Targeting Peer Contagion Dynamics in Children with ADHD: Effects from a Two-Site Randomized Controlled Trial.

OBJECTIVE: Parental Friendship Coaching (PFC) teaches parents to coach their children in friendship skills. This paper examines whether PFC fosters positive peer contagion processes (i.e. dyadic mutuality) and reduces negative peer contagion processes (i.e. coercive joining) within the friendships of children with attention-deficit/hyperactivity disorder (ADHD). METHOD: Participants were 134 families of children with ADHD and peer problems (age 6-11 years; 69% male; 72% white) at two Canadian sites, randomized to PFC or CARE (an active comparison intervention). Children were observed in the lab at baseline, post-treatment, and at 8-month follow-up during cooperation and competition tasks with a real-life friend. Amount and reciprocity of dyadic mutuality indicators (i.e. positive affect and positive behaviors) and coercive joining indicators (i.e. aggressive, controlling, and rule-breaking behaviors) between friends were coded. RESULTS: Across treatment conditions, children showed an increase in the amount of dyadic mutuality during cooperation and a decrease in the amount of coercive joining during competition over time. Relative to CARE, PFC induced a reduced amount of coercive joining behaviors during cooperation at post-treatment and follow-up. However, PFC led to decreases in the reciprocity of positive affect during cooperation at post-treatment and to increases in the reciprocity of coercive joining during competition at follow-up relative to CARE. Moderation analyses suggest PFC was associated with better outcomes for children with externalizing comorbidity, and for those with a stable or a best friend. CONCLUSIONS: Findings highlight the importance of transactional processes, contextual differences, externalizing comorbidities, and friendship status when assessing the efficacy of PFC.

A Multi-Method Examination of Peer Functioning in Children with and without Cognitive Disengagement Syndrome.

OBJECTIVE: Cognitive disengagement syndrome (CDS) includes excessive daydreaming, mental confusion, and hypoactive behaviors that are distinct from attention-deficit/hyperactivity disorder inattentive (ADHD-IN) symptoms. A growing number of studies indicate that CDS symptoms may be associated with ratings of social withdrawal. However, it is important to examine this association in children specifically recruited for the presence or absence of CDS, and to incorporate multiple methods including direct observations of peer interactions. The current study builds on previous research by recruiting children with and without clinically elevated CDS symptoms and using a multi-method, multi-informant design including recess observations and parent, teacher, and child rating scales. METHOD: Participants were 207 children in grades 2-5 (63.3% male), including 103 with CDS and 104 without CDS, closely matched on grade and sex. RESULTS: Controlling for family income, medication status, internalizing symptoms, and ADHD-IN severity, children with CDS were observed during recess to spend more time alone or engaging in parallel play, as well as less time involved in direct social interactions, than children without CDS. Children with CDS were also rated by teachers as being more asocial, shy, and socially disinterested than children without CDS. Although children with and without CDS did not differ on parent- or self-report ratings of shyness or social disinterest, children with CDS rated themselves as lonelier than children without CDS. CONCLUSIONS: Findings indicate that children with CDS have a distinct profile of peer functioning and point to the potential importance of targeting withdrawal in interventions for youth with elevated CDS symptoms.

Social Media Posts from Friends during Late Adolescence as Predictors of Young Adult Physical Health.

Although an increasing body of literature has linked social experiences to physical health, research has yet to consider how specific aspects of social experiences taking place on social media during late adolescence may predict future physical health outcomes. This study thus examined qualities of social media posts received from peers at age 21 as predictors of participants' physical health (e.g., Interleukin-6 (inflammation), sleep problems, problems with physical functioning, and BMI) at age 28. Participants included 138 youth (59 men and 79 women); 57% of participants identified as White, 30% as Black/African American, and 13% as from other or mixed racial/ethnic groups. Posts from friends and participants at age 21 characterized by social ties predicted lower levels of future physical health problems, whereas socially inappropriate "faux pas" posts that deviated from peer norms by friends predicted higher levels of physical health problems at age 28. These associations were found after accounting for factors typically associated with physical health outcomes, including participants' baseline social competence, internalizing and externalizing symptoms, alcohol use, observed physical attractiveness, and history of prior hospitalizations. The results of this study suggest the importance of both achieving social integration with peers online and adhering to peer norms in the online domain as key predictors of future physical health.

Contributions of Friends' Problem Behaviors to Friendship Quality in a Sample of Children with ADHD.

