The reality of living with AD/HD: children's concern about educational and medical support

Hughes, Lesley

doi:10.1080/13632750601135915

Cited by 14 publications

(45 citation statements)

References 4 publications

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“…The checklists are founded on normative ideas of classroom behaviour and these behaviours are evaluated on the basis of subjective perceptions, so diagnosis clearly involves sociological factors. However, there is an implicit link between ADHD symptoms and concepts of illness because diagnosis is carried out by medical doctors (because of the possible need to prescribe medication); therefore, diagnosis and pharmacological treatment of ADHD may prompt medicalised ideologies about ADHD for lay people, 260 and this was common for pupils diagnosed with ADHD in included papers for review 4a. The following discussion explores pupils' experiences of diagnosis and medication and its implicit links to polarised biological attributions for ADHD.…”

Section: Impact Of Polarised Viewsmentioning

confidence: 99%

“…These studies analyse interactions between participant types (pupils diagnosed with ADHD, their teachers and/or parents and/or peers) rather than exploring perceptions of one participant type, as was the case for included papers in reviews 4a-c. Four of the included studies involved participants from the USA, 293,347,390,391 two studies involved participants from Canada, 347,392 one study involved participants from New Zealand 290 and one study involved participants from the UK. 260 Rafalovich's 347 study included participants from both the USA and Canada. Each study is represented by a single publication.…”

Section: Study Characteristics For Review 4d (Mixed Views)mentioning

confidence: 99%

“…Where papers acknowledged qualitative analysis but did not provide sufficient detail, and contact details were available, authors were emailed to request further information. 28,[259][260][261][262][263][264][265] Five authors replied with further details. [259][260][261]263,266 METHODS FOR QUALITATIVE REVIEWS 3 AND 4…”

Section: Data Extractionmentioning

confidence: 99%

“…Although many included studies in review 4 describe a contribution of school-related factors to ADHD symptoms, 27,41,[260][261][262][263]265,266,291,293,296,314,324,[331][332][333][334]347,356 the sociological factor that teachers tended to refer to was poor parenting. Often, teachers who attributed ADHD symptoms to sociological factors were not willing to adapt their teaching approach to support pupils who displayed this behaviour, because they understood the behaviour to result from poor parenting rather than the school context.…”

Section: Perceptions Of Attention-deficit/hyperactivity Disorder Sympmentioning

confidence: 99%

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Non-pharmacological interventions for attention-deficit/hyperactivity disorder (ADHD) delivered in school settings: systematic reviews of quantitative and qualitative research

Richardson

Moore

Gwernan‐Jones

et al. 2015

Health Technol Assess

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BackgroundAttention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder characterised by age-inappropriate levels of inattention, impulsivity and hyperactivity. School can be particularly challenging for children with ADHD. Few reviews have considered non-pharmacological interventions in school settings.ObjectivesTo assess the effectiveness of non-pharmacological interventions delivered in school settings for pupils with, or at risk of, ADHD and to explore the factors that may enhance, or limit, their delivery.Data sourcesTwenty electronic databases (including PsycINFO, MEDLINE, EMBASE, Education Resources Information Centre, The Cochrane Library and Education Research Complete) were searched from 1980 to February–August 2013. Three separate searches were conducted for four systematic reviews; they were supplemented with forward and backwards citation chasing, website searching, author recommendations and hand-searches of key journals.Review methodsThe systematic reviews focused on (1) the effectiveness of school-based interventions for children with or at risk of ADHD; (2) quantitative research that explores attitudes towards school-based non-pharmacological interventions for pupils with ADHD; (3) qualitative research investigating the attitudes and experiences of children, teachers, parents and others using ADHD interventions in school settings; and (4) qualitative research exploring the experience of ADHD in school among pupils, their parents and teachers more generally. Methods of synthesis included a random-effects meta-analysis, meta-regression and narrative synthesis for review 1, narrative synthesis for review 2 and meta-ethnography and thematic analysis for reviews 3 and 4.ResultsFor review 1, 54 controlled trials met the inclusion criteria. For the 36 meta-analysed randomised controlled trials, beneficial effects (p < 0.05) were observed for several symptom and scholastic outcomes. Mean weighted effect sizes ranged from very small (d+ < 0.20) to large (d+ ≥ 0.80), but substantial heterogeneity in effect size estimates across studies was reported. Moderator analyses were not able to clarify which intervention features were linked with effectiveness. For review 2, 28 included studies revealed that educators’ attitudes towards interventions ranged in positivity. Most interventions were rated positively or neutrally across different studies. The only intervention that consistently recorded positive attitudes from educators was daily report cards. For review 3, 33 studies met the inclusion criteria. Key findings included tensions regarding the preferred format of interventions, particularly how structured interventions were and the extent to which they are tailored to the child with ADHD. There were mixed views about the impact of interventions, although it was clear that interventions both influence and are influenced by the relationships held by children with ADHD and participants’ attitudes towards school and ADHD. For review 4, 34 studies met the inclusion criteria. Key findings included the importance of causal attributions that teachers, parents and pupils made about ADHD symptoms, the decisions teachers made about treatment, the self-perceptions pupils developed about themselves, the role of the classroom environment and stigma in aggravating ADHD symptoms, and the significant barrier to treatment posed by the common presence of conflict in relationships between pupils–teachers, parents–teachers and pupils–peers in relation to ADHD. An overarching synthesis of the four reviews highlighted the importance of the context affecting interventions. It suggested that ADHD psychoeducation and relationship-building skills are potential implications for interventions.LimitationsThe breadth of both interventions and outcomes in the reviewed studies presented a challenge for categorisation, analysis and interpretation in reviews 1–3. Across reviews, relatively few studies were conducted in the UK, limiting the applicability of findings to UK education. In reviews 1 and 2, the poor methodological quality of some included studies was identified as a barrier to establishing effectiveness or comparing attitudes. In review 3 the descriptive analysis used by the majority of studies constrained theorising during synthesis. Studies in review 4 lacked detail regarding important issues like gender, pupil maturity and school level.ConclusionFindings suggest some beneficial effects of non-pharmacological interventions for ADHD used in school settings, but substantial heterogeneity in effect sizes was seen across studies. The qualitative reviews demonstrate the importance of the context in which interventions are used. Future work should consider more rigorous evaluation of interventions, as well as focus on what works, for whom and in which contexts. Gaps in current research present opportunities for the development and testing of standardised tools to describe interventions, agreement on gold-standard outcome measures assessing ADHD behaviour and testing a range of potential moderators alongside intervention trials.Study registrationThis study is registered as PROSPERO CRD42011001716.FundingThe National Institute for Health Research Health Technology Assessment programme.

