Abstract
Background:
The body of research directed at understanding the strengths and resilience of this population is growing. Research has indicated there are strengths for individuals with ADHD, and found factors important for promoting good outcomes. This study investigates positive qualities by examining the strengths and resilience of children with and without ADHD.
Methods:
The final sample included 56 children between the ages of 10 and 17 years (ADHD: n = 38; without ADHD: n = 18).
Results:
Children in both groups tended to report average levels of strengths and resilience except for school functioning, where significant differences were found between groups. Significant correlations between strengths and resilience for both groups were found. Only family involvement was not significantly correlated with resilience for the without ADHD group.
Conclusions:
Results from this study emphasize the importance of taking a strength-based perspective when working with children diagnosed with ADHD.
Keywords: ADHD, strengths, resilience, children
ADHD is a neurodevelopmental disorder that has received extensive research attention. Research has reported challenges and risks of ADHD in the areas of emotional regulation, social skills (Barkley, 2014), and academic achievement (Nigg & Barkley, 2014). Regardless, many with ADHD can be successful in social, emotional, and educational areas (Biederman et al., 1998). A plethora of research surrounds impairments, risks, and deficits in ADHD, with few focusing on strengths. Those studies examining strengths tend to focus on adults with ADHD. Nevertheless, areas of strength for those with ADHD can include good verbal abilities and logical thinking (Ek et al., 2007).
Resilience research makes up a minority of studies in the field of ADHD. Most previous studies examine resilience in typically developing children. For example, factors such as family (e.g., parenting skills), individual (e.g., good self-esteem; Herrman et al., 2011), and community (e.g., well-functioning community and school; Masten & Barnes, 2018) contribute to resilience. Research on resilience and ADHD reported similar factors including family cohesion, self-perceptions of competence, social support (Dvorsky & Langberg, 2016), and good self-esteem (Schei et al., 2018).
Despite the previous lack of attention, strengths, and resilience research is necessary. This study will take a strengths-based perspective in the examination of the strengths and resilience seen in children with ADHD. Merely viewing ADHD as a disorder does not consider the potential, strengths, and gifts that children with ADHD can possess (Sherman et al., 2006). As there is no “quick fix,” it is imperative to reconceptualize how ADHD is perceived and treated (Climie & Mastoras, 2015). Thus, a strengths-based perspective can focus on establishing resilience and positive qualities that support well-being (Climie et al., 2012).
ADHD
ADHD is a common neurodevelopmental disorder that onsets in childhood (American Psychiatric Association [APA], 2022). ADHD is associated with symptoms of inattention, hyperactivity, and impulsivity that occur at persistent and impairing levels (APA, 2022). In Canada, ADHD has an estimated 5% to 7% prevalence in school-aged children (Brault & Lacourse, 2012). Further, boys are twice as likely to be diagnosed with ADHD than girls (APA, 2022) and up to 80% of ADHD cases in child and adolescent psychiatric clinics are male (Antshel & Barkley, 2020).
Youth with ADHD are at considerable risk of experiencing impairment in social, academic, cognitive, and familial domains (Nigg & Barkley, 2014). These impairments can affect all facets of life (Nigg & Barkley, 2014). Moreover, ADHD frequently continues into adulthood and can result in impairments throughout the lifespan. Impairments can include academic underachievement, difficulties with social relationships, and emotional regulation, and day-to-day functioning (e.g., planning, time estimation; Barkley, 2014; Dvorsky & Langberg, 2016; Nigg & Barkley, 2014). Due to the greater risks associated with ADHD, it is imperative to understand how to overcome these adversities and identify strengths.
Strengths
Strengths-based research began with the positive psychology movement outlined by Seligman and Csikszentmihalyi (2000). Seligman and Csikszentmihalyi (2000) proposed that psychology must shift its focus away from pathology and move towards understanding how people flourish. A strengths-based approach recognizes that individuals have areas in their lives in which they are successful, despite the challenges they may have with other domains (Climie et al., 2012), and focuses on what is going well (Climie & Mastoras, 2015). Within this approach, research can meet Seligman and Csikszentmihalyi’s (2000) imploration by concentrating on establishing resilience and positive qualities that support well-being (Climie et al., 2012).
Research on strengths is a growing area of interest in the literature. Studies suggest that children can display a variety of character strengths including leadership (i.e., humor, perspective, and bravery), temperance (i.e., prudence, self-regulation, perseverance, and open-mindedness), intellect (i.e., curiosity, creativity, and love of learning), other-directed (i.e., modesty, forgiveness, kindness, and fairness), and transcendence (i.e., religiousness, zest, gratitude, love, and hope; Ruch et al., 2014). Specifically, children who have character strengths of hope, gratitude, love, and zest tend to report greater life satisfaction (Ruch et al., 2014).
A systematic review found the common strengths identified or focused on in research included personal competence, coping strategies, social competence, pro-social involvement, and a strong cultural identity (Brownlee et al., 2013). However, children’s greatest strengths tended to be self-esteem, self-efficacy, and optimism. Further, strengths important to youth exposed to trauma included regulation (e.g., self-control related) and meaning-making (e.g., purpose and future orientation; Hamby et al., 2020).
There is a notable paucity of research examining strengths in individuals with ADHD, although the few existing studies have found a variety of strengths and areas of competence. Despite the many possible risks youth with ADHD face, not all youth experience poor outcomes. Biederman et al. (1998) indicated that 20% of adolescents with ADHD perform well in social, emotional, and educational domains. Further, it has been proposed that some dimensions of ADHD, such as benefitting from an intense focus on areas of interest, could be adaptive instead of impairing (Lesch, 2018). Additional strengths were reported in verbal abilities, logical thinking, and reasoning (Ek et al., 2007), and emotional intelligence (Climie et al., 2019).
Qualitative research examining the strengths of high-functioning adults with ADHD found strengths in areas such as divergent thinking, adventurousness, persistence, and humor (Sedgwick et al., 2019). Meanwhile, women with ADHD have ascribed high energy, creativity, determination, high interest and excitability for new things, adventurousness, and willingness to take risks as positive traits partly related to their ADHD (Holthe & Langvik, 2017). Further, hyperfocus (i.e., working continuously for hours on tasks of interest) was frequently mentioned as another strength (Sedgwick et al., 2019).
