By Anita M. Schimizzi, Ph.D.
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