o
f
8
8
.
1
%.
Ag
g
r
eg
ate
p
r
o
g
r
am
-
le
v
el
d
ata
in
d
icate
d
n
o
n
o
tab
le
d
if
f
e
r
en
ce
s
in
g
en
d
e
r
d
is
tr
ib
u
tio
n
o
r
y
ea
r
o
f
s
tu
d
y
b
etwe
en
r
esp
o
n
d
en
ts
an
d
th
e
o
v
er
all
co
h
o
r
t.
I
n
d
i
v
id
u
al
-
lev
el
d
ata
wer
e
n
o
t
a
v
ailab
le
f
o
r
n
o
n
-
r
esp
o
n
d
e
r
s
;
h
o
wev
er
,
c
o
m
p
ar
is
o
n
u
s
in
g
av
ailab
le
ag
g
r
eg
ate
ch
ar
ac
te
r
is
tics
s
u
g
g
ests
th
at
s
y
s
tem
atic
d
if
f
er
en
ce
s
b
etwe
en
r
esp
o
n
d
en
ts
an
d
n
o
n
-
r
esp
o
n
d
en
ts
wer
e
u
n
lik
ely
.
Evaluation Warning : The document was created with Spire.PDF for Python.
I
SS
N
:
2
2
5
2
-
8
8
2
2
I
n
t
J
E
v
al
&
R
es E
d
u
c
,
Vo
l
.
15
,
No
.
3
,
J
u
n
e
20
2
6
:
2
2
2
8
-
2
2
3
8
2230
2
.
3
.
I
nclus
io
n
/
ex
clus
io
n c
rit
er
ia
a
nd
v
a
ria
bles
Par
ticip
an
ts
in
clu
d
ed
all
b
ac
h
elo
r
n
u
r
s
in
g
s
tu
d
en
ts
f
r
o
m
th
e
two
u
n
iv
er
s
ities
wh
o
co
n
s
en
ted
to
p
ar
ticip
ate.
Stu
d
en
ts
f
r
o
m
o
th
er
h
ea
lth
p
r
o
g
r
am
s
an
d
th
o
s
e
with
a
p
r
i
o
r
clin
ical
d
iag
n
o
s
is
o
f
ADHD
wer
e
ex
clu
d
ed
.
Fu
r
t
h
er
m
o
r
e,
s
o
cio
d
em
o
g
r
ap
h
ic
v
a
r
iab
les
in
clu
d
e
ag
e,
g
en
d
er
,
ac
ad
e
m
ic
y
ea
r
,
p
r
o
v
in
ce
o
f
r
esid
en
ce
,
co
m
o
r
b
id
c
o
n
d
itio
n
s
,
p
s
y
ch
iatr
ic
m
ed
icatio
n
u
s
e,
an
d
f
am
ily
h
is
to
r
y
o
f
p
s
y
ch
iat
r
ic
d
is
o
r
d
er
s
.
2.
4
.
I
ns
t
rum
ent
s
a
nd
pro
ce
du
re
s
Ad
u
lt
ADHD
s
y
m
p
to
m
s
wer
e
ass
ess
ed
u
s
in
g
th
e
ASR
S
v
1
.
1
,
an
1
8
-
item
s
cr
ee
n
in
g
to
o
l
d
ev
elo
p
e
d
b
y
th
e
W
HO
b
ased
o
n
DSM
-
5
cr
iter
ia
[
1
9
]
.
Par
t
A
(
6
item
s
)
co
n
tain
s
th
e
m
o
s
t
p
r
ed
ictiv
e
item
s
f
o
r
ADHD
,
wh
ile
p
ar
t
B
(
1
2
item
s
)
p
r
o
v
id
es
ad
d
itio
n
al
s
y
m
p
to
m
i
n
f
o
r
m
atio
n
.
T
h
e
ASR
S
is
a
v
alid
ated
to
o
l
f
o
r
s
cr
ee
n
in
g
ADHD
r
is
k
b
u
t
d
o
es
n
o
t
p
r
o
v
id
e
a
f
o
r
m
al
clin
ical
d
iag
n
o
s
is
[
1
9
]
.
Alth
o
u
g
h
a
f
o
r
m
ally
v
alid
ated
Alb
an
ian
v
er
s
io
n
o
f
t
h
e
ASR
S
is
n
o
t
cu
r
r
en
tly
av
ailab
le,
t
h
e
s
ca
le
was
tr
an
s
lated
an
d
ad
ap
ted
u
s
in
g
s
tan
d
ar
d
f
o
r
war
d
–
b
ac
k
war
d
tr
an
s
latio
n
p
r
o
ce
d
u
r
es
to
en
s
u
r
e
lin
g
u
is
tic
clar
ity
an
d
co
n
ce
p
tu
al
e
q
u
iv
alen
ce
.
C
u
t
-
o
f
f
s
co
r
es
an
d
s
y
m
p
to
m
s
ev
er
ity
ca
teg
o
r
ies
wer
e
ap
p
lied
in
ac
c
o
r
d
a
n
ce
w
ith
estab
lis
h
ed
ASR
S
s
co
r
in
g
g
u
id
elin
es
an
d
p
r
io
r
u
n
iv
er
s
ity
-
b
ased
s
tu
d
ies,
allo
win
g
f
o
r
co
m
p
a
r
ab
ilit
y
with
i
n
ter
n
atio
n
al
r
esear
c
h
.
Stu
d
en
t
s
s
co
r
in
g
h
ig
h
o
n
th
e
ASR
S we
r
e
ad
v
is
ed
to
s
ee
k
f
o
llo
w
-
u
p
clin
ical
ass
ess
m
en
t.
2.
5
.
Relia
bil
it
y
a
nd
v
a
lid
it
y
I
n
o
u
r
s
am
p
le,
t
h
e
ASR
S
d
em
o
n
s
tr
ated
g
o
o
d
in
ter
n
al
c
o
n
s
is
ten
cy
,
with
a
C
r
o
n
b
ac
h
’
s
alp
h
a
o
f
0
.
8
7
f
o
r
th
e
to
tal
s
ca
le,
0
.
8
2
f
o
r
p
ar
t
A,
an
d
0
.
7
9
f
o
r
p
a
r
t
B
.
F
o
r
Alb
an
ian
-
s
p
ea
k
in
g
p
ar
ticip
an
ts
,
th
e
AS
R
S
was
tr
an
s
lated
in
to
Alb
an
ian
u
s
in
g
a
f
o
r
war
d
-
tr
an
s
latio
n
an
d
b
ac
k
-
tr
an
s
latio
n
p
r
o
ce
d
u
r
e
to
e
n
s
u
r
e
s
em
an
tic
an
d
co
n
ce
p
tu
al
e
q
u
iv
alen
ce
.
2.
6
.
Da
t
a
c
o
llect
io
n t
o
o
l
A
s
tr
u
ctu
r
ed
q
u
esti
o
n
n
air
e
wa
s
u
s
ed
,
co
m
p
r
is
in
g
t
h
r
ee
s
ec
tio
n
s
:
−
Dem
o
g
r
ap
h
ic
ch
ar
ac
ter
is
tics
: a
g
e,
g
en
d
er
,
ac
a
d
em
ic
y
ea
r
,
p
r
o
v
in
ce
,
liv
in
g
s
itu
atio
n
.
−
Kn
o
wled
g
e
,
attitu
d
es,
an
d
p
er
ce
p
tio
n
s
r
eg
ar
d
i
n
g
ad
u
lt
ADH
D:
a
s
s
e
s
s
in
g
f
ac
tu
al
k
n
o
wled
g
e
an
d
p
er
s
o
n
al
b
elief
s
ab
o
u
t A
DHD.
−
ADHD
s
y
m
p
to
m
s
cr
ee
n
in
g
: u
s
in
g
ASR
S v
1
.
1
to
q
u
a
n
tify
s
y
m
p
to
m
f
r
eq
u
e
n
cy
an
d
s
ev
er
ity
.
2.
7
.
St
a
t
is
t
ica
l
a
na
ly
s
es
Data
wer
e
an
aly
ze
d
u
s
in
g
s
tatis
t
ical
p
ac
k
ag
e
f
o
r
th
e
s
o
cial
s
cien
ce
s
(
SP
S
S
)
v
er
s
io
n
2
6
.
0
(
I
B
M
C
o
r
p
o
r
atio
n
)
.
M
ea
n
s
an
d
s
tan
d
ar
d
d
ev
iatio
n
s
wer
e
ca
lcu
lated
f
o
r
co
n
tin
u
o
u
s
v
ar
iab
l
es (
e.
g
.
,
ag
e)
,
wh
ile
f
r
eq
u
e
n
cies
an
d
p
er
ce
n
ta
g
es
wer
e
ca
lcu
lated
f
o
r
ca
teg
o
r
ical
v
ar
ia
b
les
(
e.
g
.
,
g
e
n
d
e
r
,
ac
ad
em
ic
y
ea
r
)
.
C
ateg
o
r
ical
v
ar
iab
les
:
ass
o
cia
tio
n
s
wer
e
an
aly
ze
d
u
s
in
g
Pear
s
o
n
χ²
test
s
.
D
if
f
er
en
ce
s
b
et
wee
n
g
r
o
u
p
s
wer
e
ass
es
s
ed
u
s
in
g
in
d
ep
en
d
en
t
t
-
test
s
o
r
o
n
e
-
way
an
aly
s
is
o
f
v
ar
ian
ce
(
ANOVA
)
as
ap
p
r
o
p
r
iate.
T
o
tal
ASR
S
s
co
r
es
wer
e
d
iv
id
ed
in
to
f
o
u
r
ca
teg
o
r
ies:
lo
w,
m
ild
to
m
o
d
er
ate,
h
ig
h
,
an
d
v
er
y
h
ig
h
,
b
a
s
ed
o
n
estab
lis
h
ed
cu
t
-
o
f
f
s
co
r
es
[
1
2
]
.
Sig
n
if
ican
ce
th
r
esh
o
ld
:
a
p
-
v
alu
e<
0
.
0
5
was
co
n
s
id
er
ed
s
tatis
t
ically
s
i
g
n
if
ican
t.
Po
ten
tial
v
ar
iab
les s
u
ch
as a
g
e,
g
en
d
er
,
an
d
ac
ad
em
ic
y
ea
r
wer
e
e
x
p
lo
r
ed
u
s
in
g
b
iv
ar
iate
an
aly
s
es.
3.
RE
SU
L
T
S AN
D
D
I
SCU
SS
I
O
N
3
.
1
.
So
cio
dem
o
g
ra
ph
ic
re
s
ults
T
ab
le
1
p
r
esen
ts
th
e
s
o
cio
d
e
m
o
g
r
ap
h
ic
ch
a
r
ac
ter
is
tics
o
f
t
h
e
s
tu
d
y
s
am
p
le
(
N=
3
7
0
)
.
T
h
e
m
ea
n
a
g
e
o
f
p
ar
ticip
a
n
ts
was
2
0
.
1
9
y
ea
r
s
(
SD=5
.
2
9
)
.
T
h
e
r
elativ
ely
wid
e
ag
e
r
an
g
e
r
ef
lects
th
e
in
clu
s
io
n
o
f
s
tu
d
e
n
ts
f
r
o
m
d
if
f
er
e
n
t
ac
ad
e
m
ic
y
ea
r
s
,
as
well
as
o
ld
er
s
tu
d
e
n
ts
wh
o
en
te
r
ed
th
e
n
u
r
s
in
g
p
r
o
g
r
a
m
later
o
r
r
etu
r
n
ed
af
ter
a
b
r
ea
k
in
th
eir
s
tu
d
ies
.
