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This study examined the unique and interactive effects of receptive language ability and ADHD behaviors on six school readiness outcomes, over and above the effects of socioeconomic status, in 49 preschoolers (Mage = 3.98, SDage = .58; 53.06% female) recruited from Head Start-affiliated classrooms. Hierarchical regression analyses revealed unique positive associations between receptive language ability and cognitive and mathematics readiness, and unique negative associations between ADHD behaviors and social-emotional, physical, cognitive, and literacy readiness. Moderation analyses indicated that at higher, but not lower, levels of ADHD behaviors, lower receptive language ability was associated with lower social-emotional readiness. Results highlight that, when considered together, children’s receptive language ability and ADHD behaviors vary in how they predict school readiness. Further, results provide preliminary evidence for ADHD behaviors as a risk factor in the association between receptive language deficits and social-emotional school readiness. Educational and clinical practice implications are discussed.

Past research raises concerns about whether the presence of self-perceptual biases among children with attention-deficit/hyperactivity disorder (ADHD) interferes with accurate assessment and/or diminishes treatment response. Yet, it remains unclear whether self-perceptual bias is a construct that can be modified. The current study examines individual differences in how children with ADHD (n = 178) display and modify their self-perceptions of competence in the presence of an external motivator for self-perceptual accuracy. Participants were grouped based on the presence and modifiability of their self-perceptual biases across three experimental conditions. Results demonstrate that the presence and modifiability of participants’ self-perceptual biases across conditions was associated with adjustment (i.e., externalizing and internalizing problems) and cognitive functioning. Findings suggest multiple factors may be associated with self-perceptual bias (e.g., self-protection and cognitive impairment), and that these factors may differ across children. Implications for intervention, including whether assessment and treatment can be improved, are discussed.

Childhood attention-deficit/hyperactivity disorder (ADHD) is prospectively linked to substance use and disorder. Depression emerging in adolescence is an understudied risk factor that may explain some of this risk. In the present study, we considered mediating and moderating roles of adolescent depression in explaining this association by using longitudinal data from the prospective 16-year follow-up of the Multimodal Treatment Study of ADHD (MTA). Participants were 547 children diagnosed with DSM-IV ADHD Combined Type, and 258 age- and sex-matched comparison children. In adolescence, depressive symptoms did not exacerbate effects of childhood ADHD on any substance use. For both groups, time-varying and average depressive symptoms were associated with more frequent use of all substances. Prospectively, we found no evidence of depression mediation to adult substance use. However, adolescent depression moderated the association between childhood ADHD and adult marijuana use. Although adults without ADHD histories used marijuana more frequently if they had elevated depressive symptoms in adolescence, marijuana use by adults with ADHD histories was independent of their adolescent depression. In adulthood, depression diagnoses and ADHD persistence continued to operate as independent, additive correlates of substance use risk. Our findings suggest a circumscribed role for depression in substance use risk that adds to, but does not alter or explain, ADHD-related risk.

Factor analytic studies of attention-deficit/hyperactivity disorder (ADHD) in children and adults have shown that second-order and bifactor models better represent ADHD symptoms than two- or three-factor models, yet there is far less evidence for a bestfitting model of ADHD in adolescence. Thus, the current study examined the factor structure of ADHD in adolescence and further evaluated the external validity of the best fitting model. Participants were 588 adolescents (22 % female; 366 with a childhood ADHD diagnosis; mean age 15.9 years) from the 8-year assessment of the Multimodal Treatment Study of Children with ADHD (MTA). ADHD symptoms were assessed via adolescent self-report, parent report, and teacher report on the SNAP-IV scale. Potential factor structures for the 18 symptoms of ADHD were tested for each informant, which included traditional one-factor, two-factor, and three-factor models of ADHD, as well as second-order factor (specific factors loading onto general factor) and bifactor (items loading onto both specific and general factors) models. Unique associations between external criteria and the identified factors of each informant's best fitting model were examined. Although several of the proposed models exhibited good fit, the second-order two-factor model best accounted for ADHD in adolescence according to self-report and parent report, and the second-order three-factor model was optimal according to teacher report. Several key measurement issues emerged for the hierarchical bifactor models, such as numerous Heywood cases and out-of-bound parameter estimates, which rendered them unfit as optimal representations of ADHD in adolescence. These findings and the implications of the best fitting model of ADHD in adolescence suggest that a possible reorganization of this disorder may eventually aid clinicians in the accurate diagnosis of ADHD in adolescents.

We examined the relation between physical fitness and psychological well-being in children ages 10–14 years (N = 222), and the potential moderation of this relation by sex. Participants completed a physical fitness assessment comprised of seven tasks and a diverse set of self-report well-being measures assessing depressive symptoms, loneliness, and competence. Peers reported on social status and teachers rated adaptive functioning, internalizing symptoms, and externalizing symptoms. Multiple regression analyses indicated a significant association between physical fitness and psychological well-being for both boys and girls. Higher levels of physical fitness were associated with lower levels of peer dyadic loneliness and fewer depressive symptoms; greater cognitive, social, and athletic competence; greater feelings of self-worth; and better teacher reports of adaptive functioning. An interaction between internalizing and sex indicated a significant and negative association between physical fitness and internalizing symptoms for males only. No other moderation effects by sex were observed. Results suggest that physical fitness is associated with a range of well-being indicators for both boys and girls in this age group.

