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. Author manuscript; available in PMC: 2023 Mar 1.
Published in final edited form as: Res Dev Disabil. 2022 Jan 7;122:104156. doi: 10.1016/j.ridd.2021.104156

Examining the Effects of ADHD Symptoms and Parental Involvement on Children’s Academic Achievement

Jaida S Condo 1, Elizabeth SM Chan 1, Michael J Kofler 1
PMCID: PMC8944944  NIHMSID: NIHMS1770194  PMID: 35007980

Abstract

Objective:

Our understanding of the role of parental involvement in academic outcomes for children with ADHD is limited, with mixed evidence suggesting a positive association between parental involvement and academic achievement for pediatric ADHD but limited evidence regarding how this varies based on ADHD symptom severity, ADHD symptom domains, or co-occurring ODD symptoms. In this context, the present study aimed to examine the effects of parental involvement, ADHD symptoms, and comorbid ODD on children’s overall, reading, and math achievement.

Method:

A well-characterized clinically-evaluated sample of 162 children recruited through a university-based children’s learning/behavioral health clinic and community resources (ages 8–13; 50 girls; 69% Caucasian/Non-Hispanic) were administered standardized academic achievement tests, with parents and teachers completing measures of parental involvement and ADHD symptoms, respectively.

Results:

Inattention, but not hyperactivity-impulsivity, was associated with lower academic achievement in all tested models (β= −.16 to −.22, all p<.03). Surprisingly, parental involvement had significant negative associations with math and overall academic achievement (β= −.13 to −.26, both p ≤ .05) and did not moderate the relations between ADHD symptoms and academic achievement in any tested model. Comorbid ODD symptoms did not significantly predict academic achievement or interact with parental involvement in any tested model. These findings were robust to control for child IQ, age, sex, SES, anxiety, and depression.

Conclusion:

Parental involvement may not serve as a protective factor against academic underachievement for children with clinically elevated ADHD symptoms, and may predict lower rather than higher academic achievement for clinically evaluated children in general.

Keywords: ADHD, academic achievement, parental involvement

What this Paper Adds

Parental involvement has been shown to exert protective or promotive benefits for children’s academic achievement across racial groups, socioeconomic status, and cultures worldwide. However, emerging evidence suggests that factors that promote positive outcomes for children in general may not exert the same benefits for children with neurodevelopmental disorders such as ADHD. In a relatively large, clinically evaluated sample that completed a multi-informant/multi-method assessment and objective evaluation of academic achievement, the current study confirmed that children’s inattentive symptoms predict lower academic achievement in reading and math. Contrary to expectations, higher levels of parental involvement did not buffer against the risk conveyed by elevated ADHD inattentive symptoms, but instead uniquely predicted further academic difficulties in math and overall achievement. These findings add to a growing body of evidence suggesting that promotive factors identified in the general population cannot be assumed to operate similarly for clinically evaluated children, while emphasizing the need for further research to identify qualitative differences in parental involvement that may explain why similar levels of parental involvement predict differently valanced outcomes for these children.

Examining the Effects of ADHD Symptoms and Parental Involvement on Children’s Academic Achievement

Attention-deficit/hyperactivity disorder (ADHD) is a chronic neurodevelopmental disorder that affects approximately 5% of school-aged children (Polanczyk et al. 2014). ADHD is associated with clinically significant impairments in the family, peer, and academic domains (Pelham et al., 2005) at an annual U.S. cost of illness of over $100 billion (Zhao et al., 2019). Academic underachievement is prominent in ADHD, with approximately 33% to 63% of children with ADHD exhibiting difficulties in one or more school subjects, such as reading and math (Mayes & Calhoun 2006; Barry et al., 2002). ADHD academic difficulties start early and often persist through middle and high school (Scholtens et al., 2013; DuPaul et al., 2001). Moreover, ADHD-related academic difficulties are associated with myriad negative outcomes including increased incidence of failing grades, lower grade point averages and standardized test scores, higher rates of high school dropout, and lower college attendance when compared to their typically developing peers (Arnold et al., 2020; Kent et al., 2011; Kuriyan et al., 2013; Barkley, 2006; Frazier, 2007). ADHD status has also been found to predict later academic and occupational difficulties (McGee et al. 2002; Fredrikson et al., 2014), as well as socioeconomic status over 30 years even after controlling for IQ (Ritchie & Bates, 2013). In the context of the extensive early and long-term difficulties associated with academic impairment in ADHD, it is important to determine potential protective factors (i.e., factors associated with reducing the negative impact of risk) to combat ADHD-related academic difficulties and associated negative outcomes. Towards this aim, one factor that has been shown to have a positive effect on academic achievement in the developmental literature (e.g., Castro et al, 2015), but has not been studied extensively in children with ADHD, is parental involvement.

Parental Involvement and Academic Achievement

Parental involvement refers to a parent’s participation in school- and home-based activities with their child (Castro et al, 2015; Fan & Chen, 2001). Parental involvement has been recognized by the research community, school systems, and policy makers as a positive influence on academic achievement (Graves & Wright, 2011; Wilder, 2014; Van der Werf, Creemers, & Guldemond, 2001). Meta-analytic evidence indicates that parental involvement has a significant, small to medium magnitude effect for improving academic achievement as measured by both standardized measures of achievement and GPA for typically developing children (Fan & Chen, 2001; Jeynes, 2005; Wilder, 2014). Notably, parental involvement has also been found to positively influence academic achievement across demographic indicators, including race, socioeconomic status, and cultures worldwide (Jeynes, 2005; Kieth & Lichtman, 1994; Tam & Chan, 2009; Olatoye & Ogunkola, 2008). While parental involvement has consistently been found to positively affect academic achievement in general, there are limited and contradictory findings in regard to its impact on specific subject to overall academic achievement across areas (Boonk et al., 2018; Patall et al., 2008; Wilder, 2014). In addition, to our knowledge there have been no studies examining the association between parental involvement and specific academic domains for children with high vs. low levels of ADHD symptoms. Moreover, despite the established importance of parental involvement for educational outcomes among typically developing children, little is known about the role of parental involvement for academic outcomes in children with neurodevelopmental disorders such as ADHD. This paucity of research is concerning given that children with ADHD are at high risk for academic difficulties as noted above (e.g., Arnold et al., 2020; Kent et al., 2011), as well as nascent evidence that these children may not respond to promotive factors the same way as their non-ADHD peers (Chan et al., 2021; Dvorsky & Langberg, 2016).

