The Parent Factor in ADHD

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The Parent Factor in ADHD

• An ADHD specific parenting programme

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Introductions

• Mary Connor
• Business Development Manager-ADHD
• Barnardos
• Tel [phone]
• Email mary.connor_at_barnardos.org.uk

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What is ADHD?

• ADHD is a heterogeneous behavioural syndrome
  characterised by the core symptoms of
  hyperactivity, impulsivity and inattention.
• For a person to be diagnosed with ADHD, their
  symptoms should be associated with at least a
  moderate degree of psychological, social and/or
  educational or occupational impairment.
• (Attention Deficit Hyperactivity Disorder
  Diagnosis and management of ADHD in children,
  young people and adults NICE Sept 2008)

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Impact of ADHD

• Association between hyperactive-impulsive
  symptoms and arrest record
• Studies suggest high proportion of childhood ADHD
  in youth inmates of prisons and YOIs
• High proportion of inmates may have current
  symptoms of ADHD
• ADHD symptoms are linked to reoffending
• Significant link between ADHD/ODD and adolescent
  CD

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• More likely to be prolific offenders
• Significant cost implications to the judicial
  system
• More likely to develop a substance misuse
  disorder
• More likely to be involved with road traffic
  incidents
• Higher medical costs

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Why did Barnardos get involved?

• Increase in referrals where ADHD was a feature
• Usual parenting programmes too generic and not
  appropriate to the needs of these parents
• Individual support not effective in reducing the
  feelings of isolation and blame typically
  experienced

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Why a Parenting Programme?

• Body of Research
• NICE Guidance on Conduct Disorders
• Research specific to Parents of children with ADHD

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What did we do?

• 2003 Programme produced by working party of
  Childrens Service Managers in Barnardos North
  East Region
• Spring 2004 Piloted in Hartlepool
• Autumn 2004 Piloted in Gateshead in partnership
  with the Child and Family Unit
• Autumn 2004 to present Programme run with parents
  from Sunderland, Gateshead and Newcastle

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Programme Aims

• To increase parents knowledge of ADHD and its
  treatment
• To give parents insight into how it feels to be a
  child with ADHD
• To give parents advice on how to promote a more
  positive relationship with their child
• To educate parents on strategies for effective
  behaviour management

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Theory Base

• Solution focused theory
• Social learning theory
• Behavioural theory

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The Pre Group Meeting

• To introduce participants to each other and
  worker
• To share personal stories
• To off load and give vent to stress and
  frustration before the programme starts
• To agree groundrules
• To give information about course content
• To answer questions
• To confirm arrangements
• Attendance compulsory

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Programme Content Sessions 1 - 4

• Session 1 Aim To give parents relevant and
  understandable
• information about ADHD and how it can be
  treated. To also look at positive aspects of
  ADHD.
• Session 2 Aim To get parents to think about all
  the tasks involved
• in being a parent and then what extra tasks
  if children are diagnosed as having ADHD.
• Session 3 Aim To look at different parenting
  styles and to think
• about which style we predominantly use and
  whether this is always
• the best way.
• Session 4 Aim To demonstrate to parents, the
  importance of good
• communication (talking and listening) and
  rewarding/reinforcing
• positive behaviour.

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Sessions 5 8

• Session 5 Aim To show how important feelings are
  and to show how they nearly always impact on
  behaviour.
• Session 6 Aim To give parents relevant and
  understandable
• information about the education system and
  their rights within it.
• Session 7 Aim To help parents think about the
  different ways
• people get attention and how the response
  they get can influence
• the way they get attention in future.
• Session 8 Aim To review the programme and
  evaluate the group experience. To give out
  certificates and celebrate achievements.

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Working with Fathers

• Fathers role within family is different
• Working fathers
• Gender difference in parents reactions
• Could offer different viewpoint
• Can feel out of things
• Offer support to each other

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Feedback from Parents

• Were your expectations met?
• Most of them hoped for a solution but there
  isnt one
• Yes wanted to spend time with other parents
  because I knew that would make me feel better
• Yes its been worthwhile, I now listen to him a
  lot more
• It was lovely coming here and knowing it wasnt
  my fault and I wasnt the only one

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What did you learn?

• New strategies
• To value small successes
• To ignore negatives and reward positives
• To have more confidence in my own abilities
• To believe in myself more and the relationship I
  have with my child
• To look at things differently i.e. from childs
  point of view
• Liked the session on different parenting styles

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What did you learn?

• Doing homework was a good idea
• Liked the box making and the cartoon strips
• I have learned to pick my battles (with my child)
  
• Some things are worth standing your ground on
  some things I just make the point and then leave
  it
• Now I ask him to do things instead of tell this
  used to result in arguments and me losing my
  temper
• I dont lose my temper now I just leave him.
  He helps me more and enjoys the positive feedback

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Some Figures

• Approximately 5 8 parents invited to each group
• 100 parents have completed the programme.
• In each group there have been at least 2 women
  who never missed a session
• 4 of the groups have been co-facilitated with a
  CAMHS service

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Some Figures (ctd)

• 5 The Parent Factor in ADHD facilitators
  programmes
• 45 professionals trained
• Programmes running or soon to be running in
  Stockton, Sunderland, Newcastle, North Tyneside,
  Hartlepool, Northumberland, Malta
• 12 month evaluation completed

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A Preliminary Independent Evaluation

• Aim
• Conduct a preliminary independent evaluation of
  the Parent Factor in ADHD parenting programme
• Objectives
• 1) Review the literature
• 2) Analyse parents feedback
• 3) Peer review programme materials
• 4) Analyse childs behaviour pre and post
  parents participation in the programme
• 5) Identify gaps in the current programme
  evaluation strategy

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Parents Feedback

• End of session questionnaires
• I found the session interesting and useful
• I will use some of the things I have learned in
  the session
• I enjoyed the session
• I feel that the things I said were welcomed and
  valued by the facilitators
• The session has made me think about my own
  behaviour

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Parents Feedback

• Perceived benefits
• Reassurance
• Practical strategies
• Information about and understanding of
  ADHD-related issues
• Positive thinking
• Self reflection
• Insight into childs point of view
• Rights within the education system

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Sungate Evaluation

• Delivered to 30 parents in Sunderland Gateshead
• Young people identified as at risk of social
  exclusion and/ or being involved in offending
  behaviour
• Referrals from Youth Offending Teams or Youth
  Inclusion Support Panels

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Sungate Evaluation

• Delivered to
• 23 mums
• 3 dads
• 2 carers
• 2 not recorded
• Facilitators assessment
• 25 very positive
• 5 positive
• Parental satisfaction
• 28 very satisfied
• 2 satisfied

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Sungate Evaluation

• Being able to speak with other mothers was
  extremely helpful knowing I was not alone with
  my situation participant no. 16
• I have learnt a lot about how to react to his
  sons needs participant no. 20
• Everybody was friendly and they all understand
  nobody judged anyone participant no. 21

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Peer Review
Senior Lecturer in Forensic Clinical Psychology ?
Community Nurse ? Paediatrician ?
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Childs Behaviour Pre Post

• Outcome measures
• Strengths and Difficulties questionnaire (SDQ)
• Little difference at pre and post assessment
• Child Health and Illness Profile Scale (CHIP)
• Satisfaction with self, risk avoidance and
  individual risk avoidance better at post
  assessment

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QUESTIONS?