Researchers who have examined the impact of an ADHD child on family functioning
consistently have reported resulting difficulties
in family relationships. This is not true
for all families with an ADHD child, of course,
and does not mean that children with ADHD
cannot enjoy terrifically positive relationships
within their family.
On average, however, there exists greater
difficulty in family relationships when there
is a child with ADHD involved. In large part,
this may reflect the added stress families
experience while trying to meet the increased
needs of a child with ADHD, especially when
that child has an accompanying behavior disorder.
Also, because ADHD tends to run in families,
the child's parent often has ADHD as well,
and this can make it difficult for the parent
to consistently apply helpful behavior management
strategies.
Because stress levels do tend to be higher
in families with an ADHD child, one wonders
about the impact this may have on siblings.
Sibling relationships play an important role
in children's development and can exert significant
influence on socialization and peer relationships.
Although very little research on the impact
of siblings ADHD on siblings has been conducted,
at least one
published study indicates that there can
be significant difficulties in this experience.
It is reasonable to hypothesize that such
difficulties could have a negative impact
on the sibling's adjustment and social relationships
outside the family.
Unfortunately, research on the family relationships
and psychosocial adjustment of children with
an ADHD sibling is sparse. It is possible
that high levels of conflict in the relationship
between parents and a child with ADHD would
be associated with greater conflict in parents'
relationships with their other children. This
could occur for several different reasons.
First, parents may be stressed from the challenges
of raising a child with ADHD and this could
"spill over" into their relationships
with their other children.
Second, because the relationship between a
child with ADHD and his/her sibling may tend
to involve more conflict than most sibling
relationships, parents would have to intervene
more frequently in sibling conflicts. This
also could have a negative impact on parent-child
relationships.
Finally, a child may "model" how
their sibling with ADHD interacts with parents,
and thereby engage in behaviors that increase
the level of conflict in his/her own relationship
with parents. This may be especially true
for younger siblings who learn social interaction
skills by observing their older brothers and
sisters. Because a child's functioning at
school is critically impacted by the quality
of his/her family relationships, one would
expect that siblings of children with ADHD
might experience adjustment difficulties outside
the family. This was the hypothesis investigated
in an interesting study published recently
in the Journal of Attention Disorders (Smith,
A.J. et al. (2002). Psychosocial adjustment
and peer competence of siblings of children
with ADHD. 5, 165-175.) (Note: the Journal
of Attention Disorders is the only peer-reviewed
journal focusing exclusively on ADHD and related
learning and behavior disorders. You can learn
more about this excellent resource at http://www.mhs.com/).
Participants in this study were 30 boys with
ADHD, their mothers, and their younger siblings.
The average age of the boys with ADHD was
10.4; the age of the siblings averaged 7.9.
Among the 30 siblings who participated, sixteen
were males and 14 were females. None of the
siblings met diagnostic criteria for ADHD.
The majority of participants were from middle-class
families.
First, the mothers completed a behavior rating
scale -- the Child Behavior Checklist -- on
their child with ADHD and also completed a
questionnaire to assess their perception of
the quality of their relationship with each
child (i.e. the child with ADHD and the sibling).
The focus of the questionnaire was to assess
perceived conflict between mothers and their
children.
Then, the children with ADHD completed the
Sibling Relationship Questionnaire to assess
their perception of the quality of their relationship
with their siblings. The items on this measure
tapped two domains of the sibling relationship
-- the degree of warmth/closeness and the
degree of conflict.
As discussed above, the main focus of this
study was to examine the adjustment outside
the family for children having an older sibling
with ADHD. To examine this, the researchers
asked the teachers of these siblings to complete
two different measures. One measure -- the
Behavioral Assessment System for Children
-- provided an overall measure of the children's
psychosocial adjustments in the classroom.
The second -- the Taxonomy of Problem Situations
-- provided more specific information on siblings'
social competence with peers.
It's
not to be expected that treating this would
be the answer to the whole problem of ADHD
Professor Eric Taylor, Institute of Psychiatry
"Left neglect" is seen where the
right side of the brain is affected. It means things on someone's left-hand
side are simply not noticed, especially
if they are doing something they find boring
or unstimulating.