Using laboratory-type Theory of Mind (ToM) tasks (our measure of ‘explicit’ ToM competence) and a more ecologically-valid measure of ToM (our measure of ‘applied’ ToM competence), we found that for composite scores, typically developing (TD) males performed near ceiling levels on both indices and age-matched males with autism spectrum disorder (ASD) performed near floor levels on both indices. The scores for age-matched males with attention-deficit hyperactivity disorder (ADHD) showed a different pattern such that the ADHD group had high scores on the explicit measure and low scores on the applied measure. Subscale scores (early, basic, advanced ToM) for the two indices also revealed that (1) despite variable complexity, explicit ToM almost always distinguished the ASD group from the other two groups but never distinguished the ADHD and TD groups and (2) level of complexity was critical for distinguishing groups with regard to applied ToM. We suggest that although children with ADHD can calculate the content of traditional laboratory ToM tasks, this explicit ToM competence fails to be applied and expressed in real world demonstrations of ToM (especially when advanced ToM skills are assessed). By contrast, the ToM difficulties of children with ASD seem to be attributable to a deeper metarepresentational deficit. Our results have implications for practice and extend current models of social cognition in developmental disabilities by isolating variable aspects of competence that predict specific and testable models for future research.

We examined the relation between aerobic fitness and inhibition in young children with and without attention deficit hyperactivity disorder (ADHD)-risk status. Participants (91 ADHD risk, 107 typically developing, Mage = 6.83, 53.5% male, 68.2% Caucasian) completed an assessment of aerobic fitness and a flanker task requiring variable amounts of inhibitory control. Aerobic fitness was positively associated with inhibition. When inhibitory control demands were largest, the relation varied as a function of ADHD-risk status such that the link between aerobic fitness and inhibition was significant only for children with ADHD risk. The relation between aerobic fitness, status, and inhibition was further moderated by age for interference control. Specifically, the positive relation between aerobic fitness and interference control was only significant for younger children with ADHD risk. A fitness-cognition link appears in young childhood that seems particularly salient for those in the earliest school years with ADHD risk. The findings extend work on typically developing children and suggest that exploring aerobic fitness interventions to address executive function impairments in children at risk for ADHD is warranted.

The goal of this study was to compare the effects of before school physical activity (PA) and sedentary classroom-based (SC) interventions on the symptoms, behavior, moodiness, and peer functioning of young children (M age = 6.83) at risk for attention-deficit/hyperactivity disorder (ADHD-risk; n = 94) and typically developing children (TD; n = 108). Children were randomly assigned to either PA or SC and participated in the assigned intervention 31 min per day, each school day, over the course of 12 weeks. Parent and teacher ratings of ADHD symptoms (inattention, hyperactivity/impulsivity), oppositional behavior, moodiness, behavior toward peers, and reputation with peers, were used as dependent variables. Primary analyses indicate that the PA intervention was more effective than the SC intervention at reducing inattention and moodiness in the home context. Less conservative follow-up analyses within ADHD status and intervention groups suggest that a PA intervention may reduce impairment associated with ADHD-risk in both home and school domains; interpretive caution is warranted, however, given the liberal approach to these analyses. Unexpectedly, these findings also indicate the potential utility of a before school SC intervention as a tool for managing ADHD symptoms. Inclusion of a no treatment control group in future studies will enable further understanding of PA as an alternative management strategy for ADHD symptoms.

Peer problems are common among children with emotional and behavioral disorders (EBD). However, the extent to which children’s peer functioning varies across settings is unknown, as is the incremental power of peer functioning in different settings in predicting subsequent psychopathology. Participants were 57 children with Attention-Deficit/Hyperactivity Disorder (ADHD) who had peer sociometric nominations collected in general education classrooms and a Summer Treatment Program (STP) with all-EBD peers. Significant, small-to-medium correlations existed between nomination rates across settings. Lower rates of STP positive nominations and higher rates of STP negative nominations (but not classroom nominations) predicted exacerbated self-reported depression and antisocial behavior 1 year later. Lower rates of STP positive nominations, but higher rates of classroom positive nominations, predicted increased self-reported depression 2 years later. For children with high rates of classroom positive nominations, higher rates of STP positive nominations predicted reduced parent-reported internalizing behavior 1 year later. For children with low rates of classroom negative nominations, higher rates of STP negative nominations predicted increased teacher-reported externalizing behavior 1 year later and self-reported depression 2 years later. Results suggest that sociometric nominations collected within an EBD peer group may have stronger predictive power for later adjustment than nominations collected in a mainstream classroom.

This study investigated the role of externalizing behavior as a mediator of the relation between social self-control and peer liking among children with Attention-Deficit/Hyperactivity Disorder-Combined Type (ADHD-CT). A model was proposed whereby externalizing behavior would fully statistically account for the direct relation of social self-control to peer liking. One hundred seventy two children ages 7.0-9.9 years with ADHD-CT were rated by their teachers regarding their social self-control and by their parents and teachers regarding their rates of externalizing behavior. Same-sex classmates provided ratings of overall liking. Structural Equation Modeling (SEM) was used to assess the proposed model. Results supported the proposed model of externalizing behavior as fully statistically accounting for the relation of social self-control to peer liking. This study demonstrated the crucial role that externalizing behaviors play in the social impairment commonly seen among children with ADHD-CT.

