Penn State study links family structure to lower ADHD symptoms

Starting primary school is an important milestone, but it can be a difficult transition as children may experience separation anxiety or struggle to adjust to the rules and structure of school. However, a team led by Penn State researchers found that consistent routines at home can reduce the likelihood that children will struggle with the school transition.

In a publication at Developmental Psychologyresearchers found that when low-income rural families had stronger routines—such as regular bedtimes and shared meals—parents reported lower levels of behavior problems and attention-deficit hyperactivity disorder (ADHD) symptoms than their children. However, higher levels of harsh or aggressive parenting—such as yelling or threats from the mother or father—reduced the benefits associated with household structure.

“You need routines, but you can’t be too rigid with them,” said co-author Lisa Gatzke-Kopp, professor and head of the Department of Human Development and Family Studies at Penn State.

I always say the two most important things in parenting are consistency and flexibility. It may sound like a contradiction, but these results show that balance really does matter.”

Lisa Gatzke-Kopp, Professor and Head, Department of Human Development and Family Studies, Penn State

Researchers examined data from 999 low-income rural families in North Carolina and Pennsylvania who participated in the Family Life Project, a long-term research collaboration between Penn State, the University of North Carolina and New York University. Participants in the Family Life Project were recruited when a child was born into the family, and the study concluded when the group of children turned 19 years old.

The current study used information from three waves of data collection, starting in 2007-08 when the children were about four years old. These measurements captured preschool, kindergarten, and first grade children to document the full transition to elementary school. At each annual assessment, parents answered questions about family routines, harsh parenting behaviors, child behavior problems, and childhood ADHD symptoms. At the start of the study, the researchers also measured the parents’ ability for cognitive flexibility—the ability to adapt their thinking to a specific or changing situation.

Parents took surveys to measure harsh parenting, which included questions about yelling, cursing, throwing things, running out of the room, and engaging in other aggression. child behavior problems, which included aggressive, oppositional, and rule-breaking behaviors; and childhood ADHD symptoms, which included evidence of inattention and hyperactivity-impulsivity. Parents also answered questions about having family routines around bedtime, regular family meals, and household schedules.

In families with high levels of routine and low levels of harsh parenting across the study, parents reported lower levels of child behavior problems and ADHD symptoms. In families where harsh parenting varied from year to year, childhood ADHD symptoms were lower when parents reported less harsh parenting.

Harsh parents undermined the protective effect of family routines, the researchers explained. Children in households with high levels of routine and high levels of harsh parenting showed levels of misbehavior similar to those of children in households with low levels of routine.

In addition, parents who demonstrated cognitive flexibility were less likely to parent harshly.

“Kids are trying to figure out how the world works,” said Gatzke-Kopp, a co-sponsored faculty member at Penn State’s Institute for Social Sciences. “The more consistent and supportive their environment is, the easier it is for children to remain calm and understand how to behave in a new environment, such as school.”

For parents looking to add structure to their household, Gatzke-Kopp recommended a consistent bedtime routine that includes relaxing activities like reading to the child. She also identified regular, low-demand, screen-free family time and shared meals as great opportunities for each parent to add routine to their households.

The effects of all the factors identified in the study were small, but Gatzke-Kopp said that was to be expected.

“You can’t assume that if you create good routines, your child will have perfect behaviors,” Gatzke-Kopp said. “There are many things that influence whether your child has behavioral problems, and routines and parenting style are only part of the picture.”

Every family will face some level of conflict, he continued.

“All kids can be difficult,” Gatzke-Kopp explained. “Parents need to be reassured that negative behaviors don’t mean your child has a problem. And it doesn’t mean the parents are doing something wrong.”

Kylee Witmer, a graduate student in human development and family studies at Penn State, also contributed to this research. More information about partners and funders is available in the paper.