Parental Influences on Peer Socialization Among Children with ADHD

描述（由研究者提供）：尽管注意力缺陷/多动障碍（ADHD）的可见度很高，影响5%的学龄儿童，并构成了经常转诊到精神卫生诊所，但很少有人意识到超过一半的ADHD儿童存在严重的同伴关系问题。这些同伴问题令人担忧，因为患有ADHD的儿童在以后的生活中会出现抑郁症，犯罪行为，药物滥用和学业失败，如果他们也被同伴拒绝，他们的不良后果风险可能会成倍增加。为患有ADHD和同伴排斥的儿童制定有效的干预措施有可能减少他们的痛苦并减轻社会负担，具有很高的公共卫生意义。然而，尽管现有的心理和药物治疗可以改善注意力和冲动控制，但在改善这一人群中常见的高同伴排斥方面，治疗效果明显较差。这个应用程序检查一个未充分研究的因素，可能是至关重要的，以改善儿童多动症的同伴关系：父母的作用，鼓励他们的孩子的友谊，通过游戏。种族和社会经济多样化的儿童（6-10岁）和他们的父母将从学校，儿科医生和心理健康诊所招募。一半的孩子将患有ADHD，另一半将不符合任何疾病的标准。在研究1中，以前不认识的ADHD儿童和对照儿童没有ADHD，沿着他们的父母，将在2个月内见面三次。我假设，鼓励孩子加入同龄人的父母，当孩子表现出行为问题时进行干预的父母，以及在游戏后与孩子进行汇报的父母，将帮助他们的孩子在游戏组内外结交朋友-特别是如果他们的孩子患有多动症。在研究2中，我将随机分配ADHD儿童的父母接受旨在教授父母技能以支持孩子建立友谊的试点干预，或在非干预对照组中。我假设，干预将有助于父母鼓励他们的孩子的同伴关系，他们的孩子将更容易结交朋友，无论是在游戏组内外。这些研究的结果可能会提高对父母减少孩子同伴关系问题的方法的理解。正在测试的试点干预措施是独立的，有可能成为一种更有效和更具成本效益的治疗方法，或作为改进现有治疗方法的一个组成部分。我计划为未来的干预研究提供信息，这些研究旨在解决ADHD儿童的同伴排斥问题，包括创建一个手动治疗方案，并检查男孩与女孩的有效性是否不同，以及注意力不集中与ADHD混合亚型的儿童。

DESCRIPTION (provided by investigator): Despite the high visibility of Attention-Deficit/Hyperactivity Disorder (ADHD), which affects 5% of school-age children and constitutes a frequent referral to mental health clinics, few are aware of the serious peer relationship problems over half of children with ADHD experience. These peer problems are concerning because children with ADHD are known to develop depression, criminal behavior, substance abuse, and school failure later in life, and if they are peer-rejected as well, their risk for poor outcomes may multiply. Developing effective interventions for children with ADHD and peer rejection has the potential to reduce their suffering and to diminish societal burden, carrying high public health significance. Yet whereas available psychosocial and medication treatments improve attention span and impulse control, treatments are significantly less effective in ameliorating the high peer rejection commonly found in this population. This application examines an understudied factor that may be crucial to improving the peer relations of children with ADHD: the role of parents in encouraging their children's friendships through playdates. Ethnically- and socioeconomically-diverse children (ages 6-10) and their parents will be recruited from schools, pediatricians, and mental health clinics. Half of the children will have ADHD and the other half will not meet criteria for any disorders. In Study 1, playgroups of previously-unacquainted children with ADHD and comparison children without ADHD, along with their parents, will meet for three sessions over 2 months. I hypothesize that parents who encourage their children to join peers, who intervene when their children show behavior problems, and who debrief with their children after the playdate, will help their children make friends both in and outside of the playgroups- especially if their children have ADHD. In Study 2, I will randomly assign parents of children with ADHD to receive a pilot intervention aimed at teaching parents skills to support their children's friendship making, or to be in a non-intervention control group. I hypothesize that the intervention will help parents encourage their children's peer relationships, and that their children will make friends more easily both in and outside of playgroups. Results from these studies may improve understanding about ways in which parents can reduce their children's peer relationship problems. The pilot intervention being tested is stand-alone and has the potential to be a more efficient and cost-effective treatment, or to be added as a component to improve existing treatments. I plan for results inform future intervention studies that address peer rejection for children with ADHD, including creation of a manualized treatment protocol and examining whether effectiveness differs for boys versus girls, and for children with the Inattentive versus Combined subtype of ADHD.