Medication in the form of psychostimulants is a standard treatment of Attention Deficit Hyperactivity Disorder (ADHD). ADHD, marked by extreme inattentiveness, impulsivity, and hyperactivity, is diagnosed in almost eight percent of U.S. children, according to the Centers for Disease Control and Prevention (2005). Although medical practitioners often prescribe psychostimulants, parents’ attitudes will largely determine whether or not the child receives the medication and is compliant over time.
To gain a greater understanding of parental attitudes toward medication and how they shape treatment compliance, a mixed-method study was conducted by Susan dosReis of the John Hopkins University School of Medicine and her colleagues. Mixed-method research involves both quantitative and qualitative aspects. Qualitative research, in plumbing people’s attitudes, perspectives, and experiences without limiting them to numerical responses, is considered a way to gather more in-depth information about a topic area that is not well understood.
In this study, parents of children (most often the mother) with a recent diagnosis of ADHD were recruited from outpatient settings and interviewed over the telephone. The average age of the child was almost nine, and the majority were African-American families living in an urban area. After gathering the data, the researchers found four themes classified the way parents viewed medication. The first group was illness oriented. The people in this group saw medication as a necessary treatment for a medical condition. They believed their children’s problems were a result of a medical condition and as a result were not responsible for their children’s difficulties. The second group was problem oriented. They tended to view medication as a practical solution for behavior problems and poor grades. A third group saw medication as a generally acceptable method of treatment with both risks and benefits. These people were willing to try medication to see if it was helpful for managing their children’s behavior. A fourth group viewed medication as unacceptable as a solution.
The use of medication differed across the four groups, the researchers found at the initial interview and when parents were interviewed again a year later. While almost all those with an illness orientation, a problem orientation, or those who thought of ADHD as a generally acceptable method had initiated medication for their children, most of the parents in the unacceptable group had elected not to do so. Most of those who saw medication as generally acceptable had discontinued their use of medication, while only a minority of those with an illness-orientation (25%) or a problem-orientation (33%) had stopped medication.
Understanding the range of parental perceptions for the use of medication as a treatment method for ADHD may help providers better engage with families, as well as affect education and guidance for the different treatment options available. Parental involvement in treatment plan decision-making should lead to better compliance, with potentially more successful outcomes for children and families.
Jacqueline Corcoran, Ph.D.