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

描述（由申请人提供）：患有注意力缺陷/多动障碍（ADHD）的儿童通常不喜欢与不熟悉的同龄人相处几个小时。这些发现令人担忧，因为患有多动症的儿童在青少年时期已经处于抑郁、犯罪行为、药物滥用和学业失败的高风险中，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。为患有多动症的儿童制定有效的同伴困难干预措施，有可能减少他们的痛苦，减轻社会负担，具有与NIMH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、行为应急管理和社会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ADHD儿童的缺陷，这些缺陷导致了他们的社交困难，与此相反，本应用评估了一种新的干预方法的可行性，以增加同龄人群体的包容性和容忍度，这些同龄人群体通常拒绝ADHD儿童。我试图改变同龄人对多动症症状的耻辱感，以及同龄人对多动症儿童的负面认知偏见，这种偏见使多动症儿童的负面声誉永久化，即使多动症儿童可能表现出积极的行为改变。因为小学学龄儿童的社会地位主要是由他们的同班同学决定的，这个应用测试了老师是否能够鼓励一个更有可能接受ADHD学生的同班同学群体。我将开发手动治疗，适当的程序来评估执行的保真度，并试点测试一种创新的方法，以增加在一个受控的夏季项目环境中的同龄人群体的包容性和容忍度。通过关注同伴群体对儿童的拒绝和友谊的未充分研究的影响，本研究将理想地导致对社会问题的改进治疗的发展，并为提交后续研究提供信息，以评估社区学校的干预效果。小灵通398/2590 （Rev. 09/04，重新发布4/2006）页延续格式页

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.