How do parent priorities of tasks change from 6 to 12 and are there differences between those with and without ADHD?

Background:

Attention Deficit/Hyperactivity Disorder (ADHD) is one of the most common neurodevelopmental diagnoses among children. Its signs and symptoms are associated with inattentiveness, hyperactivity, or impulsive behavior. According to the Center for Disease Control (CDC), an estimated 7 million of U.S. children aged 3-17 years have been diagnosed.

Managing children with ADHD can be different for parents with children that have not been diagnosed, or do not show signs of ADHD. Parenting styles of children—no matter if they have ADHD or not—vary significantly across every household. Additionally, because of difficulties and costs associated with collecting naturalistic data, very little is known about the types of expectations parents set for their children across the developmental age range of 6 to 13 and/or whether these expectations differ between those with and without a diagnosis of ADHD. To this end, we were interested in leveraging our anonymized user data on hundreds of thousands of users and millions of “quests” (or tasks) to see what tasks parents were assigning children with ADHD compared to their non-ADHD counterparts of the same age. We were also interested in what quests parents prioritized as children got older and if parents of children with ADHD prioritize different tasks than parents without ADHD. 

It is important to note that children represented in the data were not formally diagnosed with ADHD by anyone from our team but instead, we have based these groupings on the information provided by the parent when onboarding in the app (i.e., Does your child have a diagnosis of ADHD?).

Summary

The data shows some differences between sets of parents. Parents of children with ADHD prioritized different tasks as the children got older compared to their non-ADHD counterparts. Quests such as no fighting and taking vitamins or medicine rank among the top 6 most commonly assigned for children with ADHD regardless of age while children without ADHD beginning around the age of 7 years were assigned both of these quests less frequently. The quest do a homework assignment was increasingly prioritized among non-ADHD children as they got older whereas for children with ADHD this does not become of increasing importance until age 13. Furthermore, the quest take 5 deep breaths is not all prioritized for ADHD children while parents of non-ADHD children increasingly prioritize this as they get older.

Data and Methods

Age Cleaning and Distribution

After examining the distribution of ages in the dataset, it was determined that a substantial number of users did not provide an age for their child, so these users were removed from the analysis.

After re-examining the distribution with these users removed, it was determined that our user base primarily consists of users between the ages of 6 and 13 with each of these age bins reflecting over 6% of the users who provided a birthdate. As a result the analysis was restricted to users between the age of 6 and 13 (n = 185,293, ~74% of all users who provided a birthdate).

Quest Cleaning and Distribution

A review of the text used to describe quests was examined and revealed a number of different ways some of the same tasks were being described by different parents (e.g., “brush your hair”; “brush hair before getting ready for bed”). In an effort to group tasks as best as possible, text was standardized for several tasks as such:

1) Any task containing the word “clean” was relabeled “clean”

2) Any tasks containing the words “brush” and “teeth” were relabeled “brush teeth”

3) Any tasks containing the words “brush” and “hair” were relabeled “brush hair”

4) Any tasks containing the word “fight” were relabeled “no fighting”

5) Any tasks containing the word “violence” were also relabeled “no fighting” 

Nearly 2.5 million quests were assigned across all users between the ages of 6 and 13.

Findings

Quest Rank (All Children Regardless of Diagnosis)

The top 10 quests assigned accounted for more than 1 in 4 (27%) tasks assigned by parents overall and included the following:

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Examining how quest rank changes over each age bin revealed that the top 3 tasks remained the same regardless of the child’s age. These included brushing teeth, cleaning, and making your bed, respectively. It is possible this is an artifact of the types of quests we are surfacing in recommendations; however, it does demonstrate that parents of children between the ages of 6 and 13 believe these are highly relevant to their children. Given the lack of variability in these quests from age 6 to 13, they were removed from further analysis.

In addition, we also removed tasks that were only present for 3 or fewer of the relevant age bins. These included putting your platebowl in the sink after each meal, reading for 15 minutes, shower, and brushing hair.

This yielded a total of six behaviors that remained in the top 10 throughout childhood and demonstrated changing trajectories across the age range of 6 to 13.

Findings: Quest Rank (ADHD vs. Not ADHD)

Priorities appear to differ between parents of children with and without ADHD (see charts below). Specifically, when comparing how the rankings of these six top ranked tasks change over the course of development, it is notable that the trajectories differ between the two groups.

