By David Rabiner, Ph.D.
What's new in the world of research related to children with learning and attention difficulties? In this summary of current peer-reviewed research, Duke University child psychologist David Rabiner, Ph.D., shares his expert perspective in practical terms for parents like you.
Although thousands of studies on children with AD/HD and their families have been conducted, it is surprising how little is known about the quality of their day-to-day lives. Behavior rating scales tell us relatively little about the quality of moment-to-moment interactions, and observational studies, although a rich source of data, are necessarily limited to extremely small samples of time.
A fascinating study to be published in an upcoming issue of the Journal of Abnormal Child Psychology addresses this important gap in the literature (Whalen, et al., 2006. Toward mapping daily challenges of living with AD/HD: Maternal and Child Perspective using Electronic Diaries).
In this study, Personal Digital Assistants (PDAs) were used to provide a unique window into the challenges of living with AD/HD, challenges that remain despite important benefits that may be provided by medication treatment.
Participants were 27 children with AD/HD (average age 10.5 years, 18 boys, 9 girls) and their moms as well as 25 children without AD/HD (average age 10.5 years, 15 boys, 10 girls) and their moms. All children in the AD/HD group were being treated with a long acting stimulant - either Concerta® or Adderall XR® - at the time of the study. Children in the comparison group had no known learning or behavioral problems. Because the authors were interested in examining mother-child relationship issues, enrollment was limited to mother-child dyads together for at least 4 hours each day.
To learn about participants' day to day experience, electronic diary monitoring using Personal Digital Assistants was scheduled across 7 consecutive days during non-school hours. The PDAs were programmed to beep approximately every 30 minutes to signal that it was time to complete a diary checklist. Both mothers and children had their own PDA, which were programmed to beep at different times, and each completed their own electronic diary. The PDAs were programmed to beep when mothers and children were likely to be together - before school, after school, and on weekends.
The diary items were selected to "…tap contexts, behaviors, and moods that are relevant to the daily lives of parents and school age children, to capture the quality of their interactions, and to include dimensions that often prove problematic for children with AD/HD.
Each time the PDA beeped, participants used the PDA to identify their location, social context, (i.e., by themselves, with each other, with peers), and their current activity. Then, mother and child rated the child's symptomatic behaviors (e.g., impatient, restless), and moods (.e.g., angry, good mood). Mothers also rated their own moods. Each also rated the difficulty of the activity they were currently engaged in and evaluated their ability to do it successfully.
Despite the frequent recording demands, moms and children did a good job of completing the diary entries. Mothers received an average of 91 signals to complete a diary entry during the 7-day period while children received an average of 95 signals. Completion rates were approximately 90% for mothers and children, and did not differ between the AD/HD and comparison group. Thus, even though some children in the study were as young as 8, the use of a PDA to learn about children's ongoing experience appears to be a very viable research method.
© 2006 David Rabiner, Ph.D. Adapted with permission from the author. Information presented in Attention Research Update is for informational purposes only, and is not a substitute for professional medical advice.
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