Parental Influences on Peer Socialization Among Children with ADHD

描述(由调查人员提供)：尽管注意力缺陷/多动障碍(ADHD)的发生率很高，影响了5%的学龄儿童，并经常被转介到心理健康诊所，但很少有人意识到超过一半有ADHD经历的儿童存在严重的同伴关系问题。这些同龄人问题令人担忧，因为ADHD儿童在以后的生活中会患上抑郁症、犯罪行为、滥用药物和学业失败，如果他们也被同龄人拒绝，他们不良结果的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，减轻社会负担，具有很高的公共卫生意义。然而，尽管可用的心理社会和药物治疗改善了注意力持续时间和冲动控制，但治疗在改善这一人群中常见的高同伴排斥方面的效果明显较差。这项申请考察了一个未被充分研究的因素，它可能是改善ADHD儿童同伴关系的关键：父母在通过玩耍来鼓励他们的孩子建立友谊方面所起的作用。种族和社会经济不同的儿童(6-10岁)及其父母将从学校、儿科医生和心理健康诊所招募。一半的儿童将患有ADHD，另一半儿童将不符合任何障碍的标准。在研究1中，由以前不认识的ADHD儿童和没有ADHD的对照儿童组成的游戏小组将与他们的父母在2个月内举行三次会议。我假设，鼓励孩子加入同龄人、在孩子出现行为问题时进行干预、在游戏约会结束后向孩子汇报情况的父母，将帮助他们的孩子在游戏小组内外结交朋友--特别是如果他们的孩子患有ADHD的话。在研究2中，我将随机分配ADHD儿童的父母接受试验性干预，目的是教授父母支持他们的孩子建立友谊的技能，或者作为非干预控制组。我推测，这种干预将有助于父母鼓励他们的孩子建立同伴关系，他们的孩子在游戏小组内外都会更容易交到朋友。这些研究的结果可能会提高人们对父母如何减少孩子的同伴关系问题的理解。正在测试的试点干预措施是独立的，有可能成为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添加。我计划为未来的干预研究提供结果，这些研究旨在解决ADHD儿童的同伴拒绝问题，包括创建一种手动治疗方案，并检查男孩和女孩以及注意力不集中和混合型ADHD儿童的有效性是否存在差异。

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.