Attention-deficit/hyperactivity disorder and oppositional/conduct problems: links to parent-child interactions.

INTRODUCTION We outline a transactional model of parent-child interactions which proposes that characteristics of attention-deficit/hyperactivity disorder (ADHD) appear early in a child's life and present challenges to the parent's ability to maintain consistent and responsive parenting. In turn, the presence of harsh or inconsistent parenting is hypothesized to contribute to the development of child oppositional behaviour and conduct problems. METHOD AND RESULTS We briefly discuss existing cross-sectional evidence in support of this model and then highlight five longitudinal studies that provide stronger support, showing that difficulties in parenting predict the development of oppositional and conduct problems in children with ADHD, over and above pre-existing levels of child problems and other predictors. CONCLUSION We conclude with a discussion of the clinical implications of this model and evidence, emphasizing the need for early interventions in ADHD focused on parenting.