Resilience
There is a lack of consensus regarding the definition of resilience as it is a complex and multifaceted term (see Masten et al., 1990). For the current study, resilience is broadly defined as the positive adaptation to adversity (Masten & Obradović, 2006). More specifically, resilience is when an individual attains a positive outcome or avoids a negative outcome despite adverse or challenging circumstances that create risk (Zolkoski & Bullock, 2012). For a person to demonstrate resilience, there must be the presence of both protective (i.e., processes that reduce, buffer, or ameliorate the effect of a risk) and risk factors (i.e., presence of adversity or risk that is known to interfere with adjustment; Herrman et al., 2011; Luthar et al., 2000; Zolkoski & Bullock, 2012). Resilience is a dynamic process of adaptation that involves the interaction of and influences of personal traits (e.g., intellectual functioning; self-perceptions) and environmental factors (e.g., family, community, and systems) that assist in overcoming adversity to have positive outcomes or avoid negative outcomes (Herrman et al., 2011; Zolkoski & Bullock, 2012). Being resilient implies possessing multiple skills to help cope with adversity (Alvord & Grados, 2005).
There are a variety of factors and dynamic processes promoting resilience. Self-regulation is an important and well-established protective factor (Masten & Barnes, 2018) and children who develop self-regulation skills earlier are better equipped to adapt to challenges and have better overall adjustment. Further, optimism, hope, and good self-esteem are protective factors that can promote resilience and coping skills (Zolkoski & Bullock, 2012). Strong cognitive abilities can operate as protective and promotive factors as children’s abilities to effectively utilize these resources can be impacted by their cognitive level (Chan et al., 2022).
Beyond the personal and individual factors that contribute to resilient functioning, research has also investigated the social mechanisms behind resilience. Children with strong social support tend to be less vulnerable to stress, depression, and externalizing problems, and experience better peer relationships (Alvord & Grados, 2005). Generally, having supportive, close, and secure relationships with friends and family can positively impact children and youth (Herrman et al., 2011; Masten & Obradović, 2006).
Resilience in ADHD Populations
Previous research investigating resilience in ADHD populations found a variety of factors with both protective and promotive effects (Dvorsky & Langberg, 2016). Social factors play an important role, where children with ADHD who had better social skills were better able to master stressful situations, relate to others, and were more resourceful and less vulnerable in stressful situations (Hai & Climie, 2021). Meanwhile, studies have supported social acceptance as buffering against conduct problems, negative parenting, and inattention (Dvorsky et al., 2018; Ray et al., 2017). Likewise, children who perceived more social support tended to have a better self-concept and emotional well-being (Mastoras et al., 2015). Being socially accepted and supported can contribute to resilient functioning in children with ADHD.
Positive self-perceptions may play a role in resilient functioning. Specifically, positive and modest self-perceptions of scholastic, athletic, behavioral, social, and overall competence have promotive effects (Dvorsky & Langberg, 2016; Ray et al., 2017). These perceptions can benefit social functioning (Ray et al., 2017), promote quality of life, and reduce emotional and behavioral problems (Schei et al., 2018). Although there is limited research exploring the effects of self-perception on resilience in individuals with ADHD, there is some evidence indicating these areas may contribute to resilient functioning (Dvorsky & Langberg, 2016).
Current Study
ADHD research has been increasingly taking on a strengths-based or positive perspective (Lesch, 2018). Comparing children with ADHD to those without ADHD provides a novel investigation into the commonalities and differences in self-perceived strengths and resilience between these groups. Self-reports can be particularly useful for understanding the experiences and perceptions of children with ADHD (Becker, 2020). This study aims to understand areas of strength and resilience among children with ADHD. Research in strengths and resilience can help build an understanding of how individuals with ADHD overcome the adversity brought on by having ADHD. To date, there have been no studies that examine strengths and resilience together. Thus, this novel study will continue the advancement of strengths-based research by exploring self-reported strengths and resilience in children with and without ADHD. Three research questions are posed:
RQ1: What are the strengths and resilience self-reported by children with and without ADHD?
RQ2: Are there significant differences in how children with and without ADHD rate themselves on strengths and resilience?
RQ3: What is the correlation between strength and resilience in children with and without ADHD?
Methodology
Participants
Eligible participants must be aged 10 to 17 years, residing with their parent/guardian, able to understand the English language, and be of Average or greater intelligence (i.e., standard score of 85 or greater). This study consisted of 56 children between the ages of 10 and 17 years (M = 12.66 years, SD = 2.08). An independent samples t-test found no difference in age between the group with ADHD (M = 12.29 years, SD = 2.14) and the control group (M = 13.44 years, SD = 1.76), t(54) = −1.99, p = .52. Participants in the group with ADHD were predominantly male (68.4%) while participants in the control group were predominantly female (61.1%). A chi-square test found significant gender differences between groups, χ2(1) = 4.40, p = .036, with significantly more boys in the ADHD group. Table 1 overviews relevant demographic information for both ADHD and control groups.
Table 1.
Participant Demographic Information by Group.
