At times almost all children have periods when their attention or behavior is out of control. For
some children, these types of actions are more than an occasional problem. But when parents are presented with the diagnosis that their child has ADHD, a mental disorder that prevents a child or adult from being able to pay attention or sit still what are they to do? ADHD prevents the child from functioning normally. There is much confusion about what ADHD is, and for parents faced with the difficult task of parenting a child with ADHD, it can be stressful. ADHD is becoming an epidemic in America, with more and more children diagnosed daily. As studies and research continue, more information about ADHD disease will be known from cause to prevention as well as further treatment procedures. This paper will take a look at the history of this disorder to the challenges, treatments, preventions, and strategies for parents, siblings and the child diagnosed with ADHD.
Parenting Children with Attention-deficit/hyperactivity Disorder
Attention-deficit/hyperactivity (ADHD) disorder is a chronic disorder with symptoms of excessive attentiveness, impulsivity, and hyperactivity which cause damage to a person’s school, work, social and family life (Phelan, 2017). ADHD is a puzzling condition for families, schools, and society. Between five to seven percent of children in the United States are frequently diagnosed with ADHD, and about three to five percent of adults (Phelan, 2017). ADHD requires a lifetime of management because it is a disorder that does not go away. Thomas Phelan (2017) reports that most children and adults who have ADHD also have a second and some a third psychiatric disorder.
ADHD impacts families and Phelan (2017) further reveals that studies show ADHD runs in families, and most mothers with ADHD children have experienced clinical depression. There is parental conflict and even divorce in families with ADHD children. Not only are parents affected but the siblings can feel neglected. Siblings are at a higher risk for ADHD because of the genetic aspect of the disorder. It is not usual for a family to have more than one child with ADHD (Phelan, 2017). Today, there is more useful scientific information available about ADHD, resulting in more children being correctly diagnosed and treated. In schools, teachers are receiving training on ADHD, and the disorder is understood to be a neurological, genetic, and treatable disorder (Phelan, 2017).
According to Barkley and Peters (2012) the German physician, Heinrich Hoffman in 1865 was the first to mention a hyperactive child. He wrote poems about the childhood conditions he saw in his medical practice. One character he called Fidgety Phil, which is believed to be a metaphor for ADHD. It was not until 1902 that British physician George Still was the first to describe the behavioral condition in children that is now known as ADHD. Barkley and Peters (2012) also report that Still described children he saw in his practice who displayed severe problems with constant attention. This conduct was consistent with William James’ view in 1890, that sustained attention is vital in proper control of behavior. Still revealed that most of his cases were quite overactive, to aggressive, and defiant, showing little or no control over behavior—a defect in moral power (Barkley & Peters, 2012).
Cause of Disorder
The cause of attention-deficit/hyperactivity is not easy to answer, with all the research and data available this disorder remains a question with some possibilities but no real answers. Dr. Michael Reiff (2011) notes, there are some risk factors identified that will affect a child’s brain development, behavior and if combined may lead to ADHD symptoms. Martorell, Papalia, and Feldman (2014) report that studies show the brains of children with ADHD grow normal, but in the frontal cortex, there is a delay in the process by three years. The frontal cortex controls movement, suppress inappropriate thoughts, actions, focus attention and all functions disturbed in children with ADHD (Martorell et al., 2014). The motor cortex develops faster than usual and possibly the consequence of restlessness and fidgeting of this condition.
Another risk factor is genetics, Martorell et al. (2014) point out that about eighty percent of ADHD is inherited. Many genes have proved to be involved with ADHD, with each contributing some influence. Low levels of a brain chemical vital for attention and cognition, dopamine, has also been linked with ADHD (Martorell et al., 2014). The environmental risk factors which appear with ADHD are birth complications with little birth weight and premature children. Exposure to early adversities, such as the mother’s alcohol or tobacco use, and oxygen deprivation. The problem with identifying possible causes is that many factors can cause and be caused by ADHD (Martorell et al., 2014).
