Designing an Intervention for Parents with ADHD and Their Children

• In Event: Dual-Generation Treatments: Addressing Parent Mental Health in Parenting and Child-Focused Prevention and Intervention Programs

Abstract

ADHD is a highly prevalent disorder that co-occurs in children and parents. Parental ADHD, present in 25-50% of families of children with ADHD and frequently untreated, interferes with effective parenting and predicts poor child developmental and behavioral treatment outcomes. The earliest possible identification and intervention in families with ADHD can improve child, parent, and family functioning, as well as prevent adverse long-term outcomes in children.

Hybrid effectiveness-implementation studies evaluate innovative and scalable treatment strategies, while also considering implementation factors such as feasibility, acceptability and sustainability. These projects hold promise for modifying the course of ADHD in young children whose parents also have ADHD in a manner that reduces barriers to health service delivery and holds potential for widespread dissemination.

The larger NIMH-funded parent grant is a randomized controlled study where parents with ADHD and their young at-risk children (3-8 years-old ) are randomized to one of two conditions: (1) stimulant medication for parents with ADHD followed by a child treatment strategy (CTS) beginning with a behavioral parenting intervention (BPI) with the added recommendation of child stimulant treatment if the child remains impaired or (2) a CTS without treatment for parental ADHD on parent, child, and family outcomes. Treatments are delivered via telehealth by mental health providers co-located in primary care. The implementation process and barriers to implementing parent mental health treatment in pediatric primary care in low-resourced communities will be discussed.

A smaller pilot study aims to develop a parenting intervention focusing on parent mental health as well as child behavior for parents of toddlers at-risk for developing ADHD, also in pediatric primary care. The goals are to (1) identify barriers and strategies to implementing a parenting intervention and stimulant medication for parents with ADHD in a low-resourced community, and (2) explore context and cultural values and how they may inform intervention development and implementation. Stakeholder interviews will be discussed. Thematic analysis will be presented to describe themes. This qualitative data will help inform the development and implementation interventions for parents with ADHD and their toddlers.

Authors

• Nicole Elise Lorenzo, American University
  Presenting Author

• Joyce Hoi Ling Lui

• Donna Marschall

• Christina Danko

• Mark Stein

• Andrea Chronis-Tuscano, University of Maryland, College Park