Graduation Date

Summer 8-17-2018

Document Type


Degree Name

Doctor of Philosophy (PhD)



First Advisor

Shinobu Watanabe-Galloway

Second Advisor

Jennie Hill

Third Advisor

Mohammad Siahpush


Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder with onset usually occurring in childhood and adolescence. During these developmental stages, social interactions and external environments can have significant impact on children’s growth and development. Few studies previously used a theoretical model to examine the effects of social and external environments on ADHD. The goal of this dissertation is to apply an ecological perspective to examine the roles of school and community in the development of childhood ADHD through school engagement and physical activity. Three studies were implemented to carry out this goal. Study 1 examined the associations of neighborhood, school, and family characteristics with school engagement. Study 2 assessed the associations between school engagement and ADHD. Finally, study 3 examined the relationship between neighborhood factors and physical activity in children with and without ADHD. We used data on 65,680 children aged 6 to 17 years from the 2011-2012 National Survey of Children’s Health (NSCH).

Results indicated that pediatric ADHD diagnosis and symptoms can be influenced by family, school, and community characteristics. Findings from studies 1 and 2 demonstrated that school engagement, family factors (socioeconomic status (SES) and adverse childhood experiences (ACE)), and community characteristics (safety and amenities) are associated with ADHD diagnosis either directly or indirectly. Meanwhile, study 3 results showed that environmental characteristics (safety, social support, and access to physical activity resources) are related to physical activity only in children without ADHD. Further research is needed to understand the levels and factors associated with physical activity in children with ADHD. Overall, our results suggested that school and community factors should be examined as potential protective pathways against ADHD in children.

Included in

Epidemiology Commons