This study extends previous research and examines whether working memory (WM) is associated with multiple measures of concurrent social functioning (peer rejection, overall social competence, relational aggression, physical aggression, and conflict resolutions skills) in typically developing fourth- and fifth-grade children (N = 116). Poor central executive WM was associated with both broad social impairments (peer rejection and poor overall social competence) and specific social impairments (physical aggression, relational aggression, and impaired conflict resolution skills); poor verbal storage was associated only with greater peer rejection, and spatial storage was not associated with any measures of social impairment. Analyses also examined whether specific impairments in aggressive behavior and conflict resolution skills mediated the association between central executive and broad measures of social functioning. Greater physical aggression and impaired conflict resolution skills were both significant mediators; relational aggression was not. Implications for theory and future research are discussed.

This study examines whether positively biased self-perceptions relate to social behaviors in children with attention-deficit/hyperactivity disorder (ADHD) as compared to control children. The social behaviors of children with ADHD ( n = 87) were examined relative to control children (CTL; n = 38) during a laboratory-based dyadic social interaction task. Children with ADHD were subgrouped into those with a positive illusory bias (PIB) in their self-perceptions (ADHD + PIB) versus those without such a bias (ADHD – PIB). Using a behavioral coding system adapted for this study, ADHD + PIB, ADHD – PIB, and CTL participants were compared on objectively coded social behaviors occurring within the context of the social interaction task. Whereas both ADHD groups displayed more disruptive behavior than controls, only the ADHD + PIB group displayed less prosocial behavior and less effortful behavior. This study breaks new ground by examining positively biased self-perceptions as they relate to social behavior in children with ADHD and provides promising new insight into the social problems experienced by these children.

Even after evidence-based treatment, Attention-Deficit/Hyperactivity Disorder (ADHD) is associated with poor long-term outcomes. These outcomes may be partly explained by difficulties in peer functioning, which are common among children with ADHD and which do not respond optimally to standard ADHD treatments. We examined whether peer rejection and lack of dyadic friendships experienced by children with ADHD after treatment contribute to long-term emotional and behavioral problems and global impairment, and whether having a reciprocal friend buffers the negative effects of peer rejection. Children with Combined type ADHD (N = 300) enrolled in the Multimodal Treatment Study of Children with ADHD (MTA) were followed for 8 years. Peer rejection and dyadic friendships were measured with sociometric assessments after the active treatment period (14 or 24 months after baseline; M ages 9.7 and 10.5 years, respectively). Outcomes included delinquency, depression, anxiety, substance use, and general impairment at 6 and 8 years after baseline (Mean ages 14.9 and 16.8 years, respectively). With inclusion of key covariates, including demographics, symptoms of ADHD, ODD, and CD, and level of the outcome variable at 24 months, peer rejection predicted cigarette smoking, delinquency, anxiety, and global impairment at 6 years and global impairment at 8 years after baseline. Having a reciprocal friend was not, however, uniquely predictive of any outcomes and did not reduce the negative effects of peer rejection. Evaluating and addressing peer rejection in treatment planning may be necessary to improve long-term outcomes in children with ADHD.

Children with Attention-Deficit/Hyperactivity Disorder (ADHD) are thought to have fundamental deficits in the allocation of attention for information processing. Furthermore, it is believed that these children possess a fundamental difficulty in motoric timing, an assertion that has been explored recently in adults and children. In the present study we extend this recent work by fully exploring the classic Wing and Kristofferson (1973) analysis of timing with typically developing children (n = 24) and children with ADHD (n = 27). We provide clear evidence that not only do children with ADHD have an overall timing deficit, they also time less consistently when using a similar strategy to typically developing children. The use of the Wing and Kristofferson approach to timing, we argue, will result in the discovery of robust ADHD-related timing differences across a variety of situations.

Mothers and fathers often disagree in their ratings of child behavior, as evidenced clinically and as supported by a substantial literature examining parental agreement on broadband rating scales. The present study examined mother—father agreement on Diagnostic and Statistical Manual—based symptom-specific ratings of Attention-Deficit/Hyperactivity Disorder (ADHD), as compared to agreement on broadband ratings of externalizing behavior. Based on mother and father ratings of 324 children who participated in the Multimodal Treatment Study of Children with ADHD (MTA), parental agreement was computed and patterns of disagreement examined. Mother—father ratings were significantly correlated; however, a clear pattern of higher ratings by mothers was present. Agreement on attention-deficit/hyperactivity disorder symptom-specific ratings was significantly lower than that for broadband externalizing behaviors and oppositional defiant disorder symptoms. Of several moderator variables tested, parental stress was the only one that predicted the discrepancy in ratings. Disagreement between parents is clinically significant and may pose complications to the diagnostic process.

Possible mediators of the relation between maternal depressive symptomatology and parenting behavior were examined for 96 children with ADHD and their mothers drawn from the Multimodal Treatment Study of Children with ADHD (MTA) as part of an add-on investigation conducted by two of the six MTA sites. General cognitions (i.e., maternal locus of control and self-esteem) and parenting-specific factors (i.e., maternal parenting efficacy and parenting stress) were examined as possible mediators. Findings provide initial support that maternal parenting stress, as well as maternal locus of control and self-esteem mediate the relation between maternal depressive symptomatology and parenting behavior. This provides support for the argument that some families of children with ADHD may benefit from an expanded version of parent management training that includes sessions directly targeting affective and cognitive factors in parents, similar to treatment programs used to treat childhood conduct problems.