Parental Involvement and Academic Achievement in ADHD

Among the few studies examining how parental involvement impacts academic achievement for children with ADHD, the findings are mixed. For example, Rogers et al. (2009a) showed that parents of children with ADHD exhibited lower levels of quality involvement in their children’s schools. Interestingly, however, in a separate study they found that supportive parental involvement was still associated with higher academic achievement for these children (Rogers et al., 2009b). Similarly, Corcoran & Dattalo (2006) conducted a meta-analytic review on psychosocial treatments for children with ADHD and concluded that parental involvement was positively associated with academic achievement. In contrast, Shelleby & Ogg (2020) found no evidence for parental involvement affecting reading achievement longitudinally, despite finding that early ADHD symptoms predicted lower levels of later parental involvement.

Thus, findings from the extant literature on parental involvement, while mixed, predominantly suggest that parental involvement may have a positive impact on academic achievement for children with ADHD. However, further research is needed to understand additional factors that may influence whether and to what extent parental involvement is associated with academic achievement in ADHD. For example, the literature indicates ADHD symptom severity is associated with greater academic difficulties (e.g., Arnold et al., 2020; Kent et al., 2011). Moreover, evidence suggests that the different ADHD symptom clusters (inattentive vs. hyperactive/impulsive) may differentially affect academic achievement. Specifically, inattention symptoms have been found to be a greater risk factor when compared with hyperactive-impulsive symptoms on academic achievement (Weiss et al., 2003; Breslau et al., 2009). In contrast, hyperactive-impulsive symptoms have minimal, if any, impact on this domain (Rogers et al., 2009b; Weiss et al., 2003; Breslau et al., 2009). Interestingly, longitudinal and experimental/intervention studies indicate that the relation between ADHD symptomology and parental involvement appears to be unidirectional, such that children’s ADHD behaviors drive lower levels of parental involvement rather than vice versa (Shelleby & Ogg, 2020; Corcoran & Dattalo, 2006). In turn, Rogers et al. (2009a) found that for children with ADHD, supportive parental involvement was associated with higher academic achievement through lower levels of inattention.

Additional factors that may influence the relation between parental involvement and academic achievement in pediatric ADHD include co-occurring disorders. Research further demonstrates that academic underachievement in ADHD tends to increase with each additional co-morbid diagnosis (Larson et al., 2011). This is of note given the high rates of comorbid disorders in ADHD, in particular oppositional defiant disorder (ODD, 30–60%; Tung et al., 2016; Jensen et al., 2001) and learning disabilities (LD, 27–31%; DuPaul & Volpe, 2009). ODD and LD are two of the most prominent co-occurring disorders in ADHD, and both disorders have been shown to be associated with greater ADHD symptom severity (Hurtig et al., 2007; Mayes, Calhoun, & Crowell, 2000; Connor & Doerfler, 2007) and identified as risk factors for subsequent academic problems (Leadbeater & Ames, 2016; Mayes, Calhoun, & Crowell, 2000; Smith & Adams, 2006). Initial findings on these diagnoses in relation to parental involvement and academic achievement, however, surprisingly suggests that ODD has no incremental, detrimental effect on parental involvement for children with ADHD (Fergusson & Horwood, 1995; Fergusson et al., 1997; Rapport et al., 1999; Rogers et al., 2009), and that for children with LD without ADHD, parental involvement does not have a significant impact on academic achievement (Patrikakou, 1996).

Current Study

In summary, children with elevated ADHD symptoms are at high risk for both short- and long-term academic difficulties and associated negative outcomes (Arnold et al., 2020; Kent et al., 2011; Kuriyan et al., 2013; McGee et al. 2002; Scholtens et al., 2013). Thus, identifying targets for academic intervention is crucial for improving outcomes for these children (Chacko et al., 2014). Among typically developing children, there is substantial evidence that parental involvement positively impacts academic achievement (Wilder, 2014; Fan & Chen, 2001; Jeynes, 2005). However, our understanding of the role of parental involvement on academic outcomes for children with elevated ADHD symptoms is limited, with mixed evidence suggesting a positive association between parental involvement and academic achievement for pediatric ADHD but limited evidence regarding how this varies based on ADHD symptom severity, ADHD symptom domains, or co-occurring ODD symptoms (Rogers et al. 2009; Corcoran & Dattalo 2006; Shelleby & Ogg, 2020). Additionally, there is mixed evidence regarding how parental involvement specifically affects different academic domains (e.g., reading versus math) in the developmental literature (Wilder, 2014), and to our knowledge no literature examining this difference in ADHD populations.

