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Identifying ADHD Symptoms Most Associated with Impairment in Early Childhood, Middle Childhood, and Adolescence Using Teacher Report

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Abstract

The purpose of this study was to examine the relationships between ADHD symptoms and impairment within a sample that includes children in early childhood (n = 250), middle childhood (n = 269) and adolescence (i.e., high school; n = 269). Nested multivariate regression analyses were used to examine the extent to which each ADHD symptom dimension (inattention and hyperactivity/impulsivity) is most associated with impairment in academic, social, and behavioral functioning within and across three developmental levels. Results indicated for academic impairment, inattention is more predictive than hyperactivity/impulsivity at all ages. For social functioning, both with peers and teachers, hyperactivity/impulsivity is more predictive than inattention but only for early childhood students; at the high school level, inattention is a significant predictor of social impairment. For behavioral functioning in the classroom, the pattern is mixed across dimensions and ages with HI decreasing in predictive utility across the three age groups and IA increasing in predictive utility. Forward stepwise regression was used to determine which of the 18 ADHD symptom items are most associated with impairment within and across developmental levels. Findings indicate that the symptoms that were most predictive of impairment varied by age group and by domain of impairment. Implications for assessment are discussed.

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Notes

  1. To examine the negative beta under academic impairment for the high school sample, post hoc analyses were conducted. Results revealed that IA was functioning as a suppressor variable. At low levels of IA the correlations between HI and academic progress were negative and at high levels of IA the correlations between HI and academic progress were positive.

  2. Just because a symptom failed to enter the final model does not mean it is unrelated to impairment, or would not be significant predictor if all symptoms were entered simultaneously. Rather the final models result in the best combination of symptoms to predict impairment at each age group.

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Acknowledgments

During the preparation of this article, Julie S. Owens and Steven W. Evans were supported by grants from the Department of Education, Institute of Educational Sciences (R324A120003; R324A120272; R324C080006) and S.W. Evans was supported by a grant from the National Institute of Mental Health (R01MH082864).

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The authors declare that they have no conflict of interest.

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Zoromski, A.K., Owens, J.S., Evans, S.W. et al. Identifying ADHD Symptoms Most Associated with Impairment in Early Childhood, Middle Childhood, and Adolescence Using Teacher Report. J Abnorm Child Psychol 43, 1243–1255 (2015). https://doi.org/10.1007/s10802-015-0017-8

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