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January 3, 2011

ADHD Families

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ADHD Brain Size (12.03.02) - Children with Attention Deficit Hyperactivity Disorder (ADHD) have smaller brains than average. Scientists have looked into whether medication is to blame.

Cognitive Behavioral Therapy (03.11.03) - Psychologists are looking for ways other than medication to help people make sense of and deal with the voices they hear. A therapy adopted in Britain seems to have the answer.


CHADD: Children and Adults with Attention-DeficitHyperactivity Disorder

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A new study is showing that the parents of ADHD children may also have attention deficit hyperactivity disorder. As this ScienCentral News video reports, that means curing the child may include treating the parent.

All in the Family

Lew Mills, a therapist in San Francisco, and his son Matthew have both been diagnosed with attention deficit hyperactivity disorder, or ADHD, which has made effective parenting more challenging than it might be under normal circumstances. "I feel like a good parent but I also feel like there are some things I just can't do and I don't know why sometimes," says Mills. "It's frustrating. Because I have ADHD myself it adds onto all the things that I have a hard time getting done and organizing…in my own life and career, so it kind of adds to that load."

ADHD affects three to five percent of all children, perhaps as many as two million American children, and two to three times more boys than girls. The most common ADHD behaviors fall into three categories: inattention, hyperactivity, and impulsivity; people with ADHD can have trouble with things like sitting still and focusing on tasks. In many cases, medications such as Ritalin are prescribed to children with ADHD.

As part of a study that was originally undertaken in order to look at whether ADHD is a valid diagnosis in young children, Andrea Chronis, a psychologist at the University of Maryland, looked at how often children with ADHD had parents with psychological disorders. She and her team studied a group of about 200 children in which half the children had ADHD and half did not, and evaluated both the children and the parents. "What we found is that for children who have ADHD, the parents are 24 times more likely to have ADHD themselves during childhood," she says. "Mothers who have children with ADHD were more likely to say, 'Yes, I was inattentive and hyperactive and impulsive myself as a child'."

The study also showed that when kids with ADHD also suffer from other serious behavioral problems, their parents are two to five times more likely to suffer from problems such as depression, anxiety and drug addictions.

Lew Mills and his son, Matthew
Treatments for children with ADHD rely heavily on the help and support of the parents, so the problems of those parents can interfere with the improvement of the children. "Parents are really critical in terms of delivering treatments to their children," says Chronis. "When parents are feeling ineffective as parents or when they're experiencing depression, children respond less optimally to treatment. As the child is more challenging, the parent tends to feel less capable and less effective. They're less able to implement the types of constraints that would make the child most successful in their environment, and so the child then acts out and escalates their behavior, which leads the parent to feel more and more ineffective. The child needs to repeatedly learn that [there] are positive consequences for behaving appropriately…and also that there will be negative consequences if you break some of the rules or don't meet certain expectations."

Chronis believes the answer is not just to treat the ADHD child, but that child's whole family. "It's a bit naive for us to think that treating the child with stimulant medication is going to address all of the problems that exist in the family," says Chronis, who suggests looking at treatments that combine medication with "psycho-social interventions that are looking at helping the child and the family function more optimally, helping the child to function more optimally in the school setting and also helping the child to be successful socially with their peers."

"I'm learning more about just actual implementing," says Mills. "I think most parents would say that they know that if you reward a behavior, then you're going to get more of that behavior, and if you don't give them praise for getting it right, they're not as likely to do it. But actually implementing it and remembering, making it a part of your routine, is difficult and it takes a long time to work that into your daily habits."

This research was published in the December, 2003 issue of the Journal of the American Academy of Child and Adolescent Psychiatry and was funded by the National Institute of Mental Health.

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