Using freelisting to understand shared decision making in ADHD: parents' and pediatricians' perspectives

Patient Educ Couns. 2011 Aug;84(2):236-44. doi: 10.1016/j.pec.2010.07.035. Epub 2010 Aug 24.


Objective: To compare and contrast notions of ADHD among pediatricians and parents of affected children to understand the perspectives they bring to shared decision making (SDM).

Methods: In this freelisting study, 60 parents of children with ADHD and 30 primary care pediatricians listed words reflecting their understanding of (1) Attention Deficit Hyperactivity Disorder (ADHD), (2) getting/offering help for ADHD, (3) talking to doctors/families about ADHD, and (4) "mental health." Smith's salience score established terms that were salient and cultural consensus analysis identified variation within subgroups of participants.

Results: Parents' terms reflected ADHD's effects on the child and family, while clinicians often mentioned school. Lists suggested differing needs and goals for clinicians and subgroups of parents in SDM: "time" for clinicians, "learning" and "understanding" for non-college educated parents, and "comfort" and "relief" for college educated parents. Neither parents nor clinicians framed ADHD in the same way as "mental health."

Conclusion: Parents and clinicians, who conceptualize ADHD differently, should negotiate a shared understanding of ADHD as a basis for SDM. Treatment discussions should be tailored to encompass families' varied emotional and educational needs.

Practice implications: Fostering SDM in primary care is consonant with notions of ADHD as distinct from mental health.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Attention Deficit Disorder with Hyperactivity*
  • Attitude of Health Personnel
  • Child
  • Child, Preschool
  • Comprehension
  • Data Collection / methods*
  • Decision Making*
  • Female
  • Health Knowledge, Attitudes, Practice
  • Hospitals, Pediatric
  • Humans
  • Interviews as Topic
  • Male
  • Parents / psychology*
  • Pediatrics
  • Perception
  • Philadelphia
  • Physicians / psychology*
  • Socioeconomic Factors
  • Surveys and Questionnaires