Does a chaotic home environment increase the risk that a child will develop attention deficit hyperactivity disorder? Or is it that a child with ADHD — and all of the stressors often associated with this neurodevelopmental disorder — makes a household chaotic?

In some ways, it’s a “which came first, the chicken or the egg?” question that parents may wonder about. The answer, according to Dr. Daniel Coury, professor of pediatrics at The Ohio State University and a developmental-behavioral pediatrician at Nationwide Children’s Hospital in Columbus, Ohio, is that “it’s a bit of both.”

[See: 10 Concerns Parents Have About Their Kids’ Health.]

He explains that the manner in which family members respond to and interact with each other is often at the heart of this topic. “Our interactions with others are constantly being modified,” he says, noting that with every new development in a home comes a myriad of first impressions, varied responses to them and numerous ways in which members of a household adapt.

Controlling the Chaos Can Depend on a Supportive Environment

In the case of a child who is newly diagnosed with ADHD, the potential for a hectic environment exists, but just how chaotic it gets is often contingent on how parents handle the situation. “It’s an adjustment process,” Coury says, “and it may take time to settle into a routine.” Parents who respond and adjust the environment in a supportive way will likely create a setting in which the child’s ADHD is positively influenced, he says.

For example, he stresses the importance of properly interacting with an ADHD child, saying that there is a difference between talking at a child and talking with a child. “Talking at a child is not good,” he says, indicating that it doesn’t convey a sense of inclusion. “Don’t do that.” Other ways to positively engage with your child, Coury notes, involve singing and reading with him or her. “Pay attention and be in the moment. This helps develop a good attention span and reduces distractibility.”

On the other hand, he explains that a child’s ADHD will be negatively impacted if parents aren’t as supportive. He mentions that adverse childhood experiences, or ACEs, which are events most every child encounters in one way or another be it the death of a family member, divorce, physical abuse or anything in between, can contribute to this and even spell trouble for other health and wellness problems down the road. The more ACEs a child experiences, he says, the more likely the child will grow up to have an increased risk for a reduced life span, possibly including cancer and heart disease.

“Childhood experiences, both positive and negative, have a tremendous impact on future violence victimization and perpetration, and lifelong health and opportunity,” the Centers for Disease Control and Prevention notes on the topic of ACEs. “As such, early experiences are an important public health issue.”

“It’s dependent on the parent’s ability to respond and adjust to the environment,” Coury explains. “It may be somewhat chaotic the first month or so during this adjustment, but then the family will find that they settle into this new normal.”

[See: 10 of the Biggest Health Threats Facing Your Kids This School Year.]

A Chaotic Household May Exacerbate ADHD Symptoms

Aniesa Hanson, a licensed mental health counselor at Hanson Complete Wellness in Tampa, Florida, agrees that a well-structured home is essential when creating a supportive environment. “A chaotic household can intensify ADHD symptoms,” she says. “In a chaotic home, a child has limited expectations of structure, which leaves them to develop an askew understanding of boundaries.” As a result, a domino effect of sorts may unravel; she explains that this skewed understanding may then seep into other aspects of a child’s life, creating the potential to impede school or sports activities. “A chaotic household can have such an impact that children even without ADHD can experience symptoms of inattention, impulsivity and even anxiety.”

She adds that a home may also be chaotic because of parental stress and the feelings of helplessness that may develop when thoughts about an inability to control an ADHD child ensue. However, “even though the parent feels burned out, they must continue to make it a priority to implement structure and consistency in the home.”

Her statements parallel the findings of a study published in the February Journal of Attention Disorders that determined that a “highly chaotic and unstructured household, to which the children’s ADHD symptoms are a contributing factor, makes it difficult for their parents to be authoritative in their upbringing.”

Despite the challenges parents may face, Hanson says that they “should not feel like they have to do this alone.” She says that with support groups, friends and family, parents should be able to find the help they need “to apply the best interventions that work for their child, practice patience and to succeed at getting their household back on track.”

Getting — and keeping — an ADHD household on track, according to Hanson, involves getting a proper diagnosis. “Often, disruptive behavior and inattention is caused by anxiety which isn’t a ‘true’ ADHD diagnosis,” she says. “This is why I always recommend parents to get a second or even third opinion before settling for a diagnosis, especially if medication is involved.”

When Parent and Child Have ADHD

Coury adds another component to the mix, saying that since it’s been shown that as much as half of children with ADHD have a parent with the disorder, the question of how an ADHD parent raises ADHD children of their own can be tricky. Such a dynamic, he says, may automatically mean that a household is inclined to be more chaotic than a household without ADHD parents. As such, he maintains that parents with ADHD should adhere to their medications; with them, they’re better able to cope and, in turn, create and manage the calming, supportive and structured environment an ADHD family needs.

[See: 8 Things You Didn’t Know About Counseling.]

Dr. Joel L. Young, medical director of the Rochester Center for Behavioral Medicine near Detroit, reinforces this notion in a Psychology Today article, stating that “a parent whose ADHD is treated is better equipped to deal with symptoms of ADHD in his or her child.”

Young adds that this is important because the potential exists for parents with ADHD to expose their child to a more challenging setting which can make it difficult for a child to manage his or her symptoms. “Parents who don’t treat their ADHD may even model unhealthy behaviors and coping mechanisms to their children. For example, a mother with ADHD who never plans her time or who frequently misses appointments models this same behavior to her child, causing poor time management and chaos to feel ‘normal.'”

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Is a Chaotic Household Linked to Risk of Children Having ADHD? originally appeared on usnews.com