Kara E. McGoey

Preschool Children With Attention-Deficit/Hyperactivity Disorder: Impairments in Behavioral, Social, and School Functioning

OBJECTIVE To examine differences in home, school, and medical functioning between preschool-age children with attentiondeficit/hyperactivity disorder (ADHD) and normal control children. METHOD A sample of 94 children (58 with ADHD, 36 normal controls) between 3 and 5 years old participated. Dependent measures included parent and teacher ratings of problem behavior and social skills, parent ratings of stress and family functioning, medical functioning data, observations of parent-child interactions and classroom behavior, and a test of preacademic skills. RESULTS Young children with ADHD exhibited more problem behavior and were less socially skilled than their normal counterparts according to behavior ratings. Parents of children with ADHD experienced greater stress and were coping less adaptively than parents of non-ADHD children. Children with ADHD exhibited more noncompliant and inappropriate behavior than normal controls, particularly during task situations. Parents of children with ADHD were more likely to display negative behavior toward their children. Children with ADHD exhibited more negative social behavior in preschool settings and scored significantly lower on a test of preacademic skills. No significant differences in injuries or utilization of medical services were found. CONCLUSIONS Preschool-age children with ADHD are at significant risk for behavioral, social, familial, and academic difficulties relative to their normal counterparts.

Parent ratings of attention-deficit/hyperactivity disorder symptoms: Factor structure and normative data.

Changes in the diagnostic criteria for attention-deficit/hyperactivity disorder (ADHD) have necessitated the creation of new measures for clinical assessment. The factor structure of a parent rating scale containing the 18 symptoms of ADHD was examined in this study. Factor analyses and assessment of differences in ADHD ratings across sex, age, and ethnic group were conducted using a sample of 4666 participants ranging in age from 4 to 20 years old who attended kindergarten through 12th grade in 22 school districts across the United States. Two factors (Inattention and Hyperactivity–Impulsivity) were derived and normative data for a nationally representative sample are presented. A higher frequency of ADHD symptoms was found for boys, younger children, and African-American participants. Potential uses of this scale in clinical practice and research are discussed.

Reliability and validity of parent and teacher ratings of Attention-Deficit/Hyperactivity Disorder symptoms.

The reliability and criterion-related validity of the Home and School versions of the AD/HD Rating Scale-IV were evaluated in a nonreferred sample of 71 students. Parent and teacher ratings were obtained 4 weeks apart at a time contemporaneous with observations of classroom behavior and academic productivity. Results indicated adequate levels of internal consistency, test-retest reliability, and cross-informant agreement for both parent and teacher ratings. Teacher ratings were significantly correlated with classroom observational data, and parent ratings were primarily related to behavior ratings. The discriminant validity of these scales also was examined in a sample of 92 clinic-referred children. Both the Home and School versions of the AD/HD Rating Scale-IV were found to discriminate significantly between children with and without AD/HD. The AD/HD Rating Scale-IV appears to have adequate psychometric properties for the screening and assessment of AD/HD.

Early Intervention for Preschool-Age Children with ADHD A Literature Review

Preschool-age children with attention-deficit/hyperactivity disorder (ADHD) are at-risk for expulsion from preschool settings due to disruptive, noncompliant behavior. Removal from preschool limits the childs exposure to preacademic instruction, socialization opportunities, and the structure of classrooms. In this review, the authors evaluate the efficacy of pharmacological, parent training, and behavioral interventions designed to manage the disruptive behavior of preschool children with ADHD. Twenty-six experimental articles were reviewed. Pharmacological intervention, which has received the most attention, was found to be generally effective, although not without problems due to side effects. Parent-training methods were found to be effective in the home setting, but minimal information has been collected on the generalization of these findings to the school setting. Very little research has been devoted to the use of behavior management in the school setting, but results from those studies that have been done appear promising. Issues regarding future research and the use of these interventions to prepare the preschool-age child with ADHD for kindergarten are discussed.

