Parental ADHD Research Articles

The Association between ADHD Symptoms and Antisocial Behavior: Differential Effects of Maternal and Paternal Parenting Behaviors

The present study examined the moderating role of maternal and paternal behaviors on the association between ADHD symptoms and antisocial behavior. The data are from a Swedish community-based study with 2886 adolescent participants, aged 13–15. We analyzed the adolescents’ self-reports of negative and positive parental behavior, ADHD symptoms, and antisocial behavior. Results show that ADHD symptoms significantly predicted levels of antisocial behavior in both maternal- and paternal-moderated regression models. Also, several significant interaction effects emerged. Fathers’ attempted understanding and mothers’ warmth significantly buffered the association with antisocial behavior. In turn, mothers’ negative behaviors—both coldness and rejection and angry outbursts—significantly enhanced the association with antisocial behavior, whereas only fathers’ angry outbursts emerged as a significant moderator. Thus, there is support for differential effects of maternal and paternal behavior on the association between ADHD symptoms and adolescent antisocial behavior.

“Mom Just Forgot Me at a Gas Station”: A Qualitative Study of Parental ADHD in the Home

“Mom Just Forgot Me at a Gas Station”: A Qualitative Study of Parental ADHD in the Home

Parent Training Tailored to Parents With ADHD: Development of the Improving Parenting Skills Adult ADHD (IPSA) Program

Objective: To describe the development of the Improving Parenting Skills Adult ADHD (IPSA) parent training (PT) program, designed for parents with ADHD. Method: IPSA was developed using an iterative co-creation approach, involving parents with ADHD from the initial knowledge mobilization phase onwards. The program prototype was evaluated by 16 parents with ADHD, in an open trial of program feasibility. Results: IPSA was deemed feasible in terms of acceptability and levels of active participation, with no evidence of unintended harm. All but one participant completed the program, attending on average 84% of sessions. Pre-to-post within-group comparisons of targeted skills and outcomes revealed changes in the expected direction regarding, for example, use of introduced parenting skills (Cohen’s d = 1.3). Conclusion: The program prototype was found acceptable, accessible, and safe. Findings support the potential value of adapting PT protocols for parents with ADHD and warrant further evaluation of IPSA in a randomized controlled trial.

51.1 Parent ADHD Is Associated With Family Sleep Disruption, and Infant Sleep Predicts ADHD-Related Behaviors in Toddlerhood

51.1 Parent ADHD Is Associated With Family Sleep Disruption, and Infant Sleep Predicts ADHD-Related Behaviors in Toddlerhood

39.5 The Impact of Parent ADHD on New Mothers and the Early Parenting Environment: Differential Associations by Mother and Father ADHD

39.5 The Impact of Parent ADHD on New Mothers and the Early Parenting Environment: Differential Associations by Mother and Father ADHD

Screening for parent and child ADHD in urban pediatric primary care: pilot implementation and stakeholder perspectives

BackgroundADHD commonly co-occurs in children and parents. When ADHD is untreated in parents, it contributes to negative child developmental and treatment outcomes. Screening for parent and child ADHD co-occurrence in pediatric primary care may be an effective strategy for early identification and treatment. There is no data on whether this screening model can be implemented successfully and there exists limited guidance on how to effectively approach parents about their own ADHD in pediatric settings. Even greater sensitivity may be required when engaging with families living in urban, low SES communities due to systemic inequities, mistrust, and stigma.MethodsThe current pilot study described the first 6 months of implementation of a parent and child ADHD screening protocol in urban pediatric primary care clinics serving a large population of families insured through Medicaid. Parents and children were screened for ADHD symptoms at annual well-child visits in pediatric primary care clinics as part of standard behavioral health screening. Independent stakeholder group meetings were held to gather feedback on factors influencing the implementation of the screening and treatment strategies. Mixed methods were used to examine initial screening completion rates and stakeholder perspectives (i.e., parents, primary care office staff, pediatricians, and behavioral health providers) on challenges of implementing the screening protocol within urban pediatric primary care.ResultsScreening completion rates were low (19.28%) during the initial 6-month implementation period. Thematic analysis of stakeholder meetings provided elaboration on the low screening completion rates. Identified themes included: 1) divergence between provider enthusiasm and parent hesitation; 2) parent preference versus logistic reality of providers; 3) centering the experiences of people with marginalized identities; and 4) sensitivity when discussing parent mental health and medication.ConclusionsFindings highlight the importance of developing flexible approaches to screening parent and child ADHD in urban pediatric health settings and emphasize the importance of cultural sensitivity when working with marginalized and under-resourced families.Trial registrationNCT04240756 (27/01/2020).

