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How children’s ADHD symptoms affect parents’ feelings & parenting behavior

parenting——-

ADHD in chil­dren puts stress on par­ents. In fact, par­ents of chil­dren with ADHD report greater par­ent­ing stress, less sat­is­fac­tion in their par­ent­ing role, and more depres­sive symp­toms than oth­er par­ents. They also report more neg­a­tive inter­ac­tions with their child. This is cer­tain­ly not true in all fam­i­lies where a child has ADHD but instead reflects aver­age dif­fer­ences that have been found.

How do ADHD symp­toms in chil­dren affect par­ents’ feel­ings about par­ent­ing and their behav­ior toward their child? And, does this dif­fer for boys and girls? These ques­tions were the focus of a study pub­lished in the Jour­nal of Abnor­mal Child Psy­chol­o­gy, Par­ents’ reac­tions to youths’ hyper­ac­tive, impul­siv­i­ty and atten­tion prob­lems.

Par­tic­i­pants were 706 chil­dren (376 boys and 330) and their par­ents from a mid-sized town in Swe­den. They were drawn from a 5-year lon­gi­tu­di­nal study which includ­ed near­ly all youth from 4th thru 12th grade in this town. Youth were between 10 and 12 at the start of the study and well into ado­les­cence by the con­clu­sion. This was not a sam­ple of youth diag­nosed with ADHD but a reg­u­lar com­mu­ni­ty sam­ple.

Three waves of data were col­lect­ed from par­ents (over 70% moth­ers) with rough­ly 2 years between each wave. Mea­sures col­lect­ed dur­ing each wave includ­ed the fol­low­ing:

  • Child ADHD symp­toms — Par­ents rat­ed their child’s ADHD symp­toms using a stan­dard­ized rat­ing scale.
  • Youth defi­ance — Rat­ings of children’s oppo­si­tion­al behav­ior.
  • Unre­spon­sive­ness to Parental Cor­rec­tion — This scale mea­sured how par­ents’ felt their child nor­mal­ly respond­ed to parental attempts to influ­ence his or her behav­ior. High scores reflect par­ents’ feel­ings that their child was unre­spon­sive to such efforts.
  • Par­ents’ Feel­ings of Pow­er­less­ness — This scale mea­sured par­ents’ per­cep­tions of their inabil­i­ty to change their youth’s prob­lem­at­ic behav­ior. High scores reflect­ed a parent’s feel­ing that he/she was rel­a­tive­ly pow­er­less to change prob­lem­at­ic behav­ior in their child. A sam­ple item from this scale is “Have you ever felt on the bor­der of giv­ing up — felt that there was noth­ing you could do about the prob­lems you had with the youth?”

In addi­tion to col­lect­ing the above data from par­ents, chil­dren also com­plet­ed scales that mea­sures their per­cep­tion of their par­ents’ warmth, cold­ness and rejec­tion towards them. These scales were col­lect­ed dur­ing waves 2 and 3.

Study Hypotheses

Because data was col­lect­ed over a 5-year peri­od, the researchers could test whether ADHD symp­toms pre­dict­ed par­ents’ per­cep­tion of child unre­spon­sive­ness and their own sense of pow­er­less sev­er­al years lat­er. The spe­cif­ic pre­dic­tions test­ed were that: 1) child ADHD symp­toms lead par­ents to per­ceive their child as unre­spon­sive to cor­rec­tion; and, 2) feel­ing that one’s child is unre­spon­sive to cor­rec­tion leads to increas­es in a parent’s feel­ings of pow­er­less­ness.

The lon­gi­tu­di­nal design also allowed the researchers to test how par­ents’ feel­ings of pow­er­less­ness may influ­ence their behav­ior towards their child. They hypoth­e­sized that par­ents who felt more pow­er­less would be per­ceived by their child to dis­play less warmth and more cold­ness and rejec­tion towards them over time.

Results

Results from this study were large­ly con­sis­tent with the above hypothe­ses. Par­ents’ report of child ADHD symp­toms at time 1 pre­dict­ed increased feel­ings that their child was unre­spon­sive to cor­rec­tion 2 years lat­er. In turn, par­ents’ reports of child unre­spon­sive­ness to cor­rec­tion at time 2 pre­dict­ed increased feel­ings of pow­er­less 2 years lat­er.

The authors next test­ed whether par­ents’ feel­ings of pow­er­less­ness pre­dict­ed youths’ per­cep­tion of how their par­ents behaved towards them. Par­ents who report­ed more pow­er­less­ness at time 1 had chil­dren who report­ed more cold and reject­ing parental behav­ior and reduced parental warmth 2 years lat­er.

The above results were large­ly con­sis­tent across boys and girls. In addi­tion, these results remained large­ly unchanged even when tak­ing children’s lev­el of defi­ance into account, sug­gest­ing that ADHD symp­toms have a direct effect on the process­es stud­ied.

Summary and Implications

The adverse impact of children’s ADHD symp­toms on par­ents’ stress lev­els, sat­is­fac­tion in the par­ent­ing role, and even depres­sive symp­toms have been known for some time. Results from this study sug­gest that it is not ADHD symp­toms them­selves that affect par­ents in these ways, but rather, it is par­ents’ per­cep­tion that their child is large­ly unre­spon­sive to cor­rec­tion that is most chal­leng­ing.

Behav­iors asso­ci­at­ed with ADHD appear to influ­ence par­ents neg­a­tive­ly because they are per­ceived to be large­ly out­side par­ents’ con­trol, which con­tributes to grow­ing feel­ings of pow­er­less­ness. Feel­ings of pow­er­less­ness, in turn, can lead par­ents to behave towards their child in ways that chil­dren increas­ing­ly view as cold­er, more reject­ing, and less warm. This cycle was large­ly sim­i­lar for boys and girls and would be expect­ed to have grow­ing neg­a­tive affects on chil­dren and par­ents over time.

What is some­what iron­ic about these find­ings is that in chil­dren with ADHD, behav­iors that reflect inat­ten­tion, hyper­ac­tiv­i­ty, and impul­siv­i­ty are believed to have strong bio­log­i­cal under­pin­nings and are legit­i­mate­ly dif­fi­cult for par­ents and chil­dren to con­trol. Thus, it is not sur­pris­ing that many par­ents expe­ri­ence chil­dren dis­play­ing high lev­els of these behav­iors as unre­spon­sive to cor­rec­tion, and these feel­ings are not nec­es­sar­i­ly inac­cu­rate. What makes these feel­ings prob­lem­at­ic, how­ev­er, is that they con­tribute to grow­ing feel­ings of pow­er­less­ness in par­ents, per­haps because the under­stand­able dif­fi­cul­ty par­ents have ‘cor­rect­ing’ behav­iors that reflect core symp­toms of ADHD can lead them to feel less con­fi­dent about influ­enc­ing their child in oth­er impor­tant domains.

An exam­ple may make this clear­er. If I have a child with ADHD who is severe­ly hyper­ac­tive, get­ting my child to sig­nif­i­cant­ly alter their activ­i­ty lev­el is going to be extreme­ly dif­fi­cult using the typ­i­cal strate­gies par­ents might engage. It is easy to imag­ine how if I con­tin­ue to focus on this, I will increas­ing­ly feel that my child is unre­spon­sive to cor­rec­tion and devel­op a grow­ing sense of pow­er­less­ness. Over time, this might con­tribute to my being less will­ing to try and exert influ­ence in impor­tant areas where I am more like­ly to be suc­cess­ful, e.g., help­ing my child devel­op a par­tic­u­lar skill or tal­ent or help­ing him learn the impor­tance of devel­op­ing rea­son­able sav­ing and spend­ing habits.

This argues for the impor­tance of help­ing par­ents rec­og­nize that although chil­dren may be ‘unre­spon­sive to cor­rec­tion’ when it comes to the core symp­toms of ADHD that have impor­tant bio­log­i­cal under­pin­nings, this does not need to gen­er­al­ize to oth­er aspects of a child’s life where par­ents are eager to have an impor­tant pos­i­tive influ­ence. Clear­ly under­stand­ing that get­ting chil­dren to change core ADHD symp­toms is dif­fi­cult — many would argue that this is where care­ful­ly mon­i­tored med­ica­tion treat­ment can play a use­ful role — may pro­tect par­ents from feel­ing increas­ing­ly pow­er­less about exert­ing pos­i­tive influ­ence on their child and help them remain engaged with their child in ways that chil­dren expe­ri­ence as warm, nur­tur­ing and sup­port­ive.

Rabiner_David– Dr. David Rabin­er is a child clin­i­cal psy­chol­o­gist and Direc­tor of Under­grad­u­ate Stud­ies in the Depart­ment of Psy­chol­ogy and Neu­ro­science at Duke Uni­ver­sity. He pub­lishes the Atten­tion Research Update, an online newslet­ter that helps par­ents, pro­fes­sion­als, and edu­ca­tors keep up with the lat­est research on ADHD, and helped pre­pare the online course How to Nav­i­gate Con­ven­tion­al and Com­ple­men­tary ADHD Treat­ments for Healthy Brain Devel­op­ment.

Relat­ed arti­cle by Dr. Rabin­er:

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