T
h
e
m
aj
o
r
ity
o
f
p
a
r
ticip
an
t
s
wer
e
f
em
ale
(
8
9
.
2
%,
n
=3
3
0
)
,
wh
er
ea
s
m
ales
ac
co
u
n
ted
f
o
r
1
0
.
8
%
(
n
=4
0
)
,
r
ef
lectin
g
a
s
am
p
le
with
a
h
ig
h
er
r
ep
r
esen
tatio
n
o
f
wo
m
en
.
R
eg
ar
d
in
g
p
lace
o
f
r
esid
en
ce
,
m
o
s
t
p
ar
ticip
an
ts
r
esid
ed
in
u
r
b
an
ar
ea
s
(
9
1
.
9
%,
n
=3
4
0
)
,
with
a
s
m
aller
p
r
o
p
o
r
tio
n
liv
in
g
in
r
u
r
al
ar
ea
s
(
8
.
1
%,
n
=3
0
)
.
T
h
is
d
i
s
tr
ib
u
tio
n
h
i
g
h
lig
h
ts
th
at
th
e
s
am
p
le
is
p
r
im
a
r
ily
u
r
b
a
n
-
b
ased
,
wh
ich
m
ay
in
f
lu
en
ce
life
s
ty
le,
ac
ce
s
s
to
r
eso
u
r
ce
s
,
an
d
s
o
cial
s
u
p
p
o
r
t
s
y
s
tem
s
.
R
eg
ar
d
in
g
p
r
o
x
im
ity
to
f
am
ily
,
6
0
.
8
%
(
n
=2
2
5
)
o
f
s
tu
d
en
ts
liv
ed
n
ea
r
th
eir
f
am
ilies
,
wh
ile
3
9
.
2
%
(
n
=1
4
5
)
liv
e
d
awa
y
f
r
o
m
f
am
ily
.
T
h
is
v
ar
iatio
n
m
ay
af
f
ec
t stu
d
e
n
ts
’
d
aily
r
o
u
t
in
es,
in
d
ep
en
d
en
ce
,
a
n
d
co
p
in
g
s
tr
ateg
ies.
Par
ticip
an
ts
r
ep
o
r
ted
a
r
an
g
e
o
f
ch
allen
g
es
in
d
aily
life
.
E
co
n
o
m
ic
d
if
f
icu
lties
wer
e
th
e
m
o
s
t
co
m
m
o
n
l
y
r
e
p
o
r
ted
(
5
1
.
1
%,
n
=1
8
9
)
,
f
o
llo
we
d
b
y
s
o
cial
d
if
f
icu
lties
(
1
3
.
5
%,
n
=5
0
)
,
cu
ltu
r
al
d
if
f
icu
lties
(
6
.
2
%,
n
=
2
3
)
,
an
d
o
th
er
u
n
s
p
ec
if
ied
d
if
f
icu
lties
(
2
9
.
2
%,
n
=1
0
8
)
.
T
h
ese
r
esu
lts
s
u
g
g
est
th
at
f
in
an
cial
ch
allen
g
es
r
ep
r
esen
t
a
m
aj
o
r
s
o
u
r
ce
o
f
s
tr
ess
am
o
n
g
u
n
i
v
er
s
ity
s
tu
d
en
ts
,
p
o
ten
tially
i
m
p
ac
tin
g
ac
ad
e
m
ic
p
er
f
o
r
m
an
ce
an
d
well
-
b
ein
g
.
R
eg
ar
d
in
g
s
o
cial
in
teg
r
atio
n
,
5
3
.
0
% o
f
s
tu
d
en
ts
r
ep
o
r
ted
b
ei
n
g
a
litt
le
in
teg
r
ated
in
to
th
e
u
n
i
v
er
s
ity
co
m
m
u
n
it
y
,
3
5
.
7
%
in
d
icate
d
b
ein
g
v
er
y
m
u
c
h
i
n
teg
r
ated
,
an
d
1
1
.
4
%
r
ep
o
r
te
d
n
o
t
at
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d
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o
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g
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a
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r
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f a
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r
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in
teg
r
ated
.
T
h
is
d
is
tr
ib
u
tio
n
i
n
d
icate
s
th
at
wh
ile
a
m
ajo
r
ity
o
f
s
tu
d
en
ts
h
av
e
s
o
m
e
lev
el
o
f
en
g
ag
e
m
en
t
with
p
ee
r
s
,
a
n
o
tab
le
s
u
b
s
et
r
em
ain
s
s
o
cially
u
n
in
teg
r
ated
,
wh
ich
m
ay
in
f
lu
e
n
ce
em
o
tio
n
al
well
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b
ein
g
an
d
ad
ap
tatio
n
to
u
n
iv
e
r
s
ity
life
.
W
h
en
f
ac
in
g
em
o
tio
n
al
d
is
tr
ess
,
4
4
.
6
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o
f
p
a
r
ticip
an
ts
s
o
u
g
h
t
s
u
p
p
o
r
t
f
r
o
m
f
am
ily
,
2
8
.
6
%
f
r
o
m
f
r
ien
d
s
,
2
0
.
8
%
r
elied
o
n
th
em
s
elv
e
s
,
an
d
5
.
9
%
tu
r
n
ed
t
o
o
th
e
r
s
o
u
r
ce
s
s
u
ch
as
p
s
y
ch
o
lo
g
is
ts
.
T
h
ese
f
i
n
d
in
g
s
h
ig
h
lig
h
t
th
e
ce
n
tr
al
r
o
le
o
f
f
am
ily
an
d
p
ee
r
s
u
p
p
o
r
t
in
m
an
ag
in
g
em
o
tio
n
al
d
if
f
icu
lties
am
o
n
g
s
tu
d
en
ts
,
wh
ile
s
elf
-
r
elian
ce
an
d
p
r
o
f
ess
io
n
al
h
elp
a
r
e
less
f
r
eq
u
en
tly
u
tili
ze
d
.
T
ab
le
1
.
C
h
ar
ac
ter
is
tics
o
f
p
ar
ticip
an
ts
V
a
r
i
a
b
l
e
N
%
A
g
e
2
0
.
1
9
±
5
.
2
9
—
G
e
n
d
e
r
M
a
l
e
40
1
0
.
8
F
e
mal
e
3
3
0
8
9
.
2
P
l
a
c
e
o
f
r
e
si
d
e
n
c
e
U
r
b
a
n
a
r
e
a
3
4
0
9
1
.
9
R
u
r
a
l
a
r
e
a
30
8
.
1
Li
v
i
n
g
si
t
u
a
t
i
o
n
(
i
n
r
e
l
a
t
i
o
n
t
o
f
a
mi
l
y
)
Li
v
i
n
g
n
e
a
r
f
a
mi
l
y
2
2
5
6
0
.
8
Li
v
i
n
g
a
w
a
y
f
r
o
m fam
i
l
y
1
4
5
3
9
.
2
W
h
a
t
k
i
n
d
o
f
d
i
f
f
i
c
u
l
t
i
e
s
d
o
y
o
u
f
a
c
e
i
n
d
a
i
l
y
l
i
f
e
?
Ec
o
n
o
mi
c
1
8
9
5
1
.
1
C
u
l
t
u
r
a
l
23
6
.
2
S
o
c
i
a
l
50
1
3
.
5
O
t
h
e
r
1
0
8
2
9
.
2
H
a
v
e
y
o
u
i
n
t
e
g
r
a
t
e
d
i
n
t
o
y
o
u
r
n
e
w
u
n
i
v
e
r
si
t
y
c
o
mm
u
n
i
t
y
?
N
o
t
a
t
a
l
l
42
1
1
.
4
A
l
i
t
t
l
e
1
9
6
5
3
.
0
V
e
r
y
m
u
c
h
1
3
2
3
5
.
7
W
h
e
r
e
d
o
y
o
u
se
e
k
h
e
l
p
w
h
e
n
f
e
e
l
i
n
g
e
mo
t
i
o
n
a
l
l
y
d
i
s
t
r
e
sse
d
?
M
y
s
e
l
f
77
2
0
.
8
F
a
mi
l
y
1
6
5
4
4
.
6
F
r
i
e
n
d
s
1
0
6
2
8
.
6
O
t
h
e
r
(
e
.
g
.
,
p
s
y
c
h
o
l
o
g
i
s
t
)
22
5
.
9
3
.
2
.
Resul
t
s
o
f
ASRS
s
y
m
pto
m
le
v
els
T
a
b
le
2
s
h
o
ws
t
h
e
d
is
t
r
i
b
u
ti
o
n
o
f
ADH
D
s
y
m
p
t
o
m
s
e
v
er
it
y
b
ase
d
o
n
ASR
S v
1
.
1
s
c
r
ee
n
i
n
g
,
in
cl
u
d
i
n
g
p
a
r
t
A
(
cr
ite
r
i
o
n
s
y
m
p
to
m
s
)
,
p
a
r
t
B
(
a
d
d
it
io
n
a
l
s
y
m
p
to
m
s
)
,
an
d
t
h
e
c
o
m
b
in
ed
t
o
t
al
AS
R
S
s
c
o
r
e.
O
v
e
r
a
ll
,
th
e
m
aj
o
r
it
y
o
f
p
a
r
t
ici
p
a
n
ts
we
r
e
class
if
ie
d
wi
th
in
t
h
e
l
o
w
er
s
y
m
p
t
o
m
c
ate
g
o
r
ies ac
r
o
s
s
al
l A
SR
S
c
o
m
p
o
n
e
n
ts
.
I
n
p
a
r
t
A
,
wh
ic
h
e
v
al
u
a
tes
c
o
r
e
ADHD
s
y
m
p
t
o
m
s
,
6
0
.
3
%
o
f
p
a
r
ti
ci
p
a
n
ts
we
r
e
c
at
eg
o
r
i
ze
d
as
h
av
in
g
l
o
w
s
y
m
p
t
o
m
le
v
e
ls
.
A
s
i
m
il
ar
p
a
tt
er
n
was
o
b
s
e
r
v
e
d
f
o
r
p
a
r
t
B
,
w
h
e
r
e
6
0
.
0
%
o
f
s
t
u
d
e
n
ts
f
el
l
in
t
o
t
h
e
l
o
w
c
ate
g
o
r
y
.
W
h
e
n
c
o
n
s
i
d
e
r
i
n
g
t
h
e
to
tal
A
SR
S
s
co
r
e
,
t
h
is
p
r
o
p
o
r
ti
o
n
i
n
c
r
e
ase
d
t
o
6
5
.
7
%,
i
n
d
ic
ati
n
g
t
h
at
n
ea
r
l
y
tw
o
-
th
ir
d
s
o
f
th
e
s
a
m
p
le
e
x
h
ib
ite
d
m
i
n
i
m
al
ADHD
-
r
el
ate
d
s
y
m
p
to
m
s
.
T
h
e
m
il
d
t
o
m
o
d
er
ate
s
y
m
p
t
o
m
c
ate
g
o
r
y
ac
c
o
u
n
te
d
f
o
r
a
p
p
r
o
x
im
ate
ly
o
n
e
-
q
u
ar
t
e
r
o
f
th
e
p
a
r
ti
ci
p
a
n
t
s
in
b
o
t
h
p
a
r
t
A
(
2
7
.
