Despite significant functional problems in multiple domains, children with Attention-Deficit/Hyperactivity Disorder (ADHD) unexpectedly provide extremely positive reports of their own competence in comparison to other criteria reflecting actual competence. This counterintuitive phenomenon is known as the positive illusory bias (PIB). This article provides a comprehensive and critical review of the literature examining the self-perceptions of children with ADHD and the PIB. Specifically, we analyze methodological and statistical challenges associated with the investigation of the phenomenon, the theoretical basis for the PIB, and the effects of sample heterogeneity on self-perception patterns. We conclude by discussing the implications of this work and providing recommendations for advancing research in this area.

Objective This study evaluated the efficacy of the Child Life and Attention Skills (CLAS) program, a behavioral psychosocial treatment integrated across home and school, for youth with Attention Deficit Hyperactivity Disorder-Inattentive Type (ADHD-I). Method In a two-site randomized controlled trial, 199 children (ages 7-11) were randomized to CLAS (N=74), parent-focused treatment (PFT, N=74), or treatment as usual (TAU, N=51). We compared groups on parent and teacher ratings of inattention symptoms, organizational skills, social skills, and global improvement at post-treatment, and also at follow-up during the subsequent school year. Results CLAS resulted in greater improvements in teacher-reported inattention, organizational skills, social skills, and global functioning relative to both PFT and TAU at post-treatment. Parents of children in CLAS reported greater improvement in organizational skills than PFT and greater improvements on all outcomes relative to TAU at post-treatment. Differences between CLAS and TAU were maintained at follow-up for most parent-reported measures but were not significant for teacher-reported outcomes. Conclusions These findings extend support for CLAS across two study sites, revealing that integrating parent, teacher, and child treatment components, specifically adapted for ADHD-I, is superior to parent training alone and to usual care. Direct involvement of teachers and children in CLAS appears to amplify effects at school and home and underscores the importance of coordinating parent, teacher, and child treatment components for cross-setting effects on symptoms and impairment associated with ADHD-I.

This study evaluated educationally relevant outcomes from a newly developed collaborative school–home intervention (Collaborative Life Skills Program [CLS]) for youth with attention and/or behavior problems. Participants included 17 girls and 40 boys in second through fifth grades (mean age = 8.1 years) from diverse ethnic backgrounds. CLS was implemented by 10 school-based mental health professionals at their schools and included 3 integrated components over 12 weeks: group behavioral parent training, classroom behavioral intervention, and a child social and independence skills group. Parent and teacher ratings of attention-deficit/hyperactivity disorder (ADHD) symptoms, organizational skills, and homework problems, and teacher-rated academic skills, report card grades, academic achievement, and classroom observations of student engagement were measured before and after treatment. Significant pre–post improvement was found for all measures, with large effect sizes for ADHD symptoms, organizational skills, and homework problems, and medium to large effects for teacher-rated academic skills, report card grades, academic achievement, and student engagement. Improvements in organizational skills mediated the relationship between improvement in ADHD symptoms and academic skills. Significant improvement in both ratings and objective measures (achievement testing, report cards, classroom observations) suggests that improvement exceeded what might be accounted for by expectancy or passage of time. Findings support the focus of CLS on both ADHD symptom reduction and organizational skill improvement and support the feasibility of a model which utilizes school-based mental health professionals as providers.

This study examines whether positively biased self-perceptions relate to social behaviors in children with attention-deficit/hyperactivity disorder (ADHD) as compared to control children. The social behaviors of children with ADHD (n = 87) were examined relative to control children (CTL; n = 38) during a laboratory-based dyadic social interaction task. Children with ADHD were subgrouped into those with a positive illusory bias (PIB) in their self-perceptions (ADHD+PIB) versus those without such a bias (ADHD-PIB). Using a behavioral coding system adapted for this study, ADHD+PIB, ADHD-PIB, and CTL participants were compared on objectively-coded social behaviors occurring within the context of the social interaction task. Whereas both ADHD groups displayed more disruptive behavior than controls, only the ADHD+PIB group displayed less prosocial behavior and less effortful behavior. This study breaks new ground by examining positively biased self-perceptions as they relate to social behavior in children with ADHD and provides promising new insight into the social problems experienced by these children.

Parenting and ADHD severity are independently associated with child social skill and aggressive behavior.To the extent that these associations are causal, multimodal treatment targeting both symptom reduction and improved parenting may be especially effective for the treatment of social problems related to childhood ADHD. Furthermore, evidence for parenting as a mediator of the relation between ADHD severity and child outcomes suggests that changes in child symptoms may also improve parenting practices, thus leading to improved child outcomes.