From left: Christina, Lance and Justin Hughes.

As a child, Christina Hughes had trouble paying attention in school. She was criticized for her outbursts in the classroom and constantly forgot her homework. Doctors diagnosed her with Attention Deficit Disorder (ADD), but her symptoms were never relieved by therapy. Her academics and social life suffered.

“It was always hard for me to make friends, and the ones I did make weren’t the best influence,” Hughes says.

Thirty years later, Hughes is raising two sons with similar behavioral challenges. Justin, 9, is