Parental Influence on Children with Attention-Deficit/Hyperactivity Disorder: I. Relationships Between Parent Behaviors and Child Peer Status

We examined associations between children’s peer relationships and (a) their parents’ social competence as well as (b) their parents’ behaviors during the children’s peer interactions. Participants were families of 124 children ages 6–10 (68% male), 62 with ADHD and 62 age- and sex-matched comparison youth. Children’s peer relationships were assessed via parent and teacher report, and sociometric nominations in a lab-based playgroup. Parental characteristics were assessed via parent self-report and observations of behavior during their child’s playgroup. After statistical control of relevant covariates, parents of children with ADHD reported poorer social skills of their own, arranged fewer playdates for their children, and displayed more criticism during their child’s peer interaction than did parents of comparison youth. Parents’ socialization with other parents and facilitation of the child’s peer interactions predicted their children having good peer relationships as reported by teachers and peers, whereas parental corrective feedback to the child and praise predicted poor peer relationships. Parents’ ratings of their child’s social skills were positively associated with ratings of their own social skills, but negatively associated with criticism and facilitation of the child’s peer interactions. Relationships between parental behaviors and peer relationships were stronger for youth with ADHD than for comparison youth. The relevance of findings to interventions is discussed.     

Effectiveness of a Parent Training Program for Improving Children’s Social Behavior

We tested the efficacy of a social skills training program for the parents of school-aged children experiencing socio-emotional problems. Participating families (N = 42) were randomly assigned to one of three conditions: parent social skills training; parent plus parallel child social skills training; or no-treatment control. The two treatment groups did not differ on any of the outcome measures. Treatment was associated with improvements in parent and child social skills knowledge, parent social problem solving, and child emotional functioning. In follow-up analyses examining mechanisms of change, parental attendance and change in child social skills knowledge predicted response to treatment. Overall, our results highlight the utility of engaging parents as primary participants in the treatment of children’s socio-emotional problems and suggest methods for maximizing the impact of such an intervention.     

The Role of Maternal and Child ADHD Symptoms in Shaping Interpersonal Relationships

The current study investigated the influence of maternal ADHD symptoms on: (a) mothers’ own social functioning; (b) their child’s social functioning; and (c) parent–child interactions following a lab-based playgroup involving children and their peers. Participants were 103 biological mothers of children ages 6–10. Approximately half of the children had ADHD, and the remainder were comparison youth. After statistical control of children’s ADHD diagnostic status and mothers’ educational attainment, mothers’ own inattentive ADHD symptoms predicted poorer self-reported social skills. Children with ADHD were reported to have more social problems by parents and teachers, as well as received fewer positive sociometric nominations from playgroup peers relative to children without ADHD. After control of child ADHD status, higher maternal inattention and hyperactivity/impulsivity each predicted children having more parent-reported social problems; maternal inattention predicted children receiving more negative sociometric nominations from playgroup peers. There were interactions between maternal ADHD symptoms and children’s ADHD diagnostic status in predicting some child behaviors and parent–child relationship measures. Specifically, maternal inattention was associated with decreased prosocial behavior for children without ADHD, but did not influence the prosocial behavior of children with ADHD. Maternal inattention was associated with mothers’ decreased corrective feedback and, at a trend level, decreased irritability toward their children with ADHD, but there was no relationship between maternal inattention and maternal behaviors for children without ADHD. A similar pattern was observed for maternal hyperactivity/impulsivity and mothers’ observed irritability towards their children. Treatment implications of findings are discussed.     

The Role of Maternal Depression on Treatment Outcome for Children with Externalizing Behavior Problems

Studies have shown that, on average, Parent Management Training combined with cognitive-behavioral therapy decreases children’s externalizing behavior, but some children do not improve through treatment. The current study aimed to examine the role of maternal depression in understanding this variability in treatment outcome. Children with externalizing behavioral problems and their parents were recruited from combined Parent Management Training and Cognitive-Behavioral programs in “real-world” clinical settings. At pre- and post treatment, maternal depression and children’s externalizing behavior were assessed. Results showed that treatment was less effective for children of depressed mothers compared to non-depressed mothers and that improvements in maternal depression were associated with improvements in children’s externalizing behavior. These findings suggest that treatment programs for children with externalizing problems may be able to improve outcomes if maternal depression is a target of intervention.     

