Enhancing interactions of fathers and their children with attention deficit hyperactivity disorder

2004·6.2 MB·English

by  White, Deborah Ann.

ENHANCINGINTERACTIONSOFFATHERSANDTHEIRCHILDREN
WITHATTENTIONDEFICITHYPERACTIVITYDISORDER
By
DEBORAHANNWHITE
ADISSERTATIONPRESENTEDTOTHEGRADUATESCHOOL
OFTHEUNIVERSITYOFFLORIDAINPARTIALFULFILLMENT
OFTHEREQUIREMENTSFORTHEDEGREEOF
DOCTOROFPHILOSOPHY
UNIVERSITYOFFLORDIA
2004
TothememoryofmymotherMargaretEllenMcConville-White.Althoughmy
timewithherwastooshort,sheisandhasalwaysbeenasourceofinspirationand
unwaveringstrength.
TomychildrenGreggandMerissa. Ofalltheblessingsinmylife,Iammost
proudtobetheirmother.
ACKNOWLEDGMENTS
Thepursuitandcompletionofadoctorateinphilosophyhasbeenachallenging
journeyofpersonalandprofessionalgrowth. Iwouldliketooffermygratitudeand
sincereappreciationtoeachandeverypersonwhocontributedtothecompletionofthis
dissertation. Iamespeciallygratefultomychildren,GreggandMerissafortheirbelief
inme,andtheirlove,understanding,andsupportthroughoutthisproject.
IgratefullyacknowledgethesupportandencouragementthatIreceivedfromDr.
JenniferElder. Dr.Elderhasbeentheidealadvisor/chair,mentor,andfriend. Withher
guidance,support,andpatienceIwasabletocompletethedissertation. Iamalso
appreciativeoftheopportunitytoworkasaresearchassistantinherstudywithparentsof
childrenwithautism. Thisexperienceprovidedvaluableinsightintothedevelopment
andimplementationofmyresearch.
Iwouldliketoextendmygratitudeforthecontributionsofeachcommittee
member(Dr.MaureenConroy,AssociateProfessorofSpecialEducation;Dr.Tanya
Murphy,AssociateProfessorofPsychiatry;andDr.RindaAlexander,Professorof
Nursing). Theiruniquetalents,constructiveadvice,andguidancewereappreciated.
Also,IwouldliketothankDr.CarolynYuchafortheopportunitytoworkasaresearch
assistantintheCollegeofNursingOfficeofResearch.
IamgratefultotheNationalInstituteofNursingResearchforthePre-Doctoral
FellowshipServiceAward(NRSA:F31NR0756701). Thisawardprovidedthefinancial
supportnecessarytocontinuemyeducationandresearch. Iamalsogratefulforthe
iii
scholarshipsupportthatIreceivedfromtheCollegeofNursing. Finally,Iwouldliketo
gratefullyacknowledgeandextendsincerethankstomyfamilyandfriends. Myfather,
Chip,Joe,Cathy,Lori,Linda,Ilona,andHectorprovidedaconstantsourceofenergy,
support,andencouragement.
IV
1
TABLEOFCONTENTS
PaRe
ACKNOWLEDGMENTS Hi
TABLEOFCONTENTS v
LISTOFTABLES viii
LISTOFFIGURES x
ABSTRACT xii
CHAPTER
1 INTRODUCTION 1
AnalysisoftheParentTrainingConcept 1
AnalyzingtheRangeofMeaningoftheParentTrainingConcept 2
RelatedTheoreticalPerspectives 3
AttentionDeficitHyperactivityDisorder(ADHD) 7
TheoreticalSignificanceinNursing 8
ParentTrainingResearchinNursing 9
OperationalizationofParentTraining 10
StatementofthePurpose 1
2 REVIEWOFLITERATURE 13
FeaturesofADHDinYoungChildren 14
CharacteristicsofADHD 16
AssessmentandDiagnosticProcessinChildrenwithADHD 17
ResearchonChildrenwithADHD 19
PharmacotherapyResearch 21
ParentTrainingInterventionResearch 21
In-HomeParentTraining 25
TheRoleofFathersinChildhoodBehaviorProblems 25
TheRoleofSocialReciprocityinParentTraining 27
Summary 28
METHOD 37
RationaleforUseofSingleSubjectDesign 37
ResearchPlan 39
RecruitmentofSubjects 39
InclusionCriteria 40
ExclusionCriteria 40
InstrumentsforDescribingSubjects 41
DescriptionofanIn-HomeParentTrainingInterventionforFathers 43
ProcedureforImplementingtheParentTrainingIntervention 44
ConditionA-Baseline 44
