(PS11-A22) Understanding Cause and Effect and the Social Functioning of Youth with ADHD

Friendships in childhood contribute to cognitive growth and overall wellness. Consequently, peer rejection can lead to a myriad of negative outcomes. Children with attention-deficit/hyperactivity disorder (ADHD) often struggle with peer relationships. Researchers attempting to understand how deficits associated with ADHD may account for social impairment have proposed that children with ADHD may experience peer difficulties partially due to a deficit in understanding social cause-and-effect (e.g., using understanding of another’s emotions to influence one’s own actions). The purpose of this study is to advance our understanding of relations between ADHD, the understanding of social cause-and-effect, and social functioning. Research to date is limited by an over-reliance on rating scales to measure social functioning which does not capture peer perceptions of a child’s social status along with the lack of a clear understanding of the best way to measure comprehension of cause-and-effect relationships. This study begins to address these gaps as it includes peer sociometrics, observation data, and multiple measures of causal understanding.

Data were collected from 374 children with and without ADHD (M_age = 8.89, SD = .81; 37.7% female; 42.5% White). To measure social cognitive variables, a standardized procedure was followed in which children listened to a folktale and watched a TV show and then were asked to recall and answer questions about the causal path that connects the events. To measure social functioning, children interacted in groups of 6 to 10 unfamiliar same-sex children (half with ADHD) while observers recorded social behavior. Following the three-hour session, children completed a peer sociometric measure of other participants in the group. Prior to group sessions, parents completed ratings of their child’s social behavior.

Linear regressions were conducted to identify relations between social cognitive variables and various measures of social functioning. Seven regressions (1 per social functioning variable) were conducted and the percent of correct answers about causal connections in the TV show emerged as the best predictor of peer functioning across multiple measures. Namely, it was significantly associated with observer ratings of how much peers would want to play with a child again, how much peers liked a child, and how much a child annoyed their peers; as well as parent report of social skills, and peer report of how much they would like to play with the child again (R² range = .03 - .04). This causal connection variable was also correlated with parent ratings of ADHD symptoms (r = -.153, p = .022), suggesting that this deficit may be partly a manifestation of the disorder.

The measure of percent correct causal questions can be further explored to understand why it was most associated with indices of social functioning. Further, there may be other demographic, cognitive, or behavioral variables that serve as mediators or moderators of these relations which may change the interpretation of these results. Finally, as we continue to develop models of social behavior, there will be numerous opportunities to inform treatment development and enhance our currently limited ability to effectively treat social impairment.