Family skill development for attention deficit hyperactivity disorder behavior problem alleviation model in at-risk preschool children: a mixed methods study
Downloads
Introduction: Attention Deficit Hyperactivity Disorder is the most prevalent childhood mental health problem. This study examined families caring for children with ADHD and created a model to alleviate behavior problems in at-risk preschoolers.
Methods: This exploratory sequential mixed-methods study comprised two phases. Phase 1 included a qualitative retrospective survey that examined family experiences in caring for ADHD children. This involved in-depth interviews with 14 family caregivers (FCGs) and utilized thematic content analysis. Phase 2 involved creating, implementing, and evaluating a family skill development model using a quasi-experimental design. Thirty FCG- ADHD at-risk preschool child dyads, utilizing services at two Child Development Clinics, were paired and equally divided into experimental and control groups. Data analysis used repeated measures ANOVA and covariances (ANCOVA).
Results: The study FCGs reported that family-child interactions and positive parenting alleviated the ADHD at-risk preschool child's behavior problems. The Family Skill Development for ADHD Behavior Problem Alleviation Model was constructed and validated. Results from within-group comparisons showed significant improvements in the experimental group, with reduced behavior problems (p<0.05, ηp2=0.28) in ADHD at-risk children, improved caregiver behaviors to alleviate the child's behavior problems (p<0.01, ηp2=0.37), and enhanced family functions (p< 0.001, ηp2=0.42).
Conclusions: The model significantly aids families in alleviating behavior problems in ADHD at-risk children, improving family functions and caregivers' efforts to address the children's behavioral issues. It is a promising parental intervention model for fostering healthy families and reducing behavior problems in ADHD-at-risk preschool children in northeastern Thailand and similar contexts.
Aghebati, A. et al. (2014) ‘Triple p-positive parenting program for mothers of ADHD children’, Iranian Journal of Psychiatry and Behavioral Sciences, 8(1), pp. 59–65. Available at: https://pubmed.ncbi.nlm.nih.gov/24995031.
American Psychiatric Association, A. and Association, A. P. (2013) Diagnostic and statistical manual of mental disorders: DSM-5. Washington, DC: American psychiatric association.
Anderson, P. J. and Reidy, N. (2012) ‘Assessing executive function in preschoolers’, Neuropsychology review, 22(4), pp. 345–360.
Arnold, L. E. et al. (2020) ‘Long-term outcomes of ADHD: academic achievement and performance’, Journal of Attention Disorders, 24(1), pp. 73–85.
Aytkaliyevna, Y. J. (2023) ‘Nurturing Young Minds: Understanding Factors Affecting the Psychological Development of Preschool-Aged Children’, Genius Repository, 25, pp. 70–73.
Biele, G. et al. (2022) ‘Cognitive, emotional, and social functioning of preschoolers with attention deficit hyperactivity problems’, BMC psychiatry, 22(1), pp. 1–10.
Bornstein, M. H., Hahn, C.-S. and Suwalsky, J. T. D. (2013) ‘Developmental pathways among adaptive functioning and externalizing and internalizing behavioral problems: Cascades from childhood into adolescence’, Applied developmental science, 17(2), pp. 76–87.
Cabral, M. D. I., Liu, S. and Soares, N. (2020) ‘Attention-deficit/hyperactivity disorder: diagnostic criteria, epidemiology, risk factors and evaluation in youth’, Transl Pediatr, 9(Suppl 1), pp. S104-s113. doi: 10.21037/tp.2019.09.08.
Charach, A. et al. (2013) ‘Interventions for Preschool Children at High Risk for ADHD: A Comparative Effectiveness Review’, Pediatrics, 131(5), pp. e1584–e1604. doi: 10.1542/peds.2012-0974.
Ching’oma, C. D. et al. (2022) ‘Experiences and challenges of parents caring for children with attention-deficit hyperactivity disorder: A qualitative study in Dar es salaam, Tanzania’, PLOS ONE, 17(8), p. e0267773. Available at: https://doi.org/10.1371/journal.pone.0267773.
Claussen, A. H. et al. (2022) ‘All in the family? A systematic review and meta-analysis of parenting and family environment as risk factors for attention-deficit/hyperactivity disorder (ADHD) in children’, Prev. Sci. doi: 10.1007/s11121-022-01358-4.
Condo, J. S., Chan, E. S. M. and Kofler, M. J. (2022) ‘Examining the effects of ADHD symptoms and parental involvement on children’s academic achievement’, Res. Dev. Disabil., 122(104156), p. 104156. doi: 10.1016/j.ridd.2021.104156.
