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Preschool Children With Attention-Deficit/Hyperactivity Disorder: Impairments in Behavioral, Social, and School Functioning

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ABSTRACT

Objective

To examine differences in home, school, and medical functioning between preschool-age children with attention-deficit/hyperactivity disorder (ADHD) and normal control children.

Method

A sample of 94 children (58 with ADHD, 36 normal controls) between 3 and 5 years old participated. Dependent measures included parent and teacher ratings of problem behavior and social skills, parent ratings of stress and family functioning, medical functioning data, observations of parent–child interactions and classroom behavior, and a test of preacademic skills.

Results

Young children with ADHD exhibited more problem behavior and were less socially skilled than their normal counterparts according to behavior ratings. Parents of children with ADHD experienced greater stress and were coping less adaptively than parents of non-ADHD children. Children with ADHD exhibited more noncompliant and inappropriate behavior than normal controls, particularly during task situations. Parents of children with ADHD were more likely to display negative behavior toward their children. Children with ADHD exhibited more negative social behavior in preschool settings and scored significantly lower on a test of preacademic skills. No significant differences in injuries or utilization of medical services were found.

Conclusions

Preschool-age children with ADHD are at significant risk for behavioral, social, familial, and academic difficulties relative to their normal counterparts.

Section snippets

Participants

Ninety-four children between 3 and 5 years of age (mean = 4.0; SD = 0.09) from a moderately sized urban area in the northeastern United States participated in the investigation. Fifty-eight of these children (50 boys, 8 girls) were identified as having one of the three subtypes of ADHD. Thirty-six children (20 boys, 16 girls) were assigned to a normal control group. Participants in both groups were primarily from middle-class socioeconomic backgrounds and predominantly white (ADHD group: 79%

RESULTS

Results were analyzed within each general category of dependent measures using Hotelling T2 tests (i.e., multivariate form of the t test) with an α level of .05. Significant Hotelling T2 tests were followed by univariate t tests using an α level of .01 to control for experiment-wise type I error. Effect sizes (ES) were calculated for the analysis of each variable to elucidate the magnitude of group differences in standard deviation units. Effect sizes were calculated by taking the difference

DISCUSSION

Young children with ADHD exhibited more problem behavior and were less socially skilled than their normal counterparts according to parent and teacher ratings. Group differences in behavior ratings were expected because (1) children were assigned to groups based, in part, on behavior ratings, and (2) prior research studies have documented high levels of disruptive behavior and social performance deficits in young children with ADHD (Alessandri, 1992, Byrne et al., 1998, Shelton et al., 1998).

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This study was funded by a grant from the D.R. Pool Heathcare Trust, Allentown PA. The authors thank our research assistants including Amy Boyajian, Alexander Hirsch, Jessica Hoffman, Karen Neifer, Kristin Renouf, and Marcie Handler.

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