8
%
)
an
d
p
a
r
t
B
(
2
7
.
6
%)
.
Ho
w
ev
er
,
a
l
o
w
er
p
e
r
c
e
n
ta
g
e
(
2
1
.
6
%
)
f
el
l
in
to
t
h
is
ca
t
e
g
o
r
y
ac
c
o
r
d
in
g
t
o
t
h
e
t
o
t
al
s
c
o
r
e
,
s
u
g
g
esti
n
g
t
h
at
s
o
m
e
in
d
i
v
i
d
u
als
wit
h
m
i
ld
s
y
m
p
t
o
m
s
i
n
o
n
e
s
u
b
s
ca
l
e
d
i
d
n
o
t
r
e
tai
n
t
h
e
s
a
m
e
cl
ass
i
f
ic
ati
o
n
w
h
e
n
b
o
t
h
s
u
b
s
c
ales
wer
e
c
o
m
b
i
n
e
d
.
H
ig
h
er
s
y
m
p
t
o
m
l
ev
els
we
r
e
l
ess
co
m
m
o
n
.
Sp
e
ci
f
ic
all
y
,
h
i
g
h
s
y
m
p
to
m
s
e
v
e
r
it
y
was
r
e
p
o
r
t
e
d
in
9
%
o
f
p
ar
t
ici
p
an
ts
i
n
p
a
r
t
A
a
n
d
6
.
5
%
i
n
p
a
r
t
B
,
w
h
il
e
8
.
1
%
w
er
e
c
lass
i
f
i
ed
as
h
i
g
h
b
ase
d
o
n
th
e
t
o
t
al
ASR
S
s
co
r
e
.
A
s
m
a
ll
b
u
t
n
o
ta
b
l
e
p
r
o
p
o
r
ti
o
n
o
f
s
t
u
d
e
n
ts
d
e
m
o
n
s
tr
ate
d
v
e
r
y
h
i
g
h
s
y
m
p
t
o
m
le
v
e
l
s
:
2
.
9
%
i
n
p
a
r
t
A
,
5
.
9
%
i
n
p
a
r
t
B
,
a
n
d
4
.
6
%
w
h
e
n
c
o
n
s
i
d
e
r
i
n
g
t
h
e
to
tal
s
co
r
e.
T
h
es
e
f
i
n
d
i
n
g
s
r
ef
l
ec
t th
e
d
is
t
r
i
b
u
ti
o
n
o
f
s
c
r
e
e
n
i
n
g
-
p
o
s
iti
v
e
ADH
D
s
y
m
p
t
o
m
l
ev
e
ls
r
at
h
e
r
t
h
a
n
t
h
e
p
r
e
v
a
le
n
c
e
o
f
c
li
n
ic
all
y
d
i
a
g
n
o
s
e
d
ADHD
.
All
c
o
m
p
o
n
en
ts
o
f
th
e
ASR
S h
ad
a
to
tal
v
alid
r
esp
o
n
s
e
co
u
n
t o
f
3
7
0
s
tu
d
en
ts
,
e
n
s
u
r
in
g
co
n
s
is
ten
cy
ac
r
o
s
s
th
e
ass
es
s
m
en
t
.
T
ab
le
2
.
Dis
tr
ib
u
tio
n
o
f
ADH
D
s
y
m
p
to
m
lev
els
(
ASR
S v
1
.
1
s
cr
ee
n
in
g
)
A
S
R
S
l
e
v
e
l
s
C
r
i
t
e
r
i
o
n
(
P
a
r
t
A
)
(
0
-
2
4
)
A
d
d
i
t
i
o
n
a
l
s
y
m
p
t
o
ms (
P
a
r
t
B
)
To
t
a
l
sc
o
r
e
A
S
R
S
N
%
N
%
N
%
Lo
w
2
2
3
6
0
.
3
2
2
2
6
0
.
0
2
4
3
6
5
.
7
M
i
l
d
t
o
m
o
d
e
r
a
t
e
1
0
3
2
7
.
8
1
0
2
2
7
.
6
80
2
1
.
6
H
i
g
h
33
9
.
0
24
6
.
5
30
8
.
1
V
e
r
y
h
i
g
h
11
2
.
9
22
5
.
9
17
4
.
6
To
t
a
l
3
7
0
1
0
0
3
7
0
1
0
0
3
7
0
1
0
0
3
.
3
.
Resul
t
s
o
n
g
ender
diff
er
ence
s
in ASR
S
s
co
re
s
T
ab
le
3
p
r
esen
ts
th
e
co
m
p
ar
is
o
n
o
f
ASR
S
s
co
r
es
b
etwe
e
n
m
ale
an
d
f
em
ale
p
ar
ticip
a
n
ts
ac
r
o
s
s
p
ar
t
A
(
c
r
iter
io
n
s
y
m
p
to
m
s
)
,
p
ar
t
B
(
a
d
d
itio
n
al
s
y
m
p
t
o
m
s
)
,
an
d
th
e
t
o
tal
ADHD
s
co
r
e.
Ov
er
all,
n
o
s
tatis
t
ically
s
ig
n
if
ican
t
g
en
d
er
d
if
f
er
en
ce
s
wer
e
o
b
s
er
v
e
d
in
an
y
o
f
th
e
ASR
S
co
m
p
o
n
en
ts
.
Fo
r
p
ar
t
A,
m
ales
h
ad
a
m
ea
n
s
co
r
e
o
f
7
.
9
5
(
SD=4
.
3
7
)
,
wh
ile
f
em
ales
h
a
d
a
s
lig
h
tly
h
ig
h
er
m
ea
n
s
co
r
e
o
f
8
.
7
6
(
SD=4
.
3
3
)
.
Ho
wev
er
,
th
is
d
if
f
er
en
ce
was
n
o
t
s
tatis
tically
s
ig
n
if
ican
t
(
F=0
.
0
6
1
,
p
=
0
.
8
0
5
)
.
A
s
im
ilar
p
atter
n
was
f
o
u
n
d
in
Evaluation Warning : The document was created with Spire.PDF for Python.
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2
2
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al
&
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es E
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c
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15
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2232
p
ar
t
B
.
Ma
le
p
ar
ticip
an
ts
r
ep
o
r
ted
a
m
ea
n
s
co
r
e
o
f
1
5
.
8
5
(
S
D=
7
.
4
5
)
,
c
o
m
p
ar
e
d
with
1
8
.
4
0
(
SD=8
.
5
0
)
am
o
n
g
f
em
ale
p
ar
ticip
an
ts
,
an
d
th
is
d
if
f
er
en
ce
was
also
n
o
t
s
tatis
tically
s
ig
n
if
ican
t
(
F=1
.
3
7
0
,
p
=0
.
2
4
3
)
.
W
h
en
an
aly
zin
g
t
h
e
t
o
tal
ADHD
s
co
r
e,
m
ales
o
b
tain
e
d
a
m
ea
n
o
f
2
3
.
8
0
(
SD=1
1
.
3
1
)
,
wh
er
ea
s
f
e
m
ales
s
co
r
ed
2
7
.
1
6
(
SD=1
1
.
9
4
)
.
Desp
ite
th
e
h
ig
h
er
av
er
ag
e
s
co
r
e
am
o
n
g
f
e
m
ales,
th
e
d
if
f
er
en
ce
d
i
d
n
o
t
r
ea
ch
s
tatis
tica
l
s
ig
n
if
ican
ce
(
F=0
.
2
7
4
,
p
=
0
.
6
0
1
)
.
Alth
o
u
g
h
f
e
m
ale
p
ar
ticip
a
n
ts
ex
h
ib
ited
h
ig
h
er
m
ea
n
s
co
r
es
ac
r
o
s
s
all
AS
R
S
d
o
m
ain
s
,
th
ese
d
if
f
er
en
ce
s
d
id
n
o
t
r
ea
ch
s
tatis
tical
s
ig
n
if
ican
ce
,
in
d
icatin
g
co
m
p
a
r
ab
l
e
lev
els
o
f
ADH
D
s
y
m
p
to
m
s
ev
er
ity
b
etwe
en
m
ale
an
d
f
em
ale
s
tu
d
en
ts
in
th
e
p
r
esen
t
s
am
p
le.
I
t
s
h
o
u
ld
b
e
n
o
ted
,
h
o
wev
er
,
th
at
th
e
m
ale
s
u
b
s
am
p
le
(
n
=4
0
)
w
as
co
n
s
id
er
ab
ly
s
m
aller
th
a
n
t
h
e
f
em
ale
g
r
o
u
p
(
n
=3
3
0
)
,
wh
i
ch
m
ay
h
a
v
e
lim
ited
s
tatis
t
ical
p
o
wer
to
d
etec
t
s
u
b
t
le
g
en
d
er
-
r
elate
d
d
if
f
er
e
n
ce
s
.
Acc
o
r
d
in
g
ly
,
th
ese
f
in
d
in
g
s
s
h
o
u
ld
b
e
in
ter
p
r
eted
with
ca
u
tio
n
,
an
d
f
u
t
u
r
e
s
tu
d
ie
s
with
lar
g
er
an
d
m
o
r
e
b
alan
c
ed
g
en
d
er
d
is
tr
ib
u
tio
n
s
ar
e
r
ec
o
m
m
en
d
e
d
.
T
ab
le
3
.
Gen
d
er
d
if
f
er
en
ce
s
in
ASR
S
s
co
r
es
V
a
r
i
a
b
l
e
M
a
l
e
(
M
e
a
n
±
S
D
)
F
e
mal
e
(
M
e
a
n
±
S
D
)
F
S
i
g
.
(
p
-
v
a
l
u
e
)
P
a
r
t
A
7
.
9
5
±
4
.
3
7
8
.
7
6
±
4
.
3
3
0
.
0
6
1
0
.
8
0
5
P
a
r
t
B
1
5
.
8
5
±
7
.
4
5
1
8
.
4
0
±
8
.
5
0
1
.
3
7
0
0
.
2
4
3
To
t
a
l
A
D
H
D
2
3
.
8
0
±
1
1
.
3
1
2
7
.
1
6
±
1
1
.
9
4
0
.
2
7
4
0
.
6
0
1
3
.
4
.
Resul
t
s
o
n
t
he
a
s
s
o
cia
t
io
n
o
f
ADH
D
s
y
m
pto
m
lev
els
wit
h
s
o
cio
dem
o
g
ra
ph
ic
a
nd
ps
y
cho
s
o
cia
l
f
a
ct
o
rs
T
ab
le
4
p
r
esen
ts
ADHD
s
y
m
p
to
m
lev
els
(
lo
w,
m
ild
to
m
o
d
er
ate,
h
ig
h
,
v
er
y
h
ig
h
)
ac
r
o
s
s
s
o
cio
d
em
o
g
r
ap
h
ic
a
n
d
p
s
y
ch
o
s
o
cial
v
ar
iab
les,
in
clu
d
i
n
g
χ²
an
d
p
-
v
alu
es.
T
h
er
e
was
a
s
ig
n
if
ican
t
ass
o
ciatio
n
b
etwe
en
s
o
u
r
ce
o
f
e
m
o
tio
n
al
s
u
p
p
o
r
t
a
n
d
ADHD
s
y
m
p
to
m
s
ev
er
ity
(
χ²=
2
2
.