Objective: To evaluate two hypotheses: that self-selection bias contributed to lack of medication advantage at the 36-month assessment of the Multimodal Treatment Study of Children With ADHD (MTA) and that overall improvement over time obscured treatment effects in subgroups with different outcome trajectories. Method: Propensity score analyses, using baseline characteristics and severity of attention-deficit/hyperactivity disorder symptoms at follow-up, established five subgroups (quintiles) based on tendency to take medication at the 36-month assessment. Growth mixture model (GMM) analyses were performed to identify subgroups (classes) with different patterns of outcome over time. Results: All five propensity subgroups showed initial advantage of medication that disappeared by the 36-month assessment. GMM analyses identified heterogeneity of trajectories over time and three classes: class 1 (34% of the MTA sample) with initial small improvement followed by gradual improvement that produced significant medication effects; class 2 (52%) with initial large improvement maintained for 3 years and overrepresentation of cases treated with the MTA Medication Algorithm; and class 3 (14%) with initial large improvement followed by deterioration. Conclusions: We failed to confirm the self-selection hypothesis. We found suggestive evidence of residual but not current benefits of assigned medication in class 2 and small current benefits of actual treatment with medication in class 1.

This article describes what is currently known about the peer relationships of children with attention-deficit/hyperactivity disorder (ADHD). This topic is addressed both from the perspective of how ADHD initially contributes to problematic relationships with peers, and also from the perspective of how peers' reactions to these problems may serve to maintain them. Given the limited improvement typically obtained in treatment studies that use peer report measures as outcomes with ADHD samples and the well-documented predictive validity of peer reports for later adjustment, the need for more intensive interventions and novel approaches to address the peer problems of children with ADHD is emphasized.

Objective: Children with ADHD experience peer problems that may place them at risk for adverse outcomes. Using a short-term longitudinal design, this study links specific behaviors to peer functioning in groups of previously unfamiliar children with ADHD. Method: The participants were 268 children with ADHD who took part in an intensive summer treatment program. The program used a comprehensive behavioral point system that yielded observational data for 12 behavioral categories. These behavioral categories were used to predict peer acceptance, rejection, and liking assessed at three times during the program. Results: Following activity rules, helping, whining, and attention emerged as best predictors of initial peer status. Subsequent helping behaviors and activity rule following predicted changes in peer status, but their contributions were small. Conclusion: The results indicate that increasing helping and rule- following behaviors may improve peer functioning of children with ADHD in similar settings. (J. of Att. Dis. 2007; 10(4) 359-371)

The goal of the present study was to consider the associations between family functioning (parenting and family loneliness) and peer functioning in a sample of boys with ADHD (N = 110) and their mothers (N = 108) and fathers (N = 53). Results indicated that higher paternal warmth was associated with more peer acceptance, less peer rejection, and less problematic social behavior, but only for boys who reported low levels of family loneliness. In addition, more paternal power assertion was related to less peer acceptance, but only for boys who reported low levels of family loneliness. Maternal warmth and power assertion were not significantly related to boys' peer functioning. We discuss these findings in the context of the processes by which parenting may affect the peer relationships of these children.

This study proposed and tested a developmental model of impression formation based on observed behavior, prior expectancies, and additional incongruent information. Participants were 51 kindergartners, 53 second graders, and 104 college students who provided trait and liking judgments after watching a child actor engage in behaviors from three behavioral dimensions. Reaction times of judgments were also measured. Results showed that all age groups made dispositional attributions for all three presented traits. Nevertheless, young children had some difficulty conceiving of others as possessing both positive and negative attributes and provided less negative judgments. Prior expectancy strengthened judgments of the expected trait but did not suppress encoding of other traits. Judgments of likability were most strongly influenced by prosocial-antisocial behavior. Unlike prosocial and smart behavior, shyness influenced only adults' liking of the actor. Additional incongruent behaviors produced a substantial modification of impressions in all groups except for kindergartners who held positive impressions.

Efficacious treatments for childhood attention-deficit/hyperactivity disorder (ADHD) have been clearly documented in the extant literature. However, significant challenges remain in delivering these treatments to the children and families they were developed to benefit. With the aim of better understanding the obstacles that impede delivery of treatments for ADHD, this paper reviews what is known regarding predictors of treatment acceptance, adherence, and success among families of children with ADHD. We identify several gaps in this literature, including the need for a strong, theoretically-driven model that encompasses parental cognitive variables in understanding the treatment experiences of these families.

Background Despite their potential to influence treatment decisions, parents’ beliefs and attitudes regarding attention deficit hyperactivity disorder (ADHD) have not been widely studied. This research examined relations between parents’ beliefs and attitudes and their experiences with different treatments for their children's ADHD. Methods Canadian parents of 73, 5- to 13-year-old, boys with ADHD completed questionnaires measuring beliefs about ADHD, attributions for ADHD behaviours, and treatment experiences. Results Parents reported using primarily behaviour management and stimulant medications in treating ADHD. Approximately half of the families also used diet/vitamin therapies. Parents were knowledgeable about ADHD and held generally accurate beliefs. They saw ADHD symptoms as predominantly internal to the child and as relatively enduring and pervasive. Parents’ beliefs were related to their use of different treatments and parents who used less empirically supported treatments were more likely to see ADHD behaviours as internal to the child, enduring and pervasive. Conclusions The findings highlight the importance of assessing parents’ use of alternate treatments for ADHD and the potential role of parents’ beliefs and attributions in shaping treatment choices.

