Screening Kids for ADHD
A team of two researchers hypothesized that children with a diagnosis of Attention Deficit Hyperactivity Disorder (ADHD) might be more susceptible to bullying. With this as their working hypothesis, Holmberg & Hjern (2008) studied the phenomenon of bullying within the population of all fourth grade students in the Sigtuna, a Swedish municipality near Stockholm. Students were screened for ADHD in a two-step procedure. Parents and teachers were asked initially to complete a questionnaire including Connors’ 10-item scale, a tool commonly used to measure behavior related to ADHD symptoms. Children who tested positively for behavioral problems associated with ADHD (characteristics such as impulsivity and difficulties in emotional regulation) were then invited to complete a more intensive clinical evaluation by a child neurologist. After a clinical interview, each positively identified child was classified into one of four categories:
(1) Pervasive ADHD
(2) Situational ADHD
(3) Sub-threshold ADHD
(4) No ADHD
The ADHD Categories
Pervasive ADHD was reflected by children who manifested ADHD symptoms both at home and during school. Conversely, the category of situational ADHD was designated for children who manifested symptoms only in one setting or the other. The term sub-threshold ADHD was used to describe children who met between four and five criteria for an ADHD diagnosis in one or two settings. Finally, the children classified as not having ADHD were grouped with the students who had not been selected for clinical assessment. All children were then asked to report information about bullying on a survey questionnaire, administered by school nurses.
ADHD – Risk Factor for Bullying and Victimization
The results of the analysis by Holmberg & Hjern (2008) indicated that children with ADHD are both more likely to experience peer victimization and to bully others. The researchers noted that 24% of children diagnosed with pervasive ADHD and 25% diagnosed with situational ADHD reported bullying others. These percentages are in stark contrast to those reported by children with sub-threshold ADHD at 11% and those without ADHD at 7%. Thus, children in this fourth grade sample diagnosed with pervasive or situational ADHD reported bullying behaviors three times as often as their peers. Additionally, the researchers reported that children with situational ADHD reported being bullied most frequently, closely followed by children with pervasive and sub-threshold ADHD. The pervasive ADHD and the situational ADHD groups reported victimization up to 10 times as often as their counterparts.
Intervention and Prevention Programs
Holmberg & Hjern (2008) encourage practitioners to conduct a thorough investigation into social relationships and difficulties at school when treating children with an ADHD diagnosis. Intervention and prevention programs should be tailored to intervene at many levels including classroom training, parental training, and individual social skill training should all be incorporated as necessary.
References
Conners, C. K. (1969). A teacher rating scale for use in drug studies with children. American Journal of Psychiatry, 126: 884–888.
Conners, C. K. (1990) Manual for Conners Rating Scales. Toronto: Multi-Health Systems.
Holmberg, K. & Hjern, A., (2008). Bullying and attention deficit hyperactivity disorder in 10 year olds in a Swedish community. Developmental Medicine & Child Neurology, 50: 134-138.