1
1
8
,
p
=0
.
0
0
9
)
.
Am
o
n
g
s
tu
d
en
ts
r
ely
in
g
o
n
th
em
s
elv
es
(
n
=7
7
)
,
5
0
.
6
%
wer
e
lo
w,
2
6
.
0
%
m
ild
to
m
o
d
er
ate,
1
3
.
0
%
h
i
g
h
,
an
d
1
0
.
4
%
v
e
r
y
h
ig
h
.
T
h
o
s
e
s
ee
k
in
g
f
am
ily
s
u
p
p
o
r
t
(
n
=1
6
5
)
h
ad
7
1
.
5
%
lo
w,
2
0
.
6
%
m
ild
to
m
o
d
er
ate,
6
.
1
%
h
ig
h
,
an
d
1
.
8
%
v
er
y
h
ig
h
s
y
m
p
to
m
s
.
Stu
d
en
ts
tu
r
n
in
g
t
o
f
r
ien
d
s
(
n
=1
0
6
)
r
e
p
o
r
ted
7
1
.
7
%
l
o
w,
1
7
.
0
%
m
ild
to
m
o
d
e
r
ate,
6
.
6
%
h
ig
h
,
an
d
4
.
7
%
v
er
y
h
ig
h
,
wh
er
ea
s
th
o
s
e
u
s
in
g
o
th
er
s
o
u
r
c
es
s
u
ch
as
p
s
y
ch
o
lo
g
is
ts
(
n
=2
2
)
h
ad
4
5
.
5
%
lo
w,
3
6
.
4
%
m
ild
to
m
o
d
e
r
ate,
1
3
.
6
%
h
ig
h
,
an
d
4
.
5
%
v
er
y
h
ig
h
.
T
h
ese
r
esu
lts
h
ig
h
lig
h
t
th
at
r
ely
in
g
o
n
th
e
m
s
elv
es
o
r
lim
ited
s
u
p
p
o
r
t is ass
o
ciate
d
with
h
ig
h
e
r
ADHD
s
y
m
p
to
m
s
,
wh
ile
f
am
ily
s
u
p
p
o
r
t is p
r
o
tectiv
e.
T
ab
le
4
.
Dis
tr
ib
u
tio
n
o
f
ADH
D
s
y
m
p
to
m
s
ev
er
ity
b
y
s
o
cio
d
em
o
g
r
ap
h
ic
an
d
p
s
y
ch
o
s
o
cial
f
ac
to
r
s
V
a
r
i
a
b
l
e
C
a
t
e
g
o
r
y
Lo
w
M
i
l
d
t
o
m
o
d
e
r
a
t
e
H
i
g
h
V
e
r
y
h
i
g
h
χ²
p
-
v
a
l
u
e
To
t
a
l
W
h
e
r
e
d
o
y
o
u
se
e
k
h
e
l
p
w
h
e
n
e
m
o
t
i
o
n
a
l
l
y
d
i
st
r
e
sse
d
?
S
e
l
f
39
20
10
8
2
2
.
1
1
8
0
.
0
0
9
77
F
a
mi
l
y
1
1
8
34
10
3
—
—
1
6
5
F
r
i
e
n
d
s
76
18
7
5
—
—
1
0
6
O
t
h
e
r
10
8
3
1
—
—
22
H
a
v
e
y
o
u
i
n
t
e
g
r
a
t
e
d
w
i
t
h
y
o
u
r
n
e
w
u
n
i
v
e
r
s
i
t
y
p
e
e
r
s?
N
o
t
a
t
a
l
l
31
6
3
2
3
.
5
8
5
0
.
7
3
3
42
A
l
i
t
t
l
e
1
2
2
46
17
11
—
—
1
9
6
V
e
r
y
m
u
c
h
90
28
10
4
—
—
1
3
2
D
i
f
f
i
c
u
l
t
i
e
s
e
n
c
o
u
n
t
e
r
e
d
i
n
d
a
i
l
y
l
i
f
e
Ec
o
n
o
mi
c
1
1
0
47
16
16
1
9
.
7
0
2
0
.
0
2
1
8
9
C
u
l
t
u
r
a
l
17
3
2
1
—
—
23
S
o
c
i
a
l
35
10
5
0
—
—
50
O
t
h
e
r
81
20
7
0
—
—
1
0
8
Li
v
i
n
g
si
t
u
a
t
i
o
n
N
e
a
r
f
a
m
i
l
y
1
4
4
54
19
8
3
.
1
7
7
0
.
3
6
5
2
2
5
A
w
a
y
f
r
o
m fam
i
l
y
99
26
11
9
—
—
1
4
5
R
e
si
d
e
n
c
e
U
r
b
a
n
2
2
9
69
26
16
6
.
4
2
6
0
.
0
9
3
3
4
0
R
u
r
a
l
14
11
4
1
—
—
30
G
e
n
d
e
r
M
a
l
e
30
6
3
1
1
.
9
5
2
0
.
5
8
2
40
F
e
mal
e
2
1
3
74
27
16
—
—
3
3
0
R
eg
ar
d
in
g
p
ee
r
in
teg
r
atio
n
,
n
o
s
ig
n
if
ican
t
ass
o
ciatio
n
was
o
b
s
er
v
ed
(
χ²=
3
.
5
8
5
,
p
=0
.
7
3
3
)
.
Stu
d
en
ts
r
ep
o
r
tin
g
n
o
t
at
all
in
teg
r
ated
(
n
=4
2
)
wer
e
7
3
.
8
%
lo
w,
1
4
.
3
%
m
ild
to
m
o
d
e
r
ate,
7
.
1
%
h
ig
h
,
an
d
4
.
8
%
v
e
r
y
h
ig
h
.
T
h
o
s
e
with
a
litt
le
in
teg
r
atio
n
(
n
=
1
9
6
)
h
ad
6
2
.
2
%
lo
w,
2
3
.
5
%
m
ild
t
o
m
o
d
er
ate,
8
.
7
%
h
ig
h
,
a
n
d
5
.
6
%
v
er
y
h
ig
h
,
wh
ile
v
er
y
m
u
ch
in
teg
r
atio
n
(
n
=
1
3
2
)
s
h
o
wed
6
8
.
2
%
lo
w,
2
1
.
2
%
m
ild
to
m
o
d
e
r
ate,
7
.
6
%
h
ig
h
,
an
d
3
.
0
% v
er
y
h
ig
h
.
Peer
in
teg
r
atio
n
ap
p
ea
r
s
n
o
t to
s
ig
n
if
ican
tly
in
f
lu
en
ce
ADHD
s
y
m
p
to
m
lev
els.
E
co
n
o
m
ic
d
if
f
ic
u
lties
(
n
=1
8
9
)
wer
e
s
ig
n
if
ican
tly
ass
o
ciate
d
with
ADHD
s
y
m
p
to
m
s
(
χ²=
1
9
.
7
0
2
,
p
=0
.
0
2
)
,
with
5
8
.
2
% lo
w,
2
4
.
9
% m
ild
to
m
o
d
er
ate,
an
d
1
6
.
9
% h
ig
h
/v
er
y
h
ig
h
.
C
u
ltu
r
al
(
n
=2
3
)
,
s
o
cial
(
n
=5
0
)
,
an
d
o
t
h
er
d
i
f
f
icu
lties
(
n
=1
0
8
)
wer
e
n
o
t
s
ig
n
if
ica
n
tly
ass
o
ciate
d
,
in
d
icatin
g
ec
o
n
o
m
ic
s
tr
ess
is
a
m
o
r
e
r
elev
an
t
f
ac
to
r
f
o
r
ADHD
-
r
elate
d
b
e
h
av
io
r
s
.
L
iv
in
g
n
ea
r
v
s
.
awa
y
f
r
o
m
f
am
ily
(
χ²=
3
.
1
7
7
,
p
=0
.
3
6
5
)
,
r
esid
en
ce
in
u
r
b
an
v
s
.
r
u
r
al
ar
ea
s
(
χ²=
6
.
4
2
6
,
p
=0
.
0
9
3
)
,
an
d
g
en
d
e
r
(
χ²=
1
.
9
5
2
,
p
=0
.
5
8
2
)
wer
e
n
o
t
s
ig
n
if
ican
tly
r
elate
d
to
Evaluation Warning : The document was created with Spire.PDF for Python.
I
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J
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2252
-
8
8
2
2
P
r
ev
a
len
ce
a
n
d
s
o
cio
-
d
emo
g
r
a
p
h
ic
co
r
r
ela
tes o
f a
tten
tio
n
-
d
eficit/h
yp
era
ctivity
…
(
F
lo
r
a
Zeq
a
j La
mçja
)
2233
ADHD
s
y
m
p
to
m
lev
els,
with
m
o
s
t
s
tu
d
en
ts
in
all
ca
teg
o
r
ies
class
if
ied
as
lo
w.
I
t
s
h
o
u
l
d
b
e
n
o
ted
th
at
s
ev
er
al
s
u
b
g
r
o
u
p
s
wer
e
r
elativ
ely
s
m
all
(
e.
g
.
,
m
ale
p
a
r
ticip
an
ts
,
r
u
r
al
r
esid
en
ce
,
cu
ltu
r
al
d
if
f
ic
u
lties
,
an
d
“o
t
h
er
”
s
o
u
r
ce
s
o
f
em
o
tio
n
al
s
u
p
p
o
r
t)
,
wh
ich
m
ay
h
av
e
r
esu
lted
in
lo
w
ex
p
ec
ted
ce
ll
f
r
eq
u
en
cies
an
d
p
ar
tial
v
io
latio
n
s
o
f
ch
i
-
s
q
u
ar
e
test
ass
u
m
p
tio
n
s
.
C
o
n
s
eq
u
en
tly
,
th
ese
ass
o
ciatio
n
s
s
h
o
u
ld
b
e
in
ter
p
r
eted
wit
h
ca
u
tio
n
.
Fu
tu
r
e
s
tu
d
ies
with
l
ar
g
er
a
n
d
m
o
r
e
e
v
en
ly
d
is
tr
ib
u
ted
s
u
b
g
r
o
u
p
s
izes
ar
e
r
ec
o
m
m
en
d
ed
to
c
o
n
f
ir
m
th
e
r
o
b
u
s
tn
ess
o
f
th
ese
f
in
d
in
g
s
.
3
.
5
.
Resul
t
s
o
n t
he
f
re
qu
e
ncy
o
f
ADH
D
-
re
la
t
ed
beha
v
io
rs a
mo
ng
s
t
ud
ent
s
A
s
u
b
s
tan
tial
p
r
o
p
o
r
tio
n
o
f
s
tu
d
en
ts
r
e
p
o
r
ted
ch
allen
g
es
in
atten
tio
n
an
d
o
r
g
a
n
izatio
n
,
as
s
h
o
wn
in
T
ab
le
5
.
Sp
ec
if
ically
,
3
9
.
6
%
s
o
m
etim
es
ex
p
er
ien
ce
d
t
r
o
u
b
le
f
in
is
h
in
g
f
in
al
p
r
o
ject
d
etails,
an
d
3
9
.
1
%
s
o
m
etim
es
r
ep
o
r
ted
d
if
f
ic
u
lty
o
r
g
a
n
izin
g
task
s
.
