Friendships of children with ADHD: Exploring a parent friendship coaching intervention

Poor peer relationships, often defined in the literature by a rejected or neglected peer status, are characteristic of children with Attention Deficit Hyperactivity Disorder (Hoza et al., 2005). Intervention efforts to increase peer acceptance amongst this population have largely failed to normalize social standing (McQuade, & Hoza, 2008). As such, researchers have begun to explore friendships of children with ADHD. Friendships offer a unique context and motivation for children to acquire social skills, meet socio-emotional needs, and increase self-worth (Newcomb & Bagwell, 1995). Children with ADHD often have fewer friends than their typically developing peers and experience poorer quality friendships (Mikami, 2010). Only a handful of interventions aimed at improving friendships among children with ADHD exist (e.g., Frankel, Myatt, Cantwell & Feinberg, 1997; Mikami, Lerner, Griggs, McGrath & Calhoun, 2010). The current study explored Mikami and colleagues (2010) Parent Friendship Coaching (PFC) intervention, a parent-centered intervention aimed toward improving child friendship skills and opportunities. Twenty-four parents of children with ADHD were randomly assigned to receive PFC (n=14) or a parent support group (n=10). A parent-child interaction task and child play observations were conducted before and after receipt of treatment. Parent, child, and teacher ratings of friendship quality and social functioning were gathered pre and post treatment, as well as one month later. Secondary measures of child loneliness self-esteem, and impairment, along with parental socialization and behavior, were also collected. Results of primary parent outcomes indicated that parents who received PFC improved in their knowledge and observed use of PFC coaching skills over and above parents in the control condition. Parental involvement in playdates did not differ after treatment. For primary child outcomes, improved playdate quality and fewer negative play behaviors were found among children whose parents received PFC, as compared to the support group. Children in the PFC group were also invited to and hosted more playdates compared to the control group. For measures of child friendship quality, overall social skills, and social status, no group differences were found. Results exploring the relationship between parent and child outcomes indicated parent communication of coaching skills was correlated with less child conflict during playdates and fewer negative play behaviors. Greater knowledge of PFC skills among parents was also correlated with increased child playdates