The impact of inattention, hyperactivity/impulsivity symptoms, academic achievement, and gender on the self-esteem: a study of children in Japanese elementary schools

Abstract

The intensity of attention-deficit/hyperactivity disorder (ADHD) symptoms in children not diagnosed with ADHD has been associated with low self-esteem. This study examined gender-based self-esteem differences in elementary school children and analyzed the relationships among inattention, hyperactivity/impulsivity symptoms, academic achievement, school experience, and perceived social support on self-esteem.

The participants were 150 fifth- and sixth-grade Japanese elementary school children (70 boys and 80 girls), paired with a parent. Parents described their children’s inattention, hyperactivity/impulsivity symptoms, and academic achievement, while children self-rated their self-esteem, school experiences, and perceived social support from parents, teachers, and friends. The t-test results indicated significant differences between boys and girls in hyperactivity/impulsivity symptoms, friend-related experiences, and perceived social support from teachers and friends. Perceived social support from friends was strong for girls, and that from teachers was strong for boys. The correlation analyses showed that self-esteem linked to academic skills was significantly correlated with academic achievement and academic-related experience for both genders. Academic achievement was a strong predictor of self-esteem concerning academic skills for girls and boys, respectively. Additionally, in boys, inattention and hyperactivity/impulsivity symptoms had greater power than academic achievement in predicting self-esteem regarding athletic skills. Therefore, the findings suggested that academic achievement played an essential role in self-esteem regarding academic skills. Our results showed that academic-related experiences and perceived support were also important factors. In the future, we would like to examine these subjective indicators in light of their impact on objective indicators such as academic achievement.

Keywords:

• Self-esteem
• inattention
• hyperactivity/impulsivity
• academic achievement
• perceived social support
• elementary school

REVIEWING EDITOR:

• Daryl O’Connor, University of Leeds, United Kingdom

SUBJECTS:

• Developmental Psychology
• Child Development
• Inclusion and Special Educational Needs

1. Introduction

Self-esteem is an aspect of self-evaluation that reflects the degree to which individuals consider themselves attractive or capable. Self-esteem is widely recognized as a focal construct of psychological functioning in adolescence (Orth & Robins, 2014). It is recognized to be a subjective indicator of one’s understanding of the positions of self and others and the degree to which one is successful in maintaining interpersonal relationships (Leary et al., 1995) and is influenced by the interaction between the individual and the surroundings. Positive self-esteem is an essential feature of mental health and a protective factor for health and social conduct (Veselska et al., 2009). Conversely, negative self-esteem can lead to the development of a range of mental disorders and social problems (Mann et al., 2004).

Previous studies have reported that self-esteem influences personality (Block & Robins, 1993), school-related emotional states, stress, and friendships (Moksnes et al., 2010). Additionally, numerous studies have focused on gender differences in self-esteem, which are more pronounced in the post-secondary stages of development. Moksnes et al. (2010) investigated self-esteem in students aged 13–18 years and found boys reported higher rates of self-worth. Further, Bleidorn et al. (2016) found that self-esteem increases through middle adulthood and identified age- and gender-related cultural differences. A study by Urabe (2017) covering fourth-grade elementary students through second-grade Japanese high school students found no gender differences in self-esteem among elementary school students. However, there was a difference in the decline from junior high school, with girls showing a more marked decline compared to boys. Regarding mental disorders, boys with negative self-esteem tended to externalize their problems, whereas girls primarily internalized their difficulties (Gjerde et al., 1988).

Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder characterized by the core behavioral symptoms of inattention, hyperactivity, and impulsivity (American Psychiatric Association, 2013). Such symptoms typically appear before the age of 12. Children with ADHD are often reprimanded by elementary school teachers for their unformed attitudes toward learning and forgetfulness. Hinshaw (1992) reported increased absences and dropouts as the school year progressed. Approximately 34% of ADHD individuals are stressed about attending school and report having frequent arguments with friends. Adolescents with ADHD suffer from low self-esteem because of such daily conflicts and feelings of being different from their peers (Brook & Boaz, 2005). The higher the ADHD tendency, the greater the academic failures and friendship problems and the lower the self-esteem. Children with ADHD also tend to underachieve academically. In particular, inattention symptoms in ADHD are related to poor academic performance (eg Loe & Feldman, 2007). There are gender differences in the incidence of ADHD symptoms; ADHD is more common in boys than in girls (Bauermeister et al., 2007).