Dif
f
icu
lty
m
ain
tain
in
g
atten
tio
n
d
u
r
in
g
b
o
r
i
n
g
task
s
was
s
o
m
etim
es
r
ep
o
r
ted
b
y
3
2
.
4
%
,
wh
ile
3
5
.
6
%
r
e
p
o
r
te
d
d
if
f
icu
lty
co
n
ce
n
tr
atin
g
o
n
wh
at
o
t
h
er
s
s
ay
.
Pro
b
lem
s
r
em
em
b
er
in
g
ap
p
o
in
tm
e
n
ts
wer
e
s
o
m
etim
es
r
ep
o
r
ted
b
y
2
1
.
8
%
o
f
s
tu
d
en
ts
,
in
d
icatin
g
t
h
at
atten
tio
n
al
an
d
m
em
o
r
y
-
r
elate
d
ch
allen
g
es a
r
e
co
m
m
o
n
in
th
is
p
o
p
u
latio
n
.
Hy
p
er
ac
tiv
e
b
eh
a
v
io
r
s
wer
e
p
r
ev
alen
t.
Fid
g
etin
g
wh
ile
s
ea
ted
was
r
ep
o
r
ted
s
o
m
etim
es
b
y
3
9
.
1
%,
o
f
ten
b
y
1
3
.
6
%,
a
n
d
v
er
y
o
f
ten
b
y
1
3
.
6
%
o
f
s
tu
d
en
ts
.
Fe
elin
g
o
v
er
ly
ac
tiv
e
was
r
ep
o
r
ted
s
o
m
etim
es
b
y
2
4
.
2
%,
an
d
d
if
f
icu
lty
u
n
win
d
i
n
g
o
r
r
elax
in
g
was
r
e
p
o
r
ted
s
o
m
etim
es
b
y
2
8
.
2
%,
with
2
2
.
9
%
ex
p
er
ien
ci
n
g
t
h
is
v
er
y
o
f
ten
.
T
h
ese
r
esu
lts
s
u
g
g
est
th
at
a
n
o
tab
le
p
r
o
p
o
r
ti
o
n
o
f
s
tu
d
en
ts
d
is
p
lay
h
y
p
er
ac
tiv
e
an
d
r
estl
ess
b
eh
av
io
r
s
r
e
g
u
lar
ly
.
I
m
p
u
ls
iv
e
an
d
s
o
cially
d
is
r
u
p
tiv
e
b
eh
av
i
o
r
s
wer
e
also
e
v
id
en
t.
T
alk
in
g
ex
ce
s
s
iv
ely
in
s
o
cial
s
itu
atio
n
s
was
r
ep
o
r
ted
s
o
m
etim
es
b
y
3
6
.
4
%,
f
in
is
h
in
g
o
th
e
r
s
’
s
en
ten
ce
s
b
y
2
8
.
2
%,
an
d
d
i
f
f
icu
lty
waitin
g
f
o
r
o
n
e’
s
tu
r
n
b
y
3
7
.
8
%
o
f
s
tu
d
e
n
ts
.
I
n
ter
r
u
p
tin
g
o
th
e
r
s
o
cc
u
r
r
ed
s
o
m
etim
es
in
1
7
.
3
%
o
f
ca
s
es,
d
em
o
n
s
tr
atin
g
th
at
im
p
u
ls
iv
ity
af
f
ec
ts
a
s
ig
n
if
ican
t
s
u
b
s
et
o
f
s
tu
d
en
ts
.
Dis
tr
ac
tib
ilit
y
was
p
ar
ticu
lar
ly
p
r
o
n
o
u
n
ce
d
.
B
ein
g
d
is
tr
ac
ted
b
y
ac
tiv
ity
o
r
n
o
is
e
was
r
ep
o
r
ted
as
o
cc
u
r
r
in
g
o
f
te
n
o
r
v
er
y
o
f
te
n
b
y
5
0
%
o
f
s
tu
d
en
ts
,
h
ig
h
lig
h
tin
g
th
at
ex
ter
n
al
s
tim
u
lu
s
s
u
b
s
tan
tially
in
ter
f
er
e
with
atten
tio
n
a
n
d
task
p
er
f
o
r
m
a
n
ce
.
T
ab
le
5
.
ADHD
s
y
m
p
to
m
b
eh
av
io
r
s
: f
r
eq
u
en
cy
a
m
o
n
g
s
tu
d
en
ts
I
t
e
m
N
e
v
e
r
%
R
a
r
e
l
y
%
S
o
me
t
i
m
e
s
%
O
f
t
e
n
%
V
e
r
y
o
f
t
e
n
%
Tr
o
u
b
l
e
f
i
n
i
sh
i
n
g
f
i
n
a
l
p
r
o
j
e
c
t
d
e
t
a
i
l
s
53
1
4
.
1
1
3
3
3
5
.
4
1
4
9
3
9
.
6
20
5
.
3
15
4
.
0
D
i
f
f
i
c
u
l
t
y
o
r
g
a
n
i
z
i
n
g
t
a
sk
s
49
1
3
.
0
1
3
6
3
6
.
2
1
4
7
3
9
.
1
21
5
.
6
17
4
.
5
P
r
o
b
l
e
ms r
e
mem
b
e
r
i
n
g
a
p
p
o
i
n
t
me
n
t
s
1
5
6
4
1
.
5
1
0
8
2
8
.
7
82
2
1
.
8
15
4
.
0
9
2
.
4
A
v
o
i
d
i
n
g
t
a
s
k
s r
e
q
u
i
r
i
n
g
t
h
o
u
g
h
t
72
1
9
.
1
1
2
4
3
3
.
0
1
1
8
3
1
.
4
29
7
.
7
27
7
.
2
F
i
d
g
e
t
i
n
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w
h
i
l
e
se
a
t
e
d
30
8
.
0
91
2
4
.
2
1
4
7
3
9
.
1
51
1
3
.
6
51
1
3
.
6
F
e
e
l
i
n
g
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v
e
r
l
y
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c
t
i
v
e
1
0
3
2
7
.
4
1
4
3
3
8
.
0
91
2
4
.
2
10
2
.
7
23
6
.
1
M
a
k
i
n
g
c
a
r
e
l
e
ss m
i
st
a
k
e
s
1
0
2
2
7
.
1
1
3
1
3
4
.
8
96
2
5
.
5
21
5
.
6
20
5
.
3
D
i
f
f
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c
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l
t
y
k
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p
i
n
g
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t
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t
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n
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t
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k
s
64
1
7
.
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5
3
8
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6
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2
2
3
2
.
4
19
5
.
1
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3
D
i
f
f
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c
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l
t
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o
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c
e
n
t
r
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t
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r
s sa
y
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5
.
6
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5
M
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8
78
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25
6
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4
D
i
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t
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t
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25
6
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84
2
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Le
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v
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65
1
7
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3
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7
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3
.
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89
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3
.
7
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29
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7
D
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f
f
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t
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39
1
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8
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6
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2
86
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2
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9
Ta
l
k
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g
t
o
o
m
u
c
h
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n
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u
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t
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o
n
s
50
1
3
.
3
95
2
5
.
3
1
3
7
3
6
.
4
54
1
4
.
4
34
9
.
0
F
i
n
i
sh
i
n
g
o
t
h
e
r
s’
se
n
t
e
n
c
e
s
97
2
5
.
8
1
2
6
3
3
.
5
1
0
6
2
8
.
2
20
5
.
3
21
5
.
6
D
i
f
f
i
c
u
l
t
y
w
a
i
t
i
n
g
t
u
r
n
47
1
2
.
5
1
1
1
2
9
.
5
1
4
2
3
7
.
8
59
1
5
.
7
11
2
.
9
I
n
t
e
r
r
u
p
t
i
n
g
o
t
h
e
r
s
1
4
0
3
7
.
2
1
4
6
3
8
.
8
65
1
7
.
3
12
3
.
2
7
1
.
9
3
.
6
.
Dis
cu
s
s
io
n
Ap
p
r
o
x
im
ately
6
6
%
o
f
s
tu
d
e
n
ts
in
th
e
p
r
esen
t
s
am
p
le
r
e
p
o
r
ted
lo
w
lev
els
o
f
ADHD
s
y
m
p
to
m
s
,
wh
ile
2
1
.
6
%
f
ell
with
in
th
e
m
ild
to
m
o
d
er
ate
r
a
n
g
e
an
d
a
s
m
aller
p
r
o
p
o
r
tio
n
(
4
.
6
–
8
.
1
%)
ex
h
ib
ited
h
ig
h
o
r
v
er
y
h
ig
h
s
y
m
p
to
m
s
ev
er
ity
,
in
d
icatin
g
th
at
a
clin
icall
y
m
ea
n
in
g
f
u
l
s
u
b
g
r
o
u
p
o
f
u
n
iv
er
s
ity
s
tu
d
en
ts
ex
p
er
ien
ce
s
elev
ate
d
ADHD
-
r
elate
d
d
if
f
icu
lties
.
W
ith
in
th
e
Alb
an
ian
co
n
tex
t,
p
er
s
is
ten
t
m
en
tal
h
ea
lth
s
tig
m
a
an
d
th
e
s
o
cial
d
is
co
u
r
ag
em
en
t
o
f
p
s
y
ch
o
lo
g
ical
h
elp
-
s
ee
k
in
g
m
ay
c
o
n
tr
ib
u
te
to
u
n
d
er
d
iag
n
o
s
is
an
d
u
n
d
er
r
ep
o
r
tin
g
o
f
ADHD
s
y
m
p
to
m
s
,
p
ar
ticu
lar
ly
am
o
n
g
s
tu
d
en
ts
with
m
ild
to
m
o
d
er
ate
i
m
p
air
m
en
t
[
5
]
,
[
6
]
.
As
a
r
esu
lt,
m
an
y
s
tu
d
en
ts
r
el
y
p
r
im
ar
ily
o
n
s
elf
-
co
p
in
g
s
tr
ateg
ies
r
ath
er
th
an
p
r
o
f
ess
io
n
al
s
u
p
p
o
r
t.
Stu
d
en
ts
r
ely
in
g
o
n
s
elf
-
co
p
i
n
g
r
e
p
o
r
t
ed
h
ig
h
e
r
s
y
m
p
to
m
lev
els,
s
u
g
g
esti
n
g
a
p
o
ten
tial
ass
o
ciati
o
n
b
etwe
en
lim
ite
d
s
u
p
p
o
r
t
an
d
ADHD
s
y
m
p
to
m
s
,
alth
o
u
g
h
th
e
cr
o
s
s
-
s
ec
tio
n
a
l
d
esig
n
d
o
es
n
o
t
allo
w
d
eter
m
in
atio
n
o
f
ca
u
s
al
r
elatio
n
s
h
ip
s
.
T
h
ese
f
in
d
in
g
s
u
n
d
er
s
co
r
e
th
e
p
o
te
n
tial
im
p
o
r
tan
ce
o
f
cu
ltu
r
ally
s
en
s
itiv
e
in
ter
v
en
tio
n
s
,
in
clu
d
in
g
awa
r
en
ess
ca
m
p
aig
n
s
,
d
esti
g
m
atiza
tio
n
in
itiativ
e
s
,
an
d
t
h
e
d
e
v
elo
p
m
e
n
t
o
f
a
cc
ess
ib
le
ca
m
p
u
s
-
b
ased
p
s
y
ch
o
lo
g
ical
s
er
v
ices.