Do Late Bloomers Exist Among Adjudicated Youth?: Examining Parental Factors and ADHD Symptomatology as Contributors to Protective Bud and Bloom Effects

Do Late Bloomers Exist Among Adjudicated Youth?: Examining Parental Factors and ADHD Symptomatology as Contributors to Protective Bud and Bloom Effects

A Dynamical Systems Investigation of the Co-regulation between Perceived Daily Parental Warmth and Adolescent Attention-deficit/hyperactivity Disorder Symptoms.

Longitudinal research demonstrates that child ADHD symptoms and behaviors exhibit reciprocal associations with parenting behaviors over time. However, minimal research has investigated these associations and their dynamic links at the daily level. Intensive longitudinal data can disentangle stable between-person differences from within-person fluctuations and reveal nuanced short-term family dynamics on a micro timescale. Using 30-day daily diary data from a community sample of 86 adolescents (Mage = 14.5, 55% female, 56% White, 22% Asian) and latent differential equation modeling, this study examined the links between perceived daily parental warmth and ADHD symptoms as coupled dynamical systems. The results show that the magnitude of fluctuations in perceived daily parental warmth generally remains stable, while elevated ADHD symptoms return to their normal level over time. Perceived parental warmth is sensitive to change in ADHD symptoms such that adolescents feel that their parents will fine-tune their warmth with gradual changes when adolescents demonstrate heightened symptoms. There are substantial between-family differences in these regulating system dynamics. Among families with more baseline parental non-harsh discipline, both perceived parental warmth and ADHD symptoms tend to be more stable and fluctuate less often. Intensive longitudinal data and dynamical systems approaches offer a new lens to uncover short-term family dynamics and adolescent adjustment at a refined micro level. Future research should explore antecedents and consequences of between-family differences in these short-term family dynamics on multiple timescales.

Predictors of Engagement Barriers for Adolescent ADHD Treatment

Objective: The purpose of this study was to understand patient characteristics that predict engagement barriers during behavior therapy for ADHD. Method: Participants were 121 adolescents with ADHD and parents who received evidence-based behavior therapy for ADHD. Multiple regression examined relationships between six independent variables and frequency of barriers. Results: ODD comorbidity and parental ADHD predicted higher frequency of overall barriers. With respect to barriers subtypes, these variables also predicted higher frequencies of cognitive, teen, early-treatment and mid-treatment barriers. Late-treatment, ODD predicted higher frequency of barriers, while minority status predicted lower barriers. Conclusions: Adolescents diagnosed with ADHD and comorbid ODD, or who have parents that are also diagnosed with ADHD, are at greatest risk for engagement barriers during behavior therapy. During all phases of treatment, this patient subgroup would benefit from enhancements to standard behavior therapy that focus on therapeutic engagement—particularly targeting teen beliefs about treatment.