There are many findings on the self-esteem of children with ADHD or comorbidities with several developmental disabilities. For instance, children with ADHD scored lower in all self-esteem domains compared to controls (Mazzone et al., 2013). In addition, children with ADHD and concomitant disorders, such as aggression, depression, or anxiety, have lower self-esteem than children with only ADHD (Bussing et al., 2000; Treuting & Hinshaw, 2001). Saito (2015) discovered an association between self-esteem and ADHD symptoms in junior school students who were not diagnosed with ADHD. According to Saito (2015), children with inattention and hyperactivity/impulsivity symptoms can easily experience adverse school-related events. Negative school-related experiences cause low self-esteem and severe internalization problems. Moreover, children’s inattention and hyperactivity inclinations can result in symptoms of depression and anxiety through low self-esteem.

Social support refers to the various types of assistance individuals receive from the people around them. In studies of children, it is often measured in terms of ‘perceived social support,’ which is a subjective assessment of the likelihood of perceived support (Ishige & Muto, 2005). Many studies on the relationship between social support and mental health have employed the concept of perceived social support (Kanai, 2010; Shima, 1992). Kanai (2010) showed that people with strong autism spectrum symptoms perceived lower social support than individuals with weak autism spectrum symptoms. Emser and Christiansen (2021) found that children with ADHD perceived less overall social support than the healthy controls. To determine whether an association between perceived social support and self-esteem exists, Hosoda and Tajima (2009) investigated the relationships between self-esteem and perceived social support in junior high school students. Their results showed that perceived social support was related to self-esteem and their relationships differed between girls and boys.

This study aims to explore gender differences in self-esteem among elementary school children who have not been diagnosed with ADHD. Another goal is to determine whether, based on parent and child reports, academic achievement, school-related experiences, and perceived social support independently contribute to self-esteem. Specifically, we examine self-esteem about a factors of academic achievement, an objective indicator. In previous studies, much has been done on children’s self-esteem and the relationship between self-esteem and ADHD symptoms in ADHD children. However, we believe that the present study adds new knowledge by examining the relationship between self-esteem and academic achievement as an objective measure. We hope to build on previous research and address the following questions:

1. Are there gender differences in self-esteem in elementary school children?

2. What is the relationship between self-esteem, inattention, and hyperactivity/impulsivity symptoms in children who have not been diagnosed with ADHD?

3. Do inattention, hyperactivity/impulsivity, and academic achievement predict self-esteem?

2. Methods

2.1. Participants

The participants of this study comprised 150 fifth- and sixth-grade children attending elementary school in Japan (70 boys and 80 girls), each of whom were paired with a parent. We recruited 210 pairs children and guardians and got 150 pairs of respondents. The participating children attended regular classrooms in the selected schools in Japan. According to the information obtained from their schools, the participating children had no history of psychopathology and did not require any educational support.

2.2. Procedure

This study was approved by the Research Ethics Committee of Chiba University. No identity data were collected; hence, passive consent of the participants was allowed. The children and their parents were sent an information letter that briefly explained the study objectives and clarified that participation was voluntary, anonymous, and confidential and that participants were free to withdraw from the study at any time. We asked participants to complete questionnaires in their homes and return them to the researchers.

2.3. Measures

2.3.1. Inattention, hyperactivity/impulsivity symptoms

The ADHD-RS was used to assess ADHD symptoms (DuPaul et al., 1998; Ichikawa et al., 2008). Each item of the ADHD-RS rates the severity on a 3-point Likert scale ranging from 0 to 3, where 0 = None or very few and 3 = Very often there is. The guardians entered the requisite information regarding the 18 ADHD criteria. The ADHD-RS scale encompasses two subscales concerning inattention (nine items) and hyperactivity/impulsivity (nine items). Guardians answered each item on a four-point Likert scale to indicate never or rarely (0 points), sometimes (1 point), often (2 points), and very often (3 points). Higher scores indicate more intensive inattention and hyperactivity/impulsivity. We calculated the total item score for each factor as the subscale tally.

2.3.2. Academic achievement

Parents/guardians filled out their children’s academic achievement of their wards in the subjects of Japanese and Mathematics on a five-point Likert scale: inferior (1 point), slightly below average (2 points), around the grade average (3 points), slightly above average (4 points), and excellent (5 points). Higher scores indicate superior academic achievement.

