The impact of early morning functional impairments on family dynamics
Caregivers of children with ADHD describe the early morning experience as generally chaotic.
Chaos is a result of the untimely actions or inactions of their children from the instant they awaken to the moment they leave the household for school.1
Children with ADHD frequently display behaviors associated with inattention, restlessness, disruptiveness, impulsivity, noncompliance to instruction and disorganization that affect those living in the same household.1,2
“Parents become so frustrated with their children who are off task, disorganized, and running late, that they end up yelling and getting the day off to a very stressful start for themselves and their children.”
- Mary Ann McDonnell, RN, MS, CS, FPNP
Child and Adolescent Clinical Nurse
Specialist and Family Nurse Practitioner
“Many parents express that the morning routine sets the tone for the rest of the day; positive mornings result in a constructive, more focused attitude that lasts throughout the day”
- Andrea Marraffino, PhD
ADHD has been shown to have negative effects on families as a whole, causing2:
Disturbed interpersonal relationships
Less perceived family cohesiveness
Greater caregiver-child and sibling conflicts
Higher incidences of divorce and separation
Because of the child’s ADHD symptoms during the early morning, caregivers of children with ADHD report2:
Caregiver reactions to ADHD symptoms that affect EMF2*
“Many caregivers of children with ADHD describe the stress caused by early morning functional impairments as ‘chronic’ and ‘severe’. Factors that contribute to this stress include sibling conflicts, and failure to get ready in the morning, resulting in difficulty getting to school and/or work on time.”
- Floyd R. Sallee, MD, PhD
Adapted from Sallee, 2015.
ADHD symptoms during the early morning have a negative impact on primary caregivers3†
Aspect of caregiver’s life affected by child’s ADHD symptoms
Proportion of caregivers having administered medication prior to child’s normal awakening time
47% of these caregivers did this at least 5 days a week
- 24% of these caregivers did this every day
This approach is disruptive to the child’s sleep and caregivers would find an alternative option valuable
Caregivers value better management of their child’s ADHD during the early morning to:
Reduce their and their families’ levels of stress and frustration
Mothers of children with ADHD are more likely to report:
A lower overall quality of life
Viewing their child as limiting their family’s activities during the morning period and less likely to report that their child made them feel good as a parent, in comparison to mothers with children without an ADHD diagnosis4‡
* Information was obtained from primary caregivers (n=201) of children and adolescents with ADHD currently treated with stimulants, using a self-administered, online, anonymous, quantitative research survey.
† Results obtained from administering an online, 57-item survey to a total of 240 patients and/or caregivers of children with ADHD.
‡ Results obtained from a study designed to map the challenges of everyday family life in a sample of children (27 with ADHD, 25 without ADHD). Children with ADHD included in the study were treated with stimulants. Across 7 days, mothers and children independently reported their moods, behaviors and social contexts every 30 minutes during nonschool hours, using an electronic diary. After each day, morning and afternoon/evening summary diaries were also obtained from mothers.