How cognitive and behavioural body-functions of children with ADHD are linked to their participation and environmental supports?

Children with chronic conditions face participation restrictions and exclusions. To investigate how cognitive and behavioural body-functions are associated with 1) participation patterns and 2) environmental factors among children with attention deficit hyperactivity disorder (ADHD). The study included 83 children with ADHD. Cognitive and behavioural body-functions were assessed with Conners’ Parent Rating Scale-Revised Long-Version. The participation patterns of children were assessed with Participation and Environment Measure for Children and Youth (PEM-CY). Multiple regression analyses were used to examine the relationships between cognitive and behavioural body-functions and (1) participation patterns at home, school and community settings, and (2) environmental supports and barriers. In home setting, inattention and ADHD index which determine ADHD children from typically developing peers, were the strongest factors, explaining 24.9 % of variance in activities that mothers wanted to change. In school setting, presence/level of oppositional behaviours had the strongest effect on environmental barriers, with variation of 29.8 %. In community setting, the strongest factor explaining environmental helpfulness was anxious/shy behaviours (16.1 %). When seeking to improve participation of children with ADHD both the cognitive and behavioural demands of chosen activities should be modified while creating environments that supports these challenges. •Inattention factor explained the rate of involvement in activities at home and school.•Oppositional and anxious/shy behaviours have an impact on environmental features in all three settings.•Oppositional behaviors affect school participation most, while anxious/shy behaviors affect community participation most.