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Indian Mothers’ Perceptions of and Responses to ADHD Behaviors in Children
Attention Deficit Hyperactivity Disorder (ADHD) is highly prevalent in children worldwide as the associated behaviors have been found to be consistent cross culturally (Faraone, Seargeant, Gillberg, & Biederman, 2003). ADHD is a heterogeneous mental health disorder of unknown etiology that is mainly diagnosed in childhood and continues through into adulthood. Children diagnosed with ADHD are hyperactive, unable control their impulses, and/ or have trouble paying attention to the point it interferes with their school and home life (Farone et al., 2003). Although there is limited information about the prevalence of ADHD in Indian contexts, it is estimated that 11.32% of primary school children in India have been diagnosed, with the prevalence highest among males and lower socio-economic groups (Venkata & Panicker, 2013).
An ADHD diagnosis does not only impact the child, but also leads to an associated stigma for their mothers. Specifically, maternal parenting styles and child behavioral outcomes are closely linked, such that Indian mothers are held responsible for children’s negative externalizing behavior, regardless of a medical diagnoses (Jacobs, Woolfson, & Hunter, 2016; John, 2012; John, Bailey, & Jones, 2016). This is due in part to cultural attitudes towards mental health, and ADHD’s enormous impact on outcomes, including familial interpersonal stress, interference with academic and vocational activities, and negative effects on self-esteem (Trani et al., 2015 Viswanath & Chaturvedi, 2012). Thus, it is important to understand Indian mothers’ perceptions of ADHD, and their beliefs about appropriate responses to when their children exhibit related behaviors.
Unfortunately, research examining the influence, content, and quality of maternal communications within Indian populations is limited. This is problematic as such knowledge offers the potential of understanding how culture informs parenting styles and responses to behavioral problems cross culturally. This has implications for the development of global behavior based interventions (Faraone et al., 2003), and culturally appropriate parent- child programming for racially/ ethnic diverse immigrant populations in the United States (Jacobs et al., 2016).
Research Questions. To address this void in the literature, this mixed methods study seeks to identify 1) Indian mothers’ perceptions of ADHD behaviors, and 2) their own and family members’ potential responses if their child were to exhibit these behaviors.
Methods. Data will be collected during the 2017 Department of Psychology Global Health Study Abroad program in Mysore, India. The project mentors, Drs. Dionne Stephens (Psychology) and Purnima Madhivanan (Public Health), are conducting research at the Public Health Research Institute of India (PHRI), and have access to the necessary resources and populations for this study. Mixed methods will be used to determine Indian mothers’ beliefs about behaviors associated with ADHD. The qualitative work will take the form of three hour-long focus groups with 7 to 10 mothers of children between the ages of 5 and 12. Mothers will be asked about their perceptions of ADHD behaviors and how they would respond to these behaviors if their children exhibit these. This data collected supplemented by a quantitative survey to be completed by 75 mothers; using the Centers for Disease Control (CDC) ADHD Checklist for Children the survey will assess the presence of and responses to ADHD symptoms in their children. For their participation, participants will receive a $2 USD cash as compensation; this has been deemed appropriate by institutional review board at FIU and PHRI for similar studies.
Using NVivo qualitative analysis software, the study will identify the most common beliefs about ADHD related behaviors based on the beliefs generated in the qualitative data collection. The quantitative surveys will be analyzed using SPSS to identify base line maternal ADHD knowledge, and overall attitudes about appropriate child externalizing behaviors within the context of Indian culture.
References
Faraone, S. V., Seargeant, J., Gillberg, C., & Biederman, J. (2003). The worldwide prevalence of ADHD: Is it an American condition? World Psychiatry, 2, 104- 113.
Jacobs, M., Woolfson, L. M. & Hunter, S. C. (2016), Attributions of Stability, Control and Responsibility: How Parents of Children with Intellectual Disabilities View their Child's Problematic Behaviour and Its Causes. Journal of Applied Research on Intellectual Disabilities, 29, 58–70.
John, A. (2012), Stress among Mothers of Children with Intellectual Disabilities in Urban India: Role of Gender and Maternal Coping. Journal of Applied Research in Intellectual Disabilities, 25, 372–382
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John, A., Bailey, L. E., & Jones, J. L. (2016). Culture and context: exploring attributions and caregiving approaches of parents of children with an intellectual disability in urban India. Child & Family Social Work, doi: 10.1111/cfs.12282.
Trani, J., Bakhshi, P, Kuhlberg, J., Narayanan, S. S., Venkataraman, H., Mishra, N. N., Groce, N. E,. Jadhav, S., & Deshpande, S. (2015). Mental illness, poverty and stigma in India: a case–control study. British Medical Journal, 5(2), e006355.
Venkata, J. A., & Panicker, A. S. (2013). Prevalence of attention deficit hyperactivity disorder in primary school children. Indian Journal of Psychiatry, 55, 338- 342.