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Observed Classroom Behavior of Children with ADHD: Relationship to Gender and Comorbidity

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Abstract

Examined hypothesized gender and comorbidity differences in the observed classroom behavior of children with attention deficit hyperactivity disorder (ADHD). The behavior of 403 boys and 99 girls with ADHD, ages 7–10, was compared (a) to observed, sex-specific classroom behavior norms, (b) by sex, and (c) by comorbid subgroups. Boys and girls with ADHD deviated significantly from classroom norms on 15/16 and 13/16 categories, respectively. Compared to comparison girls, girls with ADHD had relatively high rates of verbal aggression to children. Boys with ADHD engaged in more rule-breaking and externalizing behaviors than did girls with ADHD, but the sexes did not differ on more “neutral,” unobtrusive behaviors. The sex differences are consistent with notions of why girls with ADHD are identified and referred later than boys. Contrary to hypothesis, the presence of comorbid anxiety disorder (ANX) was not associated with behavioral suppression; yet, as hypothesized, children with a comorbid disruptive behavior disorder (DBD) had higher rates of rule-breaking, and impulsive and aggressive behavior, than did children with ADHD alone and those with ADHD+ANX. Elevated rates of ADHD behaviors were also observed in children with comorbid DBD, indicating that these behaviors are truly present and suggesting that reports of higher ADHD ratings in this subgroup are not simply a consequence of negative halo effects and rater biases.

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Authors and Affiliations

  1. New York University School of Medicine, New York, New York

    Howard B. Abikoff

  2. New York State Psychiatric Institute, Columbia University, New York, New York

    Peter S. Jensen

  3. Ohio State University, Columbus, Ohio

    L. L. Eugene Arnold

  4. Purdue University, Lafayette, Indiana

    Betsy Hoza

  5. McGill University, Montreal Children's Hospital, Montreal, Quebec, Canada

    Lily Hechtman

  6. St. Johns University, Queens, New York

    Simcha Pollack

  7. Nassau Community College, Garden City, New York

    Diane Martin

  8. Duke University Medical Center, Durham, North Carolina

    John S. March

  9. University of California, Berkeley, California

    Stephen Hinshaw

  10. National Institute of Mental Health, Rockville, Maryland

    Benedetto Vitiello

  11. Mount Sinai Medical Center, New York, New York

    Jeffrey Newcorn

  12. University of Pittsburgh, Pittsburgh, Pennsylvania

    Andrew Greiner

  13. University of California, San, Francisco, California

    Glen Elliott

  14. Stanford University, Palo Alto, California

    Helena Kraemer

  15. State University of New York, Buffalo, New York

    William E. Pelham Jr.

  16. University of California, Irvine, California

    James M. Swanson

Authors
  1. Howard B. Abikoff
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  2. Peter S. Jensen
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  3. L. L. Eugene Arnold
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  4. Betsy Hoza
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  5. Lily Hechtman
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  6. Simcha Pollack
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  8. Jose Alvir
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  15. C. Keith Conners
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  22. Karen Wells
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Abikoff, H.B., Jensen, P.S., Arnold, L.L.E. et al. Observed Classroom Behavior of Children with ADHD: Relationship to Gender and Comorbidity. J Abnorm Child Psychol 30, 349–359 (2002). https://doi.org/10.1023/A:1015713807297

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