To address these gaps in the literature, the primary aims of our study were to 1) examine whether parental involvement is significantly related to academic achievement in a clinically evaluated sample of children representing the full spectrum of ADHD symptom frequency/severity, 2) determine whether parental involvement moderates the relation between ADHD symptoms and academic underachievement, and 3) explore whether co-occurring ODD impacts the expected association between parental involvement and academic achievement. We hypothesized that parental involvement would be significantly, positively related to academic achievement in our clinically evaluated sample of children (Wilder, 2014; Rogers, 2009). We also hypothesized that parental involvement would moderate the relation between ADHD symptomatology and academic achievement, such that the negative impact of ADHD symptoms on academic achievement would be mitigated (lessened) for children with more involved parents. For our exploratory analyses, we expected that increased levels of ODD symptoms would significantly and negatively moderate (i.e., decrease) the positive relation between parental involvement and academic involvement, over and above the expected impact of ADHD inattentive and hyperactive/impulsive symptoms.

Method

Participants and Procedures

The sample comprised 162 children aged 8 to 13 years (M = 10.32, SD = 1.52; 112 boys, 50 girls) from the Southeastern United States, recruited by or referred to a university-based Children’s Learning Clinic (CLC) through community resources (e.g., pediatricians, community mental health clinics, school system personnel, self-referral) from 2015 to 2020 who were included in Chan et al. (2021). The CLC is a research-practitioner training clinic known to the surrounding community for conducting developmental and clinical child research and providing pro bono comprehensive diagnostic and psychoeducational services. Its client base consists of children with suspected learning, behavioral or emotional problems, as well as typically developing children (those without a suspected psychological disorder) whose parents agreed to have them participate in developmental/clinical research studies. All parents and children gave informed consent/assent, and the Florida State University Institutional Review Board approval was obtained/maintained prior to/throughout data collection. Sample ethnicity was mixed with 111 White Non-Hispanic (69%), 17 Hispanic (10%), 19 Black (12%), 3 Asian (2%), and 12 Multiracial children (7%; Table 1). All children spoke English.

Table 1.

Sample and Demographic Variables

M SD Min Max Skewness Kurtosis
Sex (Boys/Girls) 112/50 -- -- -- --
Age 10.29 1.49 8.21 13.25 0.49 −1.04
SES 48.10 11.73 13 66 −0.67 −0.08
FSIQ (Standard Scores) 103.96 14.09 78 138 0.04 −0.61
ADHD Medication Status (Y/N) 41/121 -- -- -- --
ADHD-RS-4/5 Inattention
 Teacher (Raw Score) 15.07 7.13 0 27 −0.29 −0.77
ADHD-RS-4/5 Hyperactivity/Impulsivity
 Teacher (Raw Score) 9.93 8.58 0 27 0.60 −0.97
PRQ – Parental Involvement
 Parent (Raw Score) 15.50 5.29 2 27 0.22 −0.60
Academic Achievement
 KTEA-3 Math (Standard Score) 98.23 15.84 57 141 0.28 0.02
 KTEA-3 Reading (Standard Score) 99.88 14.88 56 144 0.14 1.20
 KTEA-3 Composite (Standard Score) 98.44 15.28 45 140 −0.21 1.28
CSI-4 Oppositional Defiant
 Teacher (Raw Score) 5.06 5.59 0 24 1.38 1.65
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Note: PRQ = Parenting Relationship Questionnaire, KTEA-3 = Kaufman Test of Educational Achievement, CSI-4 = Child Symptom Inventory-4, FSIQ = Full Scale Intelligence (WISC-V Short Form), SES = Hollingshead socioeconomic status.

All children and caregivers completed a comprehensive evaluation that included detailed, semi-structured clinical interviewing and multiple norm-referenced parent and teacher questionnaires. A detailed account of the comprehensive psychoeducational evaluation can be found in the larger study’s preregistration: : https://osf.io/nvfer. A psychoeducational report was provided to parents. The final sample included 40 children (10 girls) with ADHD only; 64 children with ADHD and common comorbidities (18 girls, 14% oppositional defiant disorder/ODD, 19% autism spectrum disorder/ASD, 6% depressive disorders, 39% anxiety disorders, and 23% with reading and/or 19% math specific learning disorders); 28 children (10 girls) with common clinical diagnoses but not ADHD (57% with anxiety disorders, 29% ASD, 7% ODD, 11% depressive disorders, and 7% with reading and/or 14% math specific learning disorders); and 30 neurotypical children (12 girls). Thirty-six (35%) children with ADHD were prescribed psychostimulant medication. Children were excluded for gross neurological, sensory, or motor impairment; history of seizure disorder, psychosis, or intellectual disability; or non-stimulant medications that could not be withheld for testing.

Children participated in a baseline psychoeducational assessment included in a larger research battery that spanned three sessions. Children were included in the present study if they completed Kaufman Test of Educational Achievement (KTEA-3; Kaufman & Kaufman, 2014) testing, their parent completed the Parenting Relationship Questionnaire, and their teacher completed the ADHD-RS-4/5 and CSI-4 questionnaires described below.

Measures

Parental Involvement

The Parenting Relationship Questionnaire (PRQ) – Child/Adolescent was completed by parents to assess the quality of the parent-child relationship (Kamphaus & Reynolds, 2006). The PRQ Involvement subscale was selected a priori for the present study and measures the extent to which a parent and child participate together in a variety of common activities, along with the parent’s knowledge of the child’s activities (Kamphaus & Reynolds, 2006). The Involvement subscale consists of 9 items rated on a 4-point Likert scale. Example items include “I teach my child new things” and “My child and I work on projects together.” The PRQ Involvement subscale has demonstrated high internal consistency reliability (α=.89-.90). Higher scores indicate higher levels of parental involvement in their child’s life.

Academic Achievement

The Kaufman Test of Educational Achievement (KTEA-3; Kaufman & Kaufman, 2014) was used to assess academic attainment (1–2 week test-retest = .80-.96; α = .92-.99). The Reading Composite (reading comprehension, letter-word identification subtests) and Math Composite (math computation, math concepts and applications subtests) scores were used in this study. Higher standard scores (age norms) reflect higher achievement.

