Socially Cohesive Neighborhoods and School-Age Children with ADHD: Connected Support for School Engagement

Background: Nearly 1 in 10 (8.4%) US children aged 2-17 years old have ADHD (Zgodic, 2024). While pathways by which social-ecological risk factors influence adverse outcomes among children with ADHD are established, fewer studies have examined how protective and promotive factors directly and indirectly facilitate optimal outcomes for these children. The developmental assets framework (Benson, 2007) suggests optimal youth development occurs when children’s personal and ecological assets combine and accumulate as this enriches them in acquiring knowledge, skills, and resources that facilitate their advancement. The current project drew from this framework to understand how familial and neighborhood assets might work together to bolster school engagement among children with ADHD. ADHD symptoms can be taxing for children and their families. However, the support from socially cohesive neighborhoods can extend directly to children and their families, which could further bolster families’ resilience to persevere and resolve their children’s unique challenges to engage and succeed in school. We hypothesized that (1) neighborhood social cohesion would directly associate with higher levels of school engagement, family resilience, and parental coping, and (2) higher levels of family resilience and parental coping would indirectly account for the association between socially cohesive neighborhoods and school engagement.

Method: A subset of 1927 children with current ADHD between 6-11 years old were drawn from the 2022 National Survey of Children’s Health, a cross-sectional, nationally representative data set of non-institutionalized US children and youth aged 0-17. Neighborhood social cohesion was assessed by three ordinal items that gauged participants’ perceptions of neighborhood social ties (e.g., neighbors help each other out). Family resilience was assessed by 4 ordinal items gauging the family’s efforts to resolve challenges (e.g., talking together when facing problems). Parental coping was assessed by a single ordinal item describing caregivers’ ability to manage parenting demands. School engagement was assessed by three items gauging children’s attitudes toward doing well in school, homework efforts, and average grades. Structural equation modeling was employed to test the direct and indirect associations and included the child’s age, gender, ADHD treatment and medication, and family SES as covariates.

Results: The measurement and structural model yielded acceptable model fit (X²(69)= 383.607 (p<0.001), RMSEA= 0.044 (CI: 0.045-0.053), CFI=0.990, and TLI= 0.987; X²(103)= 570.658 (p<0.001), RMSEA= 0.049 (CI: 0.045-0.052), CFI=0.986, and TLI= 0.983, respectively). As hypothesized, higher levels of neighborhood social cohesion were directly associated with higher levels of family resilience (b=0.344, p< 0.001), parental coping (b=0.258, p< 0.001), and school engagement (b=0.145, p< 0.001), and support for the indirect association via family resilience was evidenced (0.079, p< 0.001), but not via school engagement (b= -0.058, p= 0.174).

Conclusion/implications: The current study indicates that children with ADHD engage with school more successfully when they reside in socially cohesive neighborhoods and have families with high levels of resilience. Further, our results suggest that socially cohesive neighborhoods may, in part, account for the ways neighborhoods benefit educational success. Future research should examine these relationships longitudinally and examine if the benefits may especially be conferred at different developmental periods.