Recasting the Classroom Setting to Promote Acceptance of Youth with ADHD by Peers

描述(由申请人提供)：在与不熟悉的同龄人见面的几个小时内，大多数同龄人通常不喜欢患有注意力缺陷/多动障碍(ADHD)的儿童。这些发现令人担忧，因为患有ADHD的儿童在青春期已经有患抑郁症、犯罪行为、滥用药物和学业失败的高风险，如果他们也有同伴关系问题，不良结果的可能性会成倍增加。为ADHD儿童的同伴困难制定有效的干预措施，有可能减少他们的痛苦，减轻社会负担，具有与NIMH的使命相关的高度公共卫生意义。不幸的是，到目前为止，现有的药物治疗、行为应急管理和社交技能培训干预措施在改善ADHD儿童的同伴接受度和友谊方面取得了一定的成功。现有的干预措施主要侧重于纠正导致ADHD儿童社交困难的缺陷，与此不同，这项应用评估了一种新的干预方法的可行性，以增加通常拒绝ADHD儿童的同龄人的包容性和容忍度。我试图改变同龄人可能会对ADHD症状附加的耻辱，以及同龄人对ADHD儿童可能持有的负面认知偏见，这种偏见会使孩子的负面声誉永久化，即使ADHD儿童可能表现出积极的行为变化。因为小学生的社会地位主要是由他们的同班同学决定的，所以这款应用程序测试了老师是否能够鼓励更有可能接受ADHD学生的同龄人。我将制定机械化的治疗方法，制定适当的程序来评估实施的忠诚度，并试点测试一种创新的方法，以在受控的夏季计划环境中增加同行群体的包容性和容忍度。通过关注同龄人群体对儿童拒绝和友谊的影响，这项研究将理想地导致改进社会问题的治疗，并提交一项后续研究，以评估社区学校的干预效果。PHS 398/2590(09/04版，2006年4月4日重新发布)页面续格式页面 公共卫生相关性：患有ADHD的儿童在与同龄人相处方面存在严重问题，这些困难增加了他们在青春期患抑郁症、青少年犯罪和学业失败的风险。事实证明，同伴关系问题对于专注于纠正ADHD儿童体内缺陷的现有治疗方法来说是难以解决的。这项建议测试了一种新的心理社会治疗方法，该方法训练小学教师提高同龄人对ADHD儿童的容忍度和接受度。

DESCRIPTION (provided by applicant): Within only hours of meeting unfamiliar peers, children with Attention-Deficit/Hyperactivity Disorder (ADHD) are typically disliked by the majority of the peer group. These findings are concerning because children with ADHD are already at high risk for developing depression, criminal behavior, substance abuse, and school failure in adolescence, and if they have peer relationship problems as well, the likelihood of poor outcomes multiplies. Developing effective interventions for the peer difficulties of children with ADHD has the potential to reduce their suffering and to diminish societal burden, carrying high public health significance relevant to the mission of NIMH. Unfortunately, existing medication, behavioral contingency management, and social skills training interventions have shown modest success to date on improving the peer acceptance and friendship of children with ADHD. In contrast to existing interventions that primarily focus on remediating deficits within children with ADHD that contribute to their social difficulties, this application assesses the feasibility of a novel intervention approach to increase the inclusiveness and the tolerance of the peer group that typically rejects the child with ADHD. I attempt to alter the stigma that a peer group may attach to ADHD symptoms and the negative cognitive biases the peer group may hold against a child with ADHD that perpetuates that child's negative reputation, even when the child with ADHD may display positive behavior change. Because elementary school-age children's social status is predominately determined by their classroom peers, this application tests the possibility that the teacher may be able to encourage a peer group that is more likely to be accepting of students with ADHD. I will develop the manualized treatment, appropriate procedures to assess fidelity of implementation, and pilot test an innovative approach to increase the inclusiveness and tolerance of the peer group in a controlled summer program setting. By attending to the understudied influence of the peer group on children's rejection and friendship, this research will ideally lead to the development of an improved treatment for social problems, and inform the submission of a follow-up study to assess intervention efficacy in community schools. PHS 398/2590 (Rev. 09/04, Reissued 4/2006) Page Continuation Format Page PUBLIC HEALTH RELEVANCE: Children with ADHD have severe problems getting along with peers, and these difficulties increase their risk for depression, delinquency, and school failure in adolescence. Peer relationship problems have proved refractory to existing treatments that focus on remediating deficits within the child with ADHD. This proposal tests a novel psychosocial treatment that trains elementary school teachers to increase the tolerance and acceptance of the peer group towards children with ADHD.