According to the Center for Disease Control and Prevention (CDC) and other researchers, the prevalence of Attention Deficit and Hyperactivity Disorder (ADHD) diagnoses among school-aged children has gained the attention of researchers. Due to the large amount of time children spend in the school context, researchers have found that teachers play a vital role as valuable resources to early identification of children needs of services. The purpose of this qualitative study was to expand knowledge about the in-depth experiences of third grade reading teachers when referring for behavioral health services. Bronfenbrenner's (1979) bioecological model the was theoretical framework for this study. In this framework, a child's development was viewed by the system of relationships that comprised of their environment. The research questions addressed were (a) How do elementary school, Title 1 third grade reading teachers in this FL elementary school experience student behaviors in the classroom and (b) how do they determine what behaviors lead to student referral for ADHD testing? To address the gap in literature, six participants who were third grade reading teachers or administrators were interviewed to discuss their experience of hyperactive behaviors and how they determine what behaviors led to student referral for ADHD testing. The data were hand coded to find emergent themes. Some findings of the study were the benefits of positive teacher-student relationship as well as the importance of flexibility in teaching styles. A recommendation from the study is the need for school systems to provide teachers with adequate training and education on ADHD and other mental health disparities so that assessments are filled based on expertise and not biases. [The dissertation citations contained here are published with the permission of ProQuest LLC. Further reproduction is prohibited without permission. Copies of dissertations may be obtained by Telephone (800) 1-800-521-0600. Web page: http://bibliotheek.ehb.be:2222/en-US/products/dissertations/individuals.shtml.]