ADHD Symptoms

The ADHD Rating Scale for DSM-IV/5 (ADHD-RS-4/5; Du Paul et al., 2016) was used to assess the frequency and severity of ADHD symptoms based on DSM criteria in children and adolescents aged 5 to 17 (18 items; 4-point Likert scale). The ADHD-RS-4/5 includes two symptom subscales: Inattention (9 items) and Hyperactivity/Impulsivity (9 items). Psychometric support on the ADHD-RS-4/5 includes high internal consistency (α=0.94) and test-retest reliability (r= 0.79 to 0.85; DuPaul et al., 2016). We selected teacher reports a priori for the current study to prevent spurious associations attributable to mono-informant bias as would occur if parents reported on both their relationship with their child and their child’s behaviors. Additionally, teacher reports have been shown to outperform parent reports in regard to sensitivity, specificity, and classification accuracy of ADHD diagnosis (Tripp et al., 2006). Evidence for the validity of teacher-rated ADHD symptoms on the ADHD-RS-4/5 is supported via high correlations with other informant-based ADHD symptom measures as well as predictive validity relative to important areas of ADHD-related functional impairments (DuPaul et al., 2016).

ODD Symptoms

To assess the presence and severity of ODD symptoms, the Child Symptom Inventory-4 (CSI-4; Gadow & Sprafkin, 1994) ODD subscale was used. The teacher version was selected a priori based on the above rationale. The ODD subscale contains 8 items corresponding to the DSM-5 ODD criteria (4-point Likert scale). Discriminant and convergent validity of teacher-rated CSI-4 ODD symptoms are supported via associations with well-established standardized behavioral measures of externalizing symptoms and semi-structured diagnostic interviews (Gadow et al., 2004; Reich, Shayka, & Taibleson, 1991).

Intellectual Functioning (IQ) and Socioeconomic Status (SES)

All children were administered the WISC-V Short Form (Sattler et al. 2016) to obtain an estimate of intellectual functioning. Hollingshead (1975) SES was estimated based on caregiver(s)’ education and occupation.

Data Analysis Overview

Preliminary analyses.

Our a priori data analytic plan called for a series of backward regressions to remove nonsignificant demographic predictors, followed by hierarchical multiple regressions that retained the significant demographic predictors identified in the preliminary analyses and added the primary variables of interest as described below. For the preliminary analyses, child age, sex, SES, medication status, and IQ were entered into a series of backward regressions, separately for each of the academic domains (overall academics, math, reading). Significant predictors in each model (p < .05) were retained.1

Primary analyses.

To assess the associations between ADHD symptoms and academic achievement, and the hypothesized moderating role of parental involvement, a series of hierarchical multiple regressions were conducted. Overall academic achievement was examined first, followed by separate analyses examining math and reading achievement. As noted above, the significant demographic predictors from the preliminary analyses were entered in Step 1. ADHD inattentive and hyperactive-impulsive symptoms (Step 2) and parental involvement (Step 3) were then added. With these main effects included in the models, interaction effects of inattention x parental involvement and hyperactivity/impulsivity x parental involvement were then added (Step 4). Finally, as exploratory analyses, ODD symptom severity (Step 5) and the interaction of ODD x parental involvement (Step 6) were entered.

Results

Data Screening/Cleaning

All independent and dependent variables were screened for univariate outliers, defined as values greater than 3 SD above or below the within-group mean. Outliers were corrected to the most extreme value 3 SD above or below the within-group mean, with 0.12% of all data points being affected by this process. KTEA-3 reading data for a subset of the current sample was reported in Kofler et al. (2019) for the purposes of validating an experimental reading test; parental involvement data have not been previously reported for any children in the current sample. Intercorrelations among study variables are shown in Tables 2 and 3.

Table 2.

Zero-order Correlations Between Demographic Variables and Academic Achievement Outcomes.

Variable MAA RDA OVA Med Sex Age IQ SES
1. MAA —
2. RDA .71*** —
3. OVA .90*** .89*** —
4. MED .03 .02 .01 —
5. Sex −.08 .07 .02 −.16* —
6. Age .04 .05 .07 .16* −.05 —
7. IQ .69*** .65*** .73*** . 03 .09 −.14 —
8. SES .30*** .26*** .32*** .08 .02 .02 .27*** —
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Note. MAA = Math Academic Achievement, RDA = Reading Academic Achievement, OVA = Overall Academic Achievement, MED = Current medication status, SES = Hollingshead socioeconomic status, IQ = Full Scale Intelligence (WISC-V Short Form).

*

p < .05,

**

p < .01,

***

p < .001

Table 3.

Zero-order Correlations for Between Primary Variables and Academic Achievement Outcomes.

Variable MAA RDA OVA IA HI PI ODD
1. MAA —
2. RDA .71*** —
3. OVA .90*** .89*** —
4. IA −.40*** −.35*** −.41*** —
5. HI −.11 −.10 −.15 .47*** —
6. PI −.24** −.23** −.30*** .15 .16* —
7. ODD −.19* −.16* −.21** .37*** .59*** .15 —
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Note. MAA = Math Academic Achievement, RDA = Reading Academic Achievement, OVA = Overall Academic Achievement, IA = ADHD-RS-4/5–Inattentive symptoms, HI = ADHD-RS-4/5–Hyperactivity/Impulsivity symptoms, PI = PRQ – Parental Involvement Subscale, ODD = CSI-4 Oppositional Defiant Disorder Subscale .

