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. ? ? ?
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