Creswell, J. W. and Clark, V. L. P. (2018) Designing and conducting mixed methods research. Sage publications.
Danielson, M. L. et al. (2018) ‘Prevalence of parent-reported ADHD diagnosis and associated treatment among U.s. children and adolescents, 2016’, J. Clin. Child Adolesc. Psychol., 47(2), pp. 199–212. doi: 10.1080/15374416.2017.1417860.
Dekkers, T. J. et al. (2021) ‘The importance of parental knowledge in the association between ADHD symptomatology and related domains of impairment’, Eur. Child Adolesc. Psychiatry, 30(4), pp. 657–669. doi: 10.1007/s00787-020-01579-4.
Eanes, R. (2016) Positive parenting: an essential guide. New York: guide’ in Penguin, pp. 1-208
Feng, M. et al. (2023) ‘Behavior management training for parents of children with preschool ADHD based on parent-child interactions: A multicenter randomized controlled, follow-up study’, Behav. Neurol., 2023, p. 3735634. doi: 10.1155/2023/3735634.
Field, A. (2013) Discovering statistics using IBM SPSS statistics. sage. , pp. 1-915
Friese, S., Soratto, J. and Pires, D. (2018) ‘Carrying out a computer-aided thematic content analysis with ATLAS.ti’, IWMI Working Papers, 18.
Galra, C. et al. (2011) ‘Early risk factors for hyperactivity-impulsivity and inattention trajectories from age 17 months to 8 years’, Archives of general psychiatry, 68(12), pp. 1267–1275.
de Graaf, I. et al. (2008) ‘Effectiveness of the Triple P Positive Parenting Program on behavioral problems in children: a meta-analysis’, Behav. Modif., 32(5), pp. 714–735. doi: 10.1177/0145445508317134.
Haefner, J. (2014) ‘An application of Bowen family systems theory’, Issues Ment. Health Nurs., 35(11), pp. 835–841. doi: 10.3109/01612840.2014.921257.
Irwin, L. N. et al. (2021) ‘Activities of daily living and working memory in pediatric attention-deficit/hyperactivity disorder (ADHD)’, Child Neuropsychology, 27(4), pp. 468–490. doi: 10.1080/09297049.2020.1866521.
Jean, C. (2020) Mindfulness in Early Learning and Care, Mindfuness Jar. Dublin: Barnardos. pp. 1-33.
Lee, D. W. et al. (2019) ‘Effects of household income change on children’s problem behavior: Findings from a longitudinal study’, J. Adolesc. Health, 65(4), pp. 527–535. doi: 10.1016/j.jadohealth.2019.05.003.
Leitch, S. et al. (2019) ‘Experience of stress in parents of children with ADHD: A qualitative study’, Int. J. Qual. Stud. Health Well-being., 14(1), p. 1690091. doi: 10.1080/17482631.2019.1690091.
Lincoln, Y. S. and Guba, E. G. (1985) Naturalistic Inquiry. New York: SAGE Publications, Inc. Available at: https://us.sagepub.com/en-us/nam/naturalistic-inquiry/book842#description.
Lindsey, M. A. et al. (2013) ‘Understanding the behavioral determinants of mental health service use by urban, under-resourced Black youth: Adolescent and caregiver perspectives’, J. Child Fam. Stud., 22(1), pp. 107–121. doi: 10.1007/s10826-012-9668-z.
Miller, M. et al. (2021) ‘Can familial risk for ADHD be detected in the first two years of life?’, J. Clin. Child Adolesc. Psychol., 50(5), pp.
–631. doi: 10.1080/15374416.2019.1709196.
Okuzumi, H. et al. (2015) ‘Stroop-Like Interference in the Fruit Stroop Test in Typical Development’, Psychology, 06, pp. 643–649.
Overbeek, G. et al. (2021) ‘Longer-term outcomes of the incredible years parenting intervention’, Prevention Science, 22, pp. 419–431.
Piaget, J. (1976) ‘Piaget’s theory’, in Piaget and his school. Springer, pp. 11–23.
Pornnoppadol, C. et al. (2014) ‘The development of screening scales for attention deficit hyperactivity disorder (adhd) in thai children and adolescents age of 3-18 years’, J. Psychiatr. Assoc. Thail., 59, pp. 335–354.
