Date Presented 04/21/2023

We found that positive social relationship and support were important to improve social participation of children with attention deficit hyperactivity disorder (ADHD). OTs would need to provide emotional support programs for children with ADHD to promote their social activities.

Primary Author and Speaker: Yoo Gyeong Jeong

Contributing Authors: Hyojin Keum, Bokyeong Kwak, Jihyun Kim, Sangmi Park, Ickpyo Hong

PURPOSE: Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder and is characterized by hyperactivity, inattention, and impulsivity. Family and community supports may reduce the symptoms of ADHD and improve social performance of children with ADHD. We examined whether support of family, neighborhood and peer group are associated with social participation of children with ADHD.

DESIGN: A cross-sectional design using the 2019 and 2020 National Survey of Children’s Health (NSCH). Children aged between 6 and 17 years with ever diagnosed ADHD were included. The study data was collected from the questionnaires based on caregiver report.

METHOD: The positive social contexts were operationally defined as family resilience, supportive neighborhood and positive peer relationship. Social participation was measured children’s participation in organized activities with a binary response (Yes or No). The data were analyzed using a logistic linear regression model controlling for confounding factors. RESULT: Data from 6,474 children with ADHD (mean age: 12.6±3.9, male: 68.6 %, female: 31.4%) were used for analysis. Family resilience, supportive neighborhood, positive peer relationship were significantly associated with increased social participation in children with ADHD (odd ratio [OR]= 1.6, 95% confidence interval [CI]= 1.3-1.9; OR= 1.4, 95% CI= 1.2-1.6; OR=1.2, 95% CI=1.1-1.4, respectively). Among the confounding factors, associations of social participation with child’s sex, caregiver’s education, severity of symptoms, and medications were statistically significant. Others (i.e., child’s age, race) were not statistically significant.

CONCLUSION: The study findings revealed that children with ADHD who experienced positive social relationship and support were more likely to participate in social activities. Therapists would need to consider ADHD children’s social contexts to promote their social participation.


American Occupational Therapy Association. (2020). Occupational therapy practice framework: Domain and process (4th ed.). American Journal of Occupational Therapy, 74(Suppl. 2), 7412410010. https://doi. org/10.5014/ajot.2020.74S2001.

Child and Adolescent Health Measurement Initiative. (2021). Fast Facts: 2019-2020 National Survey of Children’s Health. Data Resource Center for Child and Adolescent Health supported by the U.S. Department of Health and Human Services, Health Resources and Services Administration (HRSA), Maternal and Child Health Bureau (MCHB). Retrieved [10/31/22] from [].

Schneider, M., VanOrmer, J., & Zlomke, K. (2019). Adverse childhood experiences and family resilience among children with autism spectrum disorder and attention-Deficit/Hyperactivity disorder. Journal of Developmental and Behavioral Pediatrics : JDBP, 40(8), 573-580.