Parental Influence on Children with Attention-Deficit/Hyperactivity Disorder: II. Results of a Pilot Intervention Training Parents as Friendship Coaches for Children

Abstract

We report findings from a pilot intervention that trained parents to be “friendship coaches” for their children with Attention-Deficit/Hyperactivity Disorder (ADHD). Parents of 62 children with ADHD (ages 6–10; 68% male) were randomly assigned to receive the parental friendship coaching (PFC) intervention, or to be in a no-treatment control group. Families of 62 children without ADHD were included as normative comparisons. PFC was administered in eight, 90-minute sessions to parents; there was no child treatment component. Parents were taught to arrange a social context in which their children were optimally likely to develop good peer relationships. Receipt of PFC predicted improvements in children’s social skills and friendship quality on playdates as reported by parents, and peer acceptance and rejection as reported by teachers unaware of treatment status. PFC also predicted increases in observed parental facilitation and corrective feedback, and reductions in criticism during the child’s peer interaction, which mediated the improvements in children’s peer relationships. However, no effects for PFC were found on the number of playdates hosted or on teacher report of child social skills. Findings lend initial support to a treatment model that targets parental behaviors to address children’s peer problems.

Evidence-Based Psychosocial Treatments for Children and Adolescents With Attention Deficit/Hyperactivity Disorder

“…The outcome measure criterion used in this study indicates that an outcome measure must be reliable, valid and gauge the problems targeted (see M4 in Table 1). As a result, the social functioning outcome measures used in the Mikami et al (2010) study of a parent friendship coaching intervention were acceptable in our review because social impairment is a very common problem for youth with ADHD. Although they also noted that impairment may be a more relevant outcome for psychosocial interventions, Sonuga-Barke et al excluded this study from their meta-analyses due to "no ADHD outcomes."…”

“…The rationale for this type of treatment is that by training staff in specific settings to manipulate contingencies in those settings, children will demonstrate improvements in social functioning. One study of BPI was published since the 2008 review and the treatment evaluated in this study (Mikami, Lerner, Griggs, McGrath & Calhoun, 2010) involved training parents to be social coaches and to modify contingencies when their children were in social situations to facilitate appropriate social behavior. Although not in a recreational setting, the manipulation in Parent Friendship Coaching (PFC) is the same as in the studies of STP; adults are taught to manipulate contingencies in a target setting to improve the social behavior of children with ADHD.…”

The Importance of Social Contextual Factors in Peer Relationships of Children with ADHD

“…The Parental Friendship Coaching (PFC) intervention consists of parent groups where instruction is provided about how parents can become "friendship coaches" for their children with ADHD [75]. Unlike typical social skills training interventions, PFC has no child treatment component and instead focuses on training the parents to address peer group factors.…”

“…Children whose parents received PFC were reported by parents to show better social behaviors, and were reported by teachers (who were unaware of whether the family was provided the intervention) to be more accepted and less rejected by their peers, relative to children whose parents were in the control group [75]. Observations of warm, non-critical, and instructive parental coaching behaviors were more frequent among parents who had received PFC, and these parental behaviors partially mediated the effect of the intervention on children's peer relationships (as reported by parents and teachers), providing support for the theoretical model of change [75].…”

How Do Children with ADHD (Mis)manage Their Real-Life Dyadic Friendships? A Multi-Method Investigation

“…Mikami and her colleagues, parents were taught to give in-vivo reminders to their children and to arrange a context that would be optimal for their children to develop good peer relationships (Mikami, Lerner, Griggs, McGrath, & Calhoun, 2010). This seems crucial for children with ADHD who are known to have difficulties generalizing the effects of the psychosocial Friendship Interactions of Children with ADHD 63 treatments they receive in clinic settings to the real world (see Abikoff, 2009, for a commentary).…”