Evaluation Warning : The document was created with Spire.PDF for Python.
I
SS
N
:
2
2
5
2
-
8
8
2
2
I
n
t
J
E
v
al
&
R
es E
d
u
c
,
Vo
l
.
15
,
No
.
3
,
J
u
n
e
20
2
6
:
2
2
2
8
-
2
2
3
8
2234
No
s
ig
n
if
ican
t
g
e
n
d
er
d
if
f
e
r
en
ce
s
wer
e
o
b
s
er
v
ed
ac
r
o
s
s
ASR
S
p
ar
t
A,
p
ar
t
B
,
o
r
to
tal
s
co
r
es,
s
u
g
g
esti
n
g
co
m
p
ar
ab
le
ADHD
s
y
m
p
to
m
s
ev
er
ity
am
o
n
g
m
ale
an
d
f
em
ale
s
tu
d
en
ts
.
T
h
is
f
in
d
in
g
is
co
n
s
is
ten
t
with
p
r
ev
io
u
s
u
n
iv
er
s
ity
-
b
ase
d
r
esear
ch
[
6
]
an
d
s
u
p
p
o
r
ts
ev
id
en
ce
th
at
g
en
d
er
d
is
p
ar
ities
co
m
m
o
n
l
y
o
b
s
er
v
e
d
in
ch
ild
h
o
o
d
ADHD
ten
d
to
d
im
in
is
h
in
a
d
u
lth
o
o
d
,
p
ar
tic
u
lar
ly
in
h
ig
h
e
r
ed
u
ca
tio
n
s
et
tin
g
s
wh
er
e
s
im
ilar
o
r
g
an
izatio
n
al
an
d
c
o
g
n
itiv
e
d
em
an
d
s
af
f
ec
t
b
o
th
g
en
d
e
r
s
.
T
h
e
o
b
s
er
v
ed
r
ig
h
t
-
s
k
ewe
d
d
is
tr
ib
u
tio
n
o
f
ADHD
s
y
m
p
to
m
s
,
with
a
p
r
e
d
o
m
in
a
n
ce
o
f
lo
w
s
co
r
es,
alig
n
s
with
i
n
ter
n
atio
n
al
ev
i
d
en
ce
in
d
icatin
g
th
at
m
o
s
t
ad
u
lts
r
ep
o
r
t
m
i
n
im
al
o
r
s
u
b
clin
ical
s
y
m
p
to
m
lev
els,
wh
ile
a
s
u
b
s
tan
tial
m
in
o
r
ity
ex
p
er
ien
ce
p
e
r
s
is
ten
t
d
if
f
icu
lties
[
1
5
]
,
[
2
0
]
.
Acr
o
s
s
d
iv
er
s
e
c
u
ltu
r
al
co
n
tex
ts
,
in
clu
d
in
g
W
ester
n
co
u
n
tr
ies,
th
e
Mid
d
le
E
a
s
t,
an
d
So
u
th
Asi
a
,
s
tu
d
ies
c
o
n
s
is
t
e
n
tl
y
r
ep
o
r
t
t
h
at
a
p
p
r
o
x
i
m
at
el
y
o
n
e
-
q
u
ar
te
r
o
f
u
n
i
v
e
r
s
it
y
s
tu
d
en
ts
p
r
ese
n
t
w
it
h
m
il
d
t
o
m
o
d
e
r
at
e
ADHD
s
y
m
p
t
o
m
s
.
P
r
ev
ale
n
c
e
esti
m
a
tes
f
r
o
m
t
h
e
U
n
it
ed
States
a
n
d
t
h
e
N
et
h
e
r
l
an
d
s
s
u
g
g
est
r
e
lat
iv
el
y
l
o
w
r
ates
o
f
f
u
ll
-
s
y
n
d
r
o
m
e
ad
u
lt
ADHD
(
ap
p
r
o
x
im
ately
3
–
4
%),
y
et
a
m
u
ch
lar
g
er
p
r
o
p
o
r
tio
n
ex
p
er
ie
n
ce
im
p
air
in
g
s
y
m
p
to
m
s
b
elo
w
d
iag
n
o
s
tic
th
r
esh
o
l
d
s
[
1
9
]
,
[
2
1
]
.
Similar
p
r
o
p
o
r
tio
n
s
o
f
m
ild
to
m
o
d
er
ate
s
y
m
p
to
m
ato
lo
g
y
h
a
v
e
b
e
en
r
e
p
o
r
t
e
d
a
m
o
n
g
u
n
iv
er
s
it
y
s
t
u
d
e
n
ts
in
Sa
u
d
i
A
r
a
b
ia
a
n
d
P
a
k
is
tan
,
s
u
p
p
o
r
t
in
g
t
h
e
v
iew
th
at
s
u
b
th
r
esh
o
ld
ADHD
s
y
m
p
to
m
s
a
r
e
co
m
m
o
n
ac
r
o
s
s
h
ig
h
er
ed
u
ca
tio
n
s
y
s
tem
s
w
o
r
ld
wid
e
[
2
2
]
,
[
2
3
]
.
T
h
ese
co
n
v
er
g
e
n
t
f
in
d
in
g
s
s
u
g
g
est
th
at,
ir
r
esp
ec
tiv
e
o
f
cu
ltu
r
al
co
n
tex
t,
u
n
i
v
er
s
ity
en
v
ir
o
n
m
e
n
ts
m
ay
b
e
ass
o
ciate
d
with
atten
tio
n
al
an
d
ex
ec
u
tiv
e
f
u
n
ctio
n
in
g
c
h
allen
g
es a
m
o
n
g
a
s
u
b
s
tan
tial m
in
o
r
ity
o
f
s
tu
d
en
ts
.
Sev
er
al
m
ec
h
an
is
m
s
m
ay
h
elp
ex
p
lain
th
ese
p
atter
n
s
.
Selectio
n
ef
f
ec
ts
m
ay
p
ar
tially
ac
co
u
n
t
f
o
r
th
e
p
r
ed
o
m
i
n
an
ce
o
f
lo
w
s
y
m
p
to
m
lev
els,
as
in
d
iv
id
u
als
with
m
o
r
e
s
ev
er
e
ADHD
ar
e
less
lik
ely
to
en
te
r
o
r
p
er
s
is
t
in
u
n
iv
er
s
ity
d
u
e
to
e
ar
lier
ac
ad
em
ic
ch
allen
g
es
o
r
d
r
o
p
o
u
t
[
2
]
.
A
d
d
itio
n
ally
,
s
t
u
d
en
ts
with
ADHD
wh
o
d
o
r
ea
ch
h
ig
h
er
ed
u
ca
ti
o
n
m
ay
em
p
lo
y
co
m
p
e
n
s
ato
r
y
s
tr
ateg
ies,
s
u
ch
as
in
cr
ea
s
ed
ef
f
o
r
t,
s
tr
u
ctu
r
e
d
lear
n
in
g
en
v
ir
o
n
m
e
n
ts
,
o
r
p
h
ar
m
ac
o
lo
g
ical
tr
ea
tm
en
t,
wh
ich
co
u
ld
r
ed
u
ce
o
b
s
er
v
a
b
le
im
p
air
m
en
t
wh
ile
in
cr
ea
s
in
g
co
g
n
itiv
e
an
d
em
o
t
io
n
al
lo
ad
[
2
4
]
.
I
n
c
o
u
n
t
r
ies
with
g
r
ea
ter
awa
r
en
ess
an
d
ac
ce
s
s
to
m
en
tal
h
ea
lth
r
eso
u
r
ce
s
,
s
u
ch
as
th
e
Un
it
ed
States
,
C
an
ad
a,
an
d
th
e
Neth
er
lan
d
s
,
ac
ad
em
ic
ac
co
m
m
o
d
atio
n
s
an
d
p
s
y
ch
o
ed
u
ca
tio
n
al
s
u
p
p
o
r
t
m
ay
f
u
r
th
er
m
itig
ate
f
u
n
ctio
n
al
im
p
air
m
en
t,
p
o
ten
tially
co
n
tr
ib
u
tin
g
to
s
im
ilar
s
y
m
p
to
m
d
is
tr
ib
u
tio
n
s
ac
r
o
s
s
co
n
tex
ts
[
3
]
.
I
m
p
o
r
ta
n
tly
,
th
e
p
r
o
p
o
r
tio
n
o
f
s
tu
d
en
ts
s
co
r
in
g
in
t
h
e
m
ild
t
o
m
o
d
er
ate
r
a
n
g
e
is
clin
ically
r
elev
an
t.
T
h
is
g
r
o
u
p
is
at
elev
ated
r
is
k
f
o
r
ac
ad
em
ic
u
n
d
er
ac
h
iev
em
e
n
t,
ex
ec
u
tiv
e
d
y
s
f
u
n
ctio
n
,
em
o
tio
n
al
d
is
tr
ess
,
an
d
r
ed
u
ce
d
well
-
b
ein
g
[
2
5
]
.
C
o
m
p
ar
ab
le
s
y
m
p
to
m
d
is
tr
ib
u
tio
n
s
h
av
e
b
ee
n
r
ep
o
r
ted
in
u
n
iv
er
s
ity
s
am
p
les
f
r
o
m
th
e
Un
ited
Kin
g
d
o
m
an
d
So
u
t
h
Ko
r
ea
[
2
6
]
,
[
2
7
]
.
Desp
ite
e
x
p
er
ien
cin
g
f
u
n
ctio
n
al
d
if
f
ic
u
lties
,
th
ese
s
tu
d
en
ts
f
r
eq
u
e
n
tly
r
em
ain
u
n
d
iag
n
o
s
ed
an
d
u
n
d
er
s
er
v
ed
,
h
ig
h
lig
h
ti
n
g
th
e
p
o
ten
tial
v
alu
e
o
f
r
o
u
tin
e
s
cr
ee
n
in
g
a
n
d
p
r
o
ac
tiv
e
ac
ad
e
m
ic
s
u
p
p
o
r
t
s
er
v
ices
with
in
u
n
iv
er
s
ity
s
ettin
g
s
[
13
]
.
Alth
o
u
g
h
less
p
r
ev
ale
n
t,
th
e
p
r
esen
ce
o
f
h
ig
h
an
d
v
er
y
h
ig
h
s
y
m
p
to
m
lev
els
in
4
.
6
–
8
.
1
%
o
f
th
e
s
am
p
le
r
em
ain
s
n
o
tewo
r
th
y
,
as
th
e
s
e
in
d
iv
id
u
als
m
ay
m
ee
t
cr
iter
ia
f
o
r
clin
ical
ADHD
an
d
r
e
q
u
ir
e
f
o
r
m
al
d
iag
n
o
s
tic
ev
alu
atio
n
[
13
]
.
Similar
s
y
m
p
to
m
lev
els
h
a
v
e
b
ee
n
d
o
cu
m
e
n
ted
am
o
n
g
u
n
i
v
er
s
ity
s
tu
d
en
ts
in
Ge
r
m
an
y
,
T
u
r
k
e
y
,
a
n
d
C
h
in
a
,
s
u
g
g
esti
n
g
th
at
clin
ically
s
ig
n
if
ican
t
ad
u
lt
ADHD
in
h
ig
h
e
r
ed
u
ca
tio
n
r
ep
r
esen
t
s
a
g
lo
b
al
p
h
e
n
o
m
e
n
o
n
with
im
p
licatio
n
s
f
o
r
ed
u
ca
tio
n
al
p
o
licy
a
n
d
m
en
ta
l
h
ea
lth
p
r
ac
tice
[
28
]
–
[
31
]
.