2.3.3. Self-esteem

Self-esteem was measured using the childhood version of the Self-Perception Scale (Maeshiro et al., 2007), which comprises 18 items, six each for the assessment of academic ability, athletic skills, and global self-worth. The last measure examines holistic self-acceptance through items such as ‘I am delighted with myself as I am’ and ‘I like the kind of person I am.’ The children were asked to register the extent to which every item applied to them on a four-point Likert scale: applies (4 points), somewhat applies (3 points), somewhat does not apply (2 points), and does not apply (1 point). Higher tallies represent greater self-reported confidence about self-esteem.

2.3.4. School-related experiences

Children answered ten questions about school-related experiences to assess the frequency of experiences they encounter in school. These inquiries used items created by Saito (2015) to probe their feelings about academics (four items) and friendships (six items) on a 4-point Likert scale: never (0 points), rarely (1 point), sometimes (2 points), and often (3 points). To calculate the frequency of adverse events at the studied schools, we reversed the scores for each joyous-event item for this analysis. Subsequently, we defined the adverse academic event score as the sum of academic-related items. The aggregate of the six friend-related items was labeled the negative friend-related event score. Higher scores indicate higher and lower frequencies of adverse and positive events, respectively.

2.3.5. Perceived social support

A 15-item questionnaire was employed to rate the extent of perceived social support from fathers, mothers, teachers, and friends (Hosoda & Tajima, 2009). The children reported the degree of perceived social support from their fathers, mothers, friends, and homeroom teachers via a four-point Likert scale: often (4 points), fairly often (3 points), not often (2 points), and not at all (1 point). High social support scores indicate an increased perception of social support from fathers, mothers, teachers, and friends.

2.4. Statistical analyses

The data analysis was conducted using the Statistical Package for the Social Sciences (SPSS) version 27.0. We performed a t-test to compare self-esteem between boys and girls. Each partial correlations about boys and girls, controlling for age, were conducted to examine the relationships between self-esteem, inattention, hyperactivity/impulsivity symptoms, academic achievement, school-related adverse experiences, and perceived social support. Finally, six multiple linear regression analyses were completed to test the effects of inattention, hyperactivity/impulsivity symptoms, and academic achievement (independent variables) on the three self-esteem dimensions (dependent variables).

3. Results

3.1. Gender-related differences in inattention, hyperactivity/impulsivity symptoms, academic achievement, self-esteem, school-related experiences, and perceived social support

The two groups of boys and girls were compared in terms of inattention, hyperactivity/impulsivity symptoms, academic achievement, self-esteem, school-related experiences, and perceived social support (see Table 1). The results indicated a statistically significant difference between the two groups in hyperactivity/impulsivity scores (p <.01), adverse friend-related experiences (p <.01), perceived social support from teachers (p <.05), and perceived support from friends (p <.01). Boys showed significantly higher hyperactivity/impulsivity scores than girls. Adverse friend-related experiences and perceived social support from teachers were also considerably higher in boys than in girls. Meanwhile, Girls’ scores were significantly higher than those of boys for perceived support from friends. There were no gender differences in self-esteem.

Table 1. Gender-related differences in inattention, hyperactivity/ implusivity, academic achievement, self-esteem, school ­experiences, and perceived social support.

	Boys		Girls		t- Value
	Mean	SD	Mean	SD
inattetion	5.57	4.55	4.43	4.47	1.55
hyperactivity/impulsivity	2.26	2.81	1.24	1.56	2.79**
academic achievement	7.13	2.01	7.23	2.40	−0.26
self-esteem
academic skills	18.29	3.66	17.31	4.57	1.43
athletic skills	16.43	3.93	15.63	4.35	1.18
global self worth	17.26	4.34	16.50	4.64	1.03
school experiences
academic	3.00	2.74	2.76	2.89	0.51
friends	4.89	3.17	3.55	3.13	2.59**
perceived social support
father	44.62	11.82	45.75	10.80	−0.61
mother	49.56	9.36	52.06	8.41	−1.73
teacher	40.90	10.11	37.71	10.58	1.87*
friend	48.06	10.29	52.21	8.01	−2.78**

* p < .05. **p < .01.