Children who do not have ADHD may also
show symptoms of the condition, the researchers
say.
The research is published in the Journal
of Child Psychology and Psychiatry, and
in Brain and Cognition.
RESULTS
There were a number of interesting results
reported by the authors. First, as expected,
the severity of the ADHD child's behavior
problems as reported by the mother was strongly
associated with the level of conflict between
the mother and that child, and between that
child and his sibling. In addition, mothers
who reported more conflict in their relationship
with their ADHD child also reported greater
levels of conflict in their relationship
with the sibling. Thus, as predicted, there
was a clear indication that high levels
of conflict between parents and their child
with ADHD "spills over" to adversely
impact their relationship with their other
children.
What
about the adjustment of ADHD siblings in
the classroom?
Here, the results were quite unexpected.
Recall that the authors had predicted high
levels of conflict within the family would
be associated with poorer adjustment and
peer competence among the siblings. Contrary
to this prediction, however, higher levels
of conflict in the family were found to
be associated with significantly more positive
adjustment and higher levels of social competency
among the siblings of ADHD children. More
specifically, the greater the amount of
conflict mothers reported with their ADHD
child, the more competent and well adjusted
the siblings were found to be by their teachers.
SUMMARY
AND IMPLICATIONS
This study presents an interesting set of
results. As expected, mothers who experienced
greater conflict with their ADHD child also
reported greater conflict with their other
children. These results are important as
they suggest that the stress associated
with parenting a child with ADHD can have
an adverse impact on a mother's relationships
with her other children. Although a variety
of explanations may exist for why this could
occur, it highlights the importance of parents
carefully attending to the quality of their
relationships with all of their children,
and working hard to make sure that struggles
with one child do not undermine their relationships
with their other children.
This can be a challenge for parents, particularly
when the efforts to help a child with ADHD
succeed can consume so much time and energy.
Finding a way to preserve individual time
with other children in the family is one
strategy that can be quite helpful in developing
and maintaining positive relations between
parents and their other children -- even
though this may be very difficult to manage
at times. Siblings of an ADHD child may
come to resent how little time and energy
parents may seem to have left for them after
dealing with the demands of the ADHD child,
which is one reason why putting aside special
individual time for each child in the family
can be so important for parents to do.
As discussed earlier, the authors had expected
that higher levels of conflict between mothers
and their child with ADHD would be associated
with poorer adjustment and social competence
in the younger siblings. The results, however,
were quite the opposite. This is certainly
an unexpected finding and the authors offer
several speculations as to why this may
have been the case.
First, they suggest that siblings of children
with ADHD may learn good social coping skills
as a result of their interactions with--
and perhaps responsibilities for -- the
ADHD sibling. In other words, perhaps the
difficulties these siblings experience in
their daily interactions with their ADHD
brother helps them develop and refine their
ability to get along with others. This is
a plausible and interesting conjecture.
A second possibility suggested by the authors
is that some siblings, who observe their
mothers' conflicted interactions with their
brothers who have ADHD, and who also experience
difficulty with their brothers, may "overcompensate"
by demonstrating good adjustment and social
competence outside the family. The idea
here is that these children try extra hard
to succeed in school so they do not create
any additional difficulties and stresses
for their parents. (It is possible that
this would put these youngsters under additional
stress to be the "good child",
but this was not examined in the current
study.)
Although the reason(s) for these interesting
findings cannot be determined from this
study alone, they do point to the need for
additional research in this area. It is
encouraging to learn that younger siblings
of an ADHD child may be able to thrive socially
despite significant conflict in the family.
But because the sample size for this study
was relatively small, these results would
ideally be replicated with a larger sample
before they could be confidently accepted.
Studies based on small samples that generate
unanticipated findings are not always replicated,
and this is important to bear in mind.
In addition, even if these results were
replicated, the finding that greater conflict
between an ADHD child and his or her mother
predicts greater social competence in younger
siblings is not necessarily positive. After
all, high levels of social competence and
adjustment in a younger sibling should not
have to depend on extensive conflict between
his ADHD sibling and parents. Instead, we
should seek to learn why that experience
may promote better social adjustment in
siblings, and then figure out how to accomplish
this in the absence of high conflict levels
between the older ADHD child and parents.
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