*

p < .05,

**

p < .01,

***

p < .001

Preliminary Analyses: Demographic Predictors of Academic Achievement

Overall academic achievement.

Results for the backward regression model indicated that age (p = .001), IQ (p < .001), and SES (p = .02) were significant predictors of overall academic achievement; medication status (p = .24) and sex (p = .37) were not retained.

Math achievement.

Sex (p = .02), age (p = .02), SES (p = .04), and IQ (p < .001) were significant predictors of math achievement; only medication status (p = .31) was not retained for the primary analyses below.

Reading achievement.

Only age (p = .01) and IQ (p < .001) were significant predictors of reading achievement; medication status (p = .70), sex (p = .74), and SES (p = .11) were not retained.

Primary Analyses: ADHD, Parental Involvement, and ODD as Predictors of Academic Achievement

Overall academic achievement.

After controlling for age, IQ, and SES (Step 1), only inattention significantly predicted overall academic achievement (β = −.17, p = .006), while hyperactivity/impulsivity was not a significant predictor (β = −.02, p = .71; Step 2). In Step 3 parental involvement was found to significantly but negatively predict overall academics (β = −.13, p = .01), suggesting that parents who report higher levels of involvement tend to have children with more academic difficulties. No subsequent variables in the overall academic achievement model were significant (See Table 4).

Table 4.

Predictors of Children’s Overall Achievement

DV: Overall Scores
R 2 inc β p
Step 1: 0.57***
 Age 0.17 0.001**
 FSIQ 0.72 < .001***
 SES 0.13 0.02*
Step 2: 0.03*
 IA −0.17 0.01**
 HI −0.02 0.71
Step 3: 0.02*
 Parental Involvement −0.13 0.01*
Step 4: 0.00
 IA x Parental Involvement 0.23 0.33
 HI x Parental Involvement −0.17 0.42
Step 5: 0.01*
 ODD −0.06 0.36
Step 6: 0.00
 ODD × Parental Involvement −0.26 0.26
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Note: N = 162. All steps are incremental, where variables in previous steps are included in the model at that step, but not presented in the table to preserve space (i.e., the table reflects the results of the final model with all predictors included). FSIQ = Full Scale Intelligence Quotient; SES = social economic status; IA = Inattention symptoms; HI = Hyperactive-impulsive symptoms; ODD = Oppositional Defiant Disorder symptoms. R2 change effect size conventions: .01 = small, .06 = medium, .14 = large (Cohen et al., 2003).

*

p < .05.

**

p < .01.

***

p < .001.

Math achievement.

After controlling for sex, age, SES, and IQ (Step 1), only inattention was found to be a significant risk factor for lower math scores (β = −.22, p < .001), while hyperactivity/impulsivity (β = −.01, p = .94; Step 2) and parental involvement (β = −.08, p = .14; Step 3) failed to significantly predict math achievement. With the interaction terms included in the model (Step 4), parental involvement significantly but negatively predicted math achievement (β = −.26, p = .05). However, no significant interactions effects between inattention and parental involvement (β = .32, p = .20) or hyperactivity/impulsivity and parental involvement (β = −.01, p = .98) were found. ODD symptoms did not predict or interact with parental involvement to predict math achievement (Steps 5–6; both p > .28; Table 5).

Table 5.

Predictors of Children’s Math Achievement

DV: Math Scores
R 2 inc β p
Step 1: 0.53***
 Sex −0.13 0.02*
 Age 0.13 0.02*
 FSIQ 0.69 < .001***
 SES 0.12 0.04*
Step 2: 0.04*
 IA −0.22 < .001***
 HI −0.01 0.9’
Step 3: 0.01*
 Parental Involvement −0.08 0.14
Step 4: 0.00
 Parental Involvement −0.26 0.05*
 IA × Parental Involvement 0.32 0.20
 HI × Parental Involvement −0.01 0.98
Step 5: 0.00
 ODD −0.07 0.33
Step 6: 0.00
 ODD × Parental Involvement −0.26 0.28
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Note: N = 162. All steps are incremental, where variables in previous steps are included in the model at that step, but not presented in the table to preserve space (i.e., the table reflects the results of the final model with all predictors included). FSIQ = Full Scale Intelligence Quotient; SES = social economic status; IA = Inattention symptoms; HI = Hyperactive-impulsive symptoms; ODD = Oppositional Defiant Disorder symptoms. R2 change effect size conventions: .01 = small, .06 = medium, .14 = large (Cohen et al., 2003).

*

p < .05.

**

p < .01.

***

p < .001.

Reading achievement.

After controlling for age and IQ (Step 1), similar to prior models only inattention was a significant risk factor for reading scores (β = −.16, p = .03), while hyperactivity/impulsivity failed to significantly predict reading scores (β = .01, p = .92; Step 2). These findings remained in Steps 3–6, where no additional variables significantly predicted reading achievement (Table 6).

Table 6.

Predictors of Children’s Reading Achievement

DV: Reading Scores
R 2 inc β p
Step 1: 0.45***
 Age 0.15 0.01*
 FSIQ 0.67 < .001***
Step 2: 0.02*
 IA −0.16 0.03*
 HI 0.01 0.92
Step 3: 0.01*
 Parental Involvement −0.08 0.1’
Step 4: 0.01*
 IA × Parental Involvement 0.34 0.21
 HI × Parental Involvement −0.19 0.43
Step 5: 0.02*
 ODD −0.04 0.59
Step 6: 0.00
 ODD × Parental Involvement −0.27 0.31
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Note: N = 162. All steps are incremental, where variables in previous steps are included in the model at that step, but not presented in the table to preserve space (i.e., the table reflects the results of the final model with all predictors included). FSIQ = Full Scale Intelligence Quotient; SES = social economic status; IA = Inattention symptoms; HI = Hyperactive-impulsive symptoms; ODD = Oppositional Defiant Disorder symptoms. R2 change effect size conventions: .01 = small, .06 = medium, .14 = large (Cohen et al., 2003).

