Poster #80 - Improving Ecological Validity in the Assessment of Caregiver-Child interactions Among Children with ADHD

• In Event: Poster Session 17

Abstract

Attention-Deficit/Hyperactivity Disorder (ADHD) is a major public health concern, affecting approximately 10-12% of children in the U.S (Danielson et al., 2018). ADHD is associated with impairments across various domains of daily life functioning at home and school. As a result, families of children with ADHD and related behavior problems commonly report increased strain in caregiver-child relationships that may maintain coercive caregiver-child interactions over time. Gold standard assessment tools evaluating child behavior and caregiver-child interactions typically relies on informant and self-report questionnaires or structured clinic observations which are susceptible to a variety of biases (e.g., recall and desirability biases, lack ecological validity). Thus, the current understanding of caregiver-child interactions among children with ADHD is significantly limited by the currently available assessment procedures. Wearable technologies have the potential to address these limitations and provide important insights that can transform assessment and treatment of ADHD and related behavioral disorders. The goal of this study was to collect pilot data using novel, unobtrusive, multimodal wearable devices that our team designed to capture audio and video data among caregivers and children with ADHD while they complete daily evening routines at home to examine the utility of an in-home recordings compared to well-established self-report assessment procedures. The feasibility and acceptability of the camera was also measured. Seven families with children with ADHD (ages 7-13, Mage = 9.5 years, 83% male) have enrolled in the study which had caregivers record routine evening activities while at home for 5 days (see Figure 1-2). Caregivers also completed a global measure of parenting style at intake and an ecological momentary assessment measuring caregivers’ perceptions of their own and their child’s behaviors each of the five days they used the wearable devices. Caregivers were on average 35.4 years old (caregivers age range = 31-50) and diverse in terms of race (70% Caucasian, 30% Black), ethnicity (80% Hispanic), language spoken in the home (66% spoke both English and Spanish). Participating children showed average intelligence (Median IQ = 104), and significant behavior problems (Disruptive Behavior Disorders rating scale M = 53.83, SD = 18.56) which caused functional impairment for the family (Impairment Rating Scale M = 31, SD = 6.13). Initial feasibility estimates suggest that the majority of families reported they had a positive experience with the cameras, with most families indicating that after a period of time using the cameras, they forgot it was there, suggesting that we can capture naturalistic observations using these devices. On average, caregivers reported that their child engaged in 2-3 instances of positive behavior and 1 instance of negative behavior per day while recording. In addition, on average, caregivers reported praising their child once or twice while recording but rarely yelling at or scolding their child. Additional analyses will examine the concordance between the multiple assessment (i.e., recordings, global self-report, momentary daily assessment). Results may have significant implications for diagnostic, assessment, progress monitoring, and treatment adaptations for families of children with ADHD.

Authors

• Jennifer Piscitello, Florida International University
  Presenting Author

• Emily L Robertson, Florida International University

• Kellina Lupas

• Ou Bai

• Chaocho Lin

• Diandra Leon, Florida International University

• Laila Tally

• William E Pelham, Florida International University