A Review of Peer Relationships and Friendships in Youth With ADHD

Objective: The purpose of this essay is to examine peer relationships in youth with ADHD and to review current peer functioning interventions. Method: The studies included in this review were identified using the following search terms: “attention-deficit/hyperactivity disorder,” “ADHD,” “peer relationships,” “friendships,” “social skills,” “intervention,” and “treatment.” Other than a few seminal studies published prior to 2000, studies included were published between 2000 and 2012. Results/Discussion: Background information regarding peer relationship difficulties and specific social skills deficits of youth with ADHD is reviewed and current social skills and friendship intervention programs are examined. Future directions also are provided

Culturally Appropriate Assessment of Functional Impairment in Diverse Children: Validation of the ADHD-FX Scale With an At-Risk Community Sample

Objective: In an effort to reduce disparities in ADHD diagnoses and treatment across cultures, the current study sought to establish initial psychometric and cultural properties of the ADHD-FX: a culturally sensitive assessment measure of functional impairment related to ADHD for diverse families. Method: Fifty-four Latino parents (44 mothers and 10 fathers) of school-aged children completed the ADHD-FX, as well as several other measures assessing child behavior and parent acculturation. Results: The ADHD-FX demonstrated adequate reliability (as demonstrated by internal consistency and test–retest reliability), psychometric construct validity (as demonstrated by associations with theoretically related measures), and cultural validity (as demonstrated by or lack of associations with acculturation measures). Conclusion: Initial psychometric and cultural properties suggest that the ADHD-FX is a reliable, valid, and culturally appropriate measure to assess functional impairment related to ADHD (i.e., difficulties with academic achievement, social competence, and familial relationships) in an at-risk, school-aged population

Examination of a Parent-Assisted, Friendship-Building Program for Adolescents With ADHD

Objective: Youth with ADHD experience significant impairment in peer functioning. Based on recommendations from the literature, the current pilot study examined the effectiveness of a parent-assisted, friendship-building program at establishing mutual friendships and improving peer relationships in adolescents with ADHD. Method: Participants included 20 adolescents with ADHD (ages 11-16 years) and their parent(s). Families completed the Program for the Evaluation and Enrichment of Relational Skills (PEERS). Measures of friendship quality, social knowledge, social self-efficacy, get-togethers, and peer conflict were completed at baseline and post-treatment. At post-treatment, participants also reported on the initiation of a new friendship. Results: Baseline to post-treatment differences were examined using paired-samples t tests. The majority of participants reported the initiation of a new friendship at post-treatment. Adolescents also demonstrated significantly improved social knowledge and increased get-togethers. Effect sizes were large. Conclusion: Following participation in PEERS, adolescents improved in several peer functioning domains and many initiated new friendships

The Role of Acculturation Differences and Acculturation Conflict in Latino Family Mental Health

In order to help address the mental health disparities that exist for Latino families in the U.S., the current study sought to examine the acculturation–mental health link within the context of Latino families and to identify potential mechanisms for intervention to alleviate mental health problems in this population. Specifically, our goal was to examine how parent–adolescent acculturation differences were related to mental health in Latino adolescents and their parents and to understand the role of acculturation conflict and family functioning within Latino families. Participants included 84 adolescent–parent dyads recruited through bilingual middle schools. We found partial support for our hypothesis that family functioning mediates the relationship between acculturation differences and mental health outcomes for Latino parents. Additionally, we found partial support for our moderated mediation hypothesis; specifically, a significant conditional indirect effect was found for Latino cognitive acculturation differences on adolescent externalizing problems via family functioning at high levels of acculturation conflict. Exploratory analyses also indicated that acculturation conflict moderates the relationship between family functioning and externalizing problems for Latino adolescents. Results highlight the importance of understanding acculturation within the context of Latino families, as findings differed for adolescents and their parents. Additionally, findings suggest that differences in acculturation may not always be problematic and their impact likely depends on how families interpret such differences

Parental Functioning in Families for Behavioral Parent Training and Importance of Clinically Meaningful Change