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Section: Impact Of Polarised Viewsmentioning

confidence: 99%

Section: Study Characteristics For Review 4d (Mixed Views)mentioning

confidence: 99%

Section: Data Extractionmentioning

confidence: 99%

Section: Perceptions Of Attention-deficit/hyperactivity Disorder Sympmentioning

confidence: 99%

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Non-pharmacological interventions for attention-deficit/hyperactivity disorder (ADHD) delivered in school settings: systematic reviews of quantitative and qualitative research

Richardson

Moore

Gwernan‐Jones

et al. 2015

Health Technol Assess

View full text Add to dashboard Cite

show abstract

“…When stigmatized, a pupil displaying ADHD symptoms can first informally, then formally be marginalized and excluded on the basis of behavioral contraventions (Bailey & Thomson, 2009;Hughes, 2007;Rafalovich, 2005). The Qualitative Intervention Review found that interventions and support intended to help the pupil function in the normal classroom can actually further aggravate stigma and marginalization, because treating the pupil differently can make any perceived differences more explicit (Ljusberg, 2011b).…”

Section: Insert Figure 1 Around Herementioning

confidence: 99%

Non-Pharmacological Interventions for ADHD in School Settings: An Overarching Synthesis of Systematic Reviews

et al. 2015

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Objective: This overarching synthesis brings together the findings of four systematic reviews including 138 studies focused on non-pharmacological interventions for ADHD used in school settings. These reviews considered the effectiveness of school-based interventions for ADHD, attitudes toward and experience of school-based interventions for ADHD, and the experience of ADHD in school settings. Method: We developed novel methods to compare the findings across these reviews inductively and deductively. Results: Key contextual issues that may influence the effectiveness and implementation of interventions include the relationships that pupils with ADHD have with their teachers and peers, the attributions individuals make about the etiology of ADHD, and stigma related to ADHD or intervention attendance. Conclusion: Although we found some positive effects for some outcomes and intervention categories, heterogeneity in effect size estimates and research evidence suggests a range of diverse contextual factors potentially moderate the implementation and effectiveness of school-based interventions for ADHD.

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Perceptions of ADHD Among Diagnosed Children and Their Parents: A Systematic Review Using the Common-Sense Model of Illness Representations

Wong

Hawes

Clarke

et al. 2017

Clin Child Fam Psychol Rev

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Research on children and parents' experiences of ADHD has grown in recent years, attracting attention to their subjective perception of ADHD as a disorder. Theoretical accounts of illness perception suggest that it is multi-dimensional, consisting of at least five core constructs (see the common-sense model of illness representations or CSM: Leventhal et al., in: Rachman (ed) Medical psychology, Pergamon, New York, vol 2, pp 7-30, 1980, in: Baum, Taylor, Singer (eds) Handbook of psychology and health: social psychological aspects of health, Earlbaum, Hillsdale, vol 4, pp 219-252, 1984). We suggest that the application of CSM in children/adolescents with ADHD and their parents may play an important role in understanding their coping behavior, treatment adherence, and emotional well-being. A systematic search identified 101 eligible studies that investigated the perception of ADHD among diagnosed children/adolescents and their parents. In general, these studies support the existence of the multiple facets of illness representations proposed by the CSM in both diagnosed youngsters and parents indicating substantial variability among both parents and youngsters on each of these facets. The comprehensive assessment of the representations of ADHD indicates imbalance attention to the different representations of ADHD in the literature; disproportional research attention has been paid to the perceived effectiveness of treatment (i.e., treatment control dimension) compared to other illness representations (e.g., timeline, consequence, and coherence), despite research showing their relevance to treatment adherence among other implications. The review identifies the limitation of existing relevant research, needed foci for future studies, specific testable hypotheses, and potential clinical implications of the multifaceted representations of ADHD among youngsters and carers alike.

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The reality of living with AD/HD: children's concern about educational and medical support

Cited by 14 publications

References 4 publications

Non-pharmacological interventions for attention-deficit/hyperactivity disorder (ADHD) delivered in school settings: systematic reviews of quantitative and qualitative research

Non-pharmacological interventions for attention-deficit/hyperactivity disorder (ADHD) delivered in school settings: systematic reviews of quantitative and qualitative research

Non-Pharmacological Interventions for ADHD in School Settings: An Overarching Synthesis of Systematic Reviews

Perceptions of ADHD Among Diagnosed Children and Their Parents: A Systematic Review Using the Common-Sense Model of Illness Representations

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