Study evaluates treating mothers with ADHD to improve outcomes in kids

"About 25 percent of the time, when a child has ADHD, there's a parent that has ADHD," said Mark Stein, UIC professor of pediatrics and psychiatry and principal investigator of the study. "We realize this is a weakness in our service delivery models, because often clinicians focus on just treating the child and ignore the fact that another family member has ADHD."

Two treatments are very effective for children with ADHD: behavior modification and stimulant medication. Both require "a very dedicated, organized person, which, if you have ADHD, that's going to be a challenge for you," said Stein, who noted that treatment is often administered by the mother, and that women are less likely to have their ADHD identified.

The Treating Mothers First Study will identify mothers of children between ages 4 and 8 with behavior problems who are at risk for ADHD -- and evaluate both the mother and child.

Mothers with ADHD will receive either a long-acting stimulant or behavioral training for eight weeks. Afterward, the mother, family and child will be re-evaluated and then receive treatment for another eight weeks with the same treatment or a combination of medication and parent training.

Parents with ADHD may have difficulty implementing consistent rules and consequences, and they may not respond to a child's appropriate or positive behavior, Stein said. As part of the study "we observe the parent trying to play with the child, trying to get the child to do things like homework or cleaning up their room," he said.

The goal is to determine if the need for stimulant medication in children can be delayed if the mother is treated first.

ADHD is often misdiagnosed as depression or anxiety in women, and it often contributes to marital, parenting, sleep and medical problems, Stein said. Many health care providers have not been trained in diagnosing and treating adult ADHD.

"When a mom complains about how bad her life is, she's given a prescription for Prozac versus understanding that she's always had issues with inattention, distractibility, or impulsivity, and that's why she's having problems," Stein says.

"When you think of ADHD, you think of a 7-year-old boy, not a mom who says 'I am overwhelmed, easily distracted, and just can't get things done,'" he said.

Co-investigators include Drs. Joshua Nathan, Janine Rosenberg, Evelyn Figueroa and Edwin Cook of UIC; and Dr. Andrea Chronis-Tuscano of the University of Maryland.