5.23 Understanding Parent-Child Communication in the Context of ADHD

Abstract

Adolescents with ADHD are at higher risk for health risk behaviors and adverse consequences. Their parents, in turn, experience greater parenting stress and lower quality of life. The objective of this study is to conduct a needs assessment of parent-adolescent communication (PAC) in this population, which will in turn be used to develop a parenting skills class that includes motivational interviewing (MI) skills to address the challenges in PAC in a developmentally appropriate way. We recruited 22 parents and 17 adolescents through outpatient clinics in an urban safety net health system. Participants engaged in interviews about PAC and a health risk discussion. In addition, they answered surveys covering demographic information, parenting stress, parenting styles, adolescent symptom burden, and MI. There are many notable sample characteristics. Twenty-seven percent of parents had taken a parenting class for children with ADHD or for divorced parents in the past; 87% of parents reported that they were having a close and supportive relationship with their adolescents; and 50% of parents felt that a parenting class should target PAC. Other common concerns included coping with mental health problems, behavioral issues, and how to provide support for the adolescents. Fifty-five percent of parents are interested or extremely interested in taking a parenting class designed for the parents of teenagers with ADHD. The Helpful Responses Questionnaire was scored on 3 dimensions of MI (MI Spirit [SP], MI Skills [MI], and promoting change talk [CT]) according to MI adherent responses (1), neutral responses (0), or MI nonadherent responses of persuasion and confrontation (–1). The average scores were –0.67 for SP, –0.79 for MI, and –0.55 for CT. Parents scored an average of 4.6 out of 16 on the MI Knowledge and Attitudes Test (MIKAT). The majority of the parents had an involved and positive parenting style as measured by the Alabama Parenting Questionnaire. Parents expressed a high level of interest in taking a parenting class that targets PAC. The parents have a low level of knowledge of or alliance with MI, despite positive and involved styles. Future directions include qualitative analysis of the parent and adolescent interviews to guide the development of a parenting class including MI skills for parents.