*

p < .05.

**

p < .01.

***

p < .001.

Sensitivity Analyses

A final set of analyses were run to probe the impact of our a priori decisions to (a) recruit a clinically heterogeneous sample that included disorders beyond just ADHD, ODD, and reading/math difficulties; and (b) include IQ as a covariate despite the potential for mono-method effects given that the IQ and academic testing were both conducted with the child (as expected, IQ correlated highly with the academic achievement outcomes at r=.65-.73; Table 2). We also explored potential interactions between ADHD and ODD symptoms given co-occurring ODD symptoms may exacerbate ADHD symptom severity as reviewed above (e.g., Hurtig et al., 2007). Finally, we probed the impact of various methods for correcting for family-wise error on the primary analyses. Results are summarized below and detailed in Supplementary (Online) Tables S1–S9.

First, to probe the impact of our clinically heterogeneous sample, we repeated the primary analyses above, this time including covariates for each diagnostic category (coded as 0=no, 1=yes for anxiety, depression, and ASD; ADHD, ODD, SLD-math, and SLD-reading diagnoses were not included because those diagnoses were based, in whole or part, on the continuous variables already included in our models). The pattern and interpretation of results was unchanged from those reported above, and none of the co-occurring diagnostic categories significantly predicted math, reading, or overall academic achievement (all p>.55).

Next, we repeated the primary analyses again, this time without IQ. As expected, these models explained less variance in academic outcomes (R2 = .24-.33 vs. .47-.63). Interestingly, however, the pattern of results was otherwise highly consistent with those reported above, including significant main effects of inattentive symptoms (β= −.34 to −.40, all p<.001) and parental involvement (β= −.21 to −.36, all p<.01) in all tested models, and no evidence of interaction effects between parental involvement and inattentive, hyperactive/impulsive, or ODD symptoms in any tested model (all p>.43). The only differences were that when IQ was omitted, parental involvement also predicted reading achievement (β= −.21, p=.01), age was not a significant predictor in any model (all p>.43), and SES was a significant predictor in all tested models (β=.26-.32, all p<.001) rather than only in the math and overall achievement models as noted above.

Next, we added interaction terms for inattention x ODD and hyperactivity/impulsivity x ODD. Once again, the pattern and interpretation of results was unchanged from the primary models, and neither of these ADHD x ODD interaction terms predicted any assessed academic outcome (all p>.11). This was also the case when exploring 3-way interactions of inattention x ODD x parent involvement and hyperactivity/impulsivity x ODD x parent involvement (all p>.33).

Finally, we examined the extent to which the primary findings were robust to correction for family-wise error. This final step was not planned a priori but was added during the peer review process. Applying the Holm-Sidak false discovery rate (FDR) correction to the primary main and interaction effects of interest for each model did not change the significance or interpretation of the results reported above. In contrast, other family-wise error correction methods (Benjamini & Hochberg [1995], Bonferroni correction) produced minor changes such that parental involvement no longer predicted math achievement and/or inattention no longer predicted reading achievement. In all cases, the significance and interpretation of results in the primary model (overall academic achievement) was unchanged, suggesting that the primary findings were not likely an artifact of Type 1 error.

Summary

In summary, results revealed that inattention symptoms uniquely and negatively predicted math, reading, and overall academic achievement (β = −.16 to −.22 when controlling for IQ, β= −.32 to −.50 when not controlling for IQ), such that higher inattentive symptoms were associated with lower academic attainment. There were also significant negative main effects of parental involvement on math and overall academic achievement (β = −.13 to −.26) when controlling for IQ, and on all three academic outcomes when not controlling for IQ (β= −.24 to −.36), such that children whose parents reported being more involved with their child tended to score lower on the academic achievement tests. In contrast, hyperactivity/impulsivity and ODD symptoms failed to predict academic achievement, and parental involvement did not interact with child ADHD/ODD symptoms in any tested model. These findings were robust to control for clinical comorbidities, child demographic characteristics, did not appear attributable to Type 1 error, and exploratory analyses indicated that ADHD and ODD symptoms did not interact with each other or with parental involvement to predict any assessed academic outcomes.

Discussion

Academic problems are highly prevalent in ADHD (Frazier et al., 2007) and can lead to both short- and long-term negative outcomes (Arnold et al., 2020; Kent et al., 2011; Kuriyan et al., 2013; McGee et al. 2002; Ritchie & Bates., 2013). Given the prominence of ADHD-related academic risks, it is imperative to identify factors such as parental involvement (Rogers et al., 2009) that both reduce risk and promote success for children with ADHD (Chan et al., 2021). Prior ADHD studies that have examined the role of parental involvement on children’s academic achievement are surprisingly sparse and the findings are mixed (e.g., Shelleby & Ogg, 2020; Rogers et al., 2009). To our knowledge, the present study was the first to examine the influence of parental involvement on multiple, objectively-assessed domains of academic achievement among children across the full range of ADHD inattentive and hyperactive/impulsive symptom frequency/severity. An additional unique contribution of the present study was the examination of whether co-occurring ODD symptoms – which are a risk-factor for ADHD symptom severity (Hurtig et al., 2007) and potentially subsequent academic problems (Leadbeater & Ames, 2017; cf. Rapport et al., 1999) – impact the association between parental involvement and academic achievement.

