Multiple Levels of Factors Protecting Against Peer Rejection in Children With Attention-Deficit/Hyperactivity Disorder

Abstract

This study investigated both the risk factors and the protective factors against peer rejection at multiple levels in children with attention-deficit/hyperactivity disorder (ADHD) and their typically developing peers. Using standard sociometric procedure, we studied the peer rejection of 108 children with ADHD (aged 7 to 12) and their classmates of the same sex and age ( n = 108). Risk factors (i.e., emotional/behavioral difficulties, academic performance, conflicts in the student-teacher relationship, parental rejection) predicted peer rejection in both groups, but the quality of relationships with teachers had a stronger predictive power in children with ADHD. Protective factors at multiple levels: individual ( extracurricular activity), family ( parental warmth and family social support), social ( school social support and friendship), compensated for all the risks of peer rejection in children with ADHD. However, the effect of prosocial behavior was insignificant after controlling for emotional/behavioral problems. Only school social support and friendship moderated the relationship between rejection and the risk factors in children with ADHD. Compensatory and moderating effects of all factors were found in the comparison group. Prevention and intervention of the peer rejection of children with ADHD should be focused on multiple levels of factors, especially social ones.