(PS1-C67) Parental ADHD and Executive Functioning: Impacts on Behavioral Parent Training Skill Use for Childhood ADHD

ADHD is a common childhood mental health condition associated with numerous adverse outcomes. Behavioral parent training (BPT) is a gold-standard treatment for ADHD, producing improvements across symptom and functional domains. During BPT, parents learn skills to reduce their child’s symptoms and improve functioning; thus, skill use is a crucial mechanism of treatment response. However, approximately 60% of parents experience difficulty engaging effectively with treatment, and many of these families consist of parents who also experience ADHD symptoms. As nearly half of children with ADHD have a parent who also meets criteria for the disorder, identifying predictors of skill use for parents with ADHD may have a large public health impact.
ADHD is neurodevelopmental disorder, and executive function (EF) deficits are consistently identified as key contributors to the core inattentive, hyperactive, and impulsive symptoms. EF refers to complex cognitive processes that enable goal directed behaviors (e.g., thinking flexibly, inhibiting behavior, planning, time management) and are necessary for effective and consistent BPT skill use. For example, inhibitory control allows parents to restrain automatic responses to child misbehavior in favor of applying BPT skills. Time management and planning abilities enable parents to create/implement behavior plans and schedule time for skill practice. Thus, EF deficits may be one reason that parents with ADHD struggle to use learned skills. However, this notion is understudied and is the focus of the present poster.  

Data on parental EF, ADHD symptoms, and BPT skill use are being collected as part of an ongoing study to examine barriers to BPT skill use among parents with ADHD. To date, ten families have completed an eight session, group based BPT program based on the Collaborative Life Skills (CLS) program (Child Age M = 8.8, SD = 0.84; 50% boys). An additional ten families are currently enrolled. By the time of the 2023 ABCT symposium, we expect to have data from 44 families.  

Parents’ baseline EF abilities will be assessed using the Barkley Deficits in Executive Functioning Scale (BDEFS) and ADHD symptoms will be measured using the Barkley Adult ADHD Rating Scale (BAARS). Quantity and quality of parental skill use will be measured weekly throughout treatment by having parents respond to the questions “Over the past week, how often did you use the skills learned during this group?” and “How well do you think you did on the homework assignment?” on a scale from 1 (not at all/not well) to 5 (every day/very well). These weekly scores will be averaged and combined into composite scores for analysis. Two hierarchical regression analyses will be conducted, one for each measure of skill use. ADHD symptoms will be included as a predictor of quantity/quality of skill use in step one and EF will be added in step two. We hypothesize that EF abilities will predict both quantity and quality skill use over and above ADHD symptoms.

 If supported, findings would suggest that EF abilities are a significant predictor of skill use among parents with ADHD. Because parental ADHD is associated with reduced skill use and outcomes, incorporating CBT-based strategies shown to improve adult ADHD and EF within a BPT program may improve outcomes.