Of primary interest in the present study was whether parental involvement attenuates (buffers against) the association between elevated ADHD symptoms and adverse academic achievement outcomes. Consistent with prior literature, we found that inattentive symptoms (β= −.16 to −.22; 3–4% variance explained), but not hyperactive/impulsive symptoms, exerted direct and negative effects on academic achievement (Weiss et al., 2003; Breslau et al., 2009). However, consistent with Shelleby & Ogg (2020), we did not find significant moderating effects of parental involvement on the relations between inattention symptoms and any assessed academic domain. Taken together, the main effect of inattention and the lack of inattention x parental involvement interactions (a) confirm that ADHD inattentive symptoms predict lower academic achievement; while (b) suggesting that parental involvement may not buffer against academic underachievement for children with elevated ADHD inattentive symptoms. Despite the consistency between our findings and prior studies that included children with ADHD (Shelleby & Ogg, 2020), this finding differs from expectations based on the developmental literature (Fan & Chen, 2001; Jeynes, 2005; Wilder, 2014), where parental involvement has been shown to protect against academic underachievement. One possible explanation for this discrepancy may be that inattention serves as a limiting factor for a child’s ability to engage with or benefit from parental attempts to bolster their child’s learning (Shelleby & Ogg, 2020). Similarly, it may be that different facets of parental involvement such as the quality (e.g., warm versus controlling; Pomerantz et al., 2007; Silinskas & Kikas, 2017), as well as whether the parent-child interactions predominantly occur at school or home (Castro et al., 2015; Fan & Chen, 2001), may also be important determinants of the relation between parental involvement and academic achievement. For example, Rogers et al. (2009a) found that a controlling parental style (defined as parental exertion of pressure through the use of commands, punishment, or coercive interactions) was associated with higher parent reported ADHD symptoms and lower academic achievement. In contrast, warm or supportive parental involvement (defined as parents demonstrating interest, attention, praise, and reinforcement related to learning) was associated with fewer parent-rated ADHD symptoms and better academic achievement. Further research is needed to assess the specific parent, child, and setting characteristics that may impact the association between parental involvement and academic achievement among children with ADHD.

Unexpectedly, parental involvement had a significant but negative direct effect on overall, math, and potentially reading achievement in our clinically evaluated sample, explaining an additional 1–2% of the variance in academic achievement over and above child demographics and cognitive abilities (β= −.08 to −.13, ΔR2 = .01 to .02). At first glance, these findings appeared surprising given the extensive evidence documenting the positive influence of greater parental involvement on higher academic achievement among typically developing children (Castro et al., 2015; Jeynes, 2005). One potential explanation for this unexpected finding may be that children with ADHD and/or other clinical disorders are at risk for experiencing negative parent-child interactions such as greater parental stress (Theule et al., 2010), hostility (Lifford et al., 2009), and negative and coercive disciplinary practices (Evinç et al., 2018; Rogers et al., 2018b) that can negatively predict academic achievement (Niggli et al., 2007).

In other words, parental involvement for clinical populations may be qualitatively different than it is for developmental samples (Rogers et al., 2009b). Thus, the same quantitative levels of parental involvement may be associated with higher vs. lower child achievement depending, qualitatively, on what that parental involvement entails and why it is initiated. This interpretation may be unlikely, however, given the lack of parental involvement x ADHD and/or ODD symptom interactions, suggesting that the negative association between parental involvement and achievement held for children with both higher and lower levels of ADHD- and ODD-related difficulties. Alternatively, the negative relation between parental involvement and academic achievement may reflect parents becoming more involved by necessity because their child is experiencing more academic difficulties (rather than greater parental involvement causing worse academic outcomes). This hypothesis is speculative, of course, but generally consistent with evidence that parents become more involved in their child’s homework and school life when their child is exhibiting academic underachievement (Silinskas et al., 2015; Dauber & Epstein, 1993; Levin et al., 1997).

Interestingly, in the present study ODD, anxiety, and depression were not associated with lower parental involvement or worse academic achievement after controlling for ADHD symptoms. These results contrasted with some prior research indicating that co-occurring conditions are associated with worse academic outcomes for children with ADHD (Larson et al., 2011). In contrast, our results were consistent with literature demonstrating ADHD symptoms may account for the relation between anxiety and academic achievement (Goldston et al., 2007), as well as moderate the relation between depression and ODD to academic achievement (Carroll et al., 2005; Visser et al., 2020; Willcutt & Pennington, 2000). Additional evidence that ODD symptoms may not directly influence academic achievement further support this lack of significance (e.g., Evans et al., 2019; Fergusson & Horwood, 1995; Rapport et al., 1999). Our results were also aligned with Rogers et al. (2009a), who found no difference in the relation between ODD and parental beliefs regarding parental involvement in a sample of children with ADHD. In the context of the discussed literature, our findings suggest that ODD symptoms may be associated with specific dimensions of the parent-child relationship such as disciplinary practices (Kashdan et al., 2004) and stress (Van de Oord et al., 2006; Kashdan et al., 2004), but not involvement per se. As a result, ODD symptoms do not appear to be a significant influence on the relation between parental involvement and academic achievement after controlling for ADHD symptoms.

Collectively, our findings indicate that parental involvement may not protect against academic underachievement for children with elevated ADHD symptoms (Jeynes, 2005; Fan & Chen, 2001), and may even be associated with lower rather than higher academic achievement for clinically evaluated children in general. These findings are disappointing in the sense that they suggest that increasing parental involvement may not be a viable intervention strategy for facilitating positive academic outcomes for children with ADHD (or children presenting for clinical evaluation in general). Nevertheless, our results are generally consistent with an emerging body of research indicating that (a) assets considered protective for children in general (Masten, 2014) may not confer the same degree of benefits for children experiencing clinically significant symptoms (e.g., Chan et al., 2021); and (b) evidence-based parent training interventions generally fail to improve academic outcomes for children with ADHD despite demonstrating robust improvements in parent involvement and parent-child relationship quality (e.g., Chacko et al., 2014). At the same time, it would seem premature to completely rule out parent involvement as a facilitative strategy because the current study and most prior work has been unable to examine whether specific facets of parental involvement (e.g., supportive versus controlling) may be related to academic outcomes for high-risk samples such as children with ADHD.

