Quality of life of children with a diagnosis of attention deficit/hyperactivity disorder: a comparison of parent and child perspectives
Galloway, Helen Catriona
Objectives: Available studies largely and consistently indicate that children with Attention Deficit Hyperactivity Disorder (ADHD) experience significantly impaired quality of life (QoL). More research is required to enable an enhanced understanding of factors which contribute to the QoL of children with this diagnosis. In relation to children with ADHD, this thesis had two main aims: to review the extent to which children and their parents agree in their assessments of the child’s QoL; and to examine the impact of parent stress on the child’s QoL from both parent and child perspectives. Method: A systematic review of studies reporting matched parent-proxy reported and child self-reported quantitative QoL measures is described in journal article 1. Journal article 2 presents the findings from a cross-sectional, quantitative study involving a matched sample of 45 children with a diagnosis of ADHD, and their parents. Correlation and multiple regression analyses examine the relationship between parent stress and each of the informants’ ratings of the child’s QoL. Results: The findings of the systematic review indicated that in a clear majority of studies, children rated their QoL more highly than their parents. However, cautious interpretation is required as some of the studies were of poor methodological quality. In the empirical study, parent stress emerged as a significant predictor of parent proxy-ratings of child QoL, but not of self-rated QoL. Parents who rated their child’s QoL lower that their children had higher perceived stress than parents who rated their child’s QoL higher than their children. There were no significant differences in self-rated or parent-rated QoL between children with ADHD and children with a learning disability or with an Autism Spectrum Disorder. In line with some previous research, agreement was poorer on psychosocial domains than physical domains. However, due to the relatively small sample size, the empirical study requires replication. Conclusions: The results of the systematic review suggest that parent and child ratings of the child’s QoL are not interchangeable in the context of ADHD. Possible explanations for this trend are discussed. The empirical study suggests that parent stress negatively impacts on children with ADHD, and that it is likely that children’s self-reports are affected by their impaired reflective capacity. Clinical implications and recommendations for future research are discussed in relation to both articles.