Meta-Analysis: Parenting Children and Adolescents With Attention-Deficit/Hyperactivity Disorder Compared to Healthy Controls.

OBJECTIVE

This systematic review and meta-analysis aimed to quantify differences in parenting practices between families of children with attention-deficit/hyperactivity disorder (ADHD) and typically developing controls.

METHOD: We conducted a systematic review and meta-analysis of studies comparing parenting practices among children and adolescents (≤18 years) with a specialist-confirmed ADHD diagnosis and non-clinical controls. PubMed, PsycINFO, Web of Science, and Scopus were searched from inception through August 12, 2025, without language restrictions. Studies were eligible if they used validated instruments to assess at least one parenting dimension and reported comparative data. A total of 62 studies from 19 countries were included (N = 13,105; ADHD = 6,543; controls = 6,562). We computed pooled standardized mean differences (Hedges g) using random-effects models and evaluated heterogeneity (Q and I2), 95% prediction intervals, and risk of bias (Newcastle-Ottawa Scale). Meta-regression and subgroup analyses examined potential moderators.

RESULTS

Parents of children with ADHD showed significantly lower levels of positive parenting (g = -0.37, 95% CI = -0.46 to -0.27) and higher levels of negative parenting (g = 0.47, 95% CI = 0.39 to 0.56) than controls. The strongest effects were found for authoritative parenting (g = -0.56), warmth (g = -0.45), abuse (g = 0.60), family conflict (g = 0.52), and hostility (g = 0.51). Heterogeneity was high (I2 ≥ 90%), and no consistent moderators or small-study effects were identified.

CONCLUSION

Parenting differs significantly between families of children with and without ADHD. Interventions should promote structured, warm, and non-coercive parenting. High heterogeneity and cross-sectional designs limit causal inference.

PLAIN LANGUAGE SUMMARY: This systematic review compared parenting in families of children with and without attention-deficit/hyperactivity disorder (ADHD). The authors reviewed 62 studies with 13,105 participants worldwide. The authors found that parenting differs significantly between families of children with and without ADHD. Parents of children with ADHD used fewer positive approaches, such as warmth and clear structure, and more negative approaches, such as hostility, conflict, and harsh discipline. Parenting is a modifiable factor, and interventions should promote structured, warm, and noncoercive parenting approaches that may improve outcomes for children with ADHD.

STUDY REGISTRATION INFORMATION: Comparison between parenting factors in the upbringing of ADHD vs. non-ADHD children and adolescents: a systematic review and meta-analysis; https://www.crd.york.ac.uk/PROSPERO/view/CRD42024623095.