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Counseling: Attention Deficit and Its Functional Impact Report (Assessment)


Research is a critical part of working as a counselor or social worker. This helps to ensure credibility and move forward the discipline with evidence-based practice while maintaining the professional competence of the counselor. This report is a comprehensive evaluation of the study Challenges of Developing an Observable Parent-Reported Measure: A Qualitative Study of Functional Impact of ADHD in Children and analysis for its use in counseling practice (Matza, Margolis, Deal, Farrand, & Erder, 2017).

Evaluation of the Research Problem

In pediatric clinical trials, the patient-reported outcome measures are most often completed by parents or guardians since children may not be able to provide valid answers adequately. These reports include both observable and nonobservable aspects. However, the International Society of Pharmacoeconomics and US Food and Drug Administration has released guidelines that the informant-reported assessment measures should focus on observable characteristics.

Evaluating the Significance of the Problem

The qualitative study is exploring the concept of observability based on an example of a child with attention deficit-hyperactivity disorder (ADHD). The competent and accurate observation of a child’s characteristics and social functioning is a critical matter in providing counseling for ADHD patients. Therefore, counselors can benefit from a multidisciplinary approach to this study. The author notes that informant-reported outcomes fail to observe vital behavioral characteristics of children with ADHD. The results of the study can help define the concept of observability and associated challenges, thus helping to enhance guidelines on the reported measures.

Evaluation of the Literature Review

The study does not have any literature review. The authors present basic background information on the topic in the introduction as they set up for their study. A qualitative study is mentioned which focused on creating parent-reported measures of ADHD, but it is described as ineffective since previous instruments have covered such areas of impact.

Evaluation of Research Purpose Statement and Questions

Research Design

It is a qualitative study that conducts concept elicitation semi-structured interviews individually with children and their parents. These interviews are meant to study the impact of ADHD on the behavior and function of children while parents were evaluated for the observability of these measures.

Research Purpose Statement

The research purpose statement of this study is to “provide an opportunity to explore the concept of observability and highlight the challenges of developing informant-reported outcome

measures that are limited to observable content” (Matza et al., 2017, p. 829). This statement is accurate and straightforward in identifying the purpose of the study. The author highlights the basic concepts and the issues which the research is meant to address.

Research Questions

There are no clear research questions identified in the study. Based on the interview questions, it can be assumed researchers attempted to determine the extent to which ADHD impacted children’s behavior and function. Furthermore, it was determined whether parents could effectively observe these impacts on their child’s life.

Evaluation of Data Collection Plan

Selection of Participants

Participants were selected from four clinical sites that specialized in childhood ADHD treatment. Children had to be between 6 and 12 years of age, with an official diagnosis of ADHD. Families were excluded if they had comorbid psychiatric diagnoses, participated in another clinical trial within the last six months, or had any impairment. Only one parent for each child participated and could be included even if the child did not respond. The sample size consisted of 30 parents and 24 children who participated in the interview. The sample could be improved by including both parents in the interview process since one parent can often contribute to or offer another perspective on the child that the other could not.

Gaining Permission

The interviewer obtained written informed consent from both parents and children before the interview. Before the study, an independent ethics committee reviewed and approved the study. This is a standard procedure for qualitative research and meets ethical standards.

Determining the Data to Collect

Researchers sought to collect the observed data on how ADHD impacts various aspects of a child’s life, including emotions. Parents were asked to evaluate this impact as well as provide examples of how they observe or learn specific factors. For some elements, such emotional impact of ADHD, parents were asked to explain how they knew there was an impact on their child. The data collected was appropriate since the researchers wanted to investigate observational measures as used in informant-reported outcomes.

Recording Data

The study does not describe how it recorded its data except for the outlines of the interviews. Since the interviews were semi-structured, all participants were asked a similar set of questions to determine results in certain areas of ADHD impact. Recording data in interviews consists of the use of transcripts, field notes, and audio recordings (Padgett, 2016). These protocols are effective for small-scale qualitative studies.

Evaluation of Data Analysis and Interpretation Plan

Preparing and Organizing Data for Analysis

This is not described in the report. I would have approached this by organizing all the interview notes and recordings based on the provided responses. I would have also sought to determine which aspects of ADHD behavior I wanted to focus on during data analysis.

