Adaptive strategies of mothers with children with attention deficit hyperactivity disorder: enfolding and unfolding occupations.

OBJECTIVE To describe adaptive strategies of time use among mothers with children with attention deficit hyperactivity disorder (ADHD) and, in particular, the adaptive strategies of unfolding occupations that were commonly used by these mothers. METHOD In-depth interviews were conducted with 17 families with children with ADHD. Parents were asked to describe their family's daily schedule, routines, and how occupations were performed. Data were analyzed using the grounded theory approach. FINDINGS Mothers used three adaptive strategies: enfolding occupations, temporal unfolding of occupations, and unfolding occupations by inclusion. Enfolding occupations means performing more than one occupation at a time. Unfolding occupations means taking chunks of activities or occupations out of previously established sequences of enfolded occupations to be performed at a different time (temporal unfolding) or by a different person (unfolding by inclusion). The child's special needs and the availability of financial and human resources influenced the selection of adaptive strategy. Using these adaptive strategies enabled the mothers to care for their children. However, using enfolding or temporal unfolding meant that mothers had less time for other occupations. CONCLUSION The benefits and limitations of the adaptive strategies of enfolding and unfolding occupations suggest a need to study time use in different contexts. Before suggesting use of these adaptive strategies by parents of children with special needs, therapists need to be aware of the family's financial and human resources.