OBJECTIVE: It is often assumed that children with attention-deficit/hyperactivity disorder (ADHD) experience friendship difficulties because of their own problem behaviors. However, friendships are dyadic relationships between two children. This study sought to understand the incremental contributions of friends' problem behaviors to dyadic friendship quality in a clinically diagnosed sample of children with ADHD. METHOD: One hundred and sixty-five dyads consisting of a target child with ADHD and social impairment (age 6-11; 67% male; 72% white) and a reciprocated, real-life friend were recruited. Parents and teachers rated the ADHD symptom severity, externalizing problems, and callous-unemotional (CU) traits of target children and friends. Friendship quality in the dyad was measured with: (a) questionnaires independently completed by target children, their parents, their friends, and the parents of their friends; and (b) observations of child-friend interactions. RESULTS: The severity of ADHD symptoms and externalizing problems (but not CU traits) in target children was associated with more negative friendship quality reported on questionnaires. Adjusting for the corresponding problem behavior in target children, each type of friends' problem behaviors incrementally predicted less positive friendship quality (on questionnaires). Friends' ADHD symptoms and CU traits also incrementally predicted more negative friendship quality (on questionnaires and observations). CONCLUSIONS: Considering problem behaviors in friends of children with ADHD (in addition to those in children with ADHD) may be important for identifying dyads at risk for lower quality friendships. These findings could possibly lead to new directions when designing and evaluating treatments targeting the friendship problems of children with ADHD.

Peer contagion dynamics in the friendships of children with ADHD.

BACKGROUND: Friendships in middle childhood carry high developmental significance. The majority of children with attention-deficit/hyperactivity disorder (ADHD) have few friendships, unstable friendships, or poor relationship quality in any friendships they have. The current study used time-window sequential analysis to map the dynamics within the friendships of children with ADHD, specifically the peer contagion processes of dyadic mutuality and coercive joining. METHODS: Participants were 164 dyads consisting of a target child with ADHD and peer problems (age 6-11 years; 68% male; and 73% white) and a reciprocated friend. Dyads were observed in the lab during a cooperative task eliciting verbal negotiation processes to decide how to share a limited resource and during a fast-paced, engrossing, and competitive task. Both tasks were designed to mirror the real-world interactions of friends. Sequences of dyadic mutuality (i.e., reciprocity of positive affect and positive behaviors) and coercive joining (i.e., reciprocity of aggressive, controlling, and rule-breaking behaviors) between target children and friends were coded. RESULTS: Regarding dyadic mutuality, target children reciprocated their friends' positive affect in both tasks. They also reciprocated their friends' positive behaviors but only in the cooperative task. In contrast, they only reciprocated their friends' coercive joining behaviors in the competitive task. Medium to large reciprocity effects was found for 36%-53% (dyadic mutuality) and 38%-55% (coercive joining) of target children. CONCLUSIONS: These results extend findings of peer contagion processes to the friendships of children with ADHD and suggest that contagion may vary according to interaction context (i.e., competition vs. cooperation). Understanding the spread of peer contagion may illuminate how children with ADHD and their friends influence each other's adjustment over time and may guide friendship-focused psychosocial interventions for this population.

Associations between cross-racial friendships and children's social and academic adjustment in racially diverse classrooms.

This study examined bidirectional associations between cross-racial friendships and children's social and academic adjustment. Participants were 583 elementary school-age children in western Canada, or the midwestern United States (4-10 years; 279 girls; 143 Asian, 88 Black, 65 Hispanic or Latinx, 171 White, 116 mixed). Children's adjustment (social preference, academic enablers, academic performance) and friendship nominations (reciprocated, received, given) were measured in fall and spring over one school year from 2017 to 2018, or from 2018 to 2019. Regarding reciprocated nominations, fall adjustment positively predicted spring reciprocated cross-racial friendships, but not vice-versa. For received nominations, academic enablers and received cross-racial friendship nominations were positively and bidirectionally related to one another. Fall same-racial friendship nominations positively predicted spring academic performance and social preference. Effect sizes were small.

Promoting Classroom Social and Academic Functioning among Children at Risk for ADHD: The MOSAIC Program.

