J Child Fam Stud (2007) 16:385–400DOI 10.1007/s10826-006-9093-2ORIGINAL PAPERFamily Interactions in Children Withand Without ADHDGail Tripp · Elizabeth A. Schaughency ·Robyn Langlands · Kelly MouatPublished online: 23 December 2006CSpringer Science+Business Media, LLC 2006Abstract We used global ratings to compare the family (parent[s]-child) interactions of 51clinic-referred children with ADHD and 32 non problem children. Children and parent(s)were videotaped while engaging in problem solving and game playing activities. Independentcoders, blind to children’s diagnostic status, rated the interactions using measures designedto assess interaction competence and quality. Significant group differences emerged betweenthe ADHD and control groups during problem solving on the interaction quality measuresof Warmth, Engagement and Communication. Comparisons of the interactions of familiesof children with ADHD, with (ADHD W) and without (ADHD W/O) comorbid disruptivebehavior disorders, were non significant, although increased symptomology was associ-ated with reduced Warmth and Engagement during problem solving. Irrespective of groupmembership family interactions were more positive during game playing versus problemsolving.Keywords ADHD.Family interaction.Comorbidity.Observation.Family assessmentConceptualized as a neurodevelopmental disorder, Attention Deficit Hyperactivity Disorder(ADHD) is characterized by developmentally inappropriate inattention, impulsivity, and/orhyperactivity (American Psychiatric Association [APA], 1994). The disorder is estimatedto occur in 3–5% of school-age children and is often associated with significant concurrentand long-term psychosocial difficulties and comorbidities with other psychiatric difficulties(APA, 1994). This association is especially true for children with ADHD, combined type andG. Tripp ()Department of Psychology, University of Otago, P.O. Box 56, Dunedin, New Zealand;Okinawa Institute of Science and Technology,12-22 Suzaki, Uruma, Okinawa 904-2234, Japane-mail: [email protected]. A. Schaughency · K. MouatDepartment of Psychology, University of Otago, Dunedin, New ZealandR. LanglandsORYGEN Research Centre, Locked Bag 10, Parkville, Victoria 3052, AustraliaSpringer386 J Child Fam Stud (2007) 16:385–400other comorbid disruptive behavior disorders such Oppositional Defiant Disorder (ODD) orConduct Disorder (CD) (Power, Costigan, Eiraldi, & Leff, 2004).Research with families of children with ADHD is consistent with much research findingparent-child interactional differences between children referred for a variety of behavioraland developmental difficulties and typically developing children (Bell & Harper, 1977).Understanding parent-child interactions in families of children with ADHD is importantfor two reasons: (1) the potential role family functioning plays in long-term prognosis ofchildren with ADHD (Ingram, Hechtman, & Morgenstern, 1999); and (2) the associationof negative child behavior and parent-child interactions with parental adjustment in thispopulation (Johnston & Mash, 2001).Descriptive research on parent-child interactions of children with ADHD during the 70s(then known as “hyperactivity”) and 80s (ADD/H) found children with this disorder to bemore negative and less compliant with their parents, and their parents to be more directiveand negative with them, when compared to non-identified children and their parents (e.g.,Barkley, 1998). However, several unresolved issues remained regarding the nature of theseobserved differences, including (1) the contributions of disruptive behavioral comorbidity tothe observed interaction patterns, (2) potential constraints of the experimental paradigm, and(3) appropriate interpretation of the observed pattern of results (Johnston & Mash, 2001).During the1980s, evidence accumulated supporting attention disorders and CD as separatediagnostic constructs with significant comorbidity, raising the question of whether correlatesof ADHD were due to ADHD or to comorbid behavioral difficulties (Hinshaw, 1987). Someresearch addressing family correlates of ADHD suggested that several family variables maybe associated predominantly with general behavioral difficulties or CD (Barkley, 1998), withnegative emotional climate, maternal hostility, and conflictual parent-child interactions morestrongly associated with families in which the child has comorbid oppositional behavior(Barkley, 1998; Seipp & Johnston, 2005).Most research on parent-child interactions of children with and without ADHD wasconducted using parent-child dyads, typically mothers and sons (Johnston & Mash, 2001).Often parent-child interactions were observed in at least two situations—one, a more childled or play activity, the other a more adult led or task activity. Typically, differences betweenparent-child interactions of children with and without ADHD were more pronounced in taskcompared with free play settings (Barkley, 1998). Extensions of this work included dyadsof fathers and sons (Johnston, 1996) or triads of parents and sons (Buhrmester, Comparo,Christensen, Gonzalez, & Hinshaw, 1992). Interactions between boys with ADHD and theirparents varied, depending on the constellation of participants (Buhrmester et al., 1992).Taken together, these findings suggest context influenced observed parent-child interactionsof children with ADHD.Dependent variables typically involved rates of behavior (e.g., rates of child compliance,frequency of maternal commands). Because children with ADHD behave differently thantheir non referred peers, quantitative differences in parent-child interactions between chil-dren with ADHD and typically developing children would be expected from an interactionistperspective postulating bi-directional influences in parent-child interactions (Bell & Harper,1977). Differences in parental behavior observed in parent-child interactions may be due toparental response to the behavioral differences of their children (Schaughency, Vannatta, &Mauro, 1993). Acknowledging that parent-child interactions of children with and withoutADHD differ, anecdotally clinical researchers have observed potentially meaningful differ-ences among families of children with ADHD in the quality of these interactions. Whilesome family interaction patterns seemed coercive (Patterson, 1982), these professionals in-formally noted that other parents appeared to provide additional support and structure neededSpringerJ Child Fam