Parenting as an adult with ADHD

Many adults first consider ADHD in themselves while sitting in a child's evaluation, hearing a description that fits their own school years. Others were diagnosed long before they had children and now find that parenting asks for exactly the skills ADHD makes hard: planning, consistency, patience under noise. This article covers what is known about ADHD in families, what the research says about parenting with ADHD, and which supports have evidence behind them.

ADHD runs in families

ADHD is among the most heritable conditions in psychiatry. A review of family, twin and adoption studies published in Molecular Psychiatry put its heritability at 74%, and cited a study of 894 children with ADHD and 1,135 of their siblings that found a ninefold increase in ADHD risk among the siblings.

Heritability is a population statistic. It describes how much of the variation in ADHD across a population is explained by genetic differences. A 74% figure does not mean a parent with ADHD has a 74% chance of having a child with ADHD, and it does not mean any particular child will or will not be affected. No genetic test diagnoses ADHD.

The practical consequence runs in both directions. When a child is diagnosed, it is reasonable for a parent who recognizes the same lifelong pattern to seek an evaluation. A parent with ADHD, in turn, can reasonably watch for the signs in a child without assuming them. An adult diagnosis requires that several symptoms were present before age 12, so a parent's own school history is part of the evidence.

What studies say about parenting with ADHD

A 2017 meta-analysis in Clinical Psychology Review pooled 32 studies of parents' ADHD symptoms and their parenting behavior. Parents with more ADHD symptoms showed, on average, somewhat more harsh parenting, somewhat more lax or inconsistent parenting, and somewhat less positive parenting.

The size of those effects deserves as much attention as their direction. Parental ADHD symptoms accounted for 2.9% of the variation in harsh parenting, 3.2% in lax parenting and 0.5% in positive parenting. The authors called the associations significant but relatively small, and similar in size to those seen with other parental mental health conditions. Put plainly, ADHD is one influence on parenting among many, and most of the difference between parents is explained by other things.

Pooled studies of this kind show an association and cannot show that ADHD causes a given parenting pattern. Children with ADHD are also harder to parent, which pushes in the same direction.

Where it tends to show up at home

The research findings map onto everyday situations that parents with ADHD describe.

These supports are common-sense adaptations, not tested treatments. The difficulty of starting, sequencing and finishing tasks that sits behind most of them is explained in executive dysfunction in adults with ADHD.

Treating the parent's ADHD

If parenting is harder because of untreated ADHD, treating the parent is the obvious step, and the evidence supports it with a caveat. A 2012 review in CNS Drugs by researchers who ran trials with mothers reported that stimulant medication was associated with reductions in the mothers' ADHD symptoms. Effects on parenting itself were limited, and the authors concluded that medication alone "may not be sufficient for many families."

That matches the wider adult evidence. The American Academy of Family Physicians review rates stimulants as first-line medication for adult ADHD and recommends cognitive behavioral therapy as a non-drug treatment. Symptom control gives a parent more capacity. Using that capacity for routines and calmer discipline still takes deliberate work. An overview of how treatment and follow-up are organized is on the adult ADHD treatment page.

Parents who are pregnant, planning a pregnancy or breastfeeding face separate medication questions, covered in ADHD medication, pregnancy and the postpartum period.

Parent training when the parent has ADHD too

For a child with ADHD, the CDC describes parent training in behavior management as a core treatment. It states that behavior therapy is most effective in young children when delivered by parents, and that parent training has been shown to work as well as medication for ADHD in young children.

Parent training asks a parent to track behavior, respond the same way each time and keep it up for weeks. A 2011 study of 70 mothers of 6 to 10 year old children with ADHD found that mothers with more ADHD symptoms of their own saw less improvement in their child's behavior after a brief parent training program. The difference was partly explained by smaller changes in negative parenting. Its authors suggested that families in which both mother and child have ADHD may need treatment for the adult's ADHD combined with parent training.

This is a reason to tell a child's clinician or parent trainer about your own ADHD. A program can be adapted with written summaries, reminders between sessions and smaller steps. It is also a reason not to read a slow result as personal failure.

Practical supports that do not depend on willpower

• Divide tasks by strength. If there are two adults in the home, the one without ADHD may be better placed to run the calendar while the other handles tasks that are active and immediate. The strain this can put on a couple is covered in adult ADHD and relationships.
• Put it outside your head. School portals, automatic bill payments, recurring alarms and a single family calendar reduce the number of things that rely on memory.
• Lock up medication. Stimulants are controlled substances. Keep them in the original pharmacy container, locked, and out of reach of children and teenagers.
• Protect sleep. A parent who is short of sleep has less attention and less patience, with or without ADHD.
• Find other parents. The CHADD chapters in Nassau, Suffolk and Westchester-Putnam serve parents as well as adults with ADHD. Details are in the guide's support group directory.

Getting evaluated as a parent

A child's diagnosis does not diagnose the parent, and a strong family resemblance is not enough. An adult evaluation looks at childhood history, current impairment in more than one setting and other explanations such as anxiety, depression and sleep loss, all of which are common in parents of young children. Report cards, a grandparent's recollections and a partner's observations are useful to bring.

The next step is deciding who should do the evaluation. Who can diagnose and treat adult ADHD in New York compares the professions and what each can and cannot do. If parenting stress has reached the point of crisis, call or text 988 at any hour.