Research Spotlights highlight scientific research focused on girls and women with ADHD and inform non-scientists about the research process. This Spotlight breaks down “Acute Effects of Parent Stimulant Medication versus Behavioral Parent Training on Mothers’ ADHD, Parenting Behavior, and At-Risk Children,” published in The Journal of Clinical Psychiatry, September 2020.
Study Goals
- To compare the effects of medication vs. behavioral parent training (BPT) provided to mothers with ADHD who have children with elevated ADHD symptoms.
- To look at the effects of the two treatments on mothers’ and children’s ADHD symptoms and impairment as well as parenting behavior.
What is already known about the topic?
- Parents of children with ADHD often have ADHD themselves.
- BPT has not been found to be as effective for children with ADHD when a parent has ADHD.
- Treating parents’ ADHD with medication can lead to improvement in adult ADHD symptoms, but the effects on parenting and child outcomes are unclear.
- Previous studies that have treated mothers with ADHD with both medication and BPT demonstrate some positive impacts on child behavior and parent ADHD symptoms, but the unique effects of each treatment could not be determined because children were taking medication for ADHD and parents received both interventions.
How was this study done?
- 35 mothers with ADHD who had a child (ages 4-8) with elevated ADHD symptoms and not taking a stimulant were assigned to take ADHD medication or receive BPT for 8 weeks.
- Core ADHD symptoms (i.e., inattention and hyperactivity/impulsivity) and other common features of ADHD (e.g., emotion regulation); impairment of the mother and child (i.e., severity of ADHD symptoms); and parenting outcomes (e.g., discipline, positive and negative parenting skills) were measured before and after treatment using multiple methods and reporters (e.g., parent rating scales, and clinician observations and ratings).
What were the study’s findings?
- Mothers’ ADHD symptoms and impairment
Mothers treated with medication had improved core ADHD symptoms and emotion regulation. Mothers treated with BPT showed improved emotional regulation but not core ADHD symptom. - Parenting
Although mothers treated with medication self-reported less inconsistent discipline and corporal punishment, clinicians did not observe improvements in parenting. According to both self-report and clinician observations, mothers in the BPT group increased their positive parenting and decreased their negative parenting, inconsistent discipline, and corporal punishment. - Child ADHD symptoms and impairment
According to clinician ratings, more children in the BPT group showed improvement in overall functioning than children in the medication group. However, most children across the two groups were still experiencing difficulties after 8 weeks.
Why are these findings important?
ADHD is a highly heritable condition. It is common that a child with ADHD will have a parent with ADHD. These study results show that stimulant medication and BPT may have unique effects on parent and child outcomes. If replicated, these findings may be helpful for parents and clinicians.
Parents with ADHD who have a child with ADHD should:
- Prioritize their own ADHD symptom management. Managing parents’ ADHD symptoms can potentially improve the effectiveness of interventions for ADHD in children, such as BPT.
- Consider medication and cognitive behavioral therapy (CBT) to help manage ADHD symptoms in adulthood.
- Check out Dr. Russell Barkley’s 12 Principles for Raising a Child with ADHD to learn parenting strategies to help support young children with ADHD.
Clinicians who treat children with ADHD should:
- Be aware of the impact of parental ADHD symptoms on parenting and intervention effectiveness.
- Consider recommending a combination of medication and behavioral therapy as this has been found to be most effective for managing ADHD symptoms in childhood and adulthood.
Terms to Know
- Evidence-based treatments (EBTs): Treatments that have been investigated through research and demonstrated to be effective.
- Behavioral Parent Training (BPT): Evidence-based therapy that addresses executive function challenges associated with ADHD by using positive attention and reinforcement and helps to change behavior incrementally.
We are grateful to Emily Rosenthal, MA, for her contributions to this Research Spotlight.