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Symptoms of Attention-Deficit/Hyperactivity Disorder and Social and School Adjustment: The Moderating Roles of Age and Parenting

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Abstract

This study examined the associations between symptoms of attention-deficit/hyperactivity disorder (ADHD) and social and school adjustment (academic performance, peer relationships, school social problems) and the moderating roles of children’s age and maternal parenting (affection and overprotection) in these associations. The sample consisted of 2,463 students who were in the first to ninth grade in northern Taiwan. Results from the linear mixed models demonstrated that ADHD symptoms were inversely associated with academic performance and positively associated with social adjustment problems. Further, children’s age and maternal parenting moderated the associations between ADHD symptoms and school and social adjustment. For example, maternal overprotection moderated the relation between hyperactivity and negative peer relationships (i.e., difficulty forming and maintaining friendships), such that this relation was stronger for children who experienced higher levels of overprotection than children who did not. Moreover, children’s age moderated the association between attention problems and decreased academic performance, such that this association was stronger for older children and adolescents than for younger children. Furthermore, children’s age and maternal affection interacted to influence the association between attention problems and school social problems (i.e., bullying, aggression, and peer rejection) with maternal affection acting as a buffer for older children (grades 4–6) only. These findings are discussed from a developmental psychopathology perspective.

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Notes

  1. The high participation rate is likely due to the corresponding author’s relationship with the school systems. The author has formed a good relationship with teachers, school principals, and parents because she has conducted multiple extensive school-based studies and provided substantial school consultations and clinical services to the primary and high schools for more than 10 years.

  2. The Chinese version of the Conners’ Parent Rating Scale-Revised: Short Form (CPRS-R:S) was not used in this particular study primarily due to a risk of inflated correlations resulting from shared method variance (both social adjustment problems and parent–child relationships were reported by parents).

  3. There is no single numerical grading system that is consistent across Taiwanese elementary schools, with teachers using different instruments to assess children’s academic performance. Therefore, academic performance was assessed via parent questionnaire (instead of grades) in part to yield a consistent metric across participants.

  4. Results of an additional analysis, using the sample reported in the referenced study demonstrated that the intraclass correlation coefficients between the interview and self-reports of the subscales of the Chinese SAICA ranged from 0.42 (problems with siblings) to 0.82 (spare time activities) for child reports and from 0.35 (spare time activities) to 0.82 (school problems) for parental reports among the 46 clinical participants.

  5. The validity of SAICA was evaluated using exploratory factor analysis (EFA). EFA extracted four factors, including academic performance, school social attitude, school social problems, and peer relationships. School social attitude and other subscales in the original measure were not included in this study because they were not a construct that clearly indicated social and school problems.

  6. Four-way interaction terms (e.g., age × parenting × ADHD symptoms × gender) were entered to investigate whether gender influences developmental processes involving age, parenting, and ADHD symptoms. The results showed that no interaction terms were significant and including these interaction terms did not improve a fit of the model. Hence, we did not include these interaction terms in the final model.

  7. The follow-up analyses for testing significant two-way and three-way interactions were also conducted using a median split. The results were similar to the results using a cutoff of one SD above and below the mean in terms of statistical significance.

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Acknowledgement

We thank the principals, teachers, parents and children for their participation in this study. Special thanks to Alan Sroufe for the comments on the earlier version of this manuscript and the six anonymous reviewers for their precious and helpful comments.

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Authors and Affiliations

  1. Fayetteville State University, Fayetteville, NC, USA

    Yoshito Kawabata

  2. University of Minnesota, Twin-Cities Campus, Minneapolis, MN, USA

    Wan-Ling Tseng

  3. Department of Psychiatry, National Taiwan University Hospital and College of Medicine, 7 Chung-Shan South Road, Taipei, 10002, Taiwan

    Susan Shur-Fen Gau

Authors
  1. Yoshito Kawabata
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  2. Wan-Ling Tseng
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  3. Susan Shur-Fen Gau
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Corresponding author

Correspondence to Susan Shur-Fen Gau.

Additional information

This study was funded by grants from Eli Lilly and Company (Taiwan) and National Health Research Institute, Taiwan (NHRI-EX94-9407PC) to the corresponding author.

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Kawabata, Y., Tseng, WL. & Gau, S.SF. Symptoms of Attention-Deficit/Hyperactivity Disorder and Social and School Adjustment: The Moderating Roles of Age and Parenting. J Abnorm Child Psychol 40, 177–188 (2012). https://doi.org/10.1007/s10802-011-9556-9

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