Variable | n | ADHD (n = 38) | n | Control (n = 18) | ||||
---|---|---|---|---|---|---|---|---|
% | M | SD | % | M | SD | |||
Age (years) | — | — | 12.29 | 2.14 | — | — | 13.44 | 1.76 |
Gender | ||||||||
Male | 26 | 68.4 | — | — | 7 | 38.9 | — | — |
Female | 12 | 31.6 | — | — | 11 | 61.1 | — | — |
Ethnicity | ||||||||
First nation/Métis | 2 | 5.3 | — | — | — | — | — | — |
European and Indian | 2 | 5.3 | — | — | — | — | — | — |
Asian and European | 1 | 2.6 | — | — | — | — | — | — |
Asian | — | — | — | — | 1 | 5.6 | — | — |
Indian | — | — | — | — | 1 | 5.6 | — | — |
Latino and European | 1 | 2.6 | — | — | — | — | — | — |
Middle eastern/Arabic | 1 | 2.6 | — | — | — | — | — | — |
Mixed | 1 | 2.6 | — | — | — | — | — | — |
White/European | 30 | 78.9 | — | — | 15 | 83.3 | — | — |
Caribbean and European | — | — | — | — | 1 | 5.6 | — | — |
Conners 3-P(S) | ||||||||
Inattention index | — | — | 74.82 | 14.00 | — | — | 52.17 | 7.80 |
Hyperactive/impulsive index | — | — | 75.29 | 13.33 | — | — | 50.89 | 7.36 |
WASI-II (standard score) | ||||||||
Full Scale IQ-2 | 38 | — | 112.47 | 11.51 | 18 | — | 113.67 | 10.32 |
Participants in the ADHD group were required to be free from other neurological or neurodevelopmental disorders such as autism spectrum disorder (ASD), or significant motor or sensory impairments. They were required to have a previous diagnosis of ADHD made by a medical professional (e.g., a psychologist or physician) and their symptoms were confirmed through elevated scores on relevant rating scales. Those in the control group could not have elevated ADHD symptoms, nor have siblings who were participating in the ADHD group.
Measures
Parents filled out demographic information and the Conners Rating Scale, third edition—Parent version, short (Conners-3 PS; Conners, 2008). The children completed the Wechsler Abbreviated Intelligence Scale—second edition (WASI-II; Wechsler, 2011) to measure intelligence, the Behavioral and Emotional Rating Scale—second edition, Youth Rating Scale (BERS-2 YRS; Epstein, 2004) to measure strengths, and the Connor-Davidson Resilience Scale 25 (CD-RISC-25; Davidson, 2021) for an overall measure of resilience.
Procedure
Recruitment occurred through virtual and physical poster advertisements. Researchers followed up with interested participants by sending additional study information and a pre-screen questionnaire. All data collection took place virtually due to the COVID-19 pandemic. Eligible participants scheduled a live zoom session with a graduate-level researcher to complete the child questionnaires and WASI-II. Parents were sent a link to the consent form and parent questionnaire to fill out on their own time. During the zoom session, researchers obtained assent from the child. Researchers would verbally read the instructions and questions to the child to ensure attention and comprehension. Children verbally responded to the questions and the researcher inputted their responses on the questionnaire. The two WASI-II subtests (Matrix Reasoning and Vocabulary) were completed according to the standards set in the manual, with the stimulus book presented on the screen. Once both the parent and child completed their surveys, the debrief form was sent along with a family-friendly gift card as a token of thanks.
Results
The information collected from participants was scored and entered into the Statistical Package for the Social Sciences (SPSS), version 26. Prior to analyses, all data was checked and cleaned. No issues were found. The first research question explored the levels of self-identified strengths and resilience reported by children with and without ADHD. On the CD-RISC-25, children with ADHD reported a mean resilience score of 63.03 (SD = 15.35), while those without ADHD reported a mean resilience score of 63.22 (SD = 13.05; see Table 2). Higher scores on the CD-RISC-25 indicate higher levels of resilience (score range: 0–100; Davidson, 2021). Children with and without ADHD report similar levels of overall resilience (i.e., similar levels of coping and adaptability).
Table 2.
Means and Standard Deviations for with and without ADHD groups on Resilience and Strengths.
With ADHD | Without ADHD | |||
---|---|---|---|---|
M | SD | M | SD | |
CD-RISC-25 overall resilience c | 63.03 | 15.35 | 63.22 | 13.05 |
BERS-2 YRS overall strengths a | 92.05 | 16.05 | 94.94 | 15.38 |
BERS-2 YRS interpersonal strengths b | 9.66 | 3.01 | 9.33 | 2.35 |
BERS-2 YRS family involvement b | 8.97 | 2.51 | 9.22 | 2.51 |
BERS-2 YRS intrapersonal strengths b | 8.61 | 2.78 | 8.83 | 2.85 |
BERS-2 YRS school functioning b | 7.92 | 2.84 | 10.22 | 2.37 |
BERS-2 YRS affective strengths b | 9.18 | 2.70 | 8.83 | 2.98 |
Standard score.
Scaled score.
Total score.
The children with ADHD reported overall strengths as average (M = 92.05, SD = 16.05), as did the children without ADHD (M = 94.94, SD = 15.38). These scores indicate that both children with and without ADHD are reporting comparable amounts of personal strengths as the norm sample. When looking at the strengths subscales, children with ADHD indicated they had average scores of interpersonal strengths (M = 9.66, SD = 3.01), family involvement (M = 8.97, SD = 2.51), intrapersonal strengths (M = 8.61, SD = 2.78), and affective strengths (M = 9.18, SD = 2.70). Similarly, the children without ADHD indicated they had average scores of interpersonal strengths (M = 9.33, SD = 2.35), family involvement (M = 9.22, SD = 2.51), intrapersonal strengths (M = 8.83, SD = 2.85), school functioning (M = 10.22, SD = 2.37), and affective strengths (M = 8.83, SD = 2.98). All children report comparable interpersonal, family involvement, intrapersonal, and affective strengths, indicating that they felt they had typical levels of strengths in these domains. Lastly, children with ADHD reported their school functioning to be below average (M = 7.92, SD = 2.84). Children with ADHD reported a lower school functioning score than the children without ADHD who felt they had typical levels of school functioning (M = 10.22, SD = 2.37).
The second research question examined the differences between the strengths and resilience reported by children with and without ADHD. Independent samples t-tests were conducted, with a Bonferroni correction. Results of the independent samples t-test revealed significant differences in school functioning between children with (M = 7.92, SD = 2.84) and without (M = 10.22, SD = 2.37) ADHD, t(54) = −2.90, p = .005, Cohen’s d = 0.85. No other significant group differences were found, p > .05 for all other comparisons.
