The Impact of Internalizing Symptoms on Impairment for Children with ADHD: A Strength-Based Perspective

Abstract

Background/Purpose: ADHD is frequently associated with functional deficits across social, familial, and academic contexts (Pelham, 2005). Children with ADHD and internalizing symptoms typically experience higher levels of functional impairment compared to their counterparts with exclusively ADHD (Bishop et al., 2019). Positive parenting practices and child strengths have been found to play a protective role for children with ADHD (Healy et al., 2011; McCrimmon et al., 2018). This study aims to investigate the influence of internalizing symptoms on functional impairment for children with ADHD. Child strengths and parenting strengths have been examined to identify moderating effects of the aforementioned constructs. Methods: Data were collected in a community mental health centre using the Child and Adolescent Needs and Strengths questionnaire (CANS) and the Child Strengths and Difficulties questionnaire (SDQ). Participants included 209 children and their caregivers seeking mental health services between the ages of 5 and 11 with an ADHD diagnosis. To examine the moderating effects of parenting and child strengths, ordinary least squares regression models were tested using the PROCESS macro for SPSS (v3.5; Hayes, 2018). Results: Results suggest that levels of internalizing symptoms influence functional impairment in children with ADHD. Child strengths moderate the relationship between internalizing symptoms and functional impairment when internalizing symptoms are medium to high. Conclusion: Findings from this study demonstrate that facilitating child strengths can help moderate functional impairment for children who experience ADHD and internalizing symptoms.