Social skills and participation in children diagnosed with Attention Deficit Hyperactivity Disorder: A comparative cross-sectional study based on maternal perspectives

Abstract

Introduction:

Attention Deficit Hyperactivity Disorder (ADHD) significantly impacts children’s social skills and participation, affecting their daily functioning.

Objectives:

This study aimed to compare social skills and participation of children with ADHD to those of typically developing peers, from maternal perspective.

Methods:

A comparative cross-sectional study was conducted with 103 mothers (52 mothers of children diagnosed with ADHD recruited from a child and adolescent psychiatry clinic and 51 mothers of typically developing children recruited using community-based snowball sampling). Groups were matched and comparable in key sociodemographic variables (p > 0.05). Data were collected using the Child and Adolescent Participation Scale (CASP) and Social Skills Questionnaire (SSQ).

Results:

Children with ADHD had significantly lower social skills (SSQ total) and participation (CASP total) scores than the control group (both p < 0.001; r = 0.86 and r = 0.86, respectively). Deficits were noted across all SSQ subdomains. Lower participation was observed in home, school, and home–community domains, while no significant difference was found in neighborhood and community participation (p = 0.506).

Conclusions:

Maternal perspectives provide valuable real-world insights into the social and participation challenges experienced by children with ADHD. The findings suggest that family-centered occupational therapy approaches may be relevant for supporting social competence and participation in everyday occupations.

Keywords

Attention Deficit Hyperactivity Disorder social skills participation maternal perspective

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References

Al-Yagon

Forte

Avrahami

(2020) Executive functions and attachment relationships in children with ADHD: Links to externalizing/internalizing problems, social skills, and negative mood regulation. Journal of Attention Disorders 24(13): 1876–1890.

American Psychiatric Association (2013) Diagnostic and statistical manual of mental disorders: DSM-5. American Psychiatric Association.

Anaby

Law

Coster

, et al. (2014) The mediating role of the environment in explaining participation of children and youth with and without disabilities across home, school, and community. Archives of Physical Medicine and Rehabilitation 95(5): 908–917.

Ataş

Efeçınar

Hİ

Tatar

(2016) Sosyal Beceri Değerlendirme Ölçeği'nin geliştirilmesi ve psikometrik özelliklerinin incelenmesi. Turkish Psychological Counseling and Guidance Journal 6(46): 71–85.

Atasavun Uysal

Dülger

Bilgin

, et al. (2018) Çocuk ve Adölesan Katılım Anketi’nin (CASP) Türkçe geçerlik vegüvenirlik çalışması. [in Turkish]. Turkish Journal of Physiotherapy Rehabilitation 2018: 29.

Barkley

(2015) Concentration deficit disorder (sluggish cognitive tempo). In: Attention-Deficit Hyperactivity Disorder: A Handbook for Diagnosis and Treatment (4th ed.). Guilford Press, pp. 81–115.

Bedell

(2009) Further validation of the Child and Adolescent Scale of Participation (CASP). Developmental neurorehabilitation 12(5): 342–351.

Chaudhari

(2021) Social functioning, interpersonal difficulties, social deficits, and social skills training in ADHD. In: Gopalan

(ed.) New Developments in Diagnosing, Assessing, and Treating ADHD. IGI Global, pp. 196–210.

Coussens

Van Driessen

De Baets

, et al. (2020) Parents’ perspectives on participation of young children with attention deficit hyperactivity disorder, developmental coordination disorder, and/or autism spectrum disorder: A systematic scoping review. Child: Care, Health and Development, 46(2): 232–243.

10.

DuPaul

Evans

Cleminshaw-Mahan

, et al. (2024) School-based intervention for adolescents with ADHD: predictors of effects on academic, behavioral, and social functioning. Behavior Therapy 55(4): 680–697.

11.

ElAdl

(2024). Executive functions and their relationship to social skills in children with and without Attention Deficit Hyperactivity Disorder (ADHD). 2(2): 89–117.