We examined hope as a potential resiliency factor for the daily strains of raising children with disruptive behavior disorders. In light of the motivational component of hope theory, initiating and sustaining effort toward goals (i.e., agency), we were interested in hope's relation to constructs addressing self-esteem, familial functioning, and stress. Two hundred, fifty-two parents of children with externalizing disorders completed self-report questionnaires. Significant associations were found among hope and parental and familial functioning indices (e.g., warm and nurturing parenting styles, cohesive and active family environment, adaptive coping strategies). Considering their conceptual overlap, we tested the unique predictive power of hope and optimistic attributions on indices of psychological functioning. Separate regressions indicated that hope significantly predicted psychological functioning beyond what was accounted for by social desirability, the severity of child symptoms, and optimi...

Pharmacological and expectancy effects of 0.3 mg/kg methylphenidate on the behavior and attributions of boys with attention-deficit/hyperactivity disorder were evaluated. In a within-subject, balanced-placebo design, 136 boys received 4 medication-expectancy conditions. Attributions for success and failure on a daily report card were gathered. Assessments took place within the setting of a summer treatment program and were repeated in boys' regular classrooms. Expectancy did not affect the boys' behavior; only active medication improved their behavior. Boys attributed their success to their effort and ability and attributed failure to task difficulty and the pill, regardless of medication and expectancy. Results were generally equivalent across the two settings; where there were differences, beneficial effects of medication were more apparent in the school setting. The findings were unaffected by individual-difference factors.

We observed mother-child interactions, at baseline, in 136 families of 7-10-year-old boys with attention-deficit/hyperactivity disorder (ADHD) who were part of a large clinical trial, the Multimodal Treatment Study of Children with ADHD. Independent coders rated stylistic aspects of maternal behavior and factor analyses revealed a responsiveness factor that included overall responsiveness and sensitivity to the child, warmth and acceptance, and appropriate control. We examined relations between maternal responsiveness and (a) maternal depressive symptoms and maternal childhood ADHD symptoms, and (b) boys' ADHD and conduct problem symptoms. Controlling for all other variables, maternal responsiveness displayed a unique negative association with mother-reported child conduct problems, but not with child ADHD symptoms, and also was negatively related to maternal depressive symptoms. We discuss the unique association between mother-reported child conduct problems and parenting, and note the utility of studying parenting style in families of children with ADHD. We describe the results within the framework of a transactional model.

Examined hypothesized gender and comorbidity differences in the observed classroom behavior of children with attention deficit hyperactivity disorder (ADHD). The behavior of 403 boys and 99 girls with ADHD, ages 7-10, was compared (a) to observed, sex-specific classroom behavior norms, (b) by sex, and (c) by comorbid subgroups. Boys and girls with ADHD deviated significantly from classroom norms on 15/16 and 13/16 categories, respectively. Compared to comparison girls, girls with ADHD had relatively high rates of verbal aggression to children. Boys with ADHD engaged in more rule-breaking and externalizing behaviors than did girls with ADHD, but the sexes did not differ on more "neutral," unobtrusive behaviors. The sex differences are consistent with notions of why girls with ADHD are identified and referred later than boys. Contrary to hypothesis, the presence of comorbid anxiety disorder (ANX) was not associated with behavioral suppression; yet, as hypothesized, children with a comorbid disruptive behavior disorder (DBD) had higher rates of rule-breaking, and impulsive and aggressive behavior, than did children with ADHD alone and those with ADHD+ANX. Elevated rates of ADHD behaviors were also observed in children with comorbid DBD, indicating that these behaviors are truly present and suggesting that reports of higher ADHD ratings in this subgroup are not simply a consequence of negative halo effects and rater biases.

Objective To determine whether childhood attention-deficit hyperactivity disorder (ADHD) and persistence of the disorder are associated with later difficulty in adolescent peer relations. Method One hundred eleven children with ADHD were interviewed as adolescents and compared with 100 adolescents without an ADHD history (aged 13–18 years). The multi-informant assessment strategy included parents, teachers, and adolescents. Results Parents of probands reported fewer close friendships and greater peer rejection compared with the non-ADHD group. Probands reported that their friends were less involved in conventional activities compared with the non-ADHD group. Childhood aggression predicted less self-perceived social competence for probands. The long-term effects of ADHD on social functioning were more pronounced for probands with persistent ADHD or conduct disorder in adolescence. Conclusions Impairments in peer relations for ADHD youths, known to be common in childhood, also exist in adolescence. Given the developmental significance of peer relations, further research into the causes and treatment of poor social functioning in youths with ADHD is recommended.

This study examined the effects of 0.3 mg/kg methylphenidate (MPH) and expectancy regarding medication on the performance and persistence of 137 boys with attention-deficit/ hyperactivity disorder (ADHD) in a get-acquainted dyadic interaction with a peer, using a balanced-placebo design. Boys in 4 groups—administered placebo or MPH crossed with being told they received placebo or MPH—interacted with child confederates in experimental situations in which social success and failure were manipulated. In contrast with studies of academic persistence, MPH did not affect boys' task persistence or performance. Boys gave more positive self-evaluations and talked more in the success condition as compared with the failure condition. Boys attributed success to effort and ability and failure to task difficulty, and neither MPH nor expectancy affected this pattern. These findings are consistent with other studies in failing to find debilitating effects of MPH or medication expectancies on ADHD boys' attributions or self-evaluations. The primary features of attention-deficityhyperactivity disorder (ADHD) include inattention, impulsivity, and excessive motor activity. ADHD also has a number of secondary features, one of the most important being peer rela

Describes the Peer Network and Dyadic Loneliness Scale (PNDLS), a new scale designed to assess simultaneously children's loneliness at multiple levels of peer relationships. Specifically, this scale measures loneliness associated with (a) lack of involvement in a social network and (b) the absence of a close dyadic friendship. Employing a sample of 209 5th-, 6th-, and 7th-grade boys and girls, the psychometric properties, interscale correlations, and preliminary validity data for the new scale are examined. Analyses revealed good internal consistency and a pattern of relationships with other loneliness, friendship quality, mutual best friendship, and sociometric social preference variables supporting the validity of the new scale.