Epidemiological Study of Parental Obstructive Sleep Apnea and Subsequent Risk of ADHD in Their Children: A Nationwide Population-Based Study

Objective: Obstructive sleep apnea (OSA), with daytime drowsiness, nocturnal hypoxia, could result in systemic inflammation and oxidative damage. We hypothesize that parental OSA, with chronic systemic inflammation and oxidative stress, might contribute to children’s neurodevelopmental disorders, such as ADHD. Method: By linking National Birth Registry with the National Health Insurance Research Database, Taiwan, we identified 2006–2015 birth cohort, which comprised 1,723,873 singleton live births, and conducted a nested case-control study. We included children with ADHD and compared them with non-ADHD controls matched with ADHD case on index date. Conditional logistic regression was utilized to calculate adjusted odds ratio (aOR) when investigating the association between parental diseases with risk of ADHD in their offspring. Results: The aOR (95% CI) of offspring’s ADHD was 1.758 (1.458–2.119) with paternal OSA and 2.159 (1.442–3.233) with maternal OSA. The subgroup analysis revealed different effects of parental diseases among children’s gender. Conclusion: Our study demonstrates an association in parental OSA and offspring ADHD, which could inspire further research to clarify the mechanisms.

Parental ADHD and ASD symptoms and contributions of psychosocial risk to childhood ADHD and ASD symptoms in children born very preterm.

Examine maternal and paternal ADHD and ASD symptoms in relation to very preterm (VPT) and full-term (FT) children's ADHD and ASD symptoms. In this longitudinal study, maternal- and teacher-report of child ADHD and ASD symptoms were obtained for 119 children (VPT = 79, FT = 40) at age 5-years using the Conner's Rating Scale-Revised (CRS-R) and Social Responsiveness Scale-2 (SRS-2). A biological parent completed self- and observer-report CRS-R and SRS-2, and measures of mood/affect, stress, and social support to assess psychosocial distress. Data were analyzed using mixed-effect models adjusted for covariates. Child ADHD symptoms were associated with VPT birth, maternal distress, and maternal ADHD symptoms (p ≤ 0.02), and paternal ADHD symptoms (p < 0.001). Regarding ASD, VPT birth and parental ASD symptoms were associated with child ASD symptoms (p ≤ 0.009). Parental symptoms and birth group had no interaction. VPT birth and parental psychopathology represent independent risks for ADHD and ASD.

Attention-Deficit/Hyperactivity Disorder and Parenting: Toward a Cognitive/Schema Model

IntroductionAttention-Deficit/Hyperactivity Disorder (ADHD) runs in families; however, there are mixed results on the interaction effects of parent’s and child’s psychopathology on parenting qualities. Cognitive/schema therapy is a promising treatment approach for adult ADHD; we know little about the effect of cognitive factors on parenting, however.ObjectivesWe aimed to fill this gap by exploring the role of dysfunctional schema modes in the associations between adult ADHD symptoms, child’s externalizing symptoms, and perceived parental competence in a dimensional approach.MethodsA community sample of parents (N=100, mean age=38.25 years, SD=5.73) filled out online questionnaires assessing ADHD symptoms (Adult ADHD Self-Report Scale), dysfunctional schema modes (Schema Mode Inventory), perceived parental competence (Parental Sense of Competence Scale), and child’s psychopathology (Strength and Difficulties Questionnaire).ResultsIn a multivariate model, higher levels of parental ADHD symptoms were related to higher levels of dysfunctional schema modes. However, neither the child’s externalizing symptoms nor the interaction term of parent’s symptoms by the child’s symptoms had any effect on dysfunctional schema modes. Furthermore, the child’s externalizing symptoms had a direct negative association with parental self-efficacy beliefs, whereas the relationship between adult ADHD symptoms and parental self-efficacy was mediated by the detached and overcompensating dysfunctional schema modes.ConclusionsOur results suggest that the activation of dysfunctional schema modes is related to the parent’s but not the child’s psychopathology. The activation of dysfunctional schema modes may play an important role in the self-efficacy beliefs of parents with ADHD. Targeting that cognitive factors may enhance the effect of behavioral parent training programs.DisclosureThis research was supported by National Research, Development, and Innovation Office (NKFIH) OTKA-PD-134849 grant.

Is Parents’ ADHD Symptomatology Associated With the Clinical Feasibility or Effectiveness of a Psychoeducational Program Targeting Their Children’s ADHD?