OBJECTIVE: Social and academic functioning are linked in elementary school, and both are frequently impaired in children with elevated symptoms of attention-deficit/hyperactivity disorder (ADHD). This study evaluated the Making Socially Accepting Inclusive Classrooms (MOSAIC) program, a classroom intervention to support children's social and academic functioning, especially for children at risk for ADHD. Teachers delivered MOSAIC practices to the whole class and applied some strategies more frequently to target children selected for elevated ADHD symptoms and peer impairment. METHOD: Participants were 34 general education teachers (grades K-5) and 558 children in their classrooms, randomized to MOSAIC or to a typical practice control group for one academic year. In the fall and spring, we assessed (a) peers' sociometric judgments of children, (b) children's self-report of supportive relationships with teachers and peers, and (c) teachers' report of children's social and academic competencies and impairments. RESULTS: Regarding whole class effects, relative to control group children, children in MOSAIC classrooms (target and non-target children) were rated by teachers in spring as having better competencies and lower impairment, after controlling for fall functioning. There were no main effects of MOSAIC on peer sociometrics or child perceptions of supportive relationships. Target status moderated some effects such that, in spring, target children in MOSAIC perceived greater support from their teachers but received poorer sociometrics than did target children in control classrooms. CONCLUSIONS: We discuss the difficulty in changing peers' perceptions of children with ADHD symptoms, even in the presence of improvements in other aspects of social and academic functioning.

The Homogeneity and Heterogeneity of Moral Functioning in Preschool.

The current study examined relations between distinct aspects of moral functioning, and their cognitive and emotional correlates, in preschool age children. Participants were 171 typically developing 3- to 6-year-olds. Each child completed several tasks, including (a) moral tasks assessing both performance of various moral actions and evaluations of moral scenarios presented both verbally and nonverbally; and (b) non-moral tasks assessing general cognitive skill, executive functioning, theory-of-mind, and emotion recognition. Shyness and empathic concern were assessed from video acquired during participation. Results demonstrated positive associations among distinct moral actions, as well as among distinct moral evaluation tasks, but few associations between tasks assessing moral actions and moral evaluation. Empathic concern and inhibitory control each emerged as important predictors of preschoolers' moral functioning.

Correlates of Loneliness in Children with Attention-Deficit/Hyperactivity Disorder: Comorbidities and Peer Problems.

Children with attention-deficit/hyperactivity disorder (ADHD) are well-documented to experience social-emotional difficulties; however, little is known about their loneliness-an aspect of social-emotional functioning. Using a cross-sectional design, we examined how loneliness relates to comorbid internalizing disorders, externalizing disorders, and peer problems in a sample of 213 children with ADHD. Children (66 girls, Mage = 8.58, SDage = 1.55) reported their loneliness. Comorbid internalizing and externalizing disorders were assessed via a multi-informant procedure. Proportion of classmates who accepted, rejected, and ignored the child, friendship quantity, and friendship quality were peer problem indicators. Results suggested that children with comorbid internalizing disorders, fewer friendships, or potentially more negative friendship quality, reported more loneliness. Gender appeared to moderate the association between peer rejection and loneliness, such that boys with peer rejection reported more loneliness than girls. Clinical implications include targeting loneliness as a social-emotional problem to assess and treat in children with ADHD.

Online Social Interactions Predict Academic and Emotional Adjustment in the Transition to University.

We investigated the developmental implications of online social interactions among 590 youth transitioning to university. We observed friends' posts on participants' Facebook pages, and considered attributes of friends' posts used to indicate positive and negative relationship quality in face-to-face interactions. After statistical control of beginning-of-year functioning and participants' Facebook content, Facebook friends' deviant content posts (swearing; illegal/sexualized activities) predicted participants' lower grade point average, Facebook friends' posts indicating connection to participants predicted participants' lower psychopathology, and Facebook friends' verbal aggression posts predicted participants' lower institutional attachment, by the end of the year. Negative effects of friends' posts were strongest for participants who were disliked by peers face to face. The online context may uniquely influence youth adjustment in conjunction with face-to-face relationships.

Do infant sociomoral evaluation and action studies predict preschool social and behavioral adjustment?

Recent studies suggest that infants and toddlers evaluate others based on their prosocial and antisocial behaviors and engage in prosocial behaviors themselves. It is unknown to what extent infants' responses in such studies reveal stable individual differences in social and/or moral competence that persist throughout development. The current study (N = 63) demonstrates that infants' performance in sociomoral evaluation and action studies (mean age = 12 months) predicts social and behavioral adjustment at age 4 years. Specifically, a stronger preference for moral actions as an infant was associated with parent reports of fewer callous-unemotional traits, the domain most conceptually related to sociomoral evaluation and action, during preschool. Critically, preschool moral adjustment was uniquely associated with infants' sociomoral responding and not with other more general aspects of infant functioning. When 2 children with an autism spectrum disorder diagnosis were included in the sample, correlations between infant and preschool functioning were more widespread. Taken together, these results provide evidence for developmental continuity in the sociomoral domain and suggest that infants' early behavioral tendencies may be building blocks for subsequent sociomoral development.

