Objective: This study evaluated a novel intervention for friendship problems in children with attention-deficit/hyperactivity disorder (ADHD). Parental Friendship Coaching (PFC) teaches parents to coach their children in targeted friendship behaviors that are lacking in children with ADHD and that help children develop good quality friendships. Method: Participants were 172 families of children with ADHD and social impairment (ages 6–11; 29.7% female) at two Canadian sites, randomized to PFC or to an active comparison intervention (Coping with ADHD through Relationships and Education; CARE) to control for common therapy factors. Questionnaire and observational measures assessing primary outcomes of children’s friendship quality and secondary outcomes of children’s friendship behaviors were collected at baseline, posttreatment, and 8-month follow-up. Results: Across both treatment conditions, children showed improvements in positive friendship quality and in friendship behaviors. Relative to CARE, PFC was associated with somewhat more positive and less negative friendship behaviors at posttreatment and follow-up, but no difference between conditions was found in friendship quality. However, moderation analyses suggested that PFC may contribute to better friendship quality among families who had previous psychosocial treatment, as well as children with comorbid externalizing disorders. Conclusions: Although PFC showed some efficacy for affecting children’s friendship behaviors, these changes may not translate into friendship quality. Nevertheless, PFC may improve friendship quality for at-risk subgroups of children with ADHD.

The unique objectives of the current investigation were: (a) to assess the fit of a multiinformant 2-factor measurement model of friendship quality in a clinical sample of children with attention-deficit/ hyperactivity disorder (ADHD); and (b) to use a multiple indicators multiple causes approach to evaluate whether comorbid externalizing and internalizing disorders incrementally predict levels of positive and negative friendship quality. Our sample included 165 target children diagnosed with ADHD (33% girls; aged 6 -11 years). Target children, their parents, their friends, and the parents of their friends independently completed a self-report measure of friendship quality about the reciprocated friendship between the target child and the friend. Results indicated that a multiinformant 2-factor measurement model with correlated positive friendship quality and negative friendship quality had good fit. The friendships of children with ADHD and a comorbid externalizing disorder were characterized by less positive friendship quality and more negative friendship quality than the friendships of children with ADHD and no externalizing disorder after controlling for the presence of a comorbid internalizing disorder. However, the presence of a comorbid internalizing disorder did not predict positive or negative friendship quality. These findings suggest that soliciting reports from parents in addition to children and friends, and measuring comorbid externalizing disorders, may be valuable evidence-based strategies when assessing friendship quality in ADHD populations. Public Significance StatementThis study suggests that the friendship quality of children with attention-deficit/hyperactivity disorder is characterized by global dimensions of positive and negative friendship features, such as companionship and conflict. Soliciting reports from parents in addition to children and friends, and measuring associated oppositional and conduct problems, may represent valuable science-based strategies when assessing friendship quality in children with attention-deficit/hyperactivity disorder.

Our objective was to identify behaviors and contextual situations associated with negative affect observed in the interactions of children with and without ADHD and their real-life friends. We expected negative affect to be linked to rule violations and disagreements about the choice of games. Loss of game was associated with episodes of negative affect in a structured game. Negative appraisal of friend's ability was most frequently associated with negative affect during unstructured free play. Comparison children expressed greater frustration regarding their own abilities, whereas children with ADHD commented more frequently about the inabilities of their friends.

Background: Friendships in middle childhood carry high developmental significance. The majority of children with attention-deficit/hyperactivity disorder (ADHD) have few friendships, unstable friendships, or poor relationship quality in any friendships they have. The current study used time-window sequential analysis to map the dynamics within the friendships of children with ADHD, specifically the peer contagion processes of dyadic mutuality and coercive joining. Methods: Participants were 164 dyads consisting of a target child with ADHD and peer problems (age 6-11 years; 68% male; and 73% white) and a reciprocated friend. Dyads were observed in the lab during a cooperative task eliciting verbal negotiation processes to decide how to share a limited resource and during a fastpaced, engrossing, and competitive task. Both tasks were designed to mirror the real-world interactions of friends. Sequences of dyadic mutuality (i.e., reciprocity of positive affect and positive behaviors) and coercive joining (i.e., reciprocity of aggressive, controlling, and rule-breaking behaviors) between target children and friends were coded. Results: Regarding dyadic mutuality, target children reciprocated their friends' positive affect in both tasks. They also reciprocated their friends' positive behaviors but only in the cooperative task. In contrast, they only reciprocated their friends' coercive joining behaviors in the competitive task. Medium to large reciprocity effects was found for 36%-53% (dyadic mutuality) and 38%-55% (coercive joining) of target children. Conclusions: These results extend findings of peer contagion processes to the friendships of children with ADHD and suggest that contagion may vary according to interaction context (i.e., competition vs. cooperation). Understanding the spread of peer contagion may illuminate how children with ADHD and their friends influence each other's adjustment over time and may guide friendship-focused psychosocial interventions for this population.