Children and ADHD
Children with ADHD have behavior problems that interfere daily with their functioning capacity. According to Reiff (2011), “attention-deficit/hyperactivity disorder is the most commonly diagnosed developmental-behavioral condition in children, affecting an estimated six to nine percent of school-aged children.” Boys are twice as likely to be concerned with ADHD than girls (Starck, Grunwald & Schlarb, 2016). The symptoms of this chronic condition can continue throughout adolescent and even into adulthood. ADHD affects a child’s learning, their ability to control behavior, social skills, and self-esteem (Reiff, 2011).
A child’s ability to filter unnecessary information is restricted to ADHD. The capacity to focus, organize, think before acting or carry out other executive brain functions that are automatic for most people is limited (Reiff, 2011). A short attention span, not able to remember, sit still or act before thinking and a high activity level is all typical characteristics all children display daily. Which is the reason most families are surprised when their child is referred for an evaluation (Reiff, 2011)? Several other disorders are similar to ADHD, like a learning disability, oppositional defiant disorder, anxiety, or depression, which can make it difficult to determine if it is ADHD (Reiff, 2011). Although ADHD is the most researched childhood behavioral disorder with many articles published, there is still much controversy on the nature of ADHD and the best method of treatment.
Parents and ADHD
Studies indicate that ADHD is inherited from either the mother, father or both parents. Starck, Grunwald, and Schlarb (2016) report that forty-one to fifty-five percent of families with a child who has ADHD also has at least one parent with the disorder. Data also provided by Starck et al. (2016) reveals that parents with ADHD have a higher rate of divorce, more relational conflicts, suffer emotional issues and have problems with planning activities. Parents have difficulty keeping appointments, are restlessness during visits and cannot remember instructions. They tend to have more car accidents along with drug and alcohol use than healthy parents.
According to Theule, Wiener, Tannock, and Jenkins (2012), parenting stress is related to parenting style and child development, and parents of children with ADHD encounter more parenting stress. Higher levels of stress impact parenting practices negatively and affect the parent-child relationship (Theule et al., 2012). Parenting stress also increases the symptoms experienced by children with ADHD. There is more hyperactivity, distractibility, and parenting stress has also been indicative of oppositional defiant, aggressive, and externalizing behaviors (Theule et al., 2012). The parent-child interactions are concerning where the parent’s stress might influence their education style and parent training. These factors play a significant role in the therapy outcome of the child with ADHD (Starck et al., 2016). Therefore, it not only becomes necessary to treat the child with ADHD but also the parents.
Siblings and ADHD
There is much discussion concerning the possible causes, symptoms, and treatments of children with ADHD, and little is known about the non-ADHD siblings. According to King, Alexander ; Seabi (2016), non-ADHD siblings feel like the focus of the family is on the sibling with ADHD and felt jealous. They think their parents expect them to take care of their ADHD sibling and expressed also feeling like a victim. There is an enormous amount of distress among the siblings of children diagnosed with ADHD and is revealed through violence and aggressive behaviors (King et al., 2016). The full impact ADHD can have on siblings is limited and more research is necessary to explore this area in-depth.
Impact on the Family
ADHD impact on the family significantly influences the quality of life for all family members, as well as social relationships. Phelan (2017) reports that ADHD is the cause of frequent disruption in the family. Sibling rivalry is intense as well as parental conflict and stress. Families with parents suffering from ADHD, which is at least one parent of a child with ADHD, shows less family structure in everyday life. “Parental ADHD might affect not only family functioning but also treatment utilization and outcome of child therapy or parent training” (Starck et al., 2016, p. 582).
Reiff (2011) states, it is essential that when a child is diagnosed with ADHD that the family is also tested to determine if there are others with ADHD. A more useful treatment plan is then possible once all ADHD family members are identified. Reiff (2011) further explains that once ADHD is diagnosed the treatment plan may include medication management, behavior therapy, and other forms of treatment. The treatment plan and additional support are specific to the individual. The treatment plan first focuses on the inattentiveness, hyperactivity, and impulsiveness of the disorder. Then it concentrates on the functional disabilities, which were the parents and teachers first concerns. ADHD is a chronic condition and parents, children, and adolescents require ongoing education and treatments over time (Reiff, 2011). The standard model of care for ADHD and any chronic condition is the medical home model. This type of care coordinates all aspects of effective treatment, where parents, children, teachers, doctors, and therapists work together to make the best decisions concerning treatment (Reiff, 2011).