Social Skills Training and ADHD-What Works?

PURPOSE OF REVIEW: Many children and adolescents with attention-deficit/hyperactivity disorder (ADHD) have difficulties in their social skills and peer relationships. Because social problems exacerbate later maladjustment in ADHD populations, it is important to address this serious impairment. Although social skills training (SST) is a common intervention approach, evidence to date suggests that SST has limited efficacy, at least when provided in traditional, clinic-based settings. The current review summarizes recent advances to traditional SST approaches that may potentially enhance their efficacy. RECENT FINDINGS: We identify two promising directions in which SST may be modified to make it more efficacious for ADHD populations. The first direction involves providing increased reinforcement and reminders of appropriate social behavior at the point of performance to youth with ADHD (e.g., in vivo, in real life peer situations as opposed to in the clinic). We note the importance of ensuring that youth with ADHD are receptive to such reminders. The second direction involves encouraging peers to be more socially accepting and inclusive of youth with ADHD. This avenue has been understudied in the literature to date. SST for children and adolescents with ADHD may be enhanced by providing more in vivo reminders and feedback at the point of performance and by making efforts to alter peers' impressions about youth with ADHD.

Perceptions of Relatedness with Classroom Peers Promote Adolescents' Behavioral Engagement and Achievement in Secondary School.

Secondary school is a vulnerable time where stagnation or declines in classroom behavioral engagement occur for many students, and peer relationships take on a heightened significance. We examined the implications of adolescents' perceptions of relatedness with classroom peers for their academic learning. Participants were 1084 adolescents (53% female) in 65 middle and high school classrooms. Multilevel cross-lagged path analyses found that adolescents' perceived relatedness with classroom peers subsequently predicted their increased self-reported behavioral engagement in that classroom from fall to winter and again from winter to spring. Higher engagement in spring predicted higher end of year objective achievement test scores after statistical control of prior year test scores. Implications are discussed for increasing classroom peer relatedness to enhance adolescents' achievement.

Wanting it Too Much: An Inverse Relation Between Social Motivation and Facial Emotion Recognition in Autism Spectrum Disorder.

This study examined social motivation and early-stage face perception as frameworks for understanding impairments in facial emotion recognition (FER) in a well-characterized sample of youth with autism spectrum disorders (ASD). Early-stage face perception (N170 event-related potential latency) was recorded while participants completed a standardized FER task, while social motivation was obtained via parent report. Participants with greater social motivation exhibited poorer FER, while those with shorter N170 latencies exhibited better FER for child angry faces stimuli. Social motivation partially mediated the relationship between a faster N170 and better FER. These effects were all robust to variations in IQ, age, and ASD severity. These findings augur against theories implicating social motivation as uniformly valuable for individuals with ASD, and augment models suggesting a close link between early-stage face perception, social motivation, and FER in this population. Broader implications for models and development of FER in ASD are discussed.

How teacher emotional support motivates students: The mediating roles of perceived peer relatedness, autonomy support, and competence.

Multilevel mediation analyses test whether students' mid-year reports of classroom experiences of autonomy, relatedness with peers, and competence mediate associations between early in the school year emotionally-supportive teacher-student interactions (independently observed) and student-reported academic year changes in mastery motivation and behavioral engagement. When teachers were observed to be more emotionally-supportive in the beginning of the school year, adolescents reported academic year increases in their behavioral engagement and mastery motivation. Mid-year student reports indicated that in emotionally-supportive classrooms, adolescents experienced more developmentally-appropriate opportunities to exercise autonomy in their day-to-day activities and had more positive relationships with their peers. Analyses of the indirect effects of teacher emotional support on students' engagement and motivation indicated significant mediating effects of autonomy and peer relatedness experiences, but not competence beliefs, in this sample of 960 students (ages 11-17) in the classrooms of 68 middle and high school teachers in 12 U.S. schools.

Closing the Racial Discipline Gap in Classrooms by Changing Teacher Practice.