A friendship intervention for children with Attention-Deficit/Hyperactivity Disorder: preliminary findings

Children with Attention-Deficit/Hyperactivity Disorder (ADHD) are known to experience difficulty in peer relationships. Neither standard interventions for ADHD nor peer acceptance-oriented interventions fully remedy this problem. We propose that interventions targeting ADHD children's dyadic friendships may be more realistic strategies for improving peer relationships. Hence, a friendship intervention, implemented within the context of an intensive behavioral treatment program with 209 ADHD children, is described. A model is proposed in which the friend's antisocial behavior relates to parental compliance with the friendship intervention, and both the friend's antisocial behavior and parental compliance predict friendship quality and treatment response. Results indicate that children paired with peers lower on antisocial behavior and children whose parents had higher levels of compliance with the friendship intervention achieved higher quality friendships and were rated by teachers as more improved.     

Individual Differences in Gender Development: Associations with Parental Sexual Orientation, Attitudes, and Division of Labor

Research on children of lesbian parents has suggested that such children are developing well, but questions have been raised about their gender development. In this study, we explored associations among parental sexual orientation, parental gender-related attitudes, parental division of labor, and children’s gender development. Participants were 66 preschool children and their 132 parents from the East Coast of the United States. Thirty-three families were headed by lesbian and 33 by heterosexual couples. Parents who divided paid and unpaid labor more unequally had children whose occupational aspirations were also more traditional. Measures of children’s gender development were generally unrelated to parental sexual orientation. Parents’ attitudes and behaviors were more strongly associated with children’s gender development than was parental sexual orientation.     

Predicting Parenting Stress in Families of Children with ADHD: Parent and Contextual Factors

We examined parental ADHD symptoms and contextual (parental education, social support, marital status) predictors of parent domain parenting stress (parental distress) as a function of child ADHD symptoms in a sample of 95 parents of 8 to 12 year-old children with and without ADHD. Parents’ perceptions of parental distress and social support were inversely-related. Parental ADHD symptomatology was the strongest predictor of parental distress of the variables considered. Models using teacher reports of child ADHD symptomatology and oppositionality differed from ones using parent reports, in that child oppositionality was only predictive of parental distress in the parent-report model. A post-hoc analysis showed that child factors did not predict parental distress over and above parent ADHD symptoms and contextual factors. These results suggest that parental ADHD symptomatology and parenting stress reduction should be considered in development of interventions for families of children with ADHD.     

The alliance in a friendship coaching intervention for parents of children with ADHD

The alliance between parent and therapist was observed in a group-based parent-training intervention to improve social competency among children with attention-deficit/hyperactivity disorder (ADHD). The intervention, called Parental Friendship Coaching (PFC), was delivered to 32 parents in small groups as part of a randomized clinical trial. PFC was delivered in eight, 90-minute sessions to parents; there was no child treatment component. Observed parent–therapist alliance recorded among 27 of the parents was measured using the Therapy Process Observational Coding System—Alliance scale (TPOCS-A; McLeod, 2005). Early alliance and change in alliance over time predicted improvements in several parenting behaviors and child outcomes, including peer sociometrics in a lab-based playgroup. These preliminary findings lend support to the importance of examining the parent–therapist alliance in parent-training groups for youth social and behavioral problems.     

The Effectiveness of Mindfulness Training for Children with ADHD and Mindful Parenting for their Parents

This study evaluated the effectiveness of an 8-week mindfulness training for children aged 8–12 with ADHD and parallel mindful parenting training for their parents. Parents (N = 22) completed questionnaires on their child’s ADHD and ODD symptoms, their own ADHD symptoms, parenting stress, parental overreactivity, permissiveness and mindful awareness before, immediately after the 8-week training and at 8-week follow-up. Teachers reported on ADHD and ODD behavior of the child. A within-group waitlist was used to control for the effects of time and repeated measurement. Training was delivered in group format. There were no significant changes between wait-list and pre-test, except on the increase of teacher-rated ODD behavior. There was a significant reduction of parent-rated ADHD behavior of themselves and their child from pre-to posttest and from pre- to follow-up test. Further, there was a significant increase of mindful awareness from pre-to posttest and a significant reduction of parental stress and overreactivity from pre-to follow-up test. Teacher-ratings showed non-significant effects. Our study shows preliminary evidence for the effectiveness of mindfulness for children with ADHD and their parents, as rated by parents. However, in the absence of substantial effects on teacher-ratings, we cannot ascertain effects are due to specific treatment procedures.     