To elucidate processes underlying therapeutic change in a large-scale randomized clinical trial, we examined whether alterations in self-reported parenting practices were associated with the effects of behavioral, medication, or combination treatments on teacher-reported outcomes (disruptive behavior, social skills, internalizing symptoms) in children with attention-deficit hyperactivity disorder (ADHD). Participants were 579 children with Combined-type ADHD, aged 7-9.9 years, in the Multimodal Treatment Study of Children with ADHD (MTA). We uncovered 2 second-order factors of parenting practices, entitled Positive Involvement and Negative/Ineffective Discipline. Although Positive Involvement was not associated with amelioration of the school-based outcome measures, reductions in Negative/Ineffective Discipline mediated improvement in children's social skills at school. For families showing the greatest reductions in Negative/Ineffective Discipline, effects of combined medication plus behavioral treatment were pronounced in relation to regular community care. Furthermore, only in combination treatment (and not in behavioral treatment alone) was decreased Negative/Ineffective Discipline associated with reduction in children's disruptive behavior at school. Here, children in families receiving combination treatment who showed the greatest reductions in Negative/Ineffective Discipline had teacher-reported disruptive behavior that was essentially normalized. Overall, the success of combination treatment for important school-related outcomes appears related to reductions in negative and ineffective parenting practices at home; we discuss problems in interpreting the temporal sequencing of such process-outcome linkages and the means by which multimodal treatment may be mediated by psychosocial processes related to parenting.

Using a subsample of 105 children and their parents (100 mothers, 57 fathers) from the Multimodal Treatment Study of Children with ADHD (the MTA), the value of parents' baseline cognitions as predictors of children's treatment outcome at 14 months was examined. Measures of parents' cognitions about themselves, their ADHD children, and their parenting, as well as a self-report measure of dysfunctional discipline were included. Both mothers' and fathers' self-reported use of dysfunctional discipline predicted worse child treatment outcome. Low self-esteem in mothers, low parenting efficacy in fathers, and fathers' attributions of noncompliance to their ADHD child's insufficient effort and bad mood also were associated with worse child treatment outcome. All of these predictive relations were obtained even after MTA treatment effects had been taken into account. Secondary analyses indicated that mothers had a more external locus of control, lower self-esteem, lower parenting efficacy, and a greater tendency to attribute noncompliance to their ADHD child's bad mood than did fathers.

The Collaborative Multimodal Treatment Study of Children with Attention Deficit Hyperactivity Disorder (ADHD), the MTA, is the first multisite, cooperative agreement treatment study of children, and the largest psychiatric/psychological treatment trial ever conducted by the National Institute of Mental Health. It examines the effectiveness of Medication vs. Psychosocial treatment vs. their combination for treatment of ADHD and compares these experimental arms to each other and to routine community care. In a parallel group design, 579 (male and female) ADHD children, aged 7-9 years, 11 months, were randomly assigned to one of the four experimental arms, and then received 14 months of prescribed treatment (or community care) with periodic reassessments. After delineating the theoretical and empirical rationales for Psychosocial treatment of ADHD, we describe the MTA's Psychosocial Treatment strategy applied to all children in two of the four experimental arms (Psychosocial treatment alone; Combined treatment). Psychosocial treatment consisted of three major components: a Parent Training component, a two-part School Intervention component, and a child treatment component anchored in an intensive Summer Treatment Program. Components were selected based on evidence of treatment efficacy and because they address comprehensive symptom targets, settings, comorbidities, and functional domains. We delineate key conceptual and logistical issues faced by clinical researchers in design and implementation of Psychosocial research with examples of how these issues were addressed in the MTA study.

As part of the behavioral treatment in the Multimodal Treatment Study of Children with ADHD (MTA9), children participated in an intensive summer treatment program (STP). This study examined the differences between 57 children in the combined treatment (Comb) group, who were medicated, and 60 children in the behavioral treatment (Beh) group, who were unmedicated throughout the STP. Comb children were significantly better than Beh on 5 measures: rule following, good sportsmanship, peer negative nominations, and STP teacher posttreatment ratings of inattention/overactivity. Groups did not differ on any of the other 30 measures, and responded similarly to the STP over time. Comparisons to normative data revealed that Comb children were more likely to fall within the normative range on 6 measures. The differences between these results and the main MTA results, in which Comb was always superior to Beh, are discussed in terms of the relative intensity of combined treatments. The implications for future studies of pharmacological and behavioral treatment for ADHD are discussed.

