A Look at Parental Stress in Families of Children with ADHD

A Look at Parental Stress in Families of Children with ADHD

Parenting a child who has been diagnosed with ADHD has certainly had many challenges for myself and my husband. As I began to notice that my son seemed to be struggling more with his behavior and inability to focus more that other children, I began to realize that I was more stressed than other parents with children who were my son's age that did not have ADHD. Research on this topic of parental stress in families of children with ADHD has begun to expand(Kendall, Leo, Perrin & Hatton, 2005). Throughout my research, I found two  that approached this topic differently, but that both ultimately open up dialogue on how to best support families of children with ADHD.

Below is a video that gives a brief vignette into a family where the parents are exhibiting distress in parenting a child with ADHD:

“Modeling ADHD Child and Family Relationships”

Kendall, Leo, Perrin and Hatton(2005) specifically examined the relationship between the child's behavior, family conflict and the mother's distress within the family. The researchers provide previous research that gives light to the presence of more interpersonal conflict in families who have a child that is diagnosed with ADHD. This interpersonal conflict appears to have a correlation with other family dynamics, particularly conflict within the marriage, increased maternal distress and less experiences within the family context that are positive. Of particular interest in this research was the focus on maternal distress, rather than looking at stress of the parents as a whole unit. Kendall, Leo, Perrin and Hatton's(2005) literature review suggested that mothers who have children with ADHD can be more susceptible to their mental health being affected, particularly being at risk for depression and anxiety. Additionally, mothers also seem to carry more of the responsibility of the issues or struggles that come in parenting a child with ADHD and also experience less connection to other family members for support.

While the study examined multiple correlations between the variables of child behavior, maternal distress and family conflict, the factor of most interest within this study was the importance of the maternal role within families of children with ADHD. The sample for the study involved 157 families. Ethnicity was recorded , with 31% being African-American, 36% Hispanic American, and 33% Caucasian. The mothers in the sample ranged from 21-79 years of age, with the children in the sample ranging from 6-18 years old, with a mean of 10.8 years. Fifty-one percent of the sample identified as single parent families. Socioeconomic status was also recorded for the families, which produced some significant results, which will be discussed(Kendall, Leo, Perrin & Hatton, 2005).

Results indicated a relationship between an increase in behavior problems of the child with the mother's distress. Additionally, mothers who reported distress had increased conflict within their families. Another relationship of interest found that African-American families reported lower levels of child behavior issues than Caucasian families. Families with a higher socioeconomic status also reported less issues with their child's behavior than families with lower income(Kendall, Leo, Perrin, & Hatton, 2005). Given these relationships, the researchers concluded that “ the pattern of these results suggests that the degree of mother's distress may mediate the relationship between child behavior problems and family conflict, indicating the pivotal nature of the role of mothers play in these families” (p. 512).

Kendall,Leo,Perrin and Hatton(2005) conclude that this maternal distress is a residual effect of the expectation that is placed on mothers in general, especially being in the role of caregiver. When this role is combined with parenting a child with ADHD, it is most often left to the mother to “carry the responsibility for the exceedingly difficult work of caring for a behaviorally disordered child while simultaneously organizing home and family life, being the family ADHD expert, and acting as the child's advocate and liason within the school, health care system, extended family, and neighborhood”(p.512). The researchers ultimately conclude that because maternal distress is a mediating factor between child behavior and family conflict, more support and resources should be provided to the mother in order to play out their role as caregiver.

“Predicting Parenting Stress in Families of Children with ADHD: Parent and Contextual Factors”

Theule,Wiener, Rogers and Marton(2011) focused on identifying how ADHD symptomology in parents and contextual factors of parenting stress, such as level of education, amount of social support and marital status may be a function of child ADHD symptoms. While the variables of contextual factors are important in understanding parental stress, of particular importance in this study was the relationship between adult ADHD in parents and parental stress. The research ultimately determined that parents who had more severe ADHD symptomology and less social supports had a higher level of parental stress. Additionally, while the research indicated that parents with ADHD had a higher level of stress, there was no significant finding that the presence of ADHD symptoms in their child provided a causal effect. The discussion of this finding offered ways in which parenting in general can be stressful for a parent with ADHD, but that additional factors to consider in parenting a child with ADHD may increase the level of stress, such as attending school meetings, medication monitoring and being consistent in parenting practives(Theule, Wiener, Rogers & Marton, 2011).

Given the importance that parent ADHD symptomology plays in the level of stress experienced, especially in parenting a child with ADHD, the authors propose a closer look into examining mental illness within the parents , and how symptomology of diagnoses may have more of an effect on parenting stress than child behavior factors. Theule, Wiener, Rogers and Marton(2011), briefly make this connection with past studies that identified levels of parental stress within mothers who were diagnosed with depression. Given this information, the researchers ultimately suggest the importance of connection to parent support groups and programs, such as parent management training being available to parents who are diagnosed with ADHD in order to reduce stress.

Closing Thoughts

The first article that was summarized was a clear indication that more efforts need to be taken within support systems to engage the whole family unit in parenting a child with ADHD. The role of primary caregiver for children is often left to the mother, as the maternal role is seen as nurturing and able to provide emotional support for their children and sometimes the whole family. This view in itself can have the ability to create higher levels of stress within mothers, as they often feel pressured to be “supermom”. When parenting a child with behavior, inattention and hyperactiviity issues, this pressure to hold the family unit together can be overwhelming. Being a mother to a son with ADHD, I have definitely experienced times where I have felt that the struggle of navigating systems to help my son succeed independently. This is not because my husband was being a passive member within my family, but rather it is the continued notion that whenever an issue would arise with my son, especially at school, I was always the first parent called to handle the situation, even though my husband was listed as a contact as well. While the researchers in the first article make a valid point that mothers do need more support in order to alleviate stress in their roles, it is also important to consider how systems, whether it be school, therapy environments or the community should be making efforts to involve both parents to communicate about the child's needs.

This notion of support for the whole family can also be extended to the second article, especially in families who have parents and children with ADHD. Creating programs or areas for conversation such as support groups about stress within these families is crucial to improve symptomology and relationships within the family unit. Within my own process, I have found that while my son's school had been very supportive in working with me, it only happened because I had the knowledge and ability to advocate for my son and myself. The ability to advocate for one's children may not always be an option for some parents, whether it be lack of knowledge or fear of stigma. Creating an open space for conversation to occur within schools will ultimately help to strengthen parent-teacher connections and may also open doors to other resources that parents can access in order to reach a healthy place within their family. My final blog will discuss the importance of parent involvement in schools and how utilization of stress-reduction techniques, such as mindfulness, can be beneficial to family unit as a whole.

References:

Kendall, J., Leo, M.C., Perrin, N. & Hatton,D. (2005). Modeling ADHD child and family relationships. Western Journal of Nursing Research, 27(4), 500-518.

Theule, J., Wiener, J., Rogers, M. A., & Marton, I. (2010). Predicting parenting stress in families of children with ADHD: Parent and contextual factors. Journal of Child and Family Studies J Child Fam Stud, 20(5), 640-647.