T
h
e
in
ter
n
al
co
n
s
is
ten
cy
o
b
s
er
v
ed
b
etwe
en
ASR
S
s
u
b
s
ca
les
(
p
ar
t
A
an
d
p
ar
t
B
)
s
u
p
p
o
r
ts
th
e
co
n
s
tr
u
ct
v
a
lid
ity
o
f
th
e
in
s
tr
u
m
e
n
t
with
in
th
is
p
o
p
u
latio
n
,
r
ein
f
o
r
cin
g
its
v
alu
e
as
a
b
r
ief
an
d
co
s
t
-
ef
f
ec
tiv
e
s
cr
ee
n
in
g
t
o
o
l
[
32
]
.
I
ts
cr
o
s
s
-
cu
ltu
r
al
ap
p
licab
ilit
y
h
as
b
ee
n
co
n
f
ir
m
e
d
in
v
alid
atio
n
s
tu
d
ie
s
ac
r
o
s
s
E
u
r
o
p
e
,
Asi
a,
an
d
th
e
Mid
d
le
E
ast,
s
u
p
p
o
r
tin
g
its
s
u
itab
ilit
y
f
o
r
u
s
e
in
d
iv
er
s
e
ed
u
ca
tio
n
al
s
ettin
g
s
[3
3
]
.
Fin
an
cial
s
tr
ess
an
d
r
elian
ce
o
n
s
elf
-
co
p
in
g
wer
e
ass
o
ciate
d
with
h
i
g
h
er
r
ep
o
r
ted
ADHD
s
y
m
p
to
m
lev
els
[
2
2
]
.
E
co
n
o
m
ic
ch
allen
g
es
m
ay
b
e
lin
k
ed
to
atten
tio
n
al
an
d
s
elf
-
r
eg
u
lato
r
y
d
if
f
icu
lt
ies
th
r
o
u
g
h
ch
r
o
n
ic
co
g
n
itiv
e
a
n
d
em
o
tio
n
al
lo
ad
,
an
d
d
elay
e
d
h
elp
-
s
ee
k
in
g
m
a
y
b
e
ass
o
ciate
d
with
in
c
r
ea
s
ed
em
o
tio
n
al
d
is
tr
ess
an
d
s
y
m
p
t
o
m
p
e
r
s
is
ten
ce
,
alth
o
u
g
h
ca
u
s
al
r
elatio
n
s
h
ip
s
ca
n
n
o
t
b
e
in
f
e
r
r
ed
f
r
o
m
th
is
cr
o
s
s
-
s
ec
tio
n
al
s
tu
d
y
[3
4
]
,
[
3
5
]
.
B
r
o
a
d
er
s
o
cio
cu
lt
u
r
al
an
d
ec
o
n
o
m
ic
s
tr
ess
o
r
s
in
Alb
an
ia,
in
clu
d
in
g
p
o
s
t
-
co
m
m
u
n
is
t
ec
o
n
o
m
ic
tr
an
s
itio
n
s
,
lim
ited
em
p
lo
y
m
e
n
t
o
p
p
o
r
tu
n
ities
,
r
estricte
d
s
o
cial
m
o
b
ilit
y
,
an
d
m
ig
r
atio
n
-
r
el
ated
p
r
ess
u
r
es
m
ay
f
u
r
th
er
i
n
ter
ac
t
with
atten
tio
n
al
an
d
s
elf
-
r
eg
u
lato
r
y
v
u
ln
e
r
a
b
ilit
ies.
I
n
co
n
tr
ast,
h
y
p
o
th
es
es
r
eg
ar
d
in
g
liv
in
g
awa
y
f
r
o
m
f
am
ily
an
d
p
ee
r
i
n
teg
r
atio
n
wer
e
n
o
t
s
u
p
p
o
r
ted
,
as
n
o
s
ig
n
if
ican
t
ass
o
ciatio
n
s
wer
e
o
b
s
er
v
e
d
in
th
is
s
am
p
le.
T
h
ese
n
u
ll
f
in
d
in
g
s
s
u
g
g
est
th
at,
in
th
is
co
n
tex
t
,
p
r
o
x
im
ity
to
f
am
ily
o
r
s
o
cial
in
teg
r
atio
n
m
ay
b
e
less
r
elev
an
t to
ADHD
s
y
m
p
to
m
s
ev
er
ity
th
a
n
f
in
an
cial
s
tr
e
s
s
o
r
co
p
in
g
s
tr
ateg
ies.
W
h
ile
q
u
an
titativ
e
s
cr
ee
n
in
g
t
o
o
ls
s
u
ch
as th
e
ASR
S v
1
.
1
p
r
o
v
id
e
v
alu
a
b
le
ep
id
em
i
o
lo
g
ica
l in
s
ig
h
ts
,
f
u
tu
r
e
q
u
alitativ
e
r
esear
ch
u
s
in
g
in
ter
v
iews
o
r
f
o
c
u
s
g
r
o
u
p
s
co
u
ld
o
f
f
e
r
a
m
o
r
e
n
u
an
ce
d
u
n
d
er
s
tan
d
in
g
o
f
h
o
w
s
tu
d
en
ts
p
e
r
ce
iv
e,
ex
p
er
i
en
ce
,
an
d
m
a
n
ag
e
ADHD
-
r
el
ated
d
if
f
icu
lties
with
in
t
h
is
cu
ltu
r
al
s
ettin
g
[
1
4
]
.
T
h
e
p
r
esen
t f
in
d
i
n
g
s
alig
n
with
in
ter
n
atio
n
al
liter
atu
r
e
in
d
e
m
o
n
s
tr
atin
g
a
r
ig
h
t
-
s
k
ewe
d
d
i
s
tr
ib
u
tio
n
o
f
ADHD
s
y
m
p
to
m
s
am
o
n
g
u
n
iv
e
r
s
ity
s
tu
d
en
ts
,
with
m
o
s
t
r
ep
o
r
ti
n
g
l
o
w
s
y
m
p
to
m
s
ev
er
ity
b
u
t
a
s
u
b
s
tan
tial
m
in
o
r
ity
ex
p
er
ien
cin
g
clin
ically
r
elev
an
t
d
if
f
icu
lties
[
2
3
]
.
T
h
ese
r
esu
lts
h
ig
h
lig
h
t
th
e
n
ee
d
f
o
r
r
o
u
tin
e
s
cr
ee
n
in
g
,
in
cr
ea
s
ed
awa
r
en
ess
,
an
d
th
e
d
ev
elo
p
m
e
n
t
o
f
tar
g
ete
d
ac
ad
em
ic
an
d
p
s
y
ch
o
lo
g
ical
in
ter
v
en
tio
n
s
,
in
cl
u
d
in
g
s
k
ills
-
b
ased
p
r
o
g
r
a
m
s
,
m
en
ta
l
h
ea
lth
liter
ac
y
in
itiativ
es,
p
ee
r
s
u
p
p
o
r
t,
a
n
d
ac
ce
s
s
ib
le
c
o
u
n
s
elin
g
s
er
v
ices.
Evaluation Warning : The document was created with Spire.PDF for Python.
I
n
t
J
E
v
al
&
R
es E
d
u
c
I
SS
N:
2252
-
8
8
2
2
P
r
ev
a
len
ce
a
n
d
s
o
cio
-
d
emo
g
r
a
p
h
ic
co
r
r
ela
tes o
f a
tten
tio
n
-
d
eficit/h
yp
era
ctivity
…
(
F
lo
r
a
Zeq
a
j La
mçja
)
2235
Ad
d
r
ess
in
g
ADHD
with
in
h
ig
h
er
ed
u
ca
tio
n
is
im
p
o
r
tan
t
f
o
r
p
r
o
m
o
tin
g
ac
ad
em
ic
s
u
cc
ess
an
d
m
en
tal
h
ea
lth
eq
u
ity
ac
r
o
s
s
u
n
i
v
er
s
ity
s
y
s
tem
s
[
1
1
]
.
3
.
7
.
Str
eng
t
hs
a
nd
lim
it
a
t
io
ns
T
h
e
m
ain
s
tr
en
g
th
s
o
f
th
is
s
tu
d
y
in
clu
d
e
its
m
eth
o
d
o
lo
g
ical
r
ig
o
r
an
d
r
eg
io
n
al
n
o
v
elty
.
T
h
e
s
u
r
v
ey
em
p
lo
y
ed
a
v
alid
ated
s
cr
ee
n
in
g
in
s
tr
u
m
en
t,
th
e
W
HO
1
8
-
ite
m
ASR
S
v
1
.
1
,
wh
ich
d
em
o
n
s
tr
ated
g
o
o
d
in
ter
n
al
co
n
s
is
ten
cy
in
th
is
s
am
p
le
(
C
r
o
n
b
ac
h
’
s
α
=0
.
8
7
)
[
9
]
.
A
to
tal
o
f
3
7
0
n
u
r
s
in
g
s
tu
d
e
n
ts
p
ar
tic
ip
ated
,
p
r
o
v
id
in
g
a
r
o
b
u
s
t
s
am
p
le
f
o
r
d
escr
ip
tiv
e
an
d
in
f
er
en
tial
an
aly
s
es.
T
h
is
s
tu
d
y
also
r
ep
r
esen
ts
t
h
e
f
ir
s
t
q
u
an
tifie
d
ass
es
s
m
en
t
o
f
ADHD
s
y
m
p
to
m
s
am
o
n
g
u
n
iv
er
s
ity
s
tu
d
en
ts
in
Alb
an
ia,
ad
d
r
ess
in
g
a
n
o
tab
le
g
ap
in
r
esear
ch
o
n
ad
u
lt AD
HD
in
th
e
B
alk
an
s
,
wh
ich
h
as p
r
ed
o
m
in
an
tly
f
o
cu
s
ed
o
n
c
h
ild
r
en
a
n
d
a
d
o
lescen
ts
[
13
].
Desp
ite
th
ese
s
tr
en
g
th
s
,
s
ev
er
al
lim
itatio
n
s
s
h
o
u
ld
b
e
ac
k
n
o
wled
g
ed
.
First,
th
e
cr
o
s
s
-
s
ec
tio
n
al
d
esig
n
p
r
ev
en
ts
in
f
er
e
n
ce
o
f
ca
u
s
al
r
e
latio
n
s
h
ip
s
b
etwe
en
ADHD
s
y
m
p
to
m
s
an
d
ac
a
d
em
ic
o
r
p
s
y
c
h
o
s
o
cial
o
u
tco
m
es
[
13
]
.
Seco
n
d
,
th
e
u
s
e
o
f
s
elf
-
r
ep
o
r
t
d
ata
m
a
y
in
tr
o
d
u
ce
b
ias,
in
clu
d
in
g
u
n
d
e
r
-
o
r
o
v
er
r
ep
o
r
tin
g
o
f
s
y
m
p
t
o
m
s
,
an
d
cu
ltu
r
al
f
ac
to
r
s
m
ay
in
f
l
u
en
ce
item
in
ter
p
r
etatio
n
[
9
]
.