3.2. Relationships among inattention, hyperactivity/impulsivity symptoms, academic achievement, school-related experiences, perceived social support, and self-esteem in boys and girls

Table 2 presents the correlations between inattention, hyperactivity/impulsivity symptoms, academic achievement, school-related experiences, perceived social support, and self-esteem in boys and girls. In boys, the correlations analyses showed that self-esteem about academic skills was significantly correlated with academic achievement (p < .01) and adverse academic-related experiences (p < .01). The correlations were moderate to large in magnitude, ranging from r = 0.49 to r = −0.75. Additionally, boys’ global self-worth was significantly associated with perceived social support from fathers (p < .01), with a moderate correlation.

Table 2. Partial Correlations between inattation, hyperactivity/implusivity, academic achievement, school-related experiences, perceived social-support, and self-esteem in boys and girls.

	IA	HI	AA	AE	FE	FS	MS	TS	BS	self-esteem academic skills	self-esteem athletic skills	self-esteem global self worth
inattetion: IA	–	0.73**	−0.21	0.03	0.19	−0.07	−0.02	−0.02	−0.18	−0.10	−0.22	−0.12
hyperactivity/implusivity: HI	0.60**	–	0.00	−0.06	0.00	0.03	0.09	0.19	0.12	0.09	−0.03	−0.04
academic achievement: AA	−0.49**	−0.25*	–	−0.47**	−0.01	0.31**	0.24*	0.33**	0.31**	0.49**	−0.05	0.08
academic-related experinces: AE	0.45**	0.14	−0.50**	–	0.12	−0.19	−0.07	−0.10	−0.22	−0.75**	−0.21	−0.21
friends-related experiences: FE	0.25*	0.22	−0.05	0.20	–	−0.47**	−0.34**	−0.46**	−0.49**	−0.23	−0.21	−0.39**
perceived social supports from father: FS	−0.29**	−0.43**	−0.01	−0.30**	−0.29**	–	0.61**	0.41**	0.41**	0.38**	0.08	0.40**
perceived social supports from mother: MS	−0.29**	−0.12	0.24*	−0.36**	−0.26*	0.39**	–	0.42**	0.51**	0.20	−0.05	0.21
perceived social supports from teacher: TS	−0.15	−0.20	0.07	−0.22	−0.41**	0.37**	0.22	–	0.57**	0.26*	0.05	0.23
perceived social supports from a friend: BS	−0.13	−0.03	0.03	−0.16	−0.36**	0.28**	0.46**	0.40**	–	0.34**	0.23	0.23
self-esteem: academic skills	−0.33**	−0.11	0.61**	−0.71**	−0.22	0.15	0.37**	0.22	0.22*	–	0.44**	0.42**
self-esteem: athletic skills	−0.15	0.00	0.05	−0.29**	−0.04	0.09	0.19	0.13	0.13	0.34**	–	0.41**
self-esteem: global self worth	−0.13	0.03	0.28*	−0.47**	−0.19	0.32**	0.54**	0.20	0.23*	0.59**	0.27*	–

Correlation for boys are above the diagonal and correlations for girls are below the diagonal.

* p < .05; **p < .01.

In girls, the correlation analyses showed that self-esteem regarding academic skills was significantly correlated with academic achievement (p < .01) and adverse academic-related experiences (p < .01), with moderate correlations ranging from r = 0.61 to −0.71. Further, girls’ overall self-esteem was significantly related to adverse academic-related experiences in school and social support from mothers (p < .01), with correlations ranging from r = −0.47 to 0.54.

3.3. Predictors of self-esteem in boys and girls

Six separate multiple regressions were conducted for each group to examine whether inattention, hyperactivity/impulsivity symptoms, and academic achievement were differentially related to three aspects of self-esteem (academic skills, athletic skills, and global self-worth) in boys and girls. The four regression models were significant, except for self-esteem about athletic skills (see Table 3).

Table 3. Multiple regression analysis of inattention, hyperactivity/impulsivity, academic achievement, predicting self-esteem in boys and girls.

