Children with attention deficit/hyperactivity disorder (ADHD) are at risk for experiencing problems with social functioning that are associated with adverse outcomes in adolescence and adulthood. To date, the most common ADHD treatments for children, psychostimulants and adult-mediated interventions, have had limited success reducing social impairments associated with ADHD. Using a non-concurrent multiple baseline across participants design, we examined the efficacy of a sibling-mediated social intervention for reducing negative and increasing positive social behaviors of three children with ADHD. We also assessed implementation integrity by the siblings, and acceptability from the perspective of the participant with ADHD, the siblings, and the parents. Results indicated that siblings learned and used specific social skills strategies with their siblings with ADHD that lead to increases in sharing, helping, and compromising behaviors for children with ADHD compared with baseline (Tau- U = 0.9531, p < .001). Summary of findings, study limitations, implications for research, and practice are discussed.

Attention-deficit/hyperactivity disorder (ADHD) is strongly associated with social functioning deficits in adolescents. However, the factors underlying this relationship are not well understood. Prior research has established that emotion dysregulation (ED) mediates the relationship between ADHD symptoms and social skills in middle school students and that the mediational role of ED is moderated by youth's level of depression. The current study examined whether this model holds true in high school students with ADHD, despite developmental and environmental changes during maturation. Cross-sectional measures of ADHD symptoms, emotion regulation, depression, and social functioning were collected from 174 high school students with ADHD (M age ϭ 14.51; 81.4% male). Analyses were conducted using the PROCESS macro for SPSS. Bootstrapping results of the omnibus effect of a multiple-mediational model indicated that ADHD and ED jointly account for 49% of the variance in parent-rated social skills (i.e., evidence of mediation by ED). However, counter to our hypothesis, depression did not moderate this relationship. This study provides evidence that ED accounts for the relationship between ADHD and social deficits in an older adolescent population. Results have significant implications for intervention strategies to improve emotional self-awareness and control in adolescents with ADHD. Impact and ImplicationsThis study builds upon prior evidence that emotion dysregulation explains the relationship between ADHD symptoms and poor social functioning in adolescents. It holds important implications for assessment and treatment of social impairment during adolescence.

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Young children exhibit relatively high rates of emotion, self-regulation, and behavior control difficulties. Epidemiological studies in the United States and Europe have found that rates of diagnosable psychiatric disorders in 3-to 5-year-olds ranged from 7.1% (Wichstrøm et al., 2012) to 21.4% (Lavigne et al., 1996). Thus, up to one in five preschoolers may exhibit significant symptoms of emotion and behavior disorders. Rates vary as a function of diagnostic criteria, respondent (e.g., parent or teacher report), diagnostician (e.g., psychologist or pediatrician), and consideration of impairment beyond display of symptomatic behaviors. Although overall rates of disorder have varied across investigations, studies are consistent in finding highest prevalence for attentiondeficit/hyperactivity disorder (ADHD) and oppositional defiant disorder (ODD), higher risk for disorder among boys, relatively strong associations across disorders (i.e., comorbidity), and very low rates of mental health service receipt (

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