ConditionB-IntroductionofParentTrainingSessions1,2,and3 45
InstrumentsandProcedureforMeasuringtheDependentVariables 45
In-HomeObservation 46
BehavioralObserverTraining 47
BehavioralResponseCategories 48
RESULTS 51
FatherandChildDyadA 51
FrequenciesofTargetBehavior 55
VisualReportofData 57
FatherandChildDyadB 59
FrequenciesofTargetBehaviors 62
VisualReportofData 64
FatherandChildDyadC 65
FrequenciesofTargetBehaviors 68
VisualReportofData 70
FatherandChildDyadD 72
FrequenciesofTargetBehaviors 75
VisualReportofDataforFatherandChildDyadD 78
SummaryoftheFourFatherandChildDyads 79
InterobserverAgreement 83
SocialValidity 84
DISCUSSION 104
InterpretationofFindings 105
UtilityofSingleSubjectDesigninNursingResearch 107
LimitationsAssociatedwiththisResearch 109
ImplicationsforClinicalPractice Ill
RecommendationsforFutureResearch 112
VI
APPENDIX
A OPERATIONALDEFINITIONSFORDEPENDENTVARIABLES 114
B PARENTTRAININGINTERVENTIONFOR FATHERSOFYOUNG
CHILDRENWITHADHD 117
Ground-Rules 117
Homework 117
Schedule 117
ParentTrainingSession1 118
ParentTrainingSession2 118
ParentTrainingSession3 119
C THEPARENTINGSCALE 120
D INTERACTIONSQUESTIONAIRE 122
E HOLLINGSHEADFOURFACTORINDEXOFSOCIALSTATUS 130
F CHILDBEHAVIORCHECKLIST 132
G THERAPYATTITUDEINVENTORY 136
H SEMISTRUCTUREDQUESTIONAIRE 137
REFERENCES 139
BIOGRAPHICALSKETCH 153
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1
LISTOFTABLES
Table Page
2-1 Reviewofparenttrainingliterature 30
3-1 Correspondencebetweeninstrumentationandsamplecharacteristics 49
3-2 In-homeparenttraininginterventionforfathers 49
3-3 Timelinefortheparenttrainingintervention 49
3-4 Procedureforinstrumentationandvideotaping 50
3-5 Correspondenceamongthevariables,instruments,andmeasurements 50
4-1 SummaryofFatherAeffectivenessindiscipline 85
4-2 SummaryofFatherAbeliefsaboutchildnoncompliance 85
4-3 MeansoftargetbehaviorsforFatherAandChildA 85
4-4 SummaryofFatherBeffectivenessindiscipline 86
4-5 SummaryofFatherBbeliefsaboutchildnoncompliance 86
4-6 MeansoftargetbehaviorsforFatherBandChildB 86
4-7 SummaryofFatherCeffectivenessindiscipline 87
4-8 SummaryofFatherCbeliefsaboutchildnoncompliance 87
4-9 MeansoftargetbehaviorsforFatherCandChildC 87
4-10 SummaryofFatherDeffectivenessindiscipline 88
4-1 SummaryofFatherDbeliefsaboutchildnoncompliance 88
4-12 MeansoftargetbehaviorsforFatherDandChildD 88
4-13 Comparisonoffamilydemographics 89
vm
4-14 Comparisonofdescriptivedataforsubjectsatcompletionofstudy 90
4-15 Meanandrangeofinterobserveragreement 91
4-16 Comparisonofmeansofreportedscoresoffather'sperceptions 91
4-17 Summaryoffather'ssatisfactionwithparenttraining 91
IX
1
LISTOFFIGURES
Figures Page
1-1 Parenttrainingprocess 12
4-1 FatherAinitiationsandChildAinitiations 92
4-2 FatherArespondingbehaviors 92
4-3 ChildAresponsesandimitationwithanimation 93
4-4 FatherAinitiationsandChildAresponses 93
4-5 FatherAandChildAturntaking 94
4-6 FatherBinitiationsandChildBinitiations 94
4-7 FatherBrespondingbehaviors 95
4-8 ChildBresponsesandimitationwithanimation 95
4-9 FatherBinitiationsandChildBresponses 96
4-10 FatherBandChildBturntaking 96
4-1 FatherCinitiationsandChildCinitiations 97
4-12 FatherCrespondingbehaviors 97
4-13 ChildCresponsesandimitationwithanimation 98
4-14 FatherCinitiationsandChildCresponses 98
4-15 FatherCandChildCturntaking 99
4-16 FatherDinitiationsandChildDinitiations 99
4-17 FatherDrespondingbehaviors 100
4-18 ChildDresponsesandimitationwithanimation 100