Considerable work has demonstrated significant impairment in social functioning for children with attention deficit/hyperactivity disorder (ADHD). The social functioning profiles of children with ADHD are marked by impairments across diverse domains as they tend to experience greater rates of peer rejection, have lower levels of social skills, and have impaired social cognitions. The purpose of this study was to (a) quantitatively examine the association between ADHD and deficits across several domains of social functioning (peer functioning, social skills, social information processing), (b) examine differences in the magnitude of such associations, and (c) examine the effect of potential moderators. A meta-analysis of 109 studies (n = 104,813) revealed that children with ADHD have the most impairment within the peer functioning domain (weighted effect size [ES] r = .33) followed by significantly smaller effects within the social skills (weighted ES r = .27) and social information-processing domains (weighted ES r = .27). When examining potential moderators, results revealed that the association between ADHD and deficits within the social skills domain was weaker among studies that controlled for co-occurring conduct problems (CP). Studies that utilized sociometric and teacher reports of peer status reported the largest effects within the peer functioning domain. In addition, studies that utilized the "gold standard" approach to diagnosing ADHD documented the largest effects within both the social skills and peer functioning domains. Last, studies utilizing younger samples revealed the largest effects for deficits within the peer functioning domain. Theoretical and clinical implications are discussed.

This study examined the construct validity and clinical utility of a brief self-regulation assessment (Head-Toes-Knees-Shoulders, HTKS) among a clinical sample of children with externalizing behavior problems (EBP). Participants for this study included 101 preschool children (72% male; Mage = 5.10 years; 79% Hispanic) with at-risk or clinically elevated levels of EBP. Self-regulation measures included the HTKS task, 4 standardized subtests from the Automated Working Memory Assessment (AWMA), parent and teacher reports of children's executive functioning (EF), and children's self-regulation performance across a series of executive functioning classroom games conducted as part of a summer treatment camp. Additional outcomes included school readiness as measured by standardized achievement tests, and parent and teacher reports of kindergarten readiness and behavioral impairment related to academic functioning. Performance on the HTKS task was moderately correlated with children's performance on the standardized working memory tasks and observed self-regulation performance in the classroom. Low to moderate correlations were observed between performance on the HTKS task and parent report of children's EF difficulties, as well as parent and teacher reports of children's kindergarten readiness and behavioral impairment related to academic functioning. Moderate to high correlations were observed between performance on the HTKS task and standardized academic outcomes. These findings highlight the promise of the HTKS task as a brief, ecologically valid, and integrative EF task tapping into both behavioral and cognitive aspects of self-regulation that are important for children with EBP's success in school.

This study investigated the extent to which parental homework completion during behavioral parent training (BPT) for children with or at risk for developmental delay contributed to parenting and child outcomes. Parents of 48 children (Mage = 44.17 months, SD = 14.29; 73% male; 72% White) with developmental delay (IQ < 75) or at risk for developmental delay (due to premature birth) with co-occurring clinically elevated externalizing behavior problems received Parent-Child Interaction Therapy (PCIT) as part of two previously completed randomized controlled trials. Parental homework completion was measured using parental report of home practice of treatment skills collected weekly by therapists. Parents also reported on child externalizing behavior problems and levels of parenting stress, while parenting skills were observed during a 5-min child directed play and child compliance was observed during a 5-min cleanup situation. Results indicated that higher rates of parental homework completion predicted parenting outcomes (i.e., increased positive parenting skills and decreased levels of parenting stress) and child outcomes (i.e., lower levels of externalizing behavior problems). Additionally, although limited by temporal precedence, there was an indirect effect of reductions in parenting stress on the negative association between parental homework completion and child externalizing behavior problems. These findings highlight the importance of parents practicing skills learned during BPT for optimizing treatment outcome. Parenting stress was also identified as a potential mechanism by which high levels of parental homework completion contributed to reductions in child externalizing behavior problems.