Parent-child Interaction of Children with ADHD: Research and Clinical Implications

注意力不足過動症兒童之親子互動：研究及臨床之意涵

李佩秦(Pei-Chin Lee)

《職能治療學會雜誌》 25卷1期 (2007/07) Pp. 34-44

https://doi.org/10.6594/JTOTA.2007.25(1).03

摘要

由於注意力不足過動症(ADHD)兒童對於指令遵從度低、活動量高、行為衝動，教養ADHD兒童對於父母而言，是一件相當艱難的任務。回顧現有ADHD兒童親子互動的研究發現，親子互動品質不僅影響ADHD兒童的問題行為，也會影響兒童面對困難情境時的情緒調適及因應策略；相較於一般兒童，ADHD兒童在親子互動中，要求較多的協助及針對表現的回饋、比較容易分心、配合度低、較缺乏調整情緒的有效方法。ADHD家長的親職效能及心理功能較一般家長低落，且會因ADHD兒童合併其他行為問題而更加惡化。除了ADHD兒童是否合併其他行為疾患，兒童的年齡、家長的親職技巧、家長對於ADHD兒童的認知會影響ADHD兒童親子互動的品質。.本文將以惡性循環理論解釋ADHD兒童親子互動的交互作用，在ADHD兒童問題行為的發生及維持，以及家長親職效能低落與心理調適不良所扮演的角色。對於ADHD兒童評量及介入的計畫應該包括兒童的行為及情緒議題、父母的親職行為及心理調適、以及親子互動的品質。

關鍵字

注意力不足過動症兒童 ； 親子互動 ； 惡性循環理論

並列摘要

Raising a child with attention-deficit hyperactivity disorder (ADHD) is an incredible challenge for parents because of the child´s noncompliant, overactive, and demanding behavior. A review of current research reveals, not only the problematic behaviors of children with ADHD, but also, that their coping strategies for challenges are influenced by the parent-child interaction or vice versa. Children with ADHD request more feedback about their performance and ask for more help on task performance. They are also more distracted, less compliant, and show less constructive patterns of coping than children without ADHD. Parents of children with ADHD often present with poor parenting practices and decreased psychological functioning, which is even more exacerbated in parents of children with ADHD and other externalized behavioral disorders. The child´s age, parenting strategies and parental perceptions of the child with ADHD might mediate or moderate the quality of parent-child interaction. A coercion theory explains the reciprocity of parentchild interaction in the establishment and maintenance of childhood behavioral problems as well as poor parental mental health and parental practice. The focus of assessment and intervention for children with ADHD should include the behavioral and emotional issues of the child, parental behavior and adjustment, as well as the quality of parent-child interaction.

並列關鍵字

children with attention deficit hyperactivity disorder ； parent-child interaction ； coercion theory