Nearly every week, I see at least one patient for evaluation to see if they have attention deficit-hyperactivity disorder (ADHD). During the visit, I discuss with the parent what this diagnosis means, what the treatment options are, and make plans for follow-up. The focus of this visit is generally the impact of ADHD on the child.
While I have always also known that ADHD impacts the parents as well, I had not thought about it that extensively until I read an article by Dr. Andrea Spencer and colleagues at Boston University and University of California-San Francisco that is being early released by Pediatrics this week, entitled “Six Stages of Engagement in ADHD Treatment Described by Diverse, Urban Parents”(10.1542/peds.2021-051261).
The authors conducted individual interviews with 41 parents of children with ADHD. The parents were quite consistent in their description of the six stages that they had to go through when they were seeking treatment for their children.
The stages were: 1) Normalization and Hesitation, 2) Fear and Stigmatization, 3) Action and Advocacy, 4) Communication and Navigation, 5) Care and Validation, and 6) Preparation and Transition. There is too much rich information provided for each of these stages to discuss in this blog, so you will want to read this article.
Reading this article reminded me of when I first learned about Kubler-Ross’ Stages of Grief, in that these 6 stages of engagement are fairly predictable in their order, they occur as a developmental process, and difficulty arises when the parent and the health care provider or teacher are at different stages.
As I read through this article, I recognized many of the feelings expressed, and I recalled parents who had told me the exact same thing. And you will as well. I think that explicitly acknowledging these stages will be helpful in my future visits with families of children with ADHD. I will be more understanding – and perhaps can better anticipate the needs, not only of the child, but of the parents as well.
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