Does Bad Parenting Cause ADHD?
In a 2012 poll, a third of respondents said that they believe that ADHD is a result of poor parenting rather than a real medical condition!
This was from an online survey in 2012 by Parents’ Magazine together with the Child Mind Institute, ironically, in honor of Children’s Mental Health Awareness Week!
Examining the evidence
We know that ADHD is currently diagnosed in 11% of children and that “ADHD is more likely to occur in males, children in families with low socioeconomic status, and children with parents who have a high school diploma or GED” (Fletcher & Wolfe, 2012). For those who wish to look no further, one could attribute ADHD to being male and growing up in a poor household with uneducated parents and call it a day.
But correlation does not imply causation.
Having poor, uneducated parents does not cause ADHD. But what does that correlation mean?
ADHD is a neurological condition affecting brain development. MRI imaging has found “abnormal grey matter and cortical thickness associated with ADHD in frontal, temporal and cerebellar regions of the brain” (from the ADHD Institute). These very real physiological differences in our brain structure and functioning are what cause the symptoms of ADHD.
If you really want to ask “does bad parenting cause ADHD?” consider this instead:
Having a child with ADHD means that there is a 30-40% chance that at least one of the parents has ADHD as well. And up to 80% of adults with ADHD are undiagnosed and untreated, meaning that they are at risk for personal and academic failure, professional difficulties, anxiety and depression, and substance use or addiction.
Rather than ‘bad parents’ causing a neurological condition, isn’t it more likely that undiagnosed Adult ADHD could be contributing to less than ideal parenting in many of the parents of the children who are diagnosed with ADHD? And couldn’t those parents be helped more by advocacy, education, and outreach than by shaming and blaming?
The Fallout of ADHD
Let’s assume, for this exercise, that ADHD is actually a highly heritable condition that has only recently begun to be well-recognized and diagnosed as a legitimate neurocognitive condition. Thirty or forty years ago, there was even less recognition, even less credibility. When a child couldn’t stay in his seat or stay on task, he was likely spanked at school and possibly worse at home.
We know people with ADHD are much more likely fail a year in school, have more truancy and suspensions, or leave school altogether (Fletcher & Wolfe, 2012). In fact, the dropout rate is 12 times higher for those with ADHD. Without intervention or accommodations, and without any support or education about symptoms management, how do you think these children fare later?
Youth at Risk
The executive functioning impairments in ADHD make it difficult to predict and adapt to the outcomes of one’s actions. When coupled with impulsivity and the socioeconomic disadvantages of a lack of education and likely coming from a poor home, having these symptoms often contribute to petty criminal activity. Adults and teens with ADHD are more likely to commit minor offenses such as traffic violations and speeding as well as major crimes. “In particular, property theft, carrying a concealed weapon, illegal drug possession, and arrests rates have been shown to be positively related to ADHD status, as have admission into juvenile justice facilities” (Fletcher & Wolfe, 2012).
In fact, one study showed that 40% of prison inmates tested were diagnosed with ADHD, but fewer than 7% of those inmates had received a diagnosis during childhood, though most of them required educational support in school. Almost all of the inmates presented with Conduct Disorder, a more serious type of Oppositional Defiant Disorder common in ADHD children and teens, appearing 41% of the time.
How does ADHD affect the family unit? Just as in every other realm of life, executive functioning deficits, lack of self-regulation, and impulsivity can also create relationship problems: ADHD partners may be distractible, forgetful, unhelpful with housework, emotionally hypersensitive or distant, and financially irresponsible. Families affected by ADHD face an increased likelihood of divorce; 22.7% of those with an ADHD child divorce, compared to 12.6% of families without an ADHD child. The statistic is testament to the increased strain of raising an ADHD child, but also possibly related to the increased likelihood that a parent is also affected by the disorder (Wymbs, et al, 2008).
More alarming are the statistics that indicate a link between childhood abuse and ADHD. Individuals with a history of abuse are seven times more likely to be diagnosed with ADHD according to investigators from the University of Toronto in Canada. The prevalence of physical abuse in that study is associated not only with ADHD but with “long-term parental unemployment, parental divorce, and parental addictions.” (Fuller-Thompson, Mehta, & Valeo, 2014).
Starting to recognize a trend?
Together, these factors paint a grim picture: ADHD is a heritable condition, and one that causes difficulties in impulse control and self-regulation that affect multiple generations within a family. Undiagnosed parents are less likely to have benefited from appropriate educational supports, and are more likely to have a history of academic failure, divorce, comorbid mental health conditions, and substance abuse or petty criminal activity.
These individuals aren’t in the best position to create a storybook homelife.
But aside from that, each of their children has a greater than 50% chance of inheriting ADHD from them. Not because they are disorganized or got divorced or are to blame, but because it is a genetic trait.
In fairness, the challenges faced by an ADHD child are likely compounded at home when one or both parents have problems with organization and maintaining consistent rules at home. Challenges with working memory make following through with discipline difficult. Impulsivity and low frustration tolerance often result in negative interactions.
Without behavioral or medical intervention, these impairments can create a feedback cycle where parents with their own poor self-management skills make it even more difficult for their ADHD children to develop healthy adaptations for their symptoms.
In turn, these ADHD children who have lacked a good model for positive coping in the face of these challenges may have higher rates of oppositional behavior, creating even more conflict in the home and adding to the stress of parenting them. You can imagine the pressure in this type of household!
These days, despite the opinions about 30% of people (according to the Parents’ Magazine poll), there is more awareness of ADHD. Better recognition results in earlier intervention for most children. More parents with Adult ADHD are being treated today than, say, 20 years ago. Still, there is a long way to go.
what if we didn’t blame the parents?
Instead of allowing a diagnosis of ADHD to carry with it a stigma of parental blame, what if we used it as an opportunity to educate families about the strong genetic link? We could refer them to the studies that show that up to 40% of parents with an ADHD child have the condition themselves, and that treatment improves parenting.
The key is advocacy and education, so that ADHD and other neurological conditions can be discussed as openly as any other health issue, without concern that people will draw conclusions or place blame about one’s parenting skills.
Instead of shaming or insulting parents who may have already faced a lifetime of shame and insults, we could offer support and empathy and ask how we can help. We can let them know they’re not alone and point them to support groups or sites like Understood.org to get resources.
And we can go ahead tell those 30% of people surveyed to shut their pie holes.
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“Establishing a Link Between Attention Deficit Disorder/Attention Deficit Hyperactivity Disorder and Childhood Physical Abuse.” Taylor & Francis. Web. 28 Mar. 2015. http://www.tandfonline.com/doi/full/10.1080/10926771.2014.873510#abstract
Fletcher, Jason, and Barbara Wolfe. “Long-term Consequences of Childhood ADHD on Criminal Activities.” The Journal of Mental Health Policy and Economics. U.S. National Library of Medicine. Web. 28 Mar. 2015. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3398051/
Ginsberg, Ylva, Tatja Hirvikoski, and Nils Lindefors. “Attention Deficit Hyperactivity Disorder (ADHD) among Longer-term Prison Inmates Is a Prevalent, Persistent and Disabling Disorder.” BMC Psychiatry 10.1 (2010): 112. Print.