The Home Observation Measure of the Environment is associated with symptoms of ADHD and oppositionality in a CAMHS sample

Abstract

Background:

Severe early deprivation has a causal role in attention-deficit/hyperactivity disorder (ADHD). Adversity in the home is associated with increased ADHD and oppositional symptoms in children with ADHD. We aimed to replicate this in an independent clinic sample.

Methods:

A total of 247 sequential families with a child referred to child and adolescent mental health services (CAMHS) were invited to participate; 100 families completed the study. The Home Observation Measure of the Environment (HOME) assessment was completed in the family home; parents completed the Conners’ Rating Scale.

Results:

A less supportive home was associated with more symptoms of inattention (r = .33, p = .001), hyperactivity/impulsivity (r = −.22, p = .028) and oppositionality (r = −.48, significant at p < .000001).

Conclusion:

The HOME correlates with ADHD and oppositional symptom severity in a clinic sample; more research is required to ascertain whether this is a causal association and the direction of causation. If causal, then the modification of the home environment may be a treatment strategy for ADHD.