The third research question investigated the relationships between the subscale strengths (i.e., BERS-2 YRS interpersonal strengths, family involvement, etc.) and overall resilience in children with and without ADHD. Pearson correlations were used to examine the relationship between subscale strengths and resilience in children with and without ADHD. For children with ADHD, there were statistically significant positive correlations between overall resilience and interpersonal strengths (r = .614, p < .001), family involvement (r = .672, p < .001), intrapersonal functioning (r = .694, p < .001), school functioning (r = .576, p < .001), and affective strength (r = .639, p < .001; see Table 3). Likewise, children without ADHD had statistically significant positive correlations between overall resilience with interpersonal strengths (r = .647, p = .004), intrapersonal functioning (r = .818, p < .001), school functioning (r = .652, p = .003), and affective strength (r = .695, p = .001), except for family involvement which was not significantly correlated with overall resilience (r = .411, p = .09; see Table 3).
Table 3.
Correlations Between Strengths and Overall Resilience.
CD-RISC-25 overall resilience | With ADHD | Without ADHD | ||
---|---|---|---|---|
r | p-Value | r | p-Value | |
BERS-2 YRS interpersonal strengths | .614 | <.001** | .647 | .004* |
BERS-2 YRS family involvement | .672 | <.001** | .411 | .09 |
BERS-2 YRS intrapersonal strengths | .694 | <.001** | .818 | <.001** |
BERS-2 YRS school functioning | .576 | <.001** | .652 | .003* |
BERS-2 YRS affective strengths | .639 | <.001** | .695 | .001* |
Indicates significance at p < .05.
Indicates significance at p < .001.
Discussion
The purpose of the current study was to explore the strengths and resilience of children with and without ADHD. Specifically, the current study sought to describe the self-reported strengths and resilience, compare children with and without ADHD on their strengths and resilience, and investigate the relationship between the self-reported strengths subscales and resilience in children with and without ADHD.
The first research question described the strengths and resilience demonstrated by children with and without ADHD. Results showed that both children with and without ADHD felt they had similar levels of overall resilience and strengths. Both groups of children felt they had many interpersonal strengths (i.e., ability to control emotions and behaviors in social situations), strengths in their family involvement (i.e., participation in and relationship with the family), intrapersonal strengths (i.e., outlooks on their competence and accomplishments), and affective strengths (i.e., accepting affection from and expressing feelings towards others). These ratings suggest that in many areas, children with ADHD feel they have abilities that are in the typical range, consistent with the reports from children without ADHD.
Compared to similar studies (Bruwer et al., 2008), the children in this study reported comparable levels of resilience. When looking at Kang et al. (2020), the overall resilience scores obtained in the current study are higher. Conversely, other studies have found higher resilience scores in children and adolescents (Ramirez-Granizo et al., 2020) than was found in the current study. As the CD-RISC-25 is sensitive to age and psychiatric concerns, this could explain the lower scores compared to the other studies. Generally, it appears the overall resilience scores found in this study are comparable with previously reported scores, although some differences based on age and psychiatric status exist.
Despite ADHD being often seen as a negative disorder with many deficits (Climie & Mastoras, 2015; Sherman et al., 2006), it appears that children with ADHD in this sample generally feel they have many strengths. Previous research has suggested that individuals with ADHD certainly have strengths and abilities in a variety of areas (i.e., optimism, high levels of energy, and hyperfocus; Sedgwick et al., 2019). These findings support the notion that ADHD is not negative in all contexts (Sherman et al., 2006).
However, children with ADHD generally felt they had fewer strengths in school functioning (i.e., belief in school and classroom activity competence) by rating their school functioning as below average. Not surprisingly, children with ADHD self-identified that they do worse in school functioning as they often struggle more in school due to ADHD (Barkley, 2014). As children and youth with ADHD are likely aware of their struggles in school (Becker, 2020), they rated themselves accordingly. Meanwhile, children without ADHD felt they had strengths in school functioning and rated their school functioning in the average range.
The second research question explored whether there were differences between the reported levels of strengths and resilience in children with and without ADHD. Results from the current study found differences in school functioning between children with and without ADHD, where children with ADHD rated themselves more poorly on school functioning. However, no differences were found between groups for strengths or resilience.
Children with ADHD felt they perform worse in school functioning compared to non-ADHD children. Not surprisingly, children with ADHD often struggle in school with their grades and classroom behavior (Barkley, 2014). The core deficits of ADHD (i.e., inattention, executive functioning) are linked to academic difficulties (Miller et al., 2012) that are likely to impact school functioning. Children with ADHD are likely aware of their struggles in school, thus they rated themselves as worse in this area. The effect size for this difference was large, indicating that the practical significance of this finding is strong; consequently, these findings are likely to be more generalizable to the broader ADHD population. Although children with ADHD generally rated themselves as having fewer strengths in school functioning, there are children with ADHD who do perform well in school. Hence, it is critical to keep in mind that general trends observed do not capture the full spectrum of variability in an ADHD population.
The finding that children and youth with ADHD report similar levels of resilience as children and youth without ADHD is somewhat contradictory to previous research; however, the previous research in this area is extremely limited and has not directly examined an ADHD population. Shi et al. (2018) found lower levels of resilience among those with more ADHD symptoms compared to those who have fewer ADHD symptoms. However, this study examined medical students at higher risk of feeling stressed and vulnerable. Due to the significant differences in the study samples (i.e., medical students vs. children and adolescents), comparisons between the studies should be taken with caution.
The lack of differences between children with and without ADHD on the overall strengths, resilience and subscale scores can be viewed positively. This finding implies that children with ADHD are doing just as well as children without ADHD in terms of their self-reported strengths and resilience. These results align with previous findings that also indicate children with ADHD have similar abilities when compared to non-ADHD peers (i.e., in reasoning, logical thinking, and emotional intelligence; Climie et al., 2019; Ek et al., 2007). Thus, children with ADHD are more similar to children without ADHD than different.
The third research question investigated the associations between the self-reported strengths subscales and resilience. It was found that family involvement, interpersonal, intrapersonal, and affective strengths were positively associated with overall resilience scores in both groups of children. However, there was also a positive relationship between school functioning and overall resilience, which was unexpected. As well, for the children without ADHD, there was no significant association between overall resilience and family involvement.