Exploring and Coding the Data

Researchers deciphered the interviews and divided them into many distinct types of ADHD impacts. These were then arranged in a descending order based on parents’ frequency of observation f. It was an effective method of accurately analyzing the data to present evident inconsistencies in observational impacts.

Using Codes to Build Description and Themes

The theme of the study suggests that parents report a greater extent of ADHD impairment than their children. Some of the concepts, such as emotion and self-efficacy, which were widely reported by parents, were rarely mentioned by children, which suggests that one of the groups may have an unclear perspective on the issue. Researchers built these themes by reviewing common outcomes reported by parents in the observational reports.

Representing and Reporting Findings

The data was presented in a tabled listing all types of ADHD impact and then displaying two columns with percentages of parents’ and children’s reported observation on the topic. It is an efficient way to demonstrate the difference amongst reported statistics. However, it seems significantly limited within the context of the in-depth interviews that were conducted.

Interpreting Findings

The researchers provided an in-depth discussion of the usefulness of their study’s findings. An interesting aspect was to highlight that parents cannot effectively observe a child’s behavior outside the home environment, and it may be inaccurate to base such observations on the reports from other people. Therefore, an inherent challenge arises as part of the observable behavior framework suggests for informer-reported outcomes. Furthermore, the study includes suggestions on how the reporting measures can be modified to include content that parents do not observe but can collect from other people. It has been found that the use of multiple informants can be more efficient in identifying children as high-risk for ADHD rather than just a single parental informant (Güler et al., 2014). The authors note that limitations include a small sample and children lacking the comfort level to speak with unfamiliar interviewers who can distort responses.

Validating the Accuracy of the Findings

The authors note that further research is necessary to assess observability measures and pediatric assessment techniques. It is not effective but an appropriate measure to validate findings. A large portion of this study’s findings deals with content validity and its implication in observation research. The authors note that parent-reported measures should be developed with the knowledge that observable content may be limited as a sole instrument of determining a child’s function under ADHD.

Evaluation of Ethical and Culturally Relevant Strategies

The authors took standard steps of obtaining consent. No other ethical measures were mentioned. This is appropriate for small scale research studies. I would have made sure to include a step that, despite the information not being published, interviews would remain confidential. Furthermore, it may have been helpful to ensure that the stressful interview did not negatively impact the children in the aftermath of the study. Qualitative research implies a researcher-participant relationship which calls for certain adult expectations from child subjects. A responsible ethical and cultural approach would be to use a research framework such as a Mosaic Approach, which would offer flexibility, engagement, and a sense of control for the children with ADHD participating in qualitative research (Tucker & Govender, 2016).


The overall quality of this qualitative study was moderate. It lacked critical aspects such as a literature review on the topic or an adequate explanation of its data collection or analysis methods. This study highlights the critical but complex challenges of observation for ADHD behavior. In counseling practice, subjective perceptions of ADHD behavior can impact coping mechanisms, treatment adherence, and emotional reactions, both from parents and children. The observational capacity and understanding of how ADHD impacts function leads to better outcomes (Wong, Hawes, Clarke, Kohn, & Dar-Nimrod, 2018). Therefore, counseling practice strongly benefits from such studies that evaluate a difference in perceptions and observational abilities of parents and children with ADHD.


Güler, A. S., Scahill, L., Jeon, S., Taşkın, B., Dedeoğlu, C., Ünal, S., & Yazgan, Y. (2014). Use of multiple informants to identify children at high risk for ADHD in Turkish school-age children. Journal of Attention Disorders, 21(9), 764-775. Web.

Matza, L. S., Margolis, M. K., Deal, L. S., Farrand, K. F., & Erder, M. H. (2017). Challenges of developing an observable parent-reported measure: A qualitative study of functional impact of ADHD in children. Value in Health, 20(6), 828-833. Web.

Padgett, D. K. (2016). Qualitative methods in social work research (3rd ed.). Los Angeles, CA: SAGE Publications

Tucker, L. A., & Govender, K. (2016). Ethical considerations for research involving boys diagnosed with attention-deficit/hyperactivity disorder. Early Child Development and Care, 187(7), 1147-1156. Web.

Wong, I. Y., Hawes, D. J., Clarke, S., Kohn, M. R., & Dar-Nimrod, I. (2018). Perceptions of ADHD among diagnosed children and their parents: A systematic review using the common-sense model of illness representations. Clinical Child and Family Psychology Review, 21(1), 57-93. Web.

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