Limitations

The current study examined relations between parental involvement, ADHD symptoms, and academic achievement across three academic domains in a clinically evaluated sample spanning the full range of ADHD inattentive and hyperactive/impulsive symptom frequency/severity. A strength of our study was the use of a psychometrically validated measure of parental involvement and objective assessment of children’s academic achievement. At the same time, informant report measures such as those used to measure parental involvement and ADHD symptoms introduce confounds such as social desirability bias (Nederhof, 1985) and retrospective recall bias (Gorin & Stone, 2001). Thus, it is possible that there may be different thresholds for, and different activities that, a parent considers to be parental involvement, which may not be detectable when using a global measure of parental involvement.

Furthermore, the cross-sectional design of the present study precludes us from drawing conclusions about cause and effect, and the lack of significant ADHD x parental involvement interactions can be interpreted differently depending on one’s frame of reference. That is, for researchers focused on ADHD, the negative main effect of ADHD inattention and its nonsignificant interaction with parental involvement suggests that parental involvement does not provide the hypothesized buffer against the negative impact of attention problems on underachievement. In contrast, for researchers focused on parental involvement, the negative main effect of parental involvement and its nonsignificant interaction with ADHD symptoms suggests that parental involvement may predict worse academic outcomes for children at both high and low levels of ADHD symptoms. Longitudinal and experimental designs will be important in expanding this line of work to clarify the influence of specific facets of parental involvement on specific ADHD symptom clusters (i.e., inattentive versus hyperactive/impulsive symptoms) and specific academic domains (e.g., Shelleby & Ogg, 2020).

In addition, while the use of dimensional rather than categorical measurement of ADHD symptomatology was a strength of our study, future studies may benefit from comparison of the relative influence of parental involvement on academic outcomes among children with and without ADHD. Similarly, though comorbid ODD, ASD, anxiety, and depression symptoms were explored in relation to parental involvement and academic achievement, additional study is needed to determine the extent to which parental involvement may reflect a protective cause vs. compensatory outcome of children’s academic performance for different groups of children (e.g., children with learning or intellectual disabilities). Relatedly, the current study focused on reading and math achievement; further study on a broader range of academic outcomes (e.g., written expression) in the context of elevated ADHD symptoms and parental involvement are needed.

Finally, an examination of the complete scope of parent-child involvement will be critical for understanding the effects of parental involvement on academic achievement in the ADHD population (Montes & Montes, 2020). Future studies should specifically examine the differential effect that supportive versus controlling parental involvement may have in buffering against the negative impact of children’s inattention and academic achievement. Similarly, the current study measured overall parental involvement based on parent report; future work may care to differentiate parental involvement that occurs at home, in school, or in other important settings (Castro et al., 2015; Fan & Chen, 2001).

Clinical and Research Implications

The present study found that parental involvement does not appear to attenuate the risk for academic underachievement conveyed by ADHD inattentive symptoms, and may even predict lower rather than higher academic achievement for clinically evaluated children in general. These results were somewhat surprising given that parental involvement has consistently been associated with higher academic achievement within the developmental literature (Olatoye & Ogunkola, 2008; Fan & Chen, 2001; Jeynes, 2005; Wilder, 2014). Nevertheless, our findings are consistent with a nascent literature demonstrating that factors considered promotive for typically developing children (Masten, 2014) may not be associated with the same positive effects for children at higher levels of risk (Chan et al., 2021; Dvorsky et al., 2016). In terms of next steps, additional research is needed to understand different dimensions of parental involvement (e.g., warmth vs. controlling) and parental involvement as it occurs in different settings (e.g., home vs. school) that may help synthesize the mixed findings across the developmental and clinical child/ADHD literatures. At present, based on the current findings and prior literature reviewed above, we recommend that clinicians and educators provide evidence-based academic interventions rather than focusing on parental involvement if the goal is to remediate academic underachievement for children with ADHD (Evans et al., 2018; DuPaul et al., 2011; Chan, Shero et al., 2021).

Supplementary Material

Supp.Tables

Highlights.

  • Multi-informant/multi-method assessment and objective evaluation of children’s academic achievement in a relatively large, clinically evaluated sample

  • Inattentive symptoms, lower IQ, younger age, and lower SES predict lower academic achievement in reading and math

  • Contrary to expectations, higher parental involvement did not buffer against the academic risks conveyed by elevated ADHD symptoms

  • Factors that promote positive outcomes for children in general may not exert the same benefits for children with elevated ADHD symptoms

Acknowledgements:

This work was supported in part by NIH grants (R34 MH102499, R01 MH115048, PI: Kofler). The sponsor had no role in design and conduct of the study; collection, management, analysis, and interpretation of the data; or preparation, review, or approval of the manuscript.

Footnotes

CRediT Author Statement

All authors contributed substantively, collaboratively, and interactively in the production of this manuscript. The authors decline to parcel credit for specific tasks to specific people because we feel this promotes competition rather than collaboration.

1

Exploratory analyses were conducted to probe the impact of our a priori decision to remove non-significant demographic predictors from each model prior to adding the primary variables of interest. Results indicated that the pattern and interpretation of all models was unchanged from those reported herein.

Conflict of Interest:

The authors have no conflicts of interest to report.

Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.

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