The Moderating role of Rapport in the Assessment of Executive Functions of Children with ADHD Symptoms

Children with ADHD have executive function (EF) and social difficulties. Rapport, an important social factor within the assessment process, is vital for successful assessment. Two sub-factors of rapport include positivity and synchronicity. The need for synchrony is more primal and necessary for homeostasis, while positivity is a higher-level need.

Therefore, it is expected that both rapport factors will predict EF performance, yet only synchronicity will impact high-stress situations. With that in mind, the current study explores how ADHD may interact with these patterns.

Forty-five children (mean age=10.49, 44.4% female) participated in two EF tasks – The Day/Night Stroop Task (DN), requiring urgency due to limited response-time; and the Wisconsin Card Sorting Test (WCST), allowing unlimited response-time. Rapport quality and incompatibility were computed using the Child Adult Rapport Measure questionnaire.

Regression findings show that both ADHD symptoms and rapport measures contributed to categories completed in the WCST (R²=.367, p<.001). These measures also predicted perseveration (R²=.305, p=.002). In addition, rapport quality moderated the ADHD effect, such that for higher quality, ADHD symptoms no longer affected perseverative behavior (∆R²=.072, p=.038).

Additionally, rapport incompatibility and ADHD predicted DN response-time (R²=.172, p=.019); while incompatibility moderated the ADHD effect, such that ADHD only predicted RT for compatible rapport (∆R²=.094, p=.028).

Results emphasize the importance of rapport on assessment and its moderating effects on children with ADHD symptoms. Moreover, findings indicate that rapport facilitates performance more in a relaxed environment, while incompatibility is more influential when there is a sense of urgency.