Objective/Method: Statistically significant and clinically meaningful effects of behavioral parent training on parental functioning were examined for 20 children with ADHD and their parents who had successfully completed a psychosocial treatment for ADHD. Results/Conclusion: Findings suggest that behavioral parent training resulted in statistically significant improvements in some domains of parenting behavior for both mothers and fathers and in reductions in most domains of parenting stress for mothers. Importantly, clinically meaningful change also was noted for these parental functioning areas, as well as for other domains of parental functioning that did not result in statistically significant findings. Clinical implications are discussed

Maternal Functioning Differences Based on ADHD Subtype

Objective: Maternal functioning differences in parenting stress, parental efficacy, and parenting behaviors were examined for mothers of children with ADHD. Method: Participants included 29 mothers of children with ADHD, Predominantly Inattentive Type (ADHD-I) and 38 mothers of children with ADHD, Predominantly Hyperactive-Impulsive or Combined Type (ADHD-HI/C). Results: Findings suggest that mothers of children with ADHD-HI/C reported significantly greater parenting stress and engaged in more negative parenting behaviors than mothers of children with ADHD-I. Conclusion: This study suggests that tailoring behavioral parent training based on ADHD subtype may be particularly helpful for parents of children with ADHD-HI/C

Incremental Clinical Utility of ADHD Assessment Measures With Latino Families

Objective: This study examined the incremental clinical utility of parent and teacher reports of ADHD symptomatology and functional impairment in Latino youth, as well as parent and teacher agreement with the final clinical judgment on a diagnostic structured interview. Method: Participants included 70 Latino youth (47 males, 23 females; M age = 8.13 years, SD = 2.51 years) and their parents and teachers; 60 participants were diagnosed with ADHD. Correlations, percent agreement, kappas, and regressions were utilized. Results: Results demonstrated that teachers agreed with the final clinical judgment more often than did parents. Results additionally demonstrated that functional impairment did not statistically significantly improve diagnostic models already including ADHD symptoms; follow-up analyses were run and are discussed. Finally, results demonstrated that teacher reports statistically significantly improved diagnostic models already including parent reports. Conclusion: The current findings suggest the importance of including both parent and teacher reports of both ADHD symptomatology and functional impairment when assessing ADHD in Latino youth

Feasibility, Acceptability, and Preliminary Outcomes of a Culturally Adapted Evidence-Based Treatment for Latino Youth With ADHD

Objective: To advance our knowledge about the most effective way to treat Latino youth with ADHD, the current feasibility and pilot study compared a culturally adapted evidence-based treatment (CAT) for ADHD to standard evidence-based treatment (EBT). Method: Following a comprehensive ADHD assessment, 61 Latino families of school-aged children (mean age of 8 years) were randomly assigned to either CAT or standard EBT (i.e., parent management training). Results: CAT outperformed standard EBT when examining homework completion and mother-reported treatment satisfaction. Apart from two trends favoring CAT, CAT and EBT both resulted in significant improvements in parent- and teacher-reported ADHD symptoms and functional impairment, as well as mother- and father-reported parental functioning. Conclusion: CAT outperformed standard EBT when examining several engagement and acceptability outcomes. CAT and EBT were equally effective when examining traditional treatment outcomes, which is impressive considering the robustness of standard EBT, especially when delivered by culturally competent staff

Advancing Our Knowledge of ADHD in Latino Children: Psychometric and Cultural Properties of Spanish-Versions of Parental/Family Functioning Measures

The lack of available Spanish versions of assessment measures contributes to insufficient research and underutilization of mental health services for Latino children with Attention-Deficit/Hyperactivity Disorder (ADHD). Thus, the goal of the current study was to examine the psychometric and cultural properties of several Spanish versions of parental/family functioning measures commonly used in comprehensive ADHD assessments (i.e., the Parenting Sense of Competence Scale, Alabama Parenting Questionnaire, and Confusion, Hubbub, and Order Scale). Participants included 68 Spanish-speaking, Latino parents in Southeast Wisconsin. In general, the Spanish translations of the measures demonstrated good reliability and validity. Furthermore, the psychometrically-sound measures were significantly related to acculturation as predicted, suggesting that the scales are not only psychometrically valid, but also culturally valid for use with Spanish-speaking, Latino families