Friendship Intimacy Exchange Buffers the Relation between ADHD Symptoms and Later Social Problems among Children Attending an After-School Care Program

The friendships of children displaying symptoms of attention-deficit/hyperactivity disorder (ADHD) have been understudied, particularly in comparison to the domain of peer rejection. This study tested whether friendship intimacy exchange buffers the prospective relation between ADHD symptoms and social problems 1 year later in a sample of children attending a community-based after-school program. Children (N?=?131; 53 % boys; 66 % African American) ranging from 5 to 13 years of age participated in this study. At baseline, children reported on friendship intimacy exchange with their identified best friend, and program staff rated children on ADHD symptoms and social problems. Staff ratings of children’s social problems were collected again 1 year later. Multiple regression analyses indicated that, after controlling for demographic variables and baseline social problems, friendship intimacy exchange significantly moderated the association between ADHD symptoms and social problems at the one-year follow-up. Specifically, the relation between ADHD and social problems was no longer significant for children reporting high levels of friendship intimacy exchange. This moderation was not further qualified by either child age or sex, although boys were more likely than girls to report low rates of friendship intimacy exchange. These findings indicate the importance of friendship intimacy for children displaying ADHD symptoms, who often experience significant peer problems. Friendship quality may be a promising target for prevention and intervention efforts in mitigating some of the long-term social problems associated with ADHD symptomatology, and future research is needed to extend these findings to other domains of friendship quality and clinical samples of children with ADHD.     

Symptoms of Attention-Deficit/Hyperactivity Disorder and Social and School Adjustment: The Moderating Roles of Age and Parenting

This study examined the associations between symptoms of attention-deficit/hyperactivity disorder (ADHD) and social and school adjustment (academic performance, peer relationships, school social problems) and the moderating roles of children’s age and maternal parenting (affection and overprotection) in these associations. The sample consisted of 2,463 students who were in the first to ninth grade in northern Taiwan. Results from the linear mixed models demonstrated that ADHD symptoms were inversely associated with academic performance and positively associated with social adjustment problems. Further, children’s age and maternal parenting moderated the associations between ADHD symptoms and school and social adjustment. For example, maternal overprotection moderated the relation between hyperactivity and negative peer relationships (i.e., difficulty forming and maintaining friendships), such that this relation was stronger for children who experienced higher levels of overprotection than children who did not. Moreover, children’s age moderated the association between attention problems and decreased academic performance, such that this association was stronger for older children and adolescents than for younger children. Furthermore, children’s age and maternal affection interacted to influence the association between attention problems and school social problems (i.e., bullying, aggression, and peer rejection) with maternal affection acting as a buffer for older children (grades 4–6) only. These findings are discussed from a developmental psychopathology perspective.     

Maltreated Children’s Social Understanding and Empathy: A Preliminary Exploration of Foster Carers’ Perspectives

Previous research suggests that parental abuse and neglect can have adverse effects on children’s peer relationships and self-perceptions. Emerging theoretical and empirical work suggests that children’s social understanding and empathy could play a key role as mediators of these effects, but we have little knowledge about the viability of such a model in explaining the everyday experiences of children in care. Thus, in order to gain an in-depth insight into the potentiality of this conceptual model, a focus group and detailed semi-structured individual interviews were conducted with a total of 10 foster carers. First, a thematic analysis revealed that problematic self-perceptions and peer relationships were indeed commonplace. Crucially, in line with our theoretical model, carers readily identified children’s difficulties with social understanding and empathy as relevant explanations for their socio-emotional problems. Carers reported using a variety of strategies to help children, but expressed a need for a clearer training package of practical strategies that could be used to encourage social understanding and empathy in children, with the aim of improving their social relationships.     

