Predicting global and specific impairment in children with ADHD: Interactions between child temperament and maternal traits

Abstract

Children with ADHD present with varying profiles of symptoms and impairment. This in part depends on individual child factors, but also on the various environmental factors that are at play. Research has shown that ADHD symptom severity is not necessarily incrementally related to the level of impairment experienced by the individual. To date, little research has explored the proportions of children who are impaired within various domains of functioning, or predictors of the type of impairment experienced, above and beyond the severity of their symptoms. The current study sought to examine the percentages of children with and without ADHD who were impaired across a wide range of areas (i.e. learning problems, study skills, adaptability, social skills, activities of daily living, leadership and functional communication), and also to examine whether, after controlling for ADHD symptom severity, child temperament and maternal factors were associated with each of these areas of impairment. Finally, we were interested in whether any of the child and maternal factors moderated the relationship between ADHD symptom severity and impairment. A sample of 133 children (6 – 12 years), 59 of whom were formally diagnosed with ADHD participated in the study. Child measures included parent and teacher ratings on the ADHD-RS and the BASC-2, parent ratings of child temperament, and clinician ratings on the CGAS. Maternal self-reports of parenting, coping style, and parenting-related stress were also obtained. As expected, more children with ADHD were impaired than children without ADHD. Further, hierarchical linear regression analyses revealed a number of significant interactions. These emerged between ADHD symptom severity and both punitive discipline and positive parenting style in predicting parent-rated impairment in social skills; ADHD symptom severity and parenting stress in predicting parent-rated impairment in leadership; and ADHD symptom severity and inconsistent parenting in predicting teacher-rated learning problems. The implications of these findings for both research and practice are discussed.