Children with ADHD draw-and-tell about what makes their life really good

Participant-generated timelines as a novel strategy for assessing youth resilience factors: A mixed-methods, community-based study

PURPOSE

The purpose of this study was to explore youth perceptions of resilience through participant-generated timelines as a potential new strategy for nursing research and practice.

DESIGN AND METHODS

We used a concurrent triangulation design to collect and analyze qualitative and quantitative data from a statewide, community-based sample of 448 youth ages 8 to 17 years. We collected three sources of data during two waves of data collection in 2019 and 2021: a participant-generated timeline, a brief structured interview, and a PROMIS pediatric global health measure.

RESULTS

The timeline activity was easy to administer and well accepted by youth in a community setting. Youth reporting an adverse experience or mental health challenge in the previous year had unique patterns of variability in the timelines, and more frequently reported certain resilience factors, including family support and regulatory, interpersonal, and meaning-making assets. Pandemic-related differences were noted between the two cohorts.

CONCLUSIONS

The timeline drawing activity reflects and extends findings from a standard measure of global health. This activity benefits both the participant and the clinician or researcher by helping youth to communicate how they make sense of the world, honoring different ways of knowing and prompting recollection of coping appraisals and resilience factors.

PRACTICE IMPLICATIONS

Participant-generated timelines are a developmentally appropriate and interactive strategy for assessing youth perceptions of their internal strengths. In conjunction with traditional assessments, this strategy may support the identification of malleable targets for intervention in practice with youth who have experienced adversity or mental health challenges.

Co-production of a nature-based intervention for children with ADHD study (CONIFAS): Protocol for co-production phases

Children with Attention Deficit Hyperactivity Disorder can face difficulties with inattention, hyperactivity, and impulsivity, which can impact many areas of their lives, including their educational attainment and social and emotional wellbeing. Involvement in nature-based activities can reduce these difficulties and improve wellbeing, but there are limited resources for supporting children with this diagnosis to access these approaches and no nature-based interventions designed with and for this group. This protocol describes a co-production study in which children diagnosed with Attention Deficit Hyperactivity Disorder aged 5–11 years old, their parents/guardians, and professionals will attend a series of workshops to share their knowledge to co-produce a new nature-based intervention for this population of children. We aim to understand how the children’s’ experiences of Attention Deficit Hyperactivity Disorder may affect their interactions with nature, identify how activity in and with nature may help with symptom reduction and general wellbeing, and co-produce an intervention for families which applies our learning. The result of this study will be the designed intervention and insights into how children and young people with Attention Deficit Hyperactivity Disorder interact with nature. The prototype intervention will then undergo feasibility testing in a future study.

Trail registration:NIHR203043; ISRCTN11763460.

What Predicts Life Satisfaction in Children and Adolescents with Attention-Deficit/Hyperactivity Disorder (ADHD)? A Study from Parent and Child/Adolescent Perspectives

The aim of this study was to analyze life satisfaction in a sample of 70 children and adolescents (M = 12.21, SD = 2.85) with Attention-Deficit/Hyperactivity Disorder (ADHD), according to parents' and children's/adolescents' reports. In addition, we examined the influence of a series of child/adolescent variables (ADHD presentation, and Conduct Disorder (CD) symptoms, age, gender, and pharmacological support status) on their levels of life satisfaction. Results indicated moderate correlations between children's/adolescents' and parents' perceptions of life satisfaction (r = .40; p < .01), with school being the area with the lowest levels of satisfaction. Also, 44.3% of the sample of parents reported that ADHD drastically interferes negatively in this context. Examining the effects of child/adolescent variables, only the variables age and CD symptoms generated statistically significant differences, showing that as children/adolescents grow up and/or present associate symptoms of CD, perceptions of life satisfaction tend to be more negative. These variables explained 34.5% of the variance of a composite score of life satisfaction, demonstrating a negative effect over the dependent variable. These results might have important implications for diagnosis and intervention in ADHD, as they highlight the relevance of considering life satisfaction as an important aspect to consider in both processes. Further studies must look more deeply into the mechanisms that explain these findings.

Life satisfaction in children with attention deficit hyperactivity disorder: Looking beyond proxy reports

PROBLEM

A common clinical approach to children with attention deficit hyperactivity disorder (ADHD) is to view them through an adult-proxy report of problems. There is little evidence on how children with ADHD evaluate their life satisfaction, how their evaluations compare with unaffected children, or how their perspectives might inform clinical practice.

METHODS

A parallel convergent mixed-methods design was used to interview 20 children (aged, 7-11 years) with ADHD. This report presents the children's responses to the 40-item Multidimensional Student Life Satisfaction Scale. Parents/guardians ( N = 20) provided contextual data consisting of demographics, ADHD-related items, and health literacy.

FINDINGS

Total life satisfaction (M = 3.08, SD = 0.35) fell within the 95% CI [2.91, 3.25] of comparative data. Overall subscale ratings (high to low) included: friends (M = 3.24, SD = 0.60), living environment (M = 3.14, SD = 0.51), family (M = 3.08, SD = 0.51), school (M = 3.0, SD = 0.65), and self (M = 2.93, SD = 0.60). Positive and negative associations are reported.

CONCLUSIONS

Including a measure of life satisfaction adds a child-centered approach to understanding children with ADHD beyond an adult-proxy report of problems that is contextually and clinically relevant.

Ask me: Children's experiences of pain explored using the draw, write, and tell method

PURPOSE

Pain management within emergency departments (ED) remains challenging. Given that unrelieved pain in children is linked to a number of negative physiological and psychological consequences, optimal management of children's pain is paramount. Many studies exploring children's pain have adopted quantitative methods or sought the perspectives of adults. Compared to adults, studies examining children's views on pain and pain management are limited. This study aimed to explore children's pain experiences, their perception of pain management and expectations of the role of the nurse.

DESIGN

This was a qualitative descriptive study using an inductive approach.

METHODS

Fifteen children, aged 4-8 years who presented to the ED of an Australian tertiary pediatric hospital in acute pain participated. Data were collected using draw, write, and tell (DWT) technique and analyzed using thematic analysis.

RESULTS

Three themes emerged (1) "Security," (2) "My pain" with subthemes: "The pain feelings" and "My sad/happy feelings," (3) "Comfort and relief" with subthemes: "Taking my mind off it," "Resting" and "Hospital things." When in pain children needed to feel secure. Parents and nurses were important in fostering a secure environment for children. Children were capable of describing their pain and identified nonpharmacological strategies to help their pain.

PRACTICE IMPLICATIONS

Children as young as 4 years old can provide detailed accounts of their pain, which extends beyond physical dimensions to include visual, auditory, and sensory features. Nurses need to listen, be honest, and develop trust with children to be helpful. Nonpharmacological pain-relieving strategies can be implemented by parents and nurses in collaboration with the child. Fostering a secure environment is essential.