title: Improving social adjustment in children with attention-deficit/hyperactivity disorder.
abstract: OBJECTIVE
  To determine if sending motivational letters would improve peer relations in children with social maladjustment and attention-deficit/hyperactivity disorder (ADHD).
  
  
  METHODS
  From a consecutive sample, a case series was followed up for 2 years.
  
  
  METHODS
  Primary care, private physician, office-based practice.
  
  
  METHODS
  Ninety-five children diagnosed as having ADHD by Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, criteria made up the consecutive sample. Twenty-one children qualified with a comorbid social maladjustment disorder with baseline t scores of 1.5 SDs or greater above the mean on the asocial domain of the Conners' Teacher Rating Scale. Seventeen children completed the study. There were no significant differences between these patients and those who did not complete the study (P = .55 for baseline score differences and P = .85 for age).
  
  
  METHODS
  In addition to conventional therapy for ADHD when children achieved a goal, such as an improved report card or better conduct, a personal letter about their success was mailed to them. Letters averaged 5 per student per year.
  
  
  METHODS
  The asocial domain of the Conners' Teacher Rating Scale was repeated during the next 2 school years for comparison. Statistical analysis was by a repeated-measures analysis of variance and Helmert contrasts.
  
  
  RESULTS
  Of 17 students who completed the study, 16 improved on the Conners' Teacher Rating Scale asocial domain, and the results were statistically significant (P<.001).
  
  
  CONCLUSIONS
  Difficulties with peer relations are commonly seen in children with ADHD. Sending motivational letters correlated with improved social adjustment in these children. The data suggest that busy practitioners might consider incorporating this successful, and time-efficient, intervention into their ADHD treatment regimens.
authors.affiliation: Family Care Center, Franklin, LA 70538, USA. buckylou2@aol.com
authors.forename: L H
authors.initials: LH
authors.lastname: McCormick
mesh_terms: D000293:Adolescent; D000704:Analysis of Variance; D001289:Attention Deficit Disorder with Hyperactivity / Q000523:psychology*; D002648:Child; D015709:Correspondence as Topic; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D009042:Motivation; D010379:Peer Group; D012917:Social Adjustment; D014481:United States