Black students are issued school discipline sanctions at rates higher than members of other racial and ethnic groups, underscoring the need for professional development that addresses this gap. In 86 secondary classrooms, a randomized controlled trial examined the effects of a 2-year teacher coaching program, My Teaching Partner Secondary (MTP-S). Results from the second year of coaching and the year after coaching was discontinued replicated previous findings from the first year of coaching-intervention teachers had no significant disparities in discipline referral between Black students and their classmates, compared to teachers in the control condition, for whom racial discipline gaps remained. Thus, MTP-S effects were replicated in the second year of coaching and maintained when coaching was withdrawn. Mediational analyses identified mechanisms for these effects; Black students had a low probability of receiving disciplinary referrals with teachers who increased skills to engage students in high-level analysis and inquiry.

Implications of parental affiliate stigma in families of children with ADHD.

This study examined parents' perceptions/awareness and internalization of public courtesy stigma (affiliate stigma) about their children's inattentive and hyperactive/impulsive symptoms, and associations between parental affiliate stigma, parental negativity expressed toward the child, and child social functioning. Participants were families of 63 children (ages 6-10; 42 boys) with attention-deficit/hyperactivity disorder, assessed in a cross-sectional design. After statistical control of children's severity of inattentive and hyperactive/impulsive symptoms (as reported by parents and teachers), parents' self-reports of greater affiliate stigma were associated with more observed negative parenting. The associations between high parental affiliate stigma and children's poorer adult informant-rated social skills and greater observed aggression were partially mediated by increased parental negativity. As well, the positive association between children's adult informant-rated aggressive behavior and parental negativity was partially mediated by parents' increased affiliate stigma. Parental affiliate stigma about their children's inattentive and hyperactive/impulsive symptoms may have negative ramifications for parent-child interactions and children's social functioning. Clinical implications for parent training interventions are discussed.

Implicit versus Explicit Rejection Self-Perceptions and Adolescents' Interpersonal Functioning.

We investigated associations between implicit and explicit self-perceptions of rejection with interpersonal functioning in close relationships. Adolescents (N=124) reported their explicit rejection self-perceptions on a questionnaire and completed the Implicit Association Test to assess their implicit rejection self-perceptions. After controlling for implicit self-perceptions, adolescents' explicit rejection self-perceptions were associated with the adolescents self-reporting more negative relationship quality with close friends and self-reporting more negative behaviors with romantic partners. After controlling for explicit self-perceptions, adolescents' implicit rejection self-perceptions were associated with their romantic partners reporting more negative relationship quality with them, and observations of adolescents displaying more negative behaviors with romantic partners. Implicit and explicit rejection self-perceptions uniquely explain individual differences in interpersonal behaviors.

Preliminary evaluation of an observational measure of group cohesion for group psychotherapy.

OBJECTIVE: Group psychotherapy research would benefit from an observational measure of group cohesion to complement existing self-report measures. This study introduces the Therapy Process Observational Coding System-Group Cohesion scale (TPOCS-GC), which observationally assesses cohesion between each member and the group. METHOD: In total 27 parents participated in a group parent-training social competency intervention for children with attention deficit-hyperactivity disorder. Independent coders double-coded group cohesion and the alliance in 144 client-sessions. Parents, teachers, and children completed cognitive, behavioral, and therapy participation measures. RESULTS: The TPOCS-GC demonstrated modest to strong item-level interrater reliability and acceptable internal consistency. Group cohesion evidenced moderate stability over the course of treatment. Relations between TPOCS-GC and theoretically linked and unrelated variables provided some evidence for construct and predictive validity. CONCLUSIONS: This preliminary study suggests that the TPOCS-GC is a reliable instrument that may help fill an instrumentation gap in the field.

Observations of Effective Teacher-Student Interactions in Secondary School Classrooms: Predicting Student Achievement With the Classroom Assessment Scoring System-Secondary.

Multilevel modeling techniques were used with a sample of 643 students enrolled in 37 secondary school classrooms to predict future student achievement (controlling for baseline achievement) from observed teacher interactions with students in the classroom, coded using the Classroom Assessment Scoring System-Secondary. After accounting for prior year test performance, qualities of teacher interactions with students predicted student performance on end-of-year standardized achievement tests. Classrooms characterized by a positive emotional climate, with sensitivity to adolescent needs and perspectives, use of diverse and engaging instructional learning formats, and a focus on analysis and problem solving were associated with higher levels of student achievement. Effects of higher quality teacher-student interactions were greatest in classrooms with fewer students. Implications for teacher performance assessment and teacher effects on achievement are discussed.