Social problem solving and language skills in children with and without attention deficit hyperactivity disorder (ADHD)

Abstract

Children with Attention Deficit Hyperactivity Disorder (ADHD) often have difficulties interacting socially with peers and adults. The research in this thesis explored the social problem solving skills and social functioning of children with and without a diagnosis of ADHD, as well as the underlying mechanisms that may be contributing to children’s social problem solving abilities and social functioning. The potential mechanisms considered in the thesis included structural and pragmatic language abilities, executive functioning, theory of mind skills, and symptoms of inattention and hyperactivity/impulsivity. The impact of age, gender, and estimated IQ were also considered in analyses.

The research used a combination of parent questionnaires and children’s own performance, when assessing children’s social functioning, social problem solving, and language skills. Children’s social problem solving abilities were assessed using three separate social information processing tasks. One of the tasks presented social dilemmas to the children verbally, while the other two tasks were presented through audio-visual video clips; the different demands of these mediums allowed a comparison of the multiple components involved in real-world social interactions. Group comparisons indicated that children with ADHD performed more poorly than typically developing children on all three social problem solving tasks. In particular, children with ADHD had impaired understanding of characters’ emotions in the social dilemmas. Furthermore, parents rated children with ADHD as having more social problems and fewer social skills compared to the control group. Children with ADHD were also impaired in their pragmatic language abilities, theory of mind skills, and working memory abilities compared to their typically developing peers.

Given the significant differences between groups in their social problem solving abilities, we investigated potential mechanisms that may contribute to children’s social problem solving performance. Regression analyses indicated that pragmatic language skills predicted children’s social problem solving abilities beyond symptoms of ADHD. Additional mechanisms, such as working memory skills and theory of mind, appeared to be contributing to children’s social problem solving through their language abilities. Exploratory regression analyses were also conducted to investigate potential mechanisms underlying parent ratings of children’s social functioning. Surprisingly, children’ social problem solving abilities were not strongly associated with parent ratings of children’s social functioning. Children’s symptoms of ADHD, their working memory skills, and language abilities all contributed to parent ratings of children’s social functioning. The results of the research suggested that there is a difference in the variables contributing to children’s cognitive social problem solving abilities compared to parent ratings of children’s social functioning. Children’s symptoms of ADHD, particularly severity of hyperactivity/impulsivity, and executive functioning skills played an important role in explaining variance in parent ratings of children’s social functioning, but were less important in explaining children’s cognitive social problem solving abilities. The language skills of children with ADHD appear to be an important contributor to both their cognitive understanding of social problems and their social functioning.