Outcomes of a multi-component intervention for preschool children at-risk for Attention-Deficit/Hyperactivity Disorder

ABSTRACT The purpose of this investigation was to investigate a comprehensive, multi-component approach to the treatment of preschool children at-risk for Attention Deficit/Hyperactivity Disorder (AD/HD) in home and school settings. The treatment program included school-based consultation, parent training, and if necessary, pharmacological treatment. A sample of 57 children identified as at-risk for AD/HD between 3 and 5 years of age were randomly assigned to an early intervention group (n = 30) or a community treatment control group (n = 27). Effect sizes were utilized to examine treatment outcomes. Results indicated mixed effects of early intervention on child behavior, parent-child interactions, family functioning, and pre-academic skills. Implications of these results for the implementation and further study of multi-component, early interventions for this population are discussed.

The relation of parenting, child temperament, and attachment security in early childhood to social competence at school entry

A wealth of research demonstrates the importance of early parent-child interactions on childrens social functioning. However, less is known about the interrelations between child and parent characteristics and parent-child interactions in early childhood. Moreover, few studies have broadly examined the longitudinal relations between these constructs and social competence. This study is an examination of the relations between parent responsiveness, negativity, and emotional supportiveness, attachment security, and child temperament, and their impact on childrens social competence from infancy to kindergarten entry. The sample was derived from the Early Childhood Longitudinal Study--Birth Cohort and included 6850 parent-child dyads. Observational and rating scale data were used. The proposed model was nearly fully supported by path analysis, and it provides insight into the complex relations between early parenting behaviors, child characteristics, and parent-child interactions in the development of social competence.

Classwide Intervention to Manage Disruptive Behavior in the Kindergarten Classroom.

The authors present an investigation of a classwide intervention to reduce disruptive behavior in a kindergarten classroom. Participants included children in 3 kindergarten classrooms and their teachers in an at-risk school district in Northeast Ohio. On the basis of student behaviors and teacher goals, the authors chose the Good Behavior Game plus Plus Merit. A total of 3 teachers implemented the Good Behavior Game Plus Merit in the classroom. The authors used a single-subject reversal design (ABAB) to test experimental control. They collected direct observations of student behavior during each phase of the intervention. Results indicated a decrease in negative, disruptive behavior during intervention. Last, the authors discuss the implications for implementing this intervention in the kindergarten classroom.

A Preliminary Investigation Into Teacher Perceptions of the Barriers to Behavior Intervention Implementation

Evidence-based practices are rarely translated into school settings. The literature examining the science-to-practice gap provides possible explanations, although these explanations are not supported with empirical evidence. Variables affecting behavior intervention implementation, such as lack of teacher training, lack of time, lack of resources, teacher stress level, and lack of administrative support, were examined in this preliminary study as possible explanations. Surveys were collected from 67 elementary teachers. Results regarding possible barriers to implementation indicate that the majority of respondents rated the severity of 12 of 19 barriers as extremely serious. Barriers rated as extremely serious were related to resources, training, and educator variables. In addition, significant correlations were found between job stress and the severity ratings of barriers related to lack of time, training, and support. Understanding these variables may provide important information to aid in the translation of current evidence-based practices into schools.

Understanding the psychometric properties of reliability and validity in assessment

This article operationalizes and describes the psychometric properties of reliability and validity within the context of assessment in rehabilitation counseling. Specifically, the authors examine those procedures by which psychometricians assess the reliability and validity of tests and other measurement instruments in the field of rehabilitation. Implications for the interpretation of scores and planning for intervention are discussed.

Normative ADHD-RS-Preschool Data in a Community Sample in Spain:

Objective: The objective was to obtain normalized data from the ADHD Rating Scale–IV–Preschool Version (ADHD-RS-IV-P) in a Spanish sample. Method: We translated and adapted the ADHD-RS-IV to our culture to obtain normalized data from a random representative sample of 1,426 Spanish preschool children (3 to <7 years old; 49.7% males). To analyze differences between evaluators, we used MANOVA. Internal consistency was assessed via Cronbach’s alpha. Results: The mean age was 4.7 years old. There was a significant sex effect. The questionnaire had an internal consistency between .86 and .96 according to subscale and evaluator. Conclusion: To evaluate ADHD in preschool children, it is necessary to use scores standardized by sex. Using a validated scale in schools and primary care centers may be useful for early detection of ADHD.