Carol Duh-Leong1,2, Anne Fuller1,3, Nicole M Brown1. 1. Division of Academic General Pediatrics, Department of Pediatrics, Children's Hospital at Montefiore, Bronx, NY. 2. Division of General Pediatrics, Departments of Pediatrics and Population Health, NYU School of Medicine, New York, NY. 3. Division of Paediatric Medicine, The Hospital for Sick Children, Toronto, ON, Canada.
Abstract
BACKGROUND: Evidence has established the association between risk factors and attention-deficit/hyperactivity disorder (ADHD) severity, but less is known about factors that may have protective effects on clinical, academic, and social outcomes among children with ADHD. OBJECTIVE: To examine associations between family cohesion, caregiver social support, community support, and (1) ADHD severity, (2) school engagement, and (3) difficulty making or keeping friends. METHODS: Cross-sectional study of school-aged and adolescent children with ADHD using data from the 2016 National Survey of Children's Health. Our outcomes were (1) parent-rated ADHD severity, (2) school engagement, and (3) difficulty making or keeping friends. Our independent variables were (1) family cohesion, (2) caregiver social support, and (3) community support. We used logistic regression models to examine associations between our independent variables and each of our outcome variables, adjusting for child and parent sociodemographic characteristics. RESULTS: In our sample (N = 4,122, weighted N = 4,734,322), children exposed to family cohesion and community support had lower odds of moderate to severe ADHD [adjusted OR (aOR): 0.73 (0.55-0.97); aOR: 0.73 (0.56-0.95), respectively], higher odds of school engagement [aOR: 1.72, (1.25-2.37); aOR: 1.38, (1.04-1.84), respectively], and lower odds of difficulty making or keeping friends [aOR: 0.64, (0.48-0.85); aOR: 0.52, (0.40-0.67), respectively]. CONCLUSION: Among children with ADHD, family cohesion and community support show protective effects in clinical, academic, and social outcomes. Systematically identifying family- and community-level strengths may be important components of multimodal treatment strategies in children with ADHD.
BACKGROUND: Evidence has established the association between risk factors and attention-deficit/hyperactivity disorder (ADHD) severity, but less is known about factors that may have protective effects on clinical, academic, and social outcomes among children with ADHD. OBJECTIVE: To examine associations between family cohesion, caregiver social support, community support, and (1) ADHD severity, (2) school engagement, and (3) difficulty making or keeping friends. METHODS: Cross-sectional study of school-aged and adolescent children with ADHD using data from the 2016 National Survey of Children's Health. Our outcomes were (1) parent-rated ADHD severity, (2) school engagement, and (3) difficulty making or keeping friends. Our independent variables were (1) family cohesion, (2) caregiver social support, and (3) community support. We used logistic regression models to examine associations between our independent variables and each of our outcome variables, adjusting for child and parent sociodemographic characteristics. RESULTS: In our sample (N = 4,122, weighted N = 4,734,322), children exposed to family cohesion and community support had lower odds of moderate to severe ADHD [adjusted OR (aOR): 0.73 (0.55-0.97); aOR: 0.73 (0.56-0.95), respectively], higher odds of school engagement [aOR: 1.72, (1.25-2.37); aOR: 1.38, (1.04-1.84), respectively], and lower odds of difficulty making or keeping friends [aOR: 0.64, (0.48-0.85); aOR: 0.52, (0.40-0.67), respectively]. CONCLUSION: Among children with ADHD, family cohesion and community support show protective effects in clinical, academic, and social outcomes. Systematically identifying family- and community-level strengths may be important components of multimodal treatment strategies in children with ADHD.
Authors: Stephen V Faraone; Tobias Banaschewski; David Coghill; Yi Zheng; Joseph Biederman; Mark A Bellgrove; Jeffrey H Newcorn; Martin Gignac; Nouf M Al Saud; Iris Manor; Luis Augusto Rohde; Li Yang; Samuele Cortese; Doron Almagor; Mark A Stein; Turki H Albatti; Haya F Aljoudi; Mohammed M J Alqahtani; Philip Asherson; Lukoye Atwoli; Sven Bölte; Jan K Buitelaar; Cleo L Crunelle; David Daley; Søren Dalsgaard; Manfred Döpfner; Stacey Espinet; Michael Fitzgerald; Barbara Franke; Manfred Gerlach; Jan Haavik; Catharina A Hartman; Cynthia M Hartung; Stephen P Hinshaw; Pieter J Hoekstra; Chris Hollis; Scott H Kollins; J J Sandra Kooij; Jonna Kuntsi; Henrik Larsson; Tingyu Li; Jing Liu; Eugene Merzon; Gregory Mattingly; Paulo Mattos; Suzanne McCarthy; Amori Yee Mikami; Brooke S G Molina; Joel T Nigg; Diane Purper-Ouakil; Olayinka O Omigbodun; Guilherme V Polanczyk; Yehuda Pollak; Alison S Poulton; Ravi Philip Rajkumar; Andrew Reding; Andreas Reif; Katya Rubia; Julia Rucklidge; Marcel Romanos; J Antoni Ramos-Quiroga; Arnt Schellekens; Anouk Scheres; Renata Schoeman; Julie B Schweitzer; Henal Shah; Mary V Solanto; Edmund Sonuga-Barke; César Soutullo; Hans-Christoph Steinhausen; James M Swanson; Anita Thapar; Gail Tripp; Geurt van de Glind; Wim van den Brink; Saskia Van der Oord; Andre Venter; Benedetto Vitiello; Susanne Walitza; Yufeng Wang Journal: Neurosci Biobehav Rev Date: 2021-02-04 Impact factor: 9.052