Examining the prevalence of ADHD and ODD among primary school students in rural Thailand: Key findings from a comprehensive school-based study

Background: Attention-deficit/hyperactivity/impulsivity disorder (ADHD) and oppositional defiant disorder (ODD) are prevalent neurodevelopmental disorders in children, often co-occurring and leading to significant academic and behavioral challenges. Despite global studies, there is limited data on the prevalence of these disorders in rural Thailand. This research aimed to identify the prevalence of ADHD and ODD among primary school children in rural Chiang Mai, Thailand, from parent and teacher perspectives and to assess the relationships between ADHD and ODD symptoms. Methods and Material: This study, conducted in two primary schools in the rural area of Chiang Mai, Thailand, involved 198 students, 11 teachers, and 198 parents, and used multistage random sampling to ensure representativeness. A cross-sectional study was conducted. Teachers evaluated the children’s behaviors using the SNAP-IV scale. Descriptive statistics were used to summarize the demographic data, and Pearson’s correlations were calculated to assess relationships between ADHD and ODD symptoms. Results: Parent assessments reported 3.03% of children at risk for inattention, 3.54% for hyperactivity/impulsivity, and 4.55% for ODD. On the contrary, teacher assessments indicated higher risks of inattention (3.54%), hyperactivity/impulsivity (13.13%), and ODD (14.65%). Strong correlations emerged between inattention and hyperactivity/impulsivity (r = 0.780) and between hyperactivity/impulsivity and ODD (r = 0.645) in parent ratings, with similar patterns in teacher ratings, showing a correlation of r = 0.674 between hyperactivity/impulsivity and ODD. Conclusions: ADHD and ODD are common among primary school children in rural Thailand, with significant symptom overlap. Differences in parent and teacher reports highlight the need for multi-informant assessments.