T
h
ir
d
,
alth
o
u
g
h
th
e
s
am
p
le
s
ize
was
ad
eq
u
ate,
p
ar
ticip
an
ts
wer
e
r
ec
r
u
ited
f
r
o
m
o
n
ly
two
u
n
iv
e
r
s
ities
,
wh
i
ch
lim
its
ex
ter
n
al
v
alid
ity
an
d
g
en
er
aliza
b
ilit
y
to
o
th
er
s
tu
d
en
t
p
o
p
u
latio
n
s
an
d
to
n
o
n
-
s
tu
d
en
t
o
r
clin
ical
ad
u
lt
s
am
p
les.
Fo
u
r
th
,
s
tu
d
en
ts
with
a
p
r
io
r
clin
ical
d
iag
n
o
s
is
o
f
ADHD
wer
e
ex
clu
d
ed
f
r
o
m
p
ar
ticip
atio
n
,
wh
ich
m
ay
h
av
e
led
to
a
n
u
n
d
er
esti
m
atio
n
o
f
th
e
o
v
er
all
b
u
r
d
e
n
o
f
ADHD
-
r
elate
d
s
y
m
p
to
m
s
with
in
t
h
e
u
n
iv
er
s
ity
p
o
p
u
latio
n
.
Fin
a
lly
,
th
e
ASR
S
is
a
s
cr
ee
n
in
g
in
s
tr
u
m
e
n
t
r
ath
er
th
an
a
d
iag
n
o
s
tic
to
o
l,
an
d
t
h
e
f
in
d
in
g
s
s
h
o
u
ld
n
o
t
b
e
i
n
ter
p
r
eted
as
f
o
r
m
al
ADHD
d
iag
n
o
s
es with
o
u
t c
o
m
p
r
eh
en
s
iv
e
clin
ical
ass
ess
m
en
t [
9
]
.
3
.
8
.
I
m
pli
ca
t
io
ns
f
o
r
f
uture
re
s
ea
rc
h a
nd
pra
ct
ice
T
h
e
f
in
d
in
g
s
h
i
g
h
lig
h
t
th
e
n
ee
d
f
o
r
in
cr
ea
s
ed
atten
tio
n
to
a
d
u
lt
ADHD
with
in
u
n
iv
e
r
s
ity
s
ettin
g
s
in
Alb
an
ia
an
d
th
e
wid
er
B
alk
an
r
eg
io
n
.
E
c
o
n
o
m
ic
s
tr
ess
an
d
lim
ited
s
o
cial
s
u
p
p
o
r
t
wer
e
s
ig
n
if
ican
tly
ass
o
ciate
d
with
h
ig
h
er
ADHD
s
y
m
p
to
m
s
ev
er
ity
,
s
u
g
g
esti
n
g
th
at
tar
g
eted
in
ter
v
en
tio
n
s
a
d
d
r
ess
in
g
f
i
n
an
cial
co
u
n
s
elin
g
an
d
p
ee
r
/f
a
m
ily
s
u
p
p
o
r
t
c
o
u
ld
m
itig
ate
s
y
m
p
to
m
im
p
ac
t
o
n
s
tu
d
e
n
ts
’
ac
ad
em
i
c
p
er
f
o
r
m
an
ce
an
d
well
-
b
ein
g
.
Un
i
v
er
s
ities
s
h
o
u
ld
co
n
s
id
er
im
p
lem
e
n
tin
g
p
s
y
ch
o
ed
u
ca
tio
n
al
p
r
o
g
r
am
s
,
c
o
g
n
itiv
e
-
b
e
h
av
io
r
al
wo
r
k
s
h
o
p
s
,
a
n
d
r
o
u
tin
e
s
cr
ee
n
in
g
in
itiativ
es
to
i
d
en
tify
at
-
r
is
k
s
tu
d
en
ts
ea
r
ly
a
n
d
p
r
o
v
id
e
tailo
r
ed
s
u
p
p
o
r
t.
Facu
lty
tr
ain
in
g
in
r
ec
o
g
n
izi
n
g
ADHD
-
r
elate
d
b
eh
av
io
r
s
an
d
p
r
o
m
o
tin
g
in
clu
s
iv
e
teac
h
in
g
s
tr
ateg
ies
m
ay
f
u
r
th
er
e
n
h
an
ce
s
tu
d
e
n
t
en
g
ag
em
en
t
an
d
ac
ad
em
ic
s
u
cc
ess
.
Fu
tu
r
e
r
esear
ch
s
h
o
u
ld
r
ep
lica
te
th
ese
f
in
d
in
g
s
in
lar
g
er
,
m
u
lti
-
u
n
iv
e
r
s
ity
co
h
o
r
ts
an
d
co
n
s
id
er
lo
n
g
itu
d
in
al
d
e
s
ig
n
s
to
ex
p
lo
r
e
s
y
m
p
to
m
tr
aj
ec
to
r
ies
o
v
er
tim
e.
I
n
co
r
p
o
r
atin
g
co
m
p
r
eh
e
n
s
iv
e
p
s
y
ch
o
lo
g
ical
ass
ess
m
en
ts
an
d
v
alid
atin
g
th
e
ASR
S
in
th
e
Alb
an
ian
co
n
tex
t
will
s
tr
en
g
th
en
th
e
r
eliab
ilit
y
an
d
ap
p
licab
ilit
y
o
f
r
esu
l
ts
.
B
y
ad
d
r
ess
in
g
b
o
th
r
ese
ar
ch
an
d
a
p
p
lied
d
im
en
s
io
n
s
,
th
is
s
tu
d
y
u
n
d
er
s
c
o
r
es th
e
im
p
o
r
tan
ce
o
f
in
teg
r
at
in
g
m
en
tal
h
ea
lth
liter
ac
y
an
d
s
tr
u
ctu
r
ed
s
u
p
p
o
r
t
s
y
s
tem
s
in
to
u
n
iv
er
s
ity
p
o
licies
ac
r
o
s
s
Alb
an
ia
an
d
th
e
B
alk
an
s
,
co
n
tr
ib
u
tin
g
to
ev
id
en
ce
-
b
ased
im
p
r
o
v
em
e
n
ts
in
s
tu
d
en
t m
e
n
tal
h
ea
lth
ca
r
e
[
2
8
]
–
[3
1
]
.
4.
CO
NCLU
SI
O
N
T
h
is
s
tu
d
y
ac
h
iev
ed
its
o
b
je
ctiv
e
o
f
ex
am
i
n
in
g
th
e
d
is
tr
ib
u
tio
n
an
d
co
r
r
elate
s
o
f
ADHD
-
r
elate
d
s
y
m
p
to
m
s
am
o
n
g
Alb
an
ian
u
n
iv
er
s
ity
s
tu
d
en
ts
.
Ap
p
r
o
x
im
ately
2
2
%
o
f
p
ar
ticip
an
t
s
r
ep
o
r
ted
m
ild
t
o
m
o
d
er
ate
lev
els
o
f
ADHD
s
y
m
p
to
m
s
,
wh
ile
1
2
.
7
%
ex
h
ib
ited
h
ig
h
o
r
v
er
y
h
ig
h
s
y
m
p
to
m
lev
els,
with
in
atten
tio
n
,
d
is
tr
ac
tib
ilit
y
,
a
n
d
im
p
u
ls
iv
ity
b
ein
g
t
h
e
m
o
s
t
f
r
eq
u
e
n
tly
r
ep
o
r
ted
f
e
atu
r
es.
Am
o
n
g
th
e
s
o
cio
d
em
o
g
r
ap
h
ic
an
d
p
s
y
ch
o
s
o
cial
f
ac
to
r
s
ex
am
in
ed
,
ec
o
n
o
m
ic
d
if
f
icu
lties
an
d
r
elian
ce
o
n
s
elf
-
co
p
i
n
g
s
tr
ateg
ies
wer
e
s
ig
n
if
ican
tly
ass
o
ciate
d
with
h
ig
h
er
ADHD
s
y
m
p
to
m
s
ev
er
ity
,
wh
er
ea
s
g
en
d
er
,
p
lace
o
f
r
esid
en
ce
,
p
ee
r
i
n
teg
r
atio
n
,
an
d
liv
in
g
c
o
n
d
itio
n
s
wer
e
n
o
t a
s
s
o
ciate
d
with
s
y
m
p
to
m
lev
els.
T
h
ese
f
in
d
in
g
s
in
d
icate
th
at
s
tu
d
en
ts
ex
p
er
ien
cin
g
f
in
an
ci
al
s
tr
ain
an
d
lim
ited
ex
ter
n
al
em
o
tio
n
al
s
u
p
p
o
r
t
m
a
y
r
ep
o
r
t
g
r
ea
ter
a
tten
tio
n
al
an
d
e
x
ec
u
tiv
e
f
u
n
c
tio
n
in
g
d
if
f
icu
lties
,
co
n
s
is
ten
t
with
co
n
ce
p
tu
al
m
o
d
els
lin
k
in
g
ADHD
-
r
elate
d
s
y
m
p
to
m
s
to
ch
allen
g
es
in
em
o
tio
n
al
r
eg
u
latio
n
an
d
ex
ec
u
tiv
e
co
n
tr
o
l.
I
m
p
o
r
ta
n
tly
,
th
e
r
esu
lts
r
ef
lec
t
s
y
m
p
to
m
-
b
ased
s
cr
ee
n
i
n
g
o
u
tco
m
es
r
ath
e
r
th
a
n
clin
ical
d
iag
n
o
s
es.
B
ased
o
n
th
ese
f
in
d
in
g
s
,
tar
g
eted
in
ter
v
en
tio
n
s
s
u
ch
as
co
g
n
itiv
e
-
b
eh
av
io
r
al
s
k
ills
wo
r
k
s
h
o
p
s
,
ac
ad
em
ic
co
ac
h
in
g
,
an
d
p
s
y
ch
o
ed
u
ca
tio
n
al
p
r
o
g
r
am
s
m
ay
b
e
b
en
e
f
icial
in
s
u
p
p
o
r
tin
g
s
tu
d
en
ts
with
elev
ated
ADHD
s
y
m
p
to
m
s
.
T
h
e
im
p
lem
e
n
tatio
n
o
f
s
u
ch
i
n
itiativ
es
with
in
Alb
an
ian
u
n
iv
er
s
ities
co
u
ld
i
n
f
o
r
m
b
r
o
ad
e
r
h
ig
h
er
ed
u
ca
tio
n
an
d
m
en
tal
h
ea
lth
s
tr
ateg
ie
s
in
th
e
B
alk
an
r
eg
io
n
,
c
o
n
tr
ib
u
tin
g
to
m
o
r
e
in
cl
u
s
iv
e,
s
u
p
p
o
r
tiv
e
,
an
d
ac
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2236
AUTHO
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,
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est.
RE
F
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R
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NC
E
S
[
1
]
S
.
V
.
F
a
r
a
o
n
e
e
t
a
l
.
,
“
T
h
e
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[
2
]
J.
A
.
S
e
d
g
w
i
c
k
,
A
.
M
e
r
w
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d
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sh
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o
n
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h
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[
3
]
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.
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.
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.
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.
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5
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.
L.
B
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.
,
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e
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[
6
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D
.
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b
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sa
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,
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.
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.
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[
7
]
J.
P
.
Tu
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,
N
.
E.
S
c
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e
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r
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c
h
,
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d
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R
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see
n
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[
9
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S
.
G
r
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y
,
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.
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,
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.
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Ta
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,
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(
A
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[
28
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S
.
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[
29
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[
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[
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[
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[
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