Parental Attention-Deficit/Hyperactivity Disorder Predicts Child and Parent Outcomes of Parental Friendship Coaching Treatment

Objective: This study investigated the impact of parental attention-deficit/hyperactivity disorder (ADHD) symptoms on the peer relationships and parent child interaction outcomes of children with ADHD among families completing a randomized controlled trial of parental friendship coaching (PFC) relative to control families. Method: Participants were 62 children with ADHD (42 boys and 20 girls, 6 through 10 years old) and their parents. Approximately half of the families received PFC (a 3-month parent training intervention targeting the peer relationships of children with ADHD), and the remainder represented a no-treatment control group. Results: Parental inattention predicted equivalent declines in children's peer acceptance in both treatment and control families. However, treatment amplified differences between parents with high versus low ADHD symptoms for some outcomes: Control families declined in functioning regardless of parents' symptom levels. However, high parental inattention predicted increased child peer rejection and high parental inattention and impulsivity predicted decreased parental facilitation among treated families (indicating reduced treatment response). Low parental symptoms among treated families were associated with improved functioning in these areas. For other outcomes, treatment attenuated differences between parents with high versus low ADHD symptoms: Among control parents, high parental impulsivity was associated with increasing criticism over time, whereas all treated parents showed reduced criticism regardless of symptom levels. Follow-up analyses indicated that the parents experiencing poor treatment response are likely those with clinical levels of ADHD symptoms. Conclusions: Results underscore the need to consider parental ADHD in parent training treatments for children with ADHD.