The Friendship Study

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 the attention span and impulse control of children with ADHD, treatments are significantly less effective in ameliorating the high peer rejection commonly found in this population.

This study examines ways in which parents can assist their elementary school-aged children with ADHD with making friends, through coaching children in social skills and strategically arranging playdates. Half the children in this study meet criteria for ADHD, and the other half are comparison children without ADHD. Data has been collected from 64 families, with plans to increase the number of participants to 100. Children, along with their parents, meet in regularly scheduled peer playgroups, where child and parent behaviors are observed in order to investigate what interactions best predict friendship development. Additionally, parents of children with ADHD are randomly assigned to parent groups where they learned strategies to support their children’s friendship-making, or to be in a control group that does not receive this pilot intervention. It is hypothesized that the intervention will help parents to encourage their children’s peer relationships, and the effectiveness of this new treatment is being evaluated as well. Graduate student Jena Saporito is researching the effect of stigma about an ADHD diagnosis on parents and children, and how stigma might potentially influence friendship-making.

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.

This study is funded by the National Institutes of Mental Health, 1R03MH079019, to Amori Mikami.

I received the Young Scientist Research Award from CHADD (Children and Adults with ADHD) for this study.

Some media that have featured the Friendship Study are UVA magazine ; in the Richmond Times ; in ADDitude (an ADHD magazine), on a NPR program “Insight” (1/12/07) and on a radio program “Empowering our Children” (4/3/07)