Rincon, P. et al. (2018) ‘Effectiveness of a Positive Parental Practices Training Program for Chilean Preschoolers’ Families: A Randomized Controlled Trial’, Frontiers in psychology, 9(1751). doi: 10.3389/fpsyg.2018.01751.
Risley, S. et al. (2020) ‘Effectiveness of behavioral parent training in the outpatient setting for preschoolers at risk for ADHD’, Journal of Behavioral and Cognitive Therapy, 30(4), pp. 291–300. doi: https://doi.org/10.1016/j.jbct.2020.09.002.
Romero-Lopez, M. et al. (2017) ‘The relationship between executive functions and externalizing behavior problems in early childhood education’, Procedia-Social and Behavioral Sciences, 237, pp. 778–783.
Sayal, K. et al. (2018) ‘ADHD in children and young people: prevalence, care pathways, and service provision’, Lancet Psychiatry, 5(2), pp. 175–186. doi: 10.1016/s2215-0366(17)30167-0.
See, L.-C. et al. (2021) ‘Knowledge of attention-deficit hyperactivity disorder among the general public, parents, and primary school teachers’, Medicine (Baltimore), 100(12), p. e25245. doi: 10.1097/MD.0000000000025245.
Sun, W., Yu, M. and Zhou, X. (2022) ‘Effects of physical exercise on attention deficit and other major symptoms in children with ADHD: A meta-analysis’, Psychiatry Res., 311(114509), p. 114509. doi: 10.1016/j.psychres.2022.114509.
Taghizade, S. et al. (2022) ‘The relationship model among parent–child relationship, coping responses and behavioral problems in children with attention deficit hyperactivity disorder’, BMC Psychiatry, 22(1), p. 596. doi: 10.1186/s12888-022-04224-3.
Tarver, J., Daley, D. and Sayal, K. (2015) ‘Beyond symptom control for attention-deficit hyperactivity disorder (ADHD): what can parents do to improve outcomes?’, Child Care Health Dev., 41(1), pp. 1–14. doi: 10.1111/cch.12159.
Trangkasombat, U. (2001) Family therapy and family counseling. Family Research and Development Center. pp. 1-414
Valero Aguayo, L. et al. (2021) ‘Meta-analysis of the efficacy and effectiveness of parent child interaction therapy (PCIT) for child behaviour problems’, Psicothema.
Vechmongkholkorn, C. S. and Surakarn, A. (2019) Development of play therapy program to enhanceexutive function of preschool children with ADHD symtoms in Bangkok school. Thesis, Srinakharinwirot University.
Visanuyothin, T. et al. (2013) ‘The prevalence of attention deficit/hyperactivity disorder in Thailand’, Journal of Mental Health of Thailand, 21(2), pp. 66–75. Available at: https://he01.tci-thaijo.org/index.php/jmht/article/view/10148.
Visser, S. N. et al. (2014) ‘Trends in the parent-report of health care provider-diagnosed and medicated attention-deficit/hyperactivity disorder: United States, 2003-2011’, J. Am. Acad. Child Adolesc. Psychiatry, 53(1), pp. 34-46.e2. doi: 10.1016/j.jaac.2013.09.001.
Wolraich, M. L. et al. (2019) ‘Clinical practice guideline for the diagnosis, evaluation, and treatment of attention-deficit/hyperactivity disorder in children and adolescents’, Pediatrics, 144(4), p. e20192528. doi: 10.1542/peds.2019-2528.
World Health Organization (2013) ‘Comprehensive mental health action plan 2013–2020. Geneva: World Health Organization’.
Zhao, X. et al. (2019) ‘Family burden of raising a child with ADHD’, J. Abnorm. Child Psychol., 47(8), pp. 1327–1338. doi: 10.1007/s10802-019-00518-5.
Copyright (c) 2024 Jurnal Ners
This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors who publish with Jurnal Ners agree to the following terms:
- Authors transfer the Copyright and grant Jurnal Ners the right of first publication with the work simultaneously licensed under a Creative Commons Attribution 4.0 International License that allows others to remix, adapt and build upon the work with an acknowledgment of the work's authorship and of the initial publication in Jurnal Ners.
- Authors are permitted to copy and redistribute the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgment of its initial publication in Jurnal Ners.
Jurnal Ners requires a formal written declaration and transfer of copyright from the author(s) for each article published. We, therefore, ask you to complete and return this form, retaining a copy for your own records. Your cooperation is essential and appreciated. Any delay will result in a delay in publication. The form can be downloaded HERE.