Objective: To examine if the clinical feasibility and effectiveness of a psychoeducational program targeting children’s ADHD differ between parents with varying ADHD symptom severities. Method: An open trial analyzed data from 549 parents of children with ADHD aged 3 to 17 years, who participated in psychoeducation at an outpatient habilitation/disability clinic. In all analyses, parents were stratified into three symptom severity groups (low/middle/high) based on scores on an ADHD screening scale. Results: Parental ADHD symptom severity was not associated with results on any outcome, although the odds of having incomplete data were higher in parents reporting higher symptom severity. Across the entire sample, we observed high program completion rates, positive acceptability ratings and large increases in parental knowledge. Conclusions: Psychoeducation may be beneficial regardless of the participating parent’s ADHD symptomatology. Further research is needed to examine whether these results are generalizable to parents diagnosed with ADHD, an underrepresented group in our study.

Examining daily parent involvement in caregivers of children with ADHD using electronic diaries

Limited research has examined the associations between child ADHD symptoms and parent involvement and has generally relied on the use of parents' retrospective reports of parent involvement and ADHD symptoms. Using daily reports, the current study explored the pathways between child ADHD symptoms and home-based parental involvement beliefs and behaviors. Data were collected daily from 26 parent participants over a 2-week period for a total of 315 time points. Daily surveys asked parents to report on child ADHD symptoms, parental self-efficacy, parental time/energy, and home-based involvement quality. Results indicated that parental self-efficacy mediated the association between children's inattentive symptoms and parental home-based involvement quality. Children's hyperactive/impulsive symptoms moderated the association between parental time/energy and parental home-based involvement quality. These results suggest that parental self-efficacy is an important factor in explaining how children's inattention is associated with parental quality of home-based involvement. In addition, the association between parental time/energy and home-based involvement quality was lower when parents perceived their child to have higher levels of symptoms.

The Impact of Parental ADHD Symptoms on Parenting Practices and Stress After Behavioral Intervention: Comparisons across Co-occurring Presentations

The Impact of Parental ADHD Symptoms on Parenting Practices and Stress After Behavioral Intervention: Comparisons across Co-occurring Presentations

Examining the effects of ADHD symptoms and parental involvement on children’s academic achievement

ObjectiveOur understanding of the role of parental involvement in academic outcomes for children with ADHD is limited, with mixed evidence suggesting a positive association between parental involvement and academic achievement for pediatric ADHD but limited evidence regarding how this varies based on ADHD symptom severity, ADHD symptom domains, or co-occurring ODD symptoms. In this context, the present study aimed to examine the effects of parental involvement, ADHD symptoms, and comorbid ODD on children’s overall, reading, and math achievement. MethodA well-characterized clinically-evaluated sample of 162 children recruited through a university-based children’s learning/behavioral health clinic and community resources (ages 8–13; 50 girls; 69% Caucasian/Non-Hispanic) were administered standardized academic achievement tests, with parents and teachers completing measures of parental involvement and ADHD symptoms, respectively. ResultsInattention, but not hyperactivity-impulsivity, was associated with lower academic achievement in all tested models (β= -.16 to -.22, all p < .03). Surprisingly, parental involvement had significant negative associations with math and overall academic achievement (β= -.13 to -.26, both p< .05) and did not moderate the relations between ADHD symptoms and academic achievement in any tested model. Comorbid ODD symptoms did not significantly predict academic achievement or interact with parental involvement in any tested model. These findings were robust to control for child IQ, age, sex, SES, anxiety, and depression. ConclusionParental involvement may not serve as a protective factor against academic underachievement for children with clinically elevated ADHD symptoms, and may predict lower rather than higher academic achievement for clinically evaluated children in general.

