We know that there is a genetic component to ADHD.  If Sally has ADHD, then she is more likely than her peers without ADHD to have a close relative with it, too.  When it comes to mothers of children with ADHD, it is estimated that 17% have it themselves.  And we also know that maternal ADHD can have a serious impact on parenting, such as higher rates of over-reactivity and poor problem solving.   So what can be done to influence these outcomes so children and parents alike with ADHD have more positive family experiences? 

In a recent study in the Journal of Abnormal Child Psychology, Chronis-Tuscano and colleagues looked at parent and child outcomes after mothers of children with ADHD attended a brief parent training program.  The results revealed a critical piece of information.  Mothers with higher ADHD symptoms saw less progress in their children following parent training and this finding appeared to be due to negative parenting holding steady.  Behaviors such as making negative commands (e.g., “Cut that out!) and critical statements (e.g., “You’re an idiot.”), as well as negative touching (e.g., hitting), fell into the category of negative parenting.

In all, 70 mother-child dyads from diverse racial and socioeconomic backgrounds were included.  While mothers did not have to have an ADHD diagnosis to participate in the study, it was predicted that they would have more symptoms related to ADHD than mothers in the general population.  And they did.

Mothers attended a 5-session course created from a longer evidence-based training program for parents of children with ADHD and disruptive behavior disorders.  The researchers gathered data on maternal ADHD (14% met criteria for a formal diagnosis of ADHD) and child ADHD symptoms, child behavior outcomes, and parenting behaviors using both parent and teacher questionnaires and observations. 

Overall, the children’s reported disruptive behaviors went down significantly across environments after completion of the parent training; however, the higher the maternal ADHD symptoms, the less improvement in behaviors that mothers reported in their children from pre- to post-parent training. 

In terms of parenting behaviors, maternal ADHD predicted less improvement in the areas of involvement and inconsistent discipline.  It also predicted less improvement from pre- to post-training in negative parenting during observations of play and homework time, as well as making repeated commands before allowing a child enough time to respond to the first command.

Here is an important piece of information.  We see that maternal ADHD predicted lower levels of improvement across a variety of areas.  The researchers examined this finding more closely to discover that negative parenting (and not positive parenting) was the critical link between maternal ADHD and child outcomes.  That is, it appears that the mothers with ADHD saw less improvement in their child’s disruptive behavior after parent training because their negative parenting did not significantly improve.  Further, mothers in the study who were able to decrease their negative parenting saw more improvement in their child’s behavior.

Think about this.  In moments of impulsivity, which are common with ADHD, it can be very difficult to rein in behaviors before acting.  So if mothers with ADHD can receive interventions that harness impulsivity better, giving them time to think before acting, might we also see a drop in negative parenting and a subsequent improvement in child outcomes?

What we can gather from this study is that efforts in improving negative parenting in mothers with ADHD are going to be critical to the behavioral success of children who also have ADHD.  And just as in children with ADHD, psychoeducation, prosocial skill-building, medication, self-monitoring, and a host of other options to address ADHD and improve relationships can be considered in mothers with ADHD.  Most importantly, mothers with ADHD will likely be best served by considering all available options and finding those that feel right for them. 

To all of the clinicians out there treating children with ADHD, the high rate of maternal ADHD that accompanies these children is worthy of exploration and intervention.  You just may find a key to improving the functioning of entire families.

Thanks for reading.  -Anita

Source: Chronis-Tuscano, A., O’Brien, K., Johnston, C., Jones, H., Clarke, T., Raggi, V., Rooney, M., Diaz, Y., Pian, J., & Seymour, K. (2011). The Relation Between Maternal ADHD Symptoms & Improvement in Child Behavior Following Brief Behavioral Parent Training is Mediated by Change in Negative Parenting Journal of Abnormal Child Psychology, 39 (7), 1047-1057 DOI: 10.1007/s10802-011-9518-2

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8 Responses to Maternal and Child ADHD: Implications for Parenting

  1. Kip Miller says:

    This article does not make sense. Is ADHD hereditary or not? If not, what is the connection between mothers and children, as opposed to fathers?

    • Anita M. Schimizzi, Ph.D. says:

      Thank you for your questions, Kip. Yes, there is a genetic component to ADHD, but it certainly does not explain all causal factors of it. There is still much to be learned in the area of “cause”. The article only focused on maternal ADHD and the effects that it can have on parenting. They did not discuss fathers.

