Using Structural Equation Modeling to Examine Effects of School and Family Support on Childhood ADHD and Meaningful Work Outcomes in Young Adulthood

Background and Purpose: Attention-deficit/hyperactivity disorder (ADHD) is one of the most common neurodevelopmental disorders diagnosed in childhood. Individuals with ADHD experience challenges in executive functioning (e.g., organizing and prioritizing tasks), and/or emotional dysregulation and inappropriate outbursts at school and in the home. Despite classroom accommodations, teachers are generally underprepared to address all inattentive, hyperactive-impulsive, and combination ADHD behaviors. Moreover, challenging behaviors can increase psychological health problems among parents, a concern given that scholars have identified parent psychological support as a significant contributor to youth’s career trajectory. Research pertaining to work outcomes among adults with ADHD primarily relies on cross-sectional data and focuses on employment type rather than job fit and satisfaction. The current study asks: Do school and family support during adolescence mediate the relationship between ADHD symptoms and meaningful work outcomes?

Methods: Data were obtained from three waves of the National Longitudinal Study of Adolescent to Adult Health (Add Health) to examine if school and family support during adolescence (Wave 1) mediated the relationship between retrospectively assessed childhood ADHD behaviors (Wave 3) and meaningful work outcomes (Wave 4). ADHD was a two-factor latent structure consisting of 18 items used to diagnose ADHD in the Diagnostic and Statistical Manual of Mental Disorders. The latent mediator family support consisted of 13 items addressing parental communication and familial attachment. The latent mediator school support consisted of 8 items addressing teacher support and school attachment. Meaningful work, the latent outcome, was constructed from 5 items describing job satisfaction and work self-efficacy. MPlus was used to perform structural equation modeling with the robust maximum likelihood (MLR) estimator to correct for missing and non-normal data.

Results: The structural model results demonstrated acceptable fit (RMSEA = 0.035, CFI = 0.913, TLI = 0.907). Endorsement of hyperactivity symptoms directly led to lower perceptions of meaningful work (β = -.274, p < .01). However, total indirect effects (β = -.078) were not statistically significant, suggesting that family support and school support do not have a strong impact on how these respondents appraised their work. Unexpectedly, inattention symptoms were positively associated with meaningful work (β = .366, p < .001), and while family support (β = .443) was not a statistically significant mediator, school support was a significant mediator in the model (β = .095, p < .05).

Conclusions and Implications: These results indicate the importance of distinguishing between different presentations of ADHD when determining how family and school support received during adolescence influence regard for future employment. Importantly, unlike hyperactivity, inattention ADHD symptoms led to greater perceived support and positive evaluation of work. One reason for this is that hyperactive-impulsive symptoms generally manifest as externalized behaviors that are more likely to be perceived negatively. When teachers and parents have more training and empathy for children with unique or combined presentations of ADHD, they are better equipped to provide psychological support; in turn, this support can shape the way young adults value their participation in the labor market and greater society.