Study: Children with ADHD Struggle Doing Chores Independently and Satisfactorily
The benefits of doing chores are well known, but a new study says children with ADHD may miss out on these life skills and lessons because they struggle to complete household and personal tasks independently and satisfactorily.
February 26, 2020
According to a new national study, children with ADHD struggle more than their neurotypical peers to complete household chores without reminders and/or assistance. Of the 797 primary caregivers surveyed, fewer than one third reported that their children with ADHD often or very often complete chores satisfactorily or independently. Additionally, this study found that more than 90% of parents believe that ADHD impedes their child’s ability to complete chores well.1
A wealth of research suggests that household routines and chores play an important role in a child’s development and psychosocial adjustment. Some studies have even linked engagement in household routines to lower levels of depression and anxiety,2 improved impulsivity control, and greater self-regulatory capacity in children.3 One study called household chores essential to a child developing a “sense of predictability, stability, and feeling of security.”4 Additionally, longitudinal studies tell researchers that the benefits of household routines and chores will continue to benefit a child’s life as participation in household chores is strongly predictive of future positive relationships with family and friends, decreased rates of substance use, and professional success during adulthood.5
This new study, published in the Journal of Attention Disorders, investigated the relationship between ADHD and household chore performance in a large, diverse national sample of youth. The study included 797 primary caregivers of children with ADHD between the ages 6 and 18. All participants’ children lived with them during the school year, and all participants lived in the United States. The study excluded children with comorbid autism spectrum disorder, intellectual disability, or another serious condition that would significantly compromise their ability to complete chores, such as cerebral palsy or arthrogryposis. Participants of this study comprised only of primary caregivers of children with ADHD: Thus, there is no non-ADHD control group available for comparison.1
The CDC-supported public information center, the National Resource Center for ADHD, and CHADD, a national nonprofit organization, recruited participants for this study through inquiries posted on Facebook and emailed via newsletters.
Caregivers took a 72-question survey developed in Qualtrics. The voluntary, anonymous online questionnaire collected demographic and clinical data as well as subjective parent assessments. Questions asked about the degree to which children with ADHD could competently or independently complete chores, the impact of ADHD on their ability to complete chores, and whether caregivers believe their children require more reminders to complete chores than do neurotypical children.
Researchers divided chores into two subtypes: Self-care chores (SC) and family-care chores (FC). Researchers asked parents about SC chores using two examples: making one’s bed and cleaning one’s bedroom. Additionally, the survey included six FC chores: setting or clearing the table, taking out the garbage, washing or drying dishes, housecleaning, laundry, and assisting with family meals or snack preparations. On top of asking about specific examples of chores, researchers offered study participants the chance to rate their child’s performance overall on each chore subtype.
Then, researchers utilized widely approved scientific analysis tools such as spearman correlation, chi-square test, and weighted kappa analysis.
In addition to inadequate chore completion, researchers found that parents of children with ADHD overwhelmingly believe their child’s symptoms detract from chore performance. Further, the majority of parents report that they believe their children need more reminders than do their neurotypical peers to complete SC and FC chores — 86.5% and 84.3%, respectively.1 These reminders can put a great strain on parents, as another study links greater parental involvement with chores with higher rates of parenting stress.6
Interestingly, this study found that when parents expected a child to complete a chore more frequently, children with ADHD were more likely to meet or exceed chore performance expectations.1 More research is needed to understand this correlation.
The large sample size allowed researchers to analyze the impact of ADHD subtype impact and comorbid Oppositional Defiant Disorder (ODD) on chore completion as well. It also examined parental expectations of chore frequency and beliefs regarding the impact on chore performance by ADHD subtype and presence of comorbid ODD.
To separately assess ODD as a variable, researchers conducted separate analyses to compare children with and without comorbid ODD. Since ODD is more commonly diagnosed in boys than in girls, researchers limited their analyses to boys between the ages of 8 and 13 years who had ADHD, combined type (CT). In all, there were 265 boys who met selection criteria: 67 boys with comorbid ODD and 198 boys without comorbid ODD.
Children with various subtypes differed in neither their ability to meet or exceed parental chore expectations nor in the number of reminders they needed to complete a chore. Likewise, there were no discrepancies between boys with comorbid ODD and boys without an ODD comorbidity in regard to chore performance.1
This finding surprised researchers, as ODD is primarily associated with oppositional behavior. Previous studies have shown that boys with higher scores on an ODD factor assessment, based on the DSM-4 criteria for ODD, had greater difficulties completing homework. Researchers expected difficulty with homework performance to go hand in hand with increased difficulty in chore performance for boys with comorbid ODD. More research must be conducted to determine the true nature of this comorbidity’s relation to chore performance.
This study examines the largest and most diverse sample to date compared to other studies investigating the same topic, but the sample group was still not representative of the general population. Surveyed caregivers were disproportionately older parents (27% of parents were over 50 years old), held more higher education degrees (39% had a graduate degree), and identified as white (88% of surveyed parents identified as white).1 Researchers hope that future studies will utilize more diverse sample groups, as well as including a baseline group of caregivers of children without ADHD for comparison.
Since many studies confirm that participation in household routines has significant implications on a child’s short-term and long-term wellbeing, the results of this study should not be taken lightly. In fact, children with ADHD may have the most to gain from participation in household chores; according to the authors of the study, “To the extent that children and adolescents with ADHD have greater issues with impulsivity and self-regulation, they likely stand to gain the most from increased engagement with household tasks.”1 More research will help clinicians illuminate the link between ADHD and chore performance.
1Spaulding, S. L., Fruitman, K., Rapoport, E., Soled, D., & Adesman, A. (2020). Impact of ADHD on Household Chores. Journal of Attention Disorders. https://doi.org/10.1177/1087054720903359
2Pennick, M. R. (2013). Understanding the relation between routines and problem behaviors in children with clinical diagnoses [Doctoral dissertation]. https://search.proquest.com/openview/0a045bfacfd5dc4b116dd68813a2e0ff/1?pq-origsite=gscholar&cbl=18750&diss=y
3Bater, L. R., Jordan, S. S. (2017). Child routines and self-regulation serially mediate parenting practices and externalizing problems in preschool children. Child Youth Care Forum, 46(2), 243–259. https://doi.org/10.1007/s10566-016-9377-7
4Sytsma, S. E., Kelley, M. L., Wymer, J. H. (2001). Development and initial validation of the child routines inventory. Journal of Psychopathology and Behavioral Assessment, 23(4), 241–251.
5Rossmann, M. (2002). Involving children in household tasks: Is it worth the effort? https://ghk.h-cdn.co/assets/cm/15/12/55071e0298a05_-_Involving-children-in-household-tasks-U-of-M.pdf
6Dunn, L., Coster, W. J., Cohn, E. S., Orsmond, G. I. (2009). Factors associated with participation of children with and without ADHD in household tasks. Physical & Occupational Therapy in Pediatrics, 29(3), 274–294. https://doi.org/10.1080/01942630903008327