  2. Prashant says:

    Dear Ms. Anita ,

    Nice article, I fully agree with you…

    Prashant

  3. Anita, thanks for your excellent article! I have to say that it is indeed unfortunate that the research focused exclusively on mothers who have ADHD or similar symptoms, and did not include fathers with the same disorder.

    I want to share some additional thoughts regarding kids struggling with their own ADHD/ADD.

    As a psychotherapist with expertise in treating individuals & families dealing with ADHD, I have to agree that the harmful effects of parents having untreated ADHD are substantial. However, negative parenting (by the parent with ADHD) is only one part of the complex dynamics impacting these children.

    When there is a parent with ADHD, there is often a very high-conflict marriage characterized by chaotic & verbally abusive communication. The children of these marriages are thereby constantly walking through a highly-emotionally charged minefield. For a child who already has a biological predisposition to ADHD, this may be truly overwhelming.

    Often, the parent with ADHD is simply unwilling to acknowledge that they themselves may have the same disorder, which further compromises their ability to parent their child appropriately. If they do not acknowledge their own ADHD issues, they will not accept intervention and treatment for themselves.

    My clinical experience is that in order for these children to make significant improvement, the parents often need to be involved in marital therapy as well. Education of parents about the nature of ADHD, and teaching them more effective parenting skills, is usually insufficient.

    I would like to see more research done on these issues.

  4. lesley says:

    Anita ,fantastic article as a mother of teen with adhd amongst other developmental disorders, i can fully understand your findings. as i strongly believe i have this same problems and issues , your words could , easily be my story ! impulsive decision making. “erratic over-reactions”

  5. lesley says:

    lack of attention to detail ,
    hence the unfinished comment!! from me , my partner of 15years , is often suggesting i speak to our family GP about possible assessment. also your statement suggesting a parent/MOTHER with undiagnosed symptoms ,tendencies to ignore or not admit to a possible problem. them or their child , a mother does not want to admit that they are reason their child has these struggles +difficulties.
    Myself i do recognize i have an unhealthy raging temper + 2weeks of the month i am different being! maybe my trait of not thinking before i speak? is actually a symptom! as i have done this my whole speaking life! Well , probably before i could actually talk….(hint of my personality for you) and i have 1 very sista-hood friend my Boo , who will and does give apolagies for my abrupt forwardness of over opinionated “as you ask! as you know” , “you will get truth +no sugar coated ” hhm thoughts for me to ponder on xx

  6. Lisa says:

    I too would like to see more research on this topic. I have recently been dx’d with adult ADD and my 11 yo son was dx’d ADHD combined type when he was 5. My problem isn’t acknowledging the problem, rather it’s that my psych doesn’t take my concerns with lack of symptom improvement very seriously. Docs want to throw anti-depressants at it instead of treating it as ADHD. I wasn’t depressed before I started the med-go-round, just distractable and struggling with my schooling, but now I’ve gained 100 lbs and don’t have the motivation to do anything. And yes, that affects my child directly, he is picking up horrible habits from me, our house is never tidy, and neither one of us finishes anything!! I also have dealt with some of the things the article points out, I have a terrible time controlling myself when I need to correct my son or when I’m stressed, etc. Eager to hear more. And would love some direction to help us help ourselves survive!

    • Anita M. Schimizzi, Ph.D. says:

      Lisa, Thank you so much for your comments. Indeed, it can be difficult to get care that really lines up with your individual needs. Without knowing more details about your specific situation, I am going to make a few suggestions. Feel free to take or leave what you think may be helpful for you and your son. For starters, if you do not feel heard by your doc in regards to medication or any other treatment options, then it might be time to see a different doc. While there are quite a few docs with child ADHD experience, not everyone has the same level of experience in treating adult ADHD so it would probably be a good idea to seek someone that has expertise in that specific area. Also, I don’t know what else you have tried, but cognitive-behavioral therapy can really help in building the skills necessary to manage your symptoms while making gains in areas like organization and planning. I am a big fan of parent education, too, as having some time with a professional well-versed in the challenges of parenting with ADHD as well as parenting a child with the disorder can bring you a lot of ideas, support, and hopefully some relief from day-to-day stresses. There are many different parenting techniques that may work well for you in terms of effectively disciplining with patience and compassion. I wish you well in finding some local resources that can ease what sounds to be a very trying time. Please email me or post back to the blog if you would like to share your experiences or post more comments/questions.

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