multiple component PROGRAM ADVISORY FOR FAMILIES WITH CHILDREN WITH ADHD
A. Miranda-Casas, D. Grau-Sevilla, A. Melia de Alba, B. Roselló
Wednesday, April 20, 2011
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disorder attention deficit hyperactivity disorder (ADHD) is a psychopathology quite common, begins in early childhood and persists, at least half the cases, in adolescence and adulthood. Numerous investigations suggest that the disorder is heritable (70-80%) and polygenic trait, in which several genes contribute to genetic defect. But the fact that ADHD is partly heritable does not eliminate the need to also take into account the action of environmental factors Therefore, the evolution of the disorder is not can be understood without considering the experiences that occur in social systems, particularly in the family as primary socialization context.
The problems of children with ADHD hampers the educational work of his parents, who often suffer from feelings of frustration, guilt, stress, low self-esteem, dissatisfaction with their parental role and mistrust in their parenting skills. Parents of children with ADHD are considered less competent in carrying out their role as parents and value their quality of life is unsatisfactory. They are often exposed social criticism because of the disruptive behavior of children, which eventually causes social isolation. Moreover, when compared with parents of children without ADHD are more depressed and consider their role as parents they are limited and conditions, greatly, personal time. Believe their children with ADHD have less emotional control and emotional and experiencing more difficulty concentrating and adapting to physical and social environment. They also show strong feelings of mismatch between their expectations and actual physical and emotional characteristics of their children.
Moreover, several empirical studies have provided information on the use of inappropriate methods of discipline in families with ADHD children: application of more aggressive strategies, use of disciplinary styles more authoritarian than parents of children with other psychopathology and less communication with their children even when they are preschoolers . In the same vein, observations of parent-child interactions have shown that parents who have children with ADHD use a more serious tone and make more negative comments about the behavior of their children, so that impose strict limits without offering explanations. By contrast, parents of children without ADHD are less tax and allow them to develop more independence. There is no doubt that children with ADHD lead to high levels of expression of negative emotions from their parents, that is, criticism, hostility or emotional over-involvement, which are associated with the development of behavioral problems in adolescence.
educational and clinical implications
Perhaps the most interesting practical conclusion is derived from the literature is the positive relationship between the stress of raising children with ADHD in the family Application inappropriate discipline techniques. Is an issue that has significance, and that disciplinary procedures characterized by the assertion of power, permissiveness or inconsistency are risk factors that increase the severity of the symptoms of ADHD and the emergence of eating disorders.
However, therapies designed to improve the symptoms of ADHD have had little impact on the quality of parenting or parental stress. Thus, data from the most comprehensive assessment to date of effectiveness of treatments for ADHD have reported that the three interventions were compared (intensive behavioral therapy, medication and combination of both) produced a greater reduction significant negative discipline / inefficient standard community treatment. However, the results were invalid in other domains of parenting, such as positive parenting, maternal depression, conflict between the couple or stress.
in mind the above considerations, counseling programs for parents should go beyond the model based solely on medication or behavior modification. Along with other components, you must provide parents with information to reduce their insecurity and feelings of guilt; facilitate strategies to reduce stress levels which may cause the behavior of their children, teach them to identify and assess progress, albeit limited, help to promote a clear division of responsibilities and roles, and build an authoritative parenting style, not coercive or overprotective.
INNOVATIONS IN THE PROGRAMS OF ADVICE TO PARENTS OF CHILDREN WITH ADHD
Some limitations in traditional programs aimed at parents have pushed in recent years the development of more complex therapeutic initiatives. Thus, Ades and Foreman have stressed the importance of group intervention with parents of children with ADHD to treat stress and the greatest number of problems faced in education of their children. The perceived benefits of such intervention group included: emotional support by sharing experiences and feelings about the impact of the problems of child with a group of parents, reducing the sense of isolation, the provision of information services relating to ADHD and improving relationships with their children due to increased knowledge.
Other experts, like DiGiuseppe, have opted for a comprehensive intervention that combines cognitive-behavioral strategies and
based on the needs of families with ADHD and a comprehensive model of action, Miranda and Garcia have raised an intervention program that includes six different modules:
Module 1. Education about ADHD
CONTENTS: History and alleged causes of ADHD. Core symptoms and associated problems. Outcomes in adolescence and adulthood. Information educational and economic rights. Community resources and how to get them.
OBJECTIVES: Correct errors of parents about the disorder and help create realistic expectations.
Module 2. Understanding of stress
CONTENTS: Definition
stress and recognize key. Effect of stress on parental roles. Stresses associated the paternity of children with ADHD: effective and ineffective ways of coping. Time management skills, relaxation techniques and coping stress.
OBJECTIVES: guide parents to find the balance between the demands of children, couples or partners and their needs.
Module 3. Cognitive restructuring CONTENTS: Teach and demonstrate the relationship between thoughts, emotions and behavior. Identify common cognitive errors and discuss its effects on emotions and behaviors. Replace cognitions mistaken for other more suitable.
OBJECTIVES: help parents develop realistic expectations about their children and themselves. Reduce arousa l
emotional when expectations are not met. Reduce the impact of the comments of others.
Module 4. Troubleshooting
CONTENTS: Description and modeling phases: - Identification and definition of the problem. - Generation of solutions (brainstorming
).
- Evaluation of alternatives. - Implementation of the chosen solution.
- Evaluation of results.
OBJECTIVES: train parents to provide adaptive responses to stressful situations. Increase their feelings of self-efficacy and self-control. Module 5. Communication skills
communication parent / child, couples, families and professionals in health and education. Description and modeling of effective strategies. Communication
basic premises. OBJECTIVES: obedience facilitate parent-child interactions. Increase support between the couple. Identify the needs of the child.
Module 6. discipline strategies
CONTENTS: Discuss the importance of consistency in the use of discipline in children with ADHD. Techniques for increasing positive behaviors (reinforcement, privileges). Techniques to decrease negative behavior (extinction, isolation, time out). Combined techniques (positive reinforcement and contingency contract).
OBJECTIVES: Use appropriate discipline, and support parents when they feel overwhelmed by their child's behavior.
CONCLUSION
families with children with ADHD should receive assistance in many aspects that go beyond increasing the structure of the environment and control of disruptive behaviors. also should be included in the advisory programs other skills needed to live and raise children with ADHD so that their emotional development progress normally.
A critical aspect is to reduce stress, improve parents' feelings about themselves and their children, helping them to redefine their perceptions of the child by training and strengthening powers of communication skills and problem-solving. SOURCE:
http://www.jmunozy.org/files/9/Necesidades_Educativas_Especificas/tdah/documentos/Fundamentacion_de_un_programa_multicomponencial_de_asesoramiento_a_flias-TDAH.pdf
[Rev Neurol 2008, 46 (Suppl. 1): S43-S45]
PMID: 18302121 - Review - Publication Date: 27/02/2008
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