ADHD Children and School
ADHD can be challenging for school-age children because of poor grades, behavior problems and the inability to interact socially with other students. Parents also find school issues a significant concern, because they may change from year to year (Reiff, 2011). Problems with attention, control impulses, and behavior can affect a child with ADHD in school and should be addressed early. Reiff (2011) says it is essential for parents to observe how their child functions in the areas of behavior management, academic progress, and social interaction. Parents must identify areas of concern, learn the classroom structure, school policies, teaching style, and what accommodations the school can provide for your child (Reiff, 2011). Teachers are important, and parents ought to require they are updated on how to manage behavioral symptoms effectively. Parents are also to learn how to promote school success at home and away (Reiff, 2011).
Parenting and ADHD Children
According to Moghaddam, Assareh, Heidaripoor, Rad, and Pishjoo (2013) “Education and Parenting is one of the most important factors affecting the development and stability of children’s behavioral problems . . .” (p. 48). Moghaddam et al. (2013) further note that parents specifically a mother’s role is essential to the cause of ADHD because she is more rigorous than the father. Parenting styles are one factor that contributes to parent-child conflict. Studies show the parenting style of parents with ADHD children is less permissive and more authoritarian (Moghaddam et al., 2013). Lowe, Danforth, and Brooks (2008) reveal that U.S. studies concede that parents of ADHD children react inappropriately to child-rearing stressors and become controlling and harsh with their children. The authoritarian style of parenting does not improve behavior but worsens the symptoms of ADHD (Moghaddam et al., 2013).
Moghaddam et al. (2013) point out that parenting children with ADHD can be difficult due to the variety of disruptive and impulsive behaviors parents are presented with daily. Parents tend to be more critical of children, choosing the wrong ways of parenting. Lowe et al. (2008) report “There is evidence to suggest that poor parenting skills may exacerbate children’s self-control deficits and contribute to the development of additional disruptive disorders . . .” (p.870).
The most effective areas to improve the parenting styles of parents with ADHD children can be accomplished by parent training, family therapy, and educational programs provided by schools and other educational programs. Behavioral parent training, as well as coping skills, can also help develop the parent-child relationship and result in successful family life. Lowe et al. (2008) reveal that “Parent training reduced children’s hyperactive, defiant, and aggressive behavior, improved parenting behavior, and reduced parent stress” (p.869).
The Bible does not explicitly mention attention deficit disorders, but there is some awareness from scripture on the subject. It is essential as Christians to recognize the limits and challenges faced daily with ADHD. Understanding that ADHD is a lifelong condition with various methods of treatments can help those diagnosed in striving to follow the commands of God. The word of God helps us to be more aware of our weaknesses and more familiar with the ways God can show Himself active in our lives. Jesus Christ offers assurance with these words, “My grace is sufficient for thee: for my strength is made perfect in weakness. Most gladly, therefore, will I rather glory in my infirmities, that the power of Christ may rest upon me. Therefore, I take pleasure in infirmities, in reproaches, in necessities, in persecutions, in distresses for Christ’s sake: for when I am weak, then am I strong” (2 Corinthians 12:9-10, KJV).
Parenting a child is difficult, but when your child has ADHD, parenting becomes a more significant challenge. There are higher demands placed on parents and the family of a child with ADHD. Their needs are more involved than other children and necessitate more patience and understanding. According to King et al. (2016), a child with ADHD increases the chances of family disturbances, marital problems, disruptive parent-child relationships and increased parental stress. There are also troubling issues for non-ADHD siblings requiring attention in hopes of improving positive outcomes in the relations of all family members. It is essential for parents to learn how to promote school success at school, home and away (Reiff, 2011). Authoritarian style parenting is not the parenting style for parents with children who have ADHD; it only produces adverse outcomes for both parent and child. ADHD is a lifelong chronic condition that requires knowledge about the disorder to raise a child with ADHD. “Parent training is the first-line treatment for preschool children, school-age children, and adolescents with ADHD” (Starck et al., 2016, p. 582).