David C. Guevremont

Parenting stress among families of children with Attention Deficit Hyperactivity Disorder

Prior research has shown that parenting stress levels can be quite high among families of children with attention deficit hyperactivity disorder (ADHD). This study investigated the degree to which such stress was related not only to the childs ADHD, but also to various other child, parent, and family-environment circumstances. Multimethod assessments were conducted on 104 clinic-referred children with ADHD. Data collected from these subjects were entered into hierarchical multiple-regression analyses, utilizing the Parenting Stress Index as the criterion. The results showed that child and parent characteristics accounted for a substantial portion of the variance in overall parenting stress. The childs oppositional-defiant behavior and maternal psychopathology were especially potent predictors. The severity of the childs ADHD, the childs health status, and maternal health status also emerged as significant predictors. These findings are discussed in terms of their impact upon the clinical management of children with ADHD.

Parent training for Attention Deficit Hyperactivity Disorder: Its impact on parent functioning

This study examined changes in parent functioning resulting from parental participation in a behavioral parent training (PT) program specifically designed for school-aged children with attention-deficit hyperactivity disorder (ADHD). Relative to wait list controls, subjects who completed the nine-session PT program showed significant posttreatment gains in both child and parent functioning, which were maintained 2 months after treatment. In particular, there were PT-induced reductions in parenting stress and increases in parenting self-esteem, which accompanied parent-reported improvements in the overall severity of their childs ADHD symptoms. In addition to their statistical importance, these findings are discussed in terms of their clinical significance, utilizing methods developed by Jacobson and Truax (1991).

Adolescents with ADHD : patterns of behavioral adjustment, academic functioning, and treatment utilization

Adolescents with attention deficit hyperactivity disorder (ADHD) were compared with a control group on a comprehensive assessment battery. More ADHD teenagers had oppositional defiant disorder (68%) and conduct disorder (39%) and were rated as more impaired in social competence, behavioral and emotional adjustment, and school performance by parents and teachers than control teens. The ADHD youths, however, rated themselves as better adjusted than did their parents and teachers, differing only from controls in depressive symptoms and antisocial acts. Poorer performances in verbal learning and vigilance and greater ADHD behaviors during a math task also distinguished the ADHD from control teenagers.

Peer Relationship Problems and Disruptive Behavior Disorders

About half of all children with attention deficit–hyperactivity disorder (ADHD) have significant problems with their peer relationships. These social difficulties appear to be related to a high rate of intrusive behavior, deficits in conversation and reciprocity, social–cognitive biases, and poor emotional regulation. Social skills interventions have been advocated to teach children and adolescents how to interact more successfully with their peers. To date, few studies have systematically evaluated social skills interventions for children with ADHD. However, studies with children and adolescents who are disruptive have pointed to serious limitations in the generalization of treatment effects to the natural environment and questionable changes in peer relationships as a result of these treatments. These limitations and potentially useful adjunctive and alternative treatment strategies are discussed, including careful attention to setting events, the strategic use of peers, and the impact of medications on peer interactions.

Attention deficit-hyperactivity disorder in adolescence: Critical assessment parameters

Abstract The nature of Attention Deficit—Hyperactivity Disorder (ADHD) and its behavioral correlates in adolescence are briefly described. An assessment protocol for evaluating this disorder among teenagers is proposed, including parent and adolescent interviews, rating scales (completed by parent, teachers, and teenagers), laboratory tasks, and direct observation techniques. The advantages and limitations of each of these are delineated to explicate the inherent complexities encountered when evaluating ADHD in adolescents. Multiple methods obtained across sources, caregivers, and settings are recommended for use in assessing ADHD with the adolescent population.

Diagnosis and assessment of attention deficit-hyperactivity disorder in children

Abstract This article provides an overview of Attention Deficit-Hyperactivity Disorder (AD-HD) in children and its behavioral correlates, emphasizing clinical issues in assessment. Diagnostic criteria for AD-HD that are presented in DSM-III-R are briefly reviewed as are additional guidelines used in making the diagnosis. A clinical assessment protocol for evaluating this disorder among children is proposed that includes parent, teacher, and child interviews, standardized parent and teacher behavior rating scales, laboratory test measures, and direct observational procedures. A multimethod assessment protocol that utilizes sources of information obtained from different settings and informants is advocated because of the inherent complexities encountered when evaluating AD-HD. The importance of differential diagnosis and the need to assess for coexisting behavioral, learning, or emotional problems is emphasized. A clinical case is presented to illustrate the diagnostic and assessment process in evaluating children for AD-HD.

Preschoolers' Goal Setting with Contracting to Facilitate Maintenance:

The effects of goal-setting and child-teacher contracting procedures on the academic performance of 3 preschool children were examined. Goal setting produced substantial improvements in the quantity and quality of the childrens work, but did not facilitate maintenance when baselines were reinstated. When performance gains were not maintained following goal setting, a child-teacher contracting procedure was introduced sequentially across subjects using a multiple-baseline design. Contracting also led to improvements in work performance and resulted in childrens use of higher self-determined goals and maintenance in subsequent baseline conditions for 2 children. Both interventions increased on-task behavior and generalized to performance during regular work periods. Contracting procedures, however, appear to be a useful transitional phase in goal-setting interventions designed to produce durable effects with young children.