Advantages and Disadvantages of Studying the Family as a Context Approach When Dealing with a School Aged Child Diagnosed with Attention Deficit Hyperactivity Disorder

Dear Editor-in-Chief

Studying the family as context is one of the approaches that focus on “persons/family members” or “individual/family subgroup” and their relationships as foreground, with the family as background (1,2). Individual family subgroup research focuses on persons as individuals and as family members and their relationship to the family from the perspective of the subject individually and in interaction (2). So, what happened when the family deals with a school-aged child diagnosed with Attention Deficit Hyperactivity Disorder (ADHD)? In both scenarios, the researcher is studying the family as context and he/she pursues the family impact and contributions to the individual’s illness or concerns that affect family relationships and interactions in a negative manner, and is associated mainly with higher rates of marital stress.

When the source of information about the family is the individual family member, this information is considered as/or represents the individual’s perspective. In this approach, researchers believe that the individual family member’s perspective is a valuable source of information about family and their school aged child diagnosed with ADHD (1,3–4), and the same is true of the relational subgroup (e.g. dyad). In such cases the individual family member or the relational subgroup is the suitable unit of analysis when the family is considered as the context for individual growth, development, well-being and adaptation (1,4, 5). In other words, the individual’s perceptions of the family’s influence on his/her development, health, illness or treatment are the focus of the study. In the case of this paper, the family relationships are viewed from the perspective of a child with ADHD, the child and the mother, the child and the father, the child and the sibling, or the parents.

An advantage of using the one-informant approach for studying the family as context is that, from a practical point of view, it is less expensive and has fewer statistical analysis problems than studying the family as a unit (1,2,6,7,8), because it involves lower administration costs and creates fewer statistical analysis problems than does studying the family as a unit (2, 6). Another advantage of using this approach is the relative ease with which this type of data is obtained (1), and the availability of appropriate instruments since the majority of were designed for administration to individuals. In addition, the ease of the scoring process also makes the data analysis simpler (3). But, major disadvantages that has been reported by many researchers is that individual-level data do not represent the “family as an entity in itself”; such data cannot be considered as family data and do not reflect real family interactions with their ADHD child, because they are merely the individual’s perception and thoughts (3,5,7,8,9). Furthermore, many of the instruments used in this approach are self-reported and are administered to individual family members who determine what and how to respond (1, 3), adding further bias to interpreting such data. In addition, this approach may limit the generalizability of conclusions because the results cannot be compared with those from studies using more than one informant (1,3, 7).

In general, one can argue that a single informant cannot describe the family experience during the present of health problem or any disabilities, because the family is a dynamic system/unit (2, 3, 7,8,9).