Symptoms of attention-deficit hyperactivity disorder (ADHD) in young children and rejection by peers tend to influence one other, creating an unfortunate cycle, according to a new longitudinal study from Norway.
In other words, young children with ADHD tend to have more social difficulties and fewer friends, and this experience, in turn, may lead to stronger symptoms of ADHD, at least in the younger years.
“ADHD predicts poor relations with peers, but do poor relations with peers affect symptoms of ADHD, forming, in effect, a vicious cycle?” said Dr. Frode Stenseng, associate professor of psychology at the Norwegian University of Science and Technology (NTNU) and the study’s lead author.
“We found that more ADHD symptoms at age four predicted more rejection by peers at age six, and reciprocally, that greater peer rejection at age four predicted more symptoms of ADHD at age six. But these effects were less evident from ages six to eight.”
The study is of interest to parents, teachers, and other practitioners, as it highlights the importance of keeping social aspects in mind when thinking about the origins of ADHD in children, the authors suggest. In particular, helping children with their peer relationships while working with them on their ADHD symptoms could be of great benefit.
The research involved 962 Norwegian children at ages four, six, and eight who took part in the Trondheim Early Secure Study conducted in 2007 and 2008. More than 99 percent of the children were of western ethnic origin (e.g., European, American), 86 percent of their parents lived together, and they were evenly divided between boys and girls.
At age eight, the researchers found, symptoms of ADHD were still adversely affected by children’s level of peer rejection at age six, but the symptoms no longer had a negative effect on peer functioning.
“In other words,” said Stenseng, “symptoms of ADHD in preschoolers — that is, four year-olds — may lead to more peer rejection later on in school, and early peer rejection may lead to more ADHD symptoms among those children already showing symptoms.”
“However, later on, we did not see a pattern that was reciprocal. Instead, from ages six to eight, greater earlier peer rejection was more likely to lead to more ADHD symptoms, but ADHD symptoms at this later age did not lead to more peer rejection.”
The findings also showed that more ADHD symptoms were simultaneously related to more peer rejection at ages four, six, and eight.
The researchers caution that their study was conducted in a country with strong social welfare supports and that while the sample overall was large, the number of children with many symptoms of ADHD was relatively small. Even so, the results suggest the potential value of interventions that target both ADHD symptoms and peer relationships.
“The bottom line is that peer rejection and ADHD symptoms are related, but they may also affect each other over time,” said co-author Dr. Jay Belsky, Robert M. and Natalie Reid Dorn Professor of Human Development at the University of California, Davis.
The study is published in the journal Child Development.