Initial moderator analyses in the Multimodal Treatment Study of Children with ADHD (MTA) suggested that child anxiety ascertained by parent report on the Diagnostic Interview Schedule for Children 2.3 (DISC Anxiety) differentially moderated the outcome of treatment. Left unanswered were questions regarding the nature of DISC Anxiety, the impact of comorbid conduct problems on the moderating effect of DISC Anxiety, and the clinical significance of DISC Anxiety as a moderator of treatment outcome. Thirty-three percent of MTA subjects met DSM-III-R criteria for an anxiety disorder excluding simple phobias. Of these, two-thirds also met DSM-III-R criteria for comorbid oppositional-defiant or conduct disorder whereas one-third did not, yielding an odds ratio of approximately two for DISC Anxiety, given conduct problems. In this context, exploratory analyses of baseline data suggest that DISC Anxiety may reflect parental attributions regarding child negative affectivity and associated behavior problems (unlike fearfulness), particularly in the area of social interactions, another core component of anxiety that is more typically associated with phobic symptoms. Analyses using hierarchical linear modeling (HLM) indicate that the moderating effect of DISC Anxiety continues to favor the inclusion of psychosocial treatment for anxious ADHD children irrespective of the presence or absence of comorbid conduct problems. This effect, which is clinically meaningful, is confined primarily to parent-reported outcomes involving disruptive behavior, internalizing symptoms, and inattention; and is generally stronger for combined than unimodal treatment. Contravening earlier studies, no adverse effect of anxiety on medication response for core ADHD or other outcomes in anxious or nonanxious ADHD children was demonstrated. When treating ADHD, it is important to search for comorbid anxiety and negative affectivity and to adjust treatment strategies accordingly.

Linear and curvilinear associations between experiences in the same- and other-sex peer groups and the protective functions of friendship with an other-sex peer for early adolescents without a same-sex friend were examined in a sample of 231 fifth, sixth, and seventh grade girls and boys. Findings indicate that (a) at the level of the individual, early adolescent girls and, to a much smaller extent, early adolescent boys show a preference for same-sex peers; (b) this unilateral difference in expansiveness accounts for differences in participation rates in same -and other-sex friendships; (c) children of both sexes who are either very popular or very unpopular are more likely than other children to have other-sex friends; and (d) among children without a same-sex friend, having an other-sex friend is linked to higher levels of perceived well-being for boys and lower levels of well-being for girls. Each of these results is discussed according to our understanding of how the same- and other-sex peer systems function as a system to affect development in early adolescence.

Over the past 15 years, three distinct models have been used to characterize the factor structure of attention deficit hyperactivity disorder (ADHD). These models correspond to descriptions of the disorder as outlined in DSM-III, DSM-III-R, and now, DSM-IV. Specifically, in DSM-III, inattention, impulsivity, and hyperactivity were treated as three separate constructs. In DSM-III-R, ADHD was treated as a unitary construct. In DSM-IV, impulsivity and hyperactivity remain combined, but inattention is considered a separate construct. The present study examined and compared each of these models using confirmatory factor analyses. A final set of comparisons was conducted examining ADHD symptoms together with oppositional defiant disorder/conduct disorder (ODD/CD) symptoms. Although support for the three-factor ADHD model (DSM-III version) was obtained when the ADHD symptoms were examined in isolation, the two-factor model of ADHD (DSM-IV version) was supported when ADHD and ODD/CD symptoms were examined together as part of a comprehensive model of disruptive behavior disorders.

A stop signal paradigm in combination with heart rate measures were used to test the hypothesis of deficient inhibitory processing in boys with attention deficit hyperactivity disorder (ADHD). The authors measured the inhibitory process initiated by a stop signal by observing its success, its latency using a horse race model, and its impact on the timing of the heartbeat. Boys with ADHD performed well and showed appropriate psychophysiological changes. Inhibition latencies were longer in the boys with ADHD, particularly those with concurrent oppositional defiant disorder, than in the controls. Cardiac evidence suggested that greater preparation was associated with inhibition failures in controls, but not in the boys with ADHD. Boys with ADHD seem capable of attending carefully to control responses, but this control appears less effective and arguably is more effortful than in other boys.

The associations between measures of popularity (acceptance, rejection and preference) and friendship were examined in three independent samples of elementary and middle school children. Data were obtained by means of sociometric nomination and rating scale procedures. Results reveal that, regardless of measurement technique, acceptance is generally more strongly related to friendship than is either rejection or preference. The size of the association between popularity and friendship decreases with age. Mean comparisons show that popularity is a predictor and/or is temporally antecedent to friendship rather than vice-versa. These results indicate that the association between popularity and friendship derives from their conceptual dependence on the construct of liking.

Within a sample of children with ADHD, it was examined whether theories on changeability of personality interact with social confidence scores in predicting treatment response in a manner consistent with Dweck and Leggett's (1988) model. This model of motivation suggests that behavior (mastery versus helpless patterns) in difficult situations can be predicted from individuals' confidence levels and their theories regarding the malleability of relevant personal characteristics. Results indicate that theory and confidence scores did predict response to treatment, but not in the manner predicted by the model. Findings suggest the existence of a self-enhancing bias in a subset of children with ADHD.

This study examined the relation between children's peer relationships and teacher-rated psychological adjustment. A number of shortcomings in the peer literature were addressed by: (a) employing carefully delineated peer variables (passive isolation, rejected isolation, aggressive-disruptive, peer preference, mutual friendship); (b) employing a data analytic strategy that permitted simultaneous examination of main effects of and interactions among peer variables; (c) using an outcome measure that is well-normed for children and widely used in studies of adjustment; and (d) controlling for outcome measures' autocorrelations across time points. For 236 school children in the third, fourth, and fifth grades, concurrent associations were examined between these peer variables and internalizing and externalizing problems. Longitudinal associations were examined over a period of 2 years. In so doing, we found that passive isolation was a risk factor for internalizing problems, and rejected isolation was marginally predictive of externalizing problems. Furthermore, we found complex moderating effects of mutual friendship, such that children who were not isolated may derive benefits from having a close mutual friend, but the results were not clear for children with poor peer-group relationships. Much additional research is needed to further clarify these findings.

