ARTICLES
Does Maternal ADHD Reduce the Effectiveness of Parent Training for Preschool Children's ADHD?

https://doi.org/10.1097/00004583-200206000-00009Get rights and content

ABSTRACT

Objective

To assess the impact of maternal attention-deficit/hyperactivity disorder (ADHD) symptoms on the effectiveness of a parent training (PT) program for preschool ADHD.

Method

Eighty-three 3-year-old children with ADHD and their mothers selected from two community cohorts living in Hampshire, England (1992–93 and –96, respectively), completed an 8-week PT program. ADHD symptoms and a number of other parent and child factors, including adult ADHD symptoms, were measured prior to the start of treatment (week 1: T1), immediately after treatment (week 8: T2), and at 15 weeks follow-up (week 23: T3).

Results

Mothers were divided into three groups on the basis of their scores (T1) on the Adult AD/HD Rating Scale (high, medium, low). Children of mothers in the high-ADHD group displayed no improvement after PT, whereas the levels of ADHD symptoms of the children of mothers in either the medium or low ADHD groups reduced substantially (F4,160 = 3.13, p < .05). This association persisted after other child and maternal factors were controlled for in multiple regression analyses (β > .30, p < .05).

Conclusions

High levels of maternal ADHD symptoms limit the improvement shown by children with ADHD after a program of PT. This effect was unrelated to other aspects of maternal mental health and child functioning. The treatment of parental ADHD may be a prerequisite for the success of psychosocial interventions for childhood ADHD.

Section snippets

SUBJECTS

Eighty-nine children with a preschool equivalent of ADHD and their mothers entered a program of PT. These children were selected at the time of their 3-year developmental check from two cohorts (1992–93 and –96, respectively). Children came from families living in the New Forest and Southampton regions of Southern England (N = 7,068). These areas comprise a mix of urban, suburban, and rural settings that include areas of prosperity and significant pockets of relative deprivation. The children

RESULTS

Only those mothers and children (n = 83) who completed the PT program were included in the analysis. To facilitate ease of interpretation, we assigned participants to one of three roughly equal sized groups on the basis of ratings of maternal ADHD symptoms (low = 0–7, medium = 8–15, high = 16 and over). The scores for background child and maternal factors for these three groups of mothers are shown in Table 1. The groups did not differ in terms of SES (χ24 = 5.47, ns) or child's sex (χ22 =

DISCUSSION

This study provides evidence of the role played by symptoms of maternal ADHD in determining the degree of improvement associated with parent-based treatments for child ADHD. This effect can be seen most strikingly in Figure 1. PT had no effect on child ADHD when mothers displayed substantial levels of ADHD symptoms (i.e., a score of more than 15 on the Adult AD/HD Rating Scale). In contrast, children whose mothers had few symptoms benefited greatly from the treatment. In the current sample,

REFERENCES (37)

  • C Webster-Stratton et al.

    Predictors of treatment outcome in parent training for families with conduct problem children

    Behav Ther

    (1990)
  • M Weiss et al.

    ADHD in parents

    J Am Acad Child Adolesc Psychiatry

    (2000)
  • EH Arnold et al.

    Father involvement and self-reported parenting of children with attention deficit hyperactivity disorder

    J Consult Clin Psychol

    (1997)
  • K Baldwin et al.

    Predictors of stress in caregivers of attention-deficit hyperactivity disordered children

    Am J Fam Ther

    (1995)
  • RA Barkley et al.

    Attention Deficit Hyperactivity Disorder: A Clinical Workbook

    (1998)
  • J Biederman et al.

    Retrospective assessment of DSM-III attention deficit disorder in non-referred individuals

    J Clin Psychiatry

    (1990)
  • NA DeWolfe et al.

    ADHD in preschool children: parent-rated psychosocial correlates

    Dev Med Child Neurol

    (2000)
  • G Edwards et al.

    Parent–adolescent conflict in teenagers with ADHD and ODD

    J Abnorm Child Psychol

    (2001)
  • Cited by (200)

    • Meta-analysis: Which Components of Parent Training Work for Children With Attention-Deficit/Hyperactivity Disorder?

      2022, Journal of the American Academy of Child and Adolescent Psychiatry
      Citation Excerpt :

      This may explain our finding that a higher dosage of stimulus control techniques was associated with improved parental mental health. This is an important finding, as parental ADHD symptoms have been found to attenuate effects of behavioral parent training.6,76 Second, higher dosages of behavioral techniques teaching parents to provide children with positive consequences after showing desired behavior, in particular, offering social rewards and responding in a consistent way, were associated with decreased negative parenting.

    View all citing articles on Scopus

    This research was supported by grants from the NHS R&D committee and the Mental Health Foundation.

    View full text