Promising effect of a family rugby programme for children with ADHD: Promoting parent-child...

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Complementary Therapies in Clinical Practice 39 (2020) 101135

Contents lists available at ScienceDirect

Complementary Therapies in Clinical Practice journal homepage: http://www.elsevier.com/locate/ctcp

Promising effect of a family rugby programme for children with ADHD: Promoting parent-child relationship and perceptual change on child’s behaviors Angela FY. Siu a, *, Julia WK. Lo b a b

Dept of Educational Psychology, The Chinese University of Hong Kong, Shatin, NT, Hong Kong Dept of Social Work, The Chinese University of Hong Kong, Shatin, NT, Hong Kong

A R T I C L E I N F O

A B S T R A C T

Keywords: Attention Deficit Hyperactive Disorder (ADHD) Chinese families Family-based programmes Rugby Sports participation

Background and purpose: This study explored the effectiveness of a family-based rugby programme to improve the parent-child relationship for children with ADHD and their parents. Materials and methods: A total of 17 Chinese families (12 fathers and 13 mothers) of children (in early primary grades) with ADHD participated in this study. Mixed methods, including questionnaires, parent focus groups, parental reflective journals, and interviews with children, were adopted. Results: Quantitative data suggested a trend of parental perceptual change on their children’s ADHD behaviors. Thematic analysis on the qualitative data further suggested the family rugby programme served as “a family play context” that helped promote parent-child relationship for the Chinese children with ADHD and their parents. Participating children experienced “a different self” and better self-control when playing rugby. Conclusion: There is a promising effect of the use of rugby as an alternative family-based approach for children with ADHD and their parents.

1. Introduction Attention Deficit Hyperactivity Disorder (ADHD) is one of the most common childhood mental disorders in the world, with a pooled prev­ alence of 7.2% [1] and affecting 6.1% of school-aged children in Hong Kong [2]. The core features of ADHD are inattention, hyperactivity, and impulsivity, and the difficulties associated with ADHD can substantially interfere with the daily lives of children and their families [3]. Compared with their typically developing peers, children with ADHD often face more challenges in interpersonal relationships and academic learning [4,5]. These pervasive impairments in social and academic achievements can negatively affect the self-competence of children with ADHD [6,7] and induce other adverse effects, such as aggressive behaviors and symptoms of depression and anxiety [8–10]. This often resulted in persistent and negative developmental outcomes [11,12]. The parent-child relationship has been identified as a key family factor in nurturing the social, behavioral, and emotional development of children with ADHD [13]. A Western study has shown a strong rejection between the parent–child relationship and ADHD symptoms [14], and a

study in Hong Kong has revealed the significant role of the father-child relationship in supporting the development of perceived competence (self-perception) in children with ADHD [15]. Yet families raising a child with ADHD often have more conflictual family relationships, less organized communication, and less affective involvement than other typical families [16]. Many Chinese parents of children with ADHD experience a burden of care in managing everyday problems given the current daily parenting practices among Chinese cultures [17]. This may explain the high parental stress of Chinese fathers and mothers of chil­ dren with ADHD [18] and the lower quality of life of Chinese parents of children with ADHD compared with other parents in the general pop­ ulation [19]. Under this high level of psychological distress, parents of children with ADHD were reported to have less warmth and less involvement with their children [20]. This lack of warmth and lack of supportive parent–child interactions have been linked with aggressive behavioral problems in children [21], putting a strain on the paren­ t–child relationships of these families.

* Corresponding author. E-mail address: afysiu@cuhk.edu.hk (A.FY. Siu). https://doi.org/10.1016/j.ctcp.2020.101135 Received 8 September 2019; Received in revised form 9 January 2020; Accepted 3 March 2020 Available online 5 March 2020 1744-3881/© 2020 Elsevier Ltd. All rights reserved.


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