Objective: This study extends previous research and examined if the longitudinal relation between self-perceived social acceptance and changes in adjustment was moderated by peer status and ADHD diagnosis. Method: A sample of children with ADHD and a normative comparison group (age 8-13 years) were assessed at baseline and one-year follow-up. Self-perceived social acceptance, peer status, and three areas of adjustment (depression symptoms, aggression/conduct problems, and social skills) were measured. Results: Moderation was found when predicting depression symptoms and aggression/conduct problems. Specifically, in children with ADHD only, higher perceived social acceptance protected against increases in depression symptoms for those with lower peer preference, but predicted greater aggression/conduct problems for those with higher peer preference. There was not evidence of significant moderation for predicting social skills; instead non-ADHD status, greater peer preference, and greater self-perceived social acceptance were each predictive of greater social skills. Conclusion: Results highlight the complex association between positive social self-perceptions and adjustment for children with ADHD and caution against a universal assumption that high self-perceptions are adaptive.

Objective: Our purpose in the current study was to examine whether children with attention-deficit/ hyperactivity disorder (ADHD) and comparison children, if adequately motivated, are able to purposefully match their teachers’ ratings of competence in multiple domains and whether any reductions in self-perceptual bias normalize self-views in relation to comparison children’s self-perceptions. Method: Participants included children with ADHD (n 178) and comparison children (n 86), between 7 and 12 years of age. The majority of participants were Caucasian (81.4%) and male (77.3%). Primary measures included the Self-Perception Profile for Children (SPPC; Harter, 1985), which was administered during a baseline assessment. In a subsequent session, children completed the SPPC twice more following instructions to first attempt to match their teachers’ ratings of competence and then following the offer of an incentive for matching their teachers’ ratings. Repeated measures analyses of covariance were conducted with between- and within-subjects factors. Results: Significant reductions in 2 of 3 domains (scholastic, behavioral conduct) were found for children with ADHD. No reductions were found across domains for comparison children or in the social domain for children with ADHD. Across conditions, the amount of bias exhibited by children with ADHD was never normalized in relation to comparison children’s ratings. Conclusions: Explicit instructions to match teacher ratings of competence and implementation of incentives were only partially effective in reducing the biased self-perceptions of children with ADHD. Results suggest that children with ADHD, on average, cannot view themselves in a completely unbiased fashion, rather than that they will not do so, although self-protection clearly plays a partial role.

The associations between measures of friendship and popularity derived from nomination and rating scales procedures were studied with a sample of school-age and early adolescent boys and girls. Confirmatory factor analyses and comparisons of the correlations among these measures showed that each of these techniques can provide parallel measures of popularity (i.e. sociometric preference) and friendship (i.e. whether the child is participating in a mutual friendship). These findings are discussed in regard to measurement issues in the study of friendship and popularity.

The Friendship Qualities Scale is a theoretically grounded, multidimensional measurement instrument to assess the quality of children's and early adolescents' relationships with their best friends according to five conceptually meaningful aspects of the friendship relation. These dimensions are companionship, conflict, help/aid, security and closeness. A confirmatory factor analysis, used to evaluate the factor structure of this instrument, demonstrated that these scales represented distinct, but related, domains of friendship. Assessments of reliability indicated the high level of internal consistency within each dimension. The validity of the scale was indicated by the observation of higher ratings for (a) mutual friends than for non-mutual friends, and (b) for stable friends than for non-stable friends. These findings are discussed according to the theoretical and practical issues related to the measurement of friendship quality.

In a previous study, Milich, Carlson, Pelham, and Licht (1991) reported that, compared to placebo, attention-deficit hyperactivity disorder (ADHD) boys on methylphenidate (MPH) showed greater persistence following exposure to insolvable tasks, and were more likely to attribute success to internal causes and blame failure on external causes. The current study, using the same task, provided evidence for the salutary effects of MPH on the performance and perceptions of ADHD boys following both solvable and insolvable puzzles and found that subjects exposed to insolvable puzzles showed greater persistence on a subsequent generalization task when receiving MPH as compared to placebo. In addition, a measure of attributional style predicted performance on the task, but not attributions for task-performance. Finally, the current study found no differences between placebo and a “no pill” condition, thus extending the results of Milich et al. (1991) by demonstrating that treatment effects on performance and self-rating measures were directly related to receiving active medication.

Examined the developmental correlates and predictors of conduct problems in children who made the transition from preschool to kindergarten. Measures of social competence, self-control, and vocabulary ability were assessed in 79 children (4 to 5 years of age) and related to teacher ratings of impulsive-aggressive problem behavior assessed concurrently and 1 year later. Boys with high behavior-problem scores performed more impulsively on a delay-of-gratification task, responded more aggressively to hypothetical peer-conflict situations, and received more negative peer nominations than others. Conduct problems in girls were associated with motor impulsivity and low vocabulary scores (suggesting a co-occurring pattern of developmental immaturity) and with measures of both positive and negative peer status.

Children's and early adolescents' preference for same-sex peers and the consistency of individual differences in reputation and popularity across the same- and other-sex domains were studied with 3 samples. Findings indicated that individual differences in the same-sex preference (a) derived from children's liking of other-sex peers, (b) were consistent over relatively long intervals, and (c) were related to children's preferences for activities requiring gross motor skills. Same- and other-sex popularity had the same reputational correlates, except that acceptance among other-sex peers was more closely tied to prominence in the peer group. These findings are discussed according to children's and early adolescents' perceptions of and experiences with same- and other-sex peers