A stable environment also helps behavior, researchers find
MONDAY, Feb. 1 (HealthDay News) -- Foster children who are placed in stable, loving homes show noticeable improvement in symptoms of inattention and hyperactivity compared to children who get moved around a lot and live with parents who are often annoyed or angry at them, research finds.
"The parenting environment and the numbers of homes or stability are tremendous factors that contribute to better adjustment for these symptoms," said L. Oriana Linares, lead author of a study appearing in the March issue of Pediatrics.
Linares, an associate professor of pediatrics and psychiatry at the Mount Sinai School of Medicine in New York City, pointed out that the children in the study did not necessarily have attention-deficit hyperactivity disorder (ADHD), but did have symptoms of inattention and impulsivity.
Such symptoms are extremely prevalent in children placed in foster homes.
"It's a common reason for what we call failed placement, when the foster mom returns the child to the agency and says the child is unmanageable," Linares said.
But while this phenomenon is well-known, experts have little information on whether the symptoms decline over time, or actually worsen, and what affects that trajectory.
The authors looked at 252 children in 95 families who had been removed from the home because of abuse or neglect. Follow-up lasted four years, during which time investigators gathered information from biological parents, foster parents, classroom teachers and the kids themselves.
"Were they always on the go? Always overactive? Climbing on things? Couldn't stop? Had to have things now? Inattention, forgetting where things were?" Those were some of their questions, Linares said.
There were three main findings.
The first was that, in general, symptoms of hyperactivity and inattention improved after the first year in a new placement. Both biological and foster parents confirmed this, although the same did not hold true in the classroom, suggesting that this is dependent on the setting.
Second, she said, "children whose parents reported higher parental warmth -- how much do the parents like the child, how much affection the parent reports towards the child, how much time they spend together -- showed fewer ADHD symptoms while children whose parents reported hostility -- being annoyed at the child, thinking the child a burden, being angry at the child -- showed more ADHD symptoms."
"What's encouraging is the rapid response in symptom reduction in response to non-hostile parenting styles," said Dr. Kathryn J. Kotrla, associate dean and chairwoman of psychiatry and behavioral science at the School of Medicine, Texas A&M Health Science Center Round Rock campus. "This makes one wonder about having more widespread education about parenting to have a significant impact on children."
The third finding was that children who were moved more frequently had more pronounced ADHD symptoms.
"And we're talking about symptoms associated with a disorder that has a proven biological component to it so it is important to understand that, even with these types of symptoms, the social environment of the child matters tremendously," Linares said.
She added that the findings could help welfare agencies pay more attention to selecting foster families, making sure the parents and children are a good match and providing better support for the foster parents.
For more on ADHD, visit the National Institute of Mental Health.
SOURCES: Kathryn J. Kotrla, M.D., associate dean and chairwoman, psychiatry and behavioral science, School of Medicine, Texas A&M Health Science Center, Round Rock campus; L. Oriana Linares, Ph.D., associate professor, pediatrics and psychiatry, Mount Sinai Adolescent Health Center and Mount Sinai School of Medicine, New York City; March 2010 Pediatrics
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