	Boys				Girls
	B	SE	β	t	B	SE	β	t
self-esteem (academic skills)		F (3,66) = 8.118**; R^2 = 0.270				F (3,76) = 13.894**; R^2 = 0.354
inattention	−0.127	0.126	−0.157	−1.006	−0.162	0.140	−0.159	−1.158
hyperactivity/impulsivity	0.267	0.199	0.204	1.343	0.217	0.347	0.074	0.625
academic achievement	0.842	0.204	0.461	4.136**	0.983	0.213	0.517	4.612**
self-esteem (athletic skills)		F (3,66) = 3.088*; R^2 = 0.123				F (3,76) =1.064; R^2 = 0.040
inattention	−0.444	0.148	−0.515	−3.005**	−0.289	0.163	−0.297	−1.776
hyperactivity/impulsivity	0.517	0.233	0.370	2.216*	0.359	0.403	0.129	0.891
academic achievement	−0.346	0.239	−0.177	−1.449	−0.252	0.248	−0.139	−1.019
self-esteem (global self worth)		F (3,66) = 0.235; R^2 = 0.011				F (3,76) = 2.128; R^2 = 0.077
inattention	−0.137	0.174	−0.143	−0.787	−0.124	0.170	−0.120	−0.729
hyperactivity/impulsivity	0.139	0.274	0.090	0.509	0.455	0.421	0.153	1.083
academic achievement	0.001	0.281	0.001	0.004	0.440	0.259	0.228	1.700

* p < .05; **p < .01.

The regressions conducted with boys indicated that academic achievement (β = 0.461, t = 4.136, p <.01) was a significant individual predictor of self-esteem regarding academic skills. Inattention (β = −0.515, t = −3.005, p <.01) and hyperactivity/impulsivity (β = 0.370, t = 2.216, p <.05) were significant individual predictors of self-esteem about athletic skills. All of the predictors collectively explained 27.0% and 12.3% of the variance in self-esteem about academic skills and athletic skills, respectively. However, no unique individual predictors of global self-worth were identified.

For girls, academic achievement (β = 0.517, t = 4.612, p <.01) was a significant individual predictor of self-esteem about academic skills. All of the predictors collectively explained 35.4% of their variance. There were no unique individual predictors of self-esteem about athletic skills and global self-worth.

4. Discussion

The present study investigated self-esteem among elementary school children who had not been diagnosed with ADHD. The first objective of this study was to examine gender-based differences in self-esteem among elementary school children. The second objective was to analyze the relationships among inattention, hyperactivity/impulsivity symptoms, academic achievement, school experience, and perceived social support on self-esteem.

First, we considered the association between self-esteem and gender, but found no gender-related differences for any self-esteem indicators. Urabe (2017) reported no gender differences in self-esteem among elementary school children, but that girls’ self-esteem fell below that of boys from middle school onward. Our study discovered no such gender differences, potentially because the participants were elementary school children. Regarding correlations between self-esteem and other variables, for both boys and girls, self-esteem about academic skills was positively correlated with academic achievement and strongly negatively correlated with academic-related experiences. This result was consistent with Saito’s (2015) findings.

However, the results for global self-worth showed different effects for boys and girls. Boys were positively correlated with perceived social support from fathers, whereas girls were negatively correlated with academic-related experiences and positively associated with perceived social support from mothers. Regarding global self-worth, girls mediate anxiety in school life (Grills & Ollendick, 2002), and school events negatively affect their global self-worth. In other words, compared to boys, girls were more significantly affected by school experience. Concerning perceived social support, middle school students showed gender differences in perceived social support from fathers and mothers, with each tending to receive more robust perceived support from parents of the same gender (Ishige & Muto, 2005). Considering that global self-worth was related to perceived social support from their fathers and mothers, respectively, it can be implied that perceived social support from same-gender parents may play an essential role in recognizing one’s personal worth. In particular, it is necessary for children beginning to enter adolescence, to model their parents and to receive encouragement and daily interactions from their same-gender parents.

Next, in terms of gender differences in variables other than self-esteem, boys had more negative friend-related experiences at school than girls (Biederman et al., 2002). Hyperactivity/impulsivity tendencies were higher among boys, which is consistent with previous reports by Gershon (2002). On the other hand, the results differed between boys and girls in terms of perceived support. Boys were higher score than that of girls in perceived social support from teachers. On perceived social support from friends, we showed opposite results. Hosoda and Tajima (2009) and Rueger et al. (2008) showed gender differences in perceived support from friends, reporting higher scores for girls than for boys. Regarding perceived support from teachers, some studies (Rueger et al., 2008) found no gender differences among elementary school students, whereas others reported gender differences among middle school students (Lifrak et al., 1997). In reports of gender differences, boys reported higher perceived support from teachers than girls, and students with higher perceived support were less likely to engage in antisocial behavior. When problems occur at school, girls are more likely than boys to engage in support-seeking behaviors such as talking to someone and asking for advice (Eschenbeck et al., 2007). Thus, it can be said that with regard to negative experiences in school life, girls are more likely to seek help from those around them to resolve their problems. There are no consistent results on perceived support from teachers indicating an influence of gender differences. However, Hosoda and Tajima (2009) noted that the intensity of perceived support between males and females differed depending on the type of support offered. Thus, it is possible that the gender differences obtained in this study also vary depending on the kind of support.