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Types of Tasks Prioritized

Interestingly, for parents of children reporting that their child has ADHD, no fighting and taking vitamins or medicine rank among the top 6 most commonly assigned quests and consistently remain the third to fourth or fifth to sixth most commonly assigned quest, respectively, across the age range of 6 to 12. In contrast, for children whose parents report their child does not have ADHD, no fighting becomes a much less frequently assigned task beginning around age 7 and demonstrates a precipitous decrease in frequency through age 11 at which point it no longer remains a top 10 assigned quest. This task is replaced with other tasks including wash hands and take 5 deep breaths. Collectively, this indicates that parents of children with ADHD may be focused on prioritizing tasks that result in significant impairment and perhaps spontaneously resolve themselves in children without ADHD over development (e.g., fighting) or are designed to reduce symptoms associated with ADHD (e.g., taking medication) throughout this time period. In contrast, parents of children without ADHD prioritize items associated with typical routine expectations (e.g., putting things away; basic hygiene) as well as self-regulatory strategies (e.g., deep breathing) as their children may no longer be exhibiting functional difficulties with behaviors such as fighting.

Trends Related to Vitamins or Medicine

Take vitamins or medicine exhibits a slightly different trajectory among parents who report their child does not have ADHD such that this is the eight ranked concern around age 6-7, becomes less common between 8 and 11 and begins to be assigned more frequently among 12 and 13 year olds. Of note, however, this still remains only the 7th most frequently assigned task at age 13 whereas it remains in the top 6 among youth whose parents report they have ADHD. This is consistent with national trends indicating that stimulant medication remains the most frequent treatment for ADHD. Interestingly, however, it is notable that in youth without ADHD, this begins to become more important as children transition into adolescents. Information regarding the specific medications this task was used for was not provided but this trend highlights that additional research on trends in prescription medication use may be warranted.

Trends Related to Homework

Another notable difference between youth whose parents report their child has ADHD and those that do not is that of do a homework assignment. Among youth whose parents report their child has ADHD, this is the 10th most frequently assigned task (i.e., lower priority) from 8 to 12 and rises slightly around age 13 to the 8th most frequently assigned task. In contrast, among those whose parents report their child does not have ADHD, this task begins rising in frequency beginning around age 9 and by age 13 is among the top 5 most frequently assigned tasks. This suggests that parents may have other tasks that are perceived as more important among youth with ADHD during the younger school-age years; however, when homework demands become exceedingly difficult in adolescents, parents begin to assign it more frequently whereas youth without ADHD have had ongoing monitoring of this behavior for many years before it becomes more of a priority among parents of children with ADHD. Alternatively, it is possible that parents of youth with ADHD are more directly involved with homework completion earlier in development relative to children without ADHD given difficulties experienced by the former and as they become older parents seek to garner greater independence for their child by assigning this as a task to be completed by their child.

Interestingly, whereas take 5 deep breaths is not among the top 10 most frequently assigned quests for youth with ADHD at any age, it is in the top 5 tasks among youth without ADHD beginning at age 7 and demonstrates an upward trajectory over time. It seems plausible that parents of youth without ADHD may begin emphasizing self-control and regulatory strategies (e.g., taking deep breaths) earlier in development than those without ADHD given other competing behaviors parents of children with ADHD are more interested in directly improving.

While the top 6 quests for youth without ADHD mirrored those found in the full sample, it was not immediately clear which tasks may be getting greater priority among parents of children reporting their child has ADHD. Examination of tasks that were among the top 10 in youth with ADHD but not in the full sample revealed that brush hair, while not among the top most frequently assigned quests, remains in the top 10 throughout the age range of 6 to 12 (despite having not been in the top 10 among the general sample after age 8, see above). Additionally, it appears give pet food and water is assigned increasingly more from the ages of 9 to 11 among children whose parents report their child has ADHD. Shower also becomes an increasingly more common quest assigned beginning around age 9 and continuing through age 13. Notably, while basic hygiene also appears to be a priority among parents of children with ADHD (e.g., brush hair; shower), different behaviors appear to be emphasized relative to those without ADHD (e.g., washing hands before eating).

Considerations

This research does not examine specific individual’s tasks over time. Joon is still a relatively new app designed to help parents direct their children to achieve tasks through innovative gaming and rewards-based instruction. This data is meant to provide a better understanding of the challenges and successes of the cohorts completing specific tasks over time and differences in priorities among parents of children with and without ADHD. Further, we aimed to characterize how these priorities change over the course of development from 6 to 13. 

For any questions or comments on this research, please contact john@joonapp.io.