For children with ADHD, interpersonal, family involvement, intrapersonal, school functioning, and affective strengths were all strongly related to resilience. Children with ADHD who felt they had many strengths in these areas, correspondingly tended to report greater levels of resilience. As expected, children without ADHD also had strong associations between, family involvement, school functioning, interpersonal, and affective strengths with resilience. Interestingly, intrapersonal strength had the strongest relationship to resilience scores for children without ADHD as this relationship had the highest correlation value. Similar to the children with ADHD, those without ADHD who rated themselves as having many strengths in the above areas tended to also have more resilience.
There are multiple possible reasons for the associations between the subscale strengths and overall resilience. It is most likely that children who perceive themselves as having strengths may be more likely to demonstrate resilience since strengths can be thought of as having more resources that may be leveraged to promote resilience (Lesch, 2018). Previous research has found that having personal strengths or competencies can act as enhancing positive outcomes and resilience (Schei et al., 2018). Therefore, the subscale strengths could be operating as factors that can promote resilience. Research with typically developing populations has found that self-regulation is an important protective factor for resilience (Zolkoski & Bullock, 2012). Since interpersonal strength involves regulating one’s behaviors and emotions, it may be that this subscale is contributing to both groups of children’s overall levels of resilience.
Many studies have shown the importance of family cohesion and positive parenting for mitigating risks and promoting positive outcomes in children with and without ADHD (Dvorsky & Langberg, 2016; Masten & Barnes, 2018; Zolkoski & Bullock, 2012). Since only children with ADHD had correlations between family involvement and overall resilience, it makes sense that their family involvement could be operating to improve and support their levels of resilience. The finding that children without ADHD did not correlate with family involvement and overall resilience was surprising. It is possible that for children without ADHD, having better family involvement is less important for their resilience; however, it is also possible that this finding was constrained by the lack of power in the sample. Additionally, research has found that having optimism, a positive outlook, hope, and good self-esteem is important for positive outcomes in children without ADHD (Masten & Barnes, 2018; Zolkoski & Bullock, 2012) while research examining children with ADHD have found that good self-worth and self-esteem is important for positive outcomes (Dvorsky et al., 2019; Schei et al., 2018). Intrapersonal strength is a measure of the child’s overall outlook on their competence and accomplishments, so this subscale may be building the children with and without ADHD’s overall resilience.
Regarding the association between resilience and school functioning, some studies have suggested that greater school involvement can help to promote positive outcomes in children without ADHD (Alvord & Grados, 2005) while research on children with ADHD has only found that academic competence can promote positive outcomes (Ray et al., 2017). Accordingly, perceived strengths in school functioning may help promote resilience in children with and without ADHD. As school functioning is the child’s belief in their school competence, it is possible that having positive perceptions of academic competence are at the root of the association. Research has suggested that higher self-perceptions of academic competence are related to better academic performance (Stringer & Heath, 2008). Performing well in school may inform the child’s ratings of their school competence. Further, positive perceptions are associated with resilient outcomes (Dvorsky et al., 2016; Ray et al., 2017), thus supporting self-perceptions as the driving force of this association. Lastly, affective strengths involve similar personal dynamics to close friendships and social support (i.e., people an individual can go to for help). Close friendships and social support are found to be related to positive outcomes for both children with and without ADHD (Dvorsky & Langberg, 2016; Masten & Barnes, 2018), so having more affective strength could also be promoting resilience.
Limitations
One salient limitation of this study was the small sample size. With a smaller sample size (n = 56), the statistical power may be limited, impacting the likelihood of finding significant results (Cohen, 1992). Further, the comparison groups had unequal sample sizes (ADHD: n = 38; without ADHD: n = 18). Although Levene’s Test for Equality of Variances was not significant, indicating that the assumption of homogeneity of variances was met, the unequal sample sizes could have impacted the findings. In addition, the sample is also limited in its diversity and gender between groups. The predominance of boys in the ADHD group is expected as ADHD is more often diagnosed in boys than girls (2:1 ratio; APA, 2022). However, the unequal representation of gender in each group may impact the results.
Additionally, this study used child self-report as the only source of information. When correlating variables, research ideally would ask multiple responders (i.e., parents and teachers) to provide ratings to build confidence. Children with ADHD are notably vulnerable to exhibiting a positive illusory bias when there is a disparity between the child’s self-report of their abilities and the child’s actual ability. Positive illusory bias is where the child markedly overestimates their abilities (Hoza et al., 2002). Children with ADHD often exhibit a greater bias than those without ADHD (Hoza et al., 2002; Owens & Hoza, 2003). Consequently, the ratings may be impacted by children reporting inflated perceptions of their abilities.
Implications
The current study reported on strengths and resilience that children with and without ADHD demonstrated along with the differences between these groups in their self-reported strengths and resilience. Additionally, this study explored the relationship between demonstrated strengths and resilience. These results have several implications.
Reinforcing a Positive Perspective Toward ADHD in the Community
ADHD is often viewed in a negative light by the community (Climie & Mastoras, 2015; Sherman et al., 2006). As a result, this negative view can create or reinforce stigma for individuals with ADHD. Deficit-focused research has contributed to the negative perspective on ADHD which is prevalent in stigma within the community. Taking a more positive perspective may help to fight stigma by reinforcing that children with ADHD are just like other children. Focusing on strengths and resilience may assist in positively reconceptualizing how the community perceives ADHD as a whole (Climie & Mastoras, 2015).
Implications for Practitioners
This research has implications for the professionals who work with children with ADHD, including psychologists and teachers. Professionals need to learn more about the strengths and resilience seen in children with ADHD as this information can be used to help identify ways of teaching and empowering students with ADHD. For example, these findings could be advantageous for use with therapy, coaching, or other interventions that are used to support individuals with ADHD (Sedgwick et al., 2019). When interventions are informed by a strengths-based perspective, they can work to improve the well-being and resilience of children by emphasizing or capitalizing on their strengths. Strength-informed interventions could help to reduce risks of negative outcomes while still boosting well-being and learning long-term coping (Climie & Mastoras, 2015). Professionals should strive to identify and foster strengths, as this may help to bolster levels of resilience.