According to the present results, perceived support from teachers and friends plays a crucial role in school friendship experiences. We showed that children with more robust perceived support from teachers and friends tended to more likely to avoid trouble. Girls were characterized by greater hyperactivity and impulsivity symptoms and weaker perceived support from their fathers. Given that the stronger the autism spectrum disorder symptoms, the weaker the perceived support (Kanai, 2010), it was hypothesized that having neurodevelopmental tendencies would lead to weaker perceived support, especially from non-same-gender parents. In addition, inattention was negatively correlated with academic achievement in girls. Inattention symptoms are known to be more strongly associated with academic achievement than hyperactivity and impulsivity symptoms, with stronger inattention symptoms leading to academic failure at older ages (Massetti et al., 2008). In addition, women with ADHD are more sensitive to praise than men, which has a greater impact on their self-esteem (Schwalbe & Staples, 1991). Furthermore, it is noted that the behavior of girls with ADHD is more poorly understood than that of boys. Girls’ inattentive symptoms may impact their schoolwork, and difficulty in gaining an understanding of their peers may lead to a vicious cycle of more negative events regarding schoolwork and academic failure.

Finally, we contemplated predictors of self-esteem, which were measured via competence ratings about academics and physical activity, with global self-worth as a superordinate concept. Multiple regression analyses revealed that academic-related experiences were explanatory factors predicting self-esteem about academic skills for both boys and girls. Academic achievement was critical predictor of self-esteem about academic skills in girls and boys. Concerning self-esteem about athletic skills, inattention and hyperactivity/impulsivity was detected as an explanatory factor for boys. The correlation between the intensity of inattentive symptoms and motor aspects (Martin et al., 2006), may have been reflected in the results. Tremblay et al. (2000) also reported that physical activity and academic achievement are related to self-esteem in elementary school students, which could explain the outcomes of the present study.

Two important results of the present study are as follows. First, there were no gender differences in self-esteem, but there were gender differences in the factors that predicted self-esteem. Particularly in self-esteem about athletic skills, inattention and hyperactivity/impulsivity were predictive factor in boys. Second, academic achievement was a strong predictors of self-esteem concerning academic skills for girls and boys, respectively. Additionally, in boys, the symptoms of inattention and hyperactivity/impulsivity had greater power than academic achievement in predicting self-esteem regarding athletic skills. Academic achievement was associated with self-esteem about academic skills in girls and boys, that findings suggest that academic achievement played important roles in self-esteem about academic skills. While academic-related experiences and perceived support are also important factors, we have demonstrated the significance of focusing on academic performance as an objective measure. In the future, we would like to examine these subjective indicators in light of their impact on objective indicators such as academic achievement.

The current study has several limitations. First, the small sample size limits the robustness of the analyses and the generation of connections between self-esteem and inattention, and hyperactivity/impulsivity symptoms. Second, the study participants were only fifth and sixth-grade children evincing typical development; thus, developmental changes could not be assessed. Finally, this survey’s evaluation of academic performance was based on parental reports. It was necessary to use objective results, such as grade-level test scores, to examine the involvement of the child’s competence without parental involvement in self-esteem.

Acknowledgments

We appreciate the families and school teachers who contributed to this study.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Data availability statement

The datasets used and/or analyzed while conducting the current study are available from the corresponding author upon reasonable request.

Additional information

Funding

This work was supported by Japan Society for the Promotion of Science (JSPS) KAKENHI (Grant Number 19K02950).

Notes on contributors

Chie Miyadera

Chie Miyadera is an associate professor in education at the Chiba University, where she conducts research into aspects of children with neurodevelopmental disabilities with a focus on psychology and their support.