12.

Glenn

Michalska

Lee

(2021) Social skills moderate the time-varying association between aggression and peer rejection among children with and without ADHD. Aggressive Behavior 47(6): 659–671.

13.

Gresham

Elliott

Kettler

(2010) Base rates of social skills acquisition/performance deficits, strengths, and problem behaviors: An analysis of the Social Skills Improvement System—Rating Scales. Psychological Assessment 22(4): 809.

14.

Hoza

(2007) Peer functioning in children with ADHD. Journal of Pediatric Psychology 32(6): 655-663.

15.

Imms

Adair

Keen

, et al. (2016) “Participation’: a systematic review of language, definitions, and constructs used in intervention research with children with disabilities. Developmental Medicine & Child Neurology 58(1): 29–38.

16.

Irwin

Soto

Chan

, et al. (2021) Activities of daily living and working memory in pediatric attention-deficit/hyperactivity disorder (ADHD). Child Neuropsychology 27(4): 468–490.

17.

Kara

Kose

, et al. (2025) School participation, supports and barriers of children with and without attention deficit hyperactivity disorder. BMJ Paediatrics Open 9(1): e002917.

18.

Kawabata

Tseng

W-L

Gau

SS-F

(2012) Symptoms of attention-deficit/hyperactivity disorder and social and school adjustment: The moderating roles of age and parenting. Journal of Abnormal Child Psychology 40(2): 177–188.

19.

King

Lawm

King

, et al. (2003) A conceptual model of the factors affecting the recreation and leisure participation of children with disabilities. Physical & Occupational Therapy in Pediatrics 23(1): 63–90.

20.

Kožárová

(2022) Specifics of social skills in students with ADHD. Štúdie zo špeciálnej pedagogiky 11(1): 9–17.

21.

Martin

Rubin

Rogers

, et al. (2025) The changing prevalence of ADHD? A systematic review. Journal of Affective Disorders 388: 119427.

22.

Mebostad

Orm

, et al. (2025) School refusal behaviour and social skills in children with attention-deficit/hyperactivity disorder. International Journal of Disability, Development and Education 72(2): 235–246.

23.

Mendes

Mancini

Miranda

(2018) Household task participation of children and adolescentes with ADHD: a systematic review. Cadernos Brasileiros de Terapia Ocupacional 26(3): 658–667.

24.

Mikami

Smit

Khalis

(2017) Social skills training and ADHD—what works? Current Psychiatry Reports 19: 1–9.

25.

Miller

Arnold

Chronis-Tuscano

, et al. (2025) Social skill profiles in ADHD and comorbid disorders. Journal of Attention Disorders 29(10): 879–895.

26.

Parke

Becker

Graves

, et al. (2021) Social cognition in children with ADHD. Journal of Attention Disorders 25(4): 519–529.

27.

Polanczyk

Willcutt

Salum

, et al. (2014) ADHD prevalence estimates across three decades: an updated systematic review and meta-regression analysis. International Journal of Epidemiology 43(2): 434–442.

28.

Shabat

Fogel-Grinvald

Anaby

, et al. (2021) Participation profile of children and youth, aged 6–14, with and without ADHD, and the impact of environmental factors. International Journal of Environmental Research and Public Health 18(2): 537.

29.

Sugma

KAA

Alawwiyah

Hasanati

(2025) Interventions to improve social skills of children with ADHD: A systematic review. International Journal of Educational and Psychological Sciences 3(3): 235–244.

30.

Tarhan

(2023) Mothers’ Perception of social participation and its reflection on their children. Journal of Social Studies Education Research 14(4): 24–50.

31.

WHO (2007) International Classification of Functioning, Disability, and Health: Children & Youth Version: ICF-CY. World Health Organization.

32.

Willcutt

(2012) The prevalence of DSM-IV attention-deficit/hyperactivity disorder: A meta-analytic review. Neurotherapeutics 9(3): 490–499.