The influence of attention deficit disorder on mother's perception of family stress: Or, 'Lady, why can't you control your child?'

Perceptions of increased stress are expected in the presence of any chronic childhood condition. Behavioral disability characteristics are expected to influence the perception of stress differently than medical or physical disorders. This qualitative study consists of interviews with 22 mothers of children with attention deficit disorder (ADD) and 23 mothers of children with cystic fibrosis (CF). Open-ended questions explore family demands, resources, time use, routines, concerns, and support.;Mothers in both groups report a persistent vigilance in the care of their child. This perceived need for vigilance created an undercurrent of tension in even routine daily activity. Both groups of mothers report problems of decreasing compliance and personal responsibility as the child enters adolescence. Mothers in both groups report a change in personal priorities and expectations resulting from interaction with their child. Both groups are highly child-focused in daily routines and leisure.;The experience of CF mothers in this study is consistent with research findings on other chronic conditions. CF mothers report family members providing extensive physical and emotional support. The mothers report a persistent emotional sorrow associated with CF, but are generally able to normalize daily routines. CF mothers describe their children and families to be "normal", and are generally positive in their outlook.;The ADD child's behavior deviations result in social censure of both the child and the mother. With this condition families are not afforded the social sanction of "illness" or social affirmation for positive parental performance. Mothers of children with ADD have less family support, high perception of child related demands, and tend toward a more negative view of themselves. The demands of ADD are not easily routinized, and few ADD mothers are able to normalize care for their child.;Mothers of adopted children with ADD fared a little better than the biological mothers. While the general patterns were similar, the adoptive mothers reported more support from their extended family and a more positive outlook. The emotional stress of vigilance and the mother's sense of personal control were important indicators of positive adaptation. Implications for health care professionals and future research are offered.