There are also implications within the classroom. Encouraging teachers to see that children with ADHD are more similar to their peers than different could help to fight stigmatizing responses (Metzger & Hamilton, 2021). Some professionals can have negative expectations of individuals with ADHD and may expect “bad behavior” or poor performance (Metzger & Hamilton, 2021). This assumption must be adjusted to help these children thrive in the classroom. By focusing on learning more about the strengths and resilience of children with ADHD, a balanced image of the child with ADHD is achieved. Also of note from the current study, children with ADHD tended to report they had fewer strengths when it came to their school functioning. Thus, children with ADHD are aware they have difficulties in academics and likely express more negative attitudes towards academics. Support for children with ADHD should continue to focus on the classroom and academics. Resilience provides children with the abilities they need to help facilitate an effective learning environment; thus, it is critical that psychologists and teachers are working to develop the school climate to foster the strengths and resilience of children with ADHD (Seligman & Csikszentmihalyi, 2000).
Psychologists are uniquely situated to benefit from the findings of this study and other strengths-based inquiries. As psychologists are often the ones treating and/or diagnosing children with ADHD, it will be important for them to be aware of and consider the strengths and resilience of the children with whom they are working. Additionally, psychologists can use the information about a child’s strengths and resilience to help make quality recommendations and resources that can best promote a child’s ability to have positive outcomes. For example, children who may be demonstrating low levels of resilience may need more targeted support to help prevent the onset of other risks and comorbidities. Psychologists may be able to help identify these children and provide specific recommendations to help foster resilience. Further, as psychologists are often responsible for educating families about the disorder, risks, and vulnerabilities, incorporating information on the strengths of the child and identifying unique characteristics will provide a direct benefit to families seeking support.
Future Directions
While the current study has promising and novel results, further investigation to understand what makes children with ADHD resilient and successful in coping with their ADHD is recommended. Future research may expand on the present study in several key directions. First, research should continue taking a positive, strengths-based perception of ADHD. Research must look beyond the deficits to find abilities, as there are implications for treatment and intervention, as well as combatting stigma. Measuring strengths and resilience longitudinally may also provide novel and enlightening information on how children and youth with ADHD respond to different life events. As resilience can be thought of as a process that changes over time, the level of resilience of individuals with ADHD may vary depending on the adversity faced. Finally, it would be informative to conduct qualitative investigations for children, adolescents, and parents to obtain a different perspective on their perceptions of the demonstrated strengths and resilience. As qualitative research provides a rich and contextualized understanding of the strengths and resilience of individuals with ADHD, the inclusion of this methodology would impart unique contributions to the research.
Conclusion
The current study undertook a novel investigation of the strengths and resilience of children with and without ADHD. Results indicate that children with ADHD have comparable strengths and levels of resilience to children without ADHD, highlighting that children with ADHD are more similar to than different from those without ADHD. Likewise, it seems that for both children with and without ADHD, there are relationships between their strengths and levels of overall resilience. Children with more strengths may demonstrate more resilience as they have more resources to pull from during times of hardship or when coping with ADHD. This research contributes to the ever-growing strengths-based literature which can help to promote parents, teachers, and psychologists in nurturing the lifelong capacities for health and well-being in children with ADHD while also promoting positive development (Masten & Barnes, 2018).
Acknowledgments
We thank the children and their parents who generously donated their time to participate in this study.
Author Biographies
Emma Charabin is a PhD Student at the University of Calgary. Her research interests focus on taking a strengths-based approach to ADHD with a particular focus on strengths, resilience, academics, and mental health in this population.
Emma A. Climie, PhD, RPsych, is an Associate Professor in the School and Applied Child Psychology program in the Werklund School of Education at the University of Calgary. She is also the lead researcher—Carlson Family Research Award in ADHD. Her research focuses on understanding children with ADHD from a strengths-based perspective, integrating primary research and intervention in the areas of resilience, stigma and mental health, and cognitive development.
Courtney Miller is a Research Associate and PhD student at the University of Calgary. Her research interests focus on strength-based analyses and interventions for children and youth with ADHD.
Kristina Jelinkova is a PhD Student at the University of Calgary. Her research interests focus on the self-perceptions of youth and adults with ADHD and their families, particularly in the context of stigma.
Jessica Wilkins is a MSc Student at the University of Calgary. Her degree is experimental psychology in human factors. Her current research focuses on the human factors design considerations of wearable technologies. Previously, her interests were focused on the link between insecure attachment styles and middle aged children with ADHD.
Footnotes
The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Funding: The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This work was supported by a grant from the Social Sciences and Humanities Research Council. The funding agencies had no role in the design and conduct of the study, in the collection, analysis, and interpretation of the data, or in the preparation, review, or approval of the manuscript.