Negative and Positive Disability-related Events and Adjustment of Parents with Acquired Physical Disabilities and of their Adolescent Children

This study merged stress-and-coping research with the social model of disability to describe the most frequently experienced disability-related events experienced by 19 parents with acquired physical disabilities and their adolescent children, and examined the relations between these events, severity of disability, and psychological adjustment. Parents and adolescents reported many more positive than negative disability-related events, although parents reported significantly more negative events than did their children. Frequency of parents’ experienced negative disability-related events correlated significantly with self-reported anxiety, depression, and weaker feelings of parental self-efficacy, with their reports of adolescents’ internalizing and externalizing problems, and with adolescents’ self-reports of depression, anxiety, and lower self-esteem. Frequency of adolescents’ negative disability-related events correlated significantly with self-reported depression and lower self-esteem, and approached significance with self-reported anxiety. There were no significant associations between parents’ positive events and self-reported or adolescent adjustment. Total frequency of adolescents’ positive events correlated significantly with less parent-reported anxiety. There were several significant associations between parental rating of severity of disability and number of physical limitations with their and their children’s adjustment. Implications for understanding the daily effects of parental physical disability on parents and their adolescent children are discussed, and recommendations are suggested for prevention interventions.     

How Lesbian and Heterosexual Parents Convey Attitudes about Gender to their Children: The Role of Gendered Environments

We studied associations among parents’ gender role attitudes, gender stereotyping in children’s environments, and children’s gender role attitudes and whether these associations were similar for families with lesbian and heterosexual parents. Fifty-seven 4- to 6-year-olds and 114 parents from the US participated. Parents completed self-report questionnaires and responded to interview questions. Researchers collected data regarding the child’s environment and attitudes about gender. Results revealed that children with lesbian mothers had less stereotyped environments and less traditional attitudes. Parental attitudes were associated with stereotyping in children’s environments and with children’s attitudes about gender. Both for lesbian and heterosexual parents, the impact of parents’ attitudes on children’s attitudes was partially mediated by the nature of children’s environments.     

Parental Perceptions of Characteristics of Non-Parental Child Care: Belief Dimensions, Family and Child Correlates

Investigators argue that it is essential to consider why parents select non-parental child care arrangements in studying the effects of that care on a child’s development. Existing investigations explore family economic and demographic characteristics as determinants of child care choice. The present investigation examined a wide array of parents’ beliefs about characteristics of child care arrangements with the goal of determining if these could be reduced to coherent dimensions. The emergent belief sets were examined in relation to maternal and child characteristics as potential correlates. Two hundred and twenty respondents with children in non-parental care completed surveys. These individuals represent diverse ethnic and economic groups. Ratings of the importance of characteristics were factor analyzed resulting in a six factor solution: Practical Concerns, Institutional Structure, Curriculum, Scheduling, Child Centered Orientation and School Readiness. The latter factor, or program components promoting social skills and classroom behaviors associated with succeeding in school, was identified as the most important dimension. Parents describing their children as more difficult temperamentally and as less developmentally advanced tended to describe school readiness and curriculum issues as less important. Child characteristics accounted for unique variance above and beyond mothers’ characteristics in predicting to parental beliefs. Results suggest that parents as consumers possess coherent belief sets and are sensitive to children’s developmental needs in evaluating care arrangements.     

The Role of Friends’ Disruptive Behavior in the Development of Children’s Tobacco Experimentation: Results from a Preventive Intervention Study

Having friends who engage in disruptive behavior in childhood may be a risk factor for childhood tobacco experimentation. This study tested the role of friends’ disruptive behavior as a mediator of the effects of a classroom based intervention on children’s tobacco experimentation. 433 Children (52% males) were randomly assigned to the Good Behavior Game (GBG) intervention, a universal preventive intervention targeting disruptive behavior, and facilitating positive prosocial peer interactions. Friends’ disruptive behavior was assessed from age 7–10 years. Participants’ experimentation with tobacco was assessed annually from age 10–13. Reduced rates in tobacco experimentation and friends’ disruptive behavior were found among GBG children, as compared to controls. Support for friends’ disruptive behavior as a mediator in the link between intervention status and tobacco experimentation was found. These results remained after controlling for friends’ and parental smoking status, and child ADHD symptoms. The results support the role of friends’ disruptive behavior in preadolescents’ tobacco experimentation.     

Biased Self-Perceptions,Peer Rejection,and Aggression in Children

This study examined whether children’s biased self-perceptions of peer acceptance are associated in a linear or curvilinear fashion with aggression, whether associations are moderated by peer rejection status, and whether associations apply uniquely to reactive aggression. Children in the 4th through 7th grades completed a self-report measure on their social functioning (SPPC; Harter 1982), and teachers reported on children’s social functioning and aggression. Self-perceptual bias was operationalized as the standardized residual difference between children’s self-perceptions and their teachers’ perceptions of their peer acceptance. Rejected status moderated associations between biased self-perceptions and reactive aggression. Among non-rejected children, biased perceptions were not significantly associated with reactive aggression. In contrast, among peer-rejected children, reactive aggression was elevated in those who greatly underestimated as well as in those who even modestly overestimated their peer acceptance. This pattern was observed whether or not proactive aggression was statistically controlled. In contrast, biased self-perceptions were not associated with proactive aggression for rejected or nonrejected children. Implications are discussed with regard to future research and potential interventions for aggressive children.     

Mediators of Neighborhood Influences on Externalizing Behavior in Preadolescent Children

This study tested a mediation model of neighborhood influences on children’s externalizing behavior. In the proposed model, neighborhood disadvantage, ethnic heterogeneity, and low residential stability affect children’s behavior indirectly through their impact on neighborhood social processes, which in turn influence parenting and deviant peer affiliations. A community sample of 704 preadolescents (76% African American, 22% Caucasian) and their parents and teachers provided information for the study. Neighborhood concentrated poverty, derived from the 2000 U.S. Census, was positively associated with children’s externalizing behavior. This effect was fully mediated by neighborhood social processes and parenting quality, while deviant peer affiliations made independent contributions to problem behavior. The final mediation model explained children’s externalizing behavior equally well across gender and ethnicity, suggesting the presence of universal processes.     

Family Emotional Climate and Sibling Relationship Quality: Influences on Behavioral Problems and Adaptation in Preschool-Aged Children

We examined the impact of family emotional climate and sibling relationship quality on behavioral problems and adaptation in preschool-aged children. Participants were 63 mothers with a preschool-aged child enrolled in a Southern Arizona Head Start Program. Siblings were identified as children closest in age to target child. Mothers of predominantly Mexican descent (95%) participated in home interviews during the Fall and Spring of the year children entered center-based programs. Sibling relationship quality (warmth, agonism/competition) was proposed to predict children’s adjustment (behavioral problems and adaptation) longitudinally. Results indicate that after controlling for child characteristics (temperament, child gender, birth order) and after accounting for family characteristics (family emotional expressiveness, child exposure to interparental conflict, and parental agreement on childrearing), sibling warmth made a significant and unique contribution to child adjustment as reported by mothers and teachers six months later. Findings are consistent with existing research indicating that sibling relationships impact children’s adjustment and shape young children’s lives in meaningful and marked ways. Moreover, these associations were found with an understudied sample of young children of predominantly Mexican descent in low-income families, and thus make an important contribution to knowledge in the field.     

Parental Experiences of Having a Child with Obsessive-Compulsive Disorder: Associations with Clinical Characteristics and Caregiver Adjustment

We examined parental experience of having a child with obsessive-compulsive disorder (OCD) in 62 parent–child dyads. Youth with a primary diagnosis of OCD and their parent(s) were administered the CY-BOCS jointly by a trained clinician. Parents completed several measures about their child’s OCD-related impairment and accommodation, emotional and behavioral functioning, parental distress, caregiver stress, and parental experiences of having a child with OCD. Results indicated that parents of children with OCD are considerably distressed about their child’s condition. As expected, negative parental experiences (e.g., anxiety about child’s condition, uncertainty about their future) were directly related to OCD symptom severity and impairment, as well as child internalizing and externalizing problems, family accommodation of symptoms, and caregiver strain. The presence of emotional resources was negatively related to most outcomes, although some of these relationships did not achieve statistical significance. The presence of internalizing symptoms mediated the relationship between parental experiences and parental distress. Given these findings, addressing parental experiences as part of a family based cognitive-behavioral treatment program for pediatric OCD may help reduce parental distress and improve patient prognosis.