The Role of Parental Knowledge and Attitudes about ADHD and Perceptions of Treatment Response in the Treatment Utilization of Families of Children with ADHD

ABSTRACT

The present study examined the impact of parental knowledge and attitudes about attention-deficit/hyperactivity disorder (ADHD), and parental perceptions of treatment response on the utilization of behavioral and pharmacological ADHD treatments, using data from a longitudinal treatment study designed to assess physical growth in children with ADHD. It also explored if these relations were moderated by race/ethnicity. Participants include 230 (74% Hispanic) families of treatment naïve children with ADHD (M age = 7.56, SD = 1.94; 73% male). Families were randomly assigned to receive behavior therapy (BT) or stimulant medication (MED; which also included low dose BT). After 6 months, families whose children still showed at least moderate impairment had access to either treatment for a total of 30 months. Utilization was measured using the number of BT sessions attended and total mg of MED taken over the study period. Families who reported more willingness to use medication for their child’s ADHD at baseline were more likely to use MED and less likely to use BT, regardless of race/ethnicity. Parental knowledge about ADHD was only important in predicting BT utilization for White non-Hispanic families. Greater reduction in ADHD symptoms and impairment significantly predicted more MED utilization for Hispanic families. Results highlight the need to explore multiple parent (e.g., medication willingness) and child (e.g., symptom severity) factors when considering treatment utilization. Results also highlight ethnic differences in which factors affect treatment utilization.

Additional information

Funding

This trial was funded by the National Institute on Mental Health (R01 MH083692). Funders had no role in the conduct of the research or preparation of the article. Authors also received support from the National Institute on Drug Abuse (T32 DA039772, R37 DA009757, UH2 DA041713) and the National Institute on Alcohol Abuse and Alcoholism (F31 AA026768). Some study medication was donated by Janssen Pharmaceuticals. In the past two years, Dr. Waxmonsky has received research funding from NIH, Supernus and Pfizer and served on the advisory board for NLS Pharma and Purdue Pharma. Dr. Pelham has received funding from NIH, NIDA, IES and the Society of Clinical Child and Adolescent Psychology. The other authors have no conflicts of interest to declare.