ORCID iDs: Emma Charabin https://orcid.org/0000-0003-1910-8014
Emma A. Climie https://orcid.org/0000-0002-0470-1598
References
- Alvord M. K., Grados J. J. (2005). Enhancing resilience in children: A proactive approach. Professional Psychology: Research and Practice, 36(3), 238–245. 10.1037/0735-7028.36.3.238 [DOI] [Google Scholar]
- American Psychiatric Association. (2022). Diagnostic and statistical manual of mental disorders: Text revision (5th ed.). American Psychiatric Publishing. [Google Scholar]
- Antshel K. M., Barkley R. (2020). Attention deficit hyperactivity disorder. In Gallagher A., Bulteau C., Cohen D., Michaud J. L. (Eds.), Handbook of clinical neurology (Vol.174, pp. 37–45). 10.1016/B978-0-444-64148-9.00003-X [DOI] [PubMed]
- Barkley R. A. (Ed.). (2014). Attention-deficit hyperactivity disorder: A handbook for diagnosis and treatment (4th ed.). The Guilford Press. [Google Scholar]
- Becker S. P. (2020). ADHD in adolescents: Commentary on the special issue of ripple effects in self-perceptions and social relationships. Canadian Journal of School Psychology, 35(4), 311–322. https://doi.org/10.1177%2F0829573520954584 [Google Scholar]
- Biederman J., Mick E., Faraone S. V. (1998). Normalized functioning in youths with persistent attention-deficit/hyperactivity disorder. Journal of Pediatrics, 133(4), 544–551. 10.1016/S0022-3476(98)70065-4 [DOI] [PubMed] [Google Scholar]
- Brault M. C., Lacourse É. (2012). Prevalence of prescribed attention-deficit hyperactivity disorder medications and diagnosis among Canadian preschoolers and school-age children: 1994-2007. Canadian Journal of Psychiatry, 57(2), 93–101. 10.1017/CBO9781107415324.004 [DOI] [PubMed] [Google Scholar]
- Brownlee K., Rawana J., Franks J., Harper J., Bajwa J., O’Brien E., Clarkson A. (2013). A systematic review of strengths and resilience outcome literature relevant to children and adolescents. Child and Adolescent Social Work Journal, 30(5), 435–459. 10.1007/s10560-013-0301-9 [DOI] [Google Scholar]
- Bruwer B., Emsley R., Kidd M., Lochner C., Seedat S. (2008). Psychometric properties of the multidimensional scale of perceived social support in youth. Comprehensive Psychiatry, 49(2), 195–201. 10.1016/j.comppsych.2007.09.002. [DOI] [PubMed] [Google Scholar]
- Chan E. S. M., Groves N. B., Marsh C. L., Miller C. E., Richmond K. P., Kofler M. J. (2022). Are there resilient children with ADHD? Journal of Attention Disorders, 26(5), 643–655. https://doi.org/10.1177%2F10870547211025629 [DOI] [PMC free article] [PubMed] [Google Scholar]
- Climie E. A., Mastoras S. M. (2015). ADHD in schools: Adopting a strengths-based perspective. Canadian Psychology, 56(3), 295–300. 10.1037/cap0000030 [DOI] [Google Scholar]
- Climie E. A., Mastoras S. M., McCrimmon A. W., Schwean V. L. (2012). Resilience in Childhood disorders. In Prince-Embury S., Saklofske D. H. (Eds.), Resilience in children, adolescents, and adults: Translating research into practice (pp. 113–131). Springer. 10.1007/978-1-4614-4939-3_8 [DOI] [Google Scholar]
- Climie E. A., Saklofske D. H., Mastoras S. M., Schwean V. L. (2019). Trait and ability emotional intelligence in children with ADHD. Journal of Attention Disorders, 23(13), 1667–1674. 10.1177/1087054717702216 [DOI] [PubMed] [Google Scholar]
- Cohen J. (1992). Statistical power analysis. Current Directions in Psychological Science, 1(3), 98–101. 10.1111/1467-8721.ep10768783 [DOI] [Google Scholar]
- Conners C. K. (2008). Conners 3rd edition: Manual. Multi-Health Systems. [Google Scholar]
- Davidson J. R. T. (2021). Connor-Davidson Resilience Scale (CD-RISC) Manual. Unpublished.
- Dvorsky M. R., Langberg J. M. (2016). A review of factors that promote resilience in youth with ADHD and ADHD symptoms. Clinical Child and Family Psychology Review, 19(4), 368–391. 10.1007/s10567-016-0216-z [DOI] [PubMed] [Google Scholar]
- Dvorsky M. R., Langberg J. M., Evans S. W., Becker S. P. (2018). The protective effects of social factors on the academic functioning of adolescents with ADHD. Journal of Clinical Child & Adolescent Psychology, 47(5), 713–726. 10.1080/15374416.2016.1138406 [DOI] [PMC free article] [PubMed] [Google Scholar]
- Dvorsky M. R., Langberg J. M., Becker S.P., Evans S.W. (2019). Trajectories of global self-worth in adolescents with adhd: Associations with academic, emotional, and social outcomes. Journal of Clinical Child & Adolescent Psychology, 48(5), 765-780. 10.1080/15374416.2018.1443460 [DOI] [PMC free article] [PubMed]
- Ek U., Fernell E., Westerlund J., Holmberg K., Olsson P. P., Gillberg C. (2007). Cognitive strengths and deficits in schoolchildren with ADHD. Acta Paediatrica, 96(5), 756–761. 10.1111/j.1651-2227.2007.00297.x [DOI] [PubMed] [Google Scholar]
- Epstein M. H. (2004). Behavioural and Emotional Ratings Scale (BERS-2): A strength-based approach to assessment (2nd ed.). PRO-ED Inc. [Google Scholar]
- Hai T., Climie E. A. (2021). Positive child personality factors in children with ADHD. Journal of Attention Disorders, 26(3), 476–486. 10.1177/1087054721997562 [DOI] [PubMed] [Google Scholar]
- Hamby S., Taylor E., Mitchell K., Jones L., Newlin C. (2020). Poly-victimization, Trauma, and resilience: Exploring strengths that promote thriving after adversity. Journal of Trauma & Dissociation, 21(3), 376–395. 10.1080/15299732.2020.1719261 [DOI] [PubMed] [Google Scholar]
- Herrman H., Stewart D. E., Diaz-Granados N., Berger E. L., Jackson B., Yuen T. (2011). What is resilience? The Canadian Journal of Psychiatry, 56(5), 258–265. 10.1177/070674371105600504 [DOI] [PubMed] [Google Scholar]
- Holthe M. E. G., Langvik E. (2017). The strives, struggles, and successes of women diagnosed with ADHD as adults. SAGE Open, 7(1), 1–12. 10.1177/2158244017701799 [DOI] [Google Scholar]
- Hoza B., Pelham W. E., Jr., Dobbs J., Owens J. S., Pillow D. R. (2002). Do boys with attention deficit/hyperactivity disorder have positive illusory self-concepts? Journal of Abnormal Psychology, 111(2), 268–278. 10.1037/0021-843X.111.2.268 [DOI] [PubMed] [Google Scholar]
- Kang C., Shi J., Gong Y., Wei J., Zhang M., Ding H., Wang K., Yu Y., Wang S., Han J. (2020). Interaction between FKBP5 polymorphisms and childhood trauma on depressive symptoms in Chinese adolescents: The moderating role of resilience. Journal of Affective Disorders, 266, 143–150. 10.1016/j.jad.2020.01.051 [DOI] [PubMed] [Google Scholar]
- Lesch K. P. (2018). ‘Shine bright like a diamond!’: Is research on high-functioning ADHD at last entering the mainstream? Journal of Child Psychology and Psychiatry, 59(3), 191–192. 10.1111/jcpp.12887 [DOI] [PubMed] [Google Scholar]
- Luthar S. S., Cicchetti D., Becker B. (2000). The construct of resilience: A critical evaluation and guidelines for future work. Child Development, 71(3), 543–562. 10.1111/1467-8624.00164 [DOI] [PMC free article] [PubMed] [Google Scholar]
- Masten A. S., Barnes A. J. (2018). Resilience in children: Developmental perspectives. Children, 5(7), 98. 10.3390/children5070098 [DOI] [PMC free article] [PubMed] [Google Scholar]
- Masten A. S., Best K. M., Garmezy N. (1990). Resilience and development: Contributions from the study of children who overcome adversity. Development and Psychopathology, 2(4), 425–444. 10.1017/S0954579400005812 [DOI] [Google Scholar]
- Masten A. S., Obradović J. (2006). Competence and resilience in development. Annals of the New York Academy of Sciences, 1094(1), 13–27. 10.1196/annals.1376.003 [DOI] [PubMed] [Google Scholar]
- Mastoras S. M., Saklofske D. H., Schwean V. L., Climie E. A. (2015). Social support in children with ADHD: An exploration of resilience. Journal of Attention Disorders, 22(8), 712–723. 10.1177/1087054715611491 [DOI] [PubMed] [Google Scholar]
- Metzger A. N., Hamilton L. T. (2021). The stigma of ADHD: Teacher ratings of labeled students. Sociological Perspectives, 64(2), 258–279. 10.1177/0731121420937739 [DOI] [Google Scholar]
- Miller M., Nevado-Montenegro A. J., Hinshaw S. P. (2012). Childhood executive function continues to predict outcomes in young adult females with and without childhood-diagnosed ADHD. Journal of Abnormal Child Psychology, 40, 657–668. 10.1007/s10802-011-9599-y [DOI] [PMC free article] [PubMed] [Google Scholar]
- Nigg J. T., Barkley R. A. (2014). Attention-deficit/hyperactivity disorder. In Mash E. J., Barkley R. A. (Eds.), Child psychopathology (3rd ed., pp. 75–144). The Guilford Press. [Google Scholar]
- Owens J. S., Hoza B. (2003). The role of inattention and hyperactivity/impulsivity in the positive illusory bias. Journal of Consulting and Clinical Psychology, 71, 680–691. 10.1037/0022-006X.71.4.680 [DOI] [PubMed] [Google Scholar]
- Ramirez-Granizo I. A., Sánchez-Zafra M., Zurita-Ortega F., Puertas-Molero P., González-Valero G., Ubago-Jiménez J. L. (2020). Multidimensional self-concept depending on levels of resilience and the motivational climate directed towards sport in schoolchildren. International Journal of Environmental Research and Public Health, 17(2), 534. 10.3390/ijerph17020534 [DOI] [PMC free article] [PubMed] [Google Scholar]
- Ray A. R., Evans S. W., Langberg J. M. (2017). Factors associated with healthy and impaired social functioning in young adolescents with ADHD. Journal of Abnormal Child Psychology, 45, 883–897. 10.1007/s10802-016-0217-x [DOI] [PMC free article] [PubMed] [Google Scholar]
- Ruch W., Weber M., Park N., Peterson C. (2014). Character strengths in children and adolescents: Reliability and initial validity of the German values in action inventory of strengths for youth (German VIA-Youth). European Journal of Psychological Assessment, 30(1), 57–64. 10.1027/1015-5759/a000169 [DOI] [Google Scholar]
- Schei J., Nøvik T. S., Thomsen P. H., Lydersen S., Indredavik M. S., Jozefiak T. (2018). What predicts a good adolescent to adult transition in ADHD? The role of self-reported resilience. Journal of Attention Disorders, 22(6), 547–560. 10.1177/1087054715604362 [DOI] [PubMed] [Google Scholar]
- Sedgwick J. A., Merwood A., Asherson P. (2019). The positive aspects of attention deficit hyperactivity disorder: A qualitative investigation of successful adults with ADHD. ADHD Attention Deficit and Hyperactivity Disorders, 11(3), 241–253. 10.1007/s12402-018-0277-6 [DOI] [PubMed] [Google Scholar]
- Seligman M. E. P., Csikszentmihalyi M. (2000). Positive psychology: An introduction. American Psychologist, 55(1), 5–14. 10.1037/0003-066X.56.1.89 [DOI] [PubMed] [Google Scholar]
- Sherman J., Rasmussen C., Baydala L. (2006). Thinking positively: How some characteristics of ADHD can be adaptive and accepted in the classroom. Childhood Education, 82(4), 196–200. 10.1080/00094056.2006.10522822 [DOI] [Google Scholar]
- Shi M., Liu Li., Sun X., Wang L. (2018). Associations between symptoms of attention-deficit/hyperactivity disorder and life satisfaction in medical students: The mediating effect of resilience. BMC Medical Education, 18, 164. 10.1186/s12909-018-1261-8 [DOI] [PMC free article] [PubMed] [Google Scholar]
- Stringer R. W., Heath N. (2008). Academic self-perception and its relationship to academic performance. Canadian Journal of Education, 31(2), 327–345. [Google Scholar]
- Wechsler D. (2011). Wechsler Abbreviated Scale of Intelligence-Second Edition (WASI-II). NCS Pearson. [Google Scholar]
- Zolkoski S. M., Bullock L. M. (2012). Resilience in children and youth: A review. Children and Youth Services Review, 34(12), 2295–2303. 10.1016/j.childyouth.2012.08.009 [DOI] [Google Scholar]