School‐based ADHD services: Perspectives from racially and ethnically minoritized students

AbstractAttention‐deficit/hyperactivity disorder (ADHD) can impact students' academic, social, and behavioral outcomes. To improve student outcomes, schools regularly identify students with ADHD and develop relevant educational programming. However, the extant research that supports these practices underrepresents racially and ethnically minoritized (REM) students. To address this gap, this study investigates the experiences of REM students (N = 35) receiving school‐based ADHD services. The average participant age was 15.8 years, and the majority of participants were male (57.1%). Results from this phenomenological investigation revealed 5 themes and 14 subthemes describing REM students' thoughts, feelings, and experiences of ADHD assessment, intervention, and parent involvement in these processes. These findings suggest REM adolescent students should be informed decision‐makers in their school‐based services, though they are often left out of the planning process. Additionally, student reports support the involvement of parents and interdisciplinary community professionals in school‐based services.

Parent ADHD Is Associated With Greater Parenting Distress in the First Year Postpartum

Objective: Little is known about the experience of parenting infants when a mother or father has ADHD. This study examined cross-sectional predictors of parenting distress experienced by parents with and without ADHD who also have infants. Methods: Participants were 73 mother-father pairs (N = 146) of infants 6 to 10 months old. Half of the families included a parent with ADHD. Psychosocial predictors were tested using multilevel modeling. Results: Parent or partner ADHD, lower parent sleep quality, fewer social supports, and less infant surgency and effortful control were associated with greater parental distress. Infant negative affect and sleep were not associated. Conclusions: Parents with ADHD and their partners experience greater parenting distress in the first year of their child’s life than parents without ADHD. Addressing parent ADHD symptoms and co-occurring difficulties, including sleep disturbances, are potential targets for early interventions to maximize both parent and infant mental health outcomes.

A Systematic Review of Longitudinal Studies Investigating the Association Between Early Life Maternal Depression and Offspring ADHD

Objective: The systematic review sought to understand the relationship between maternal depression and later ADHD in children. Method: Three databases were used to identify the studies (Medline, Web of Science and PsychInfo) resulting in 1,223 studies being screened and 14 articles being included in the review. Results: The majority of studies (N = 11) reported a significant relationship between maternal depression (across both prenatal and postnatal periods) and ADHD symptoms in children. This relationship remained significant when temperament, or past ADHD symptoms were controlled for. Several methodological issues were identified including; overreliance on maternal report and parental ADHD not being accounted for in most studies. Conclusion: The review adds to the literature regarding the temporal relationship between maternal depression and the development of ADHD in children, and thus supports the case for improving access to mental health services for mothers as a preventative strategy in the development of child psychopathology.

Family Mindfulness Training for Childhood ADHD: Short- and Long-Term Effects on Children, Fathers and Mothers

ObjectivesWe evaluated the effects of the family mindfulness-based intervention (MBI) “MYmind” for children with ADHD and their parents, and examined child and parent predictors of child outcome.MethodsUsing a pragmatic quasi-experimental waitlist design, children aged 7–19 years (n = 167), clinically referred with a DSM-IV ADHD diagnosis, and both their parents completed waitlist (average waiting time was 8 weeks), pre-test, post-test, 8-week, and 1-year follow-up measurements. MYmind consisted of eight weekly 1.5-h mindfulness-based group sessions for children and parallel for parents, and a follow-up session. We assessed children’s and both parents’ ADHD symptoms and other psychopathology, child executive function, parental stress, parental overreactivity, and mindful parenting.ResultsMultilevel analyses revealed medium-to-large effect-sized reduced child ADHD symptoms between pre- and post-test, becoming stronger at follow-ups, while no waitlist effects occurred. Parents above the ADHD threshold improved on adult ADHD symptoms with similar sized effects. Children’s and parents’ other psychopathology, child executive function, parental overreactivity, and mindful parenting improved, whereas parental stress only improved at 1-year follow-up. Child age, child gender, ADHD medication, parental ADHD, and parent participation did not predict child outcome. Parent gender however interacted with parental ADHD to predict child outcome; children of fathers (but not mothers) above the ADHD threshold improved more than children of fathers below the ADHD threshold at post-test and at 8-week follow-up. Reduced paternal ADHD from pre- to post-test mediated this effect.ConclusionsFamily MBI (MYmind) may reduce childhood ADHD and improve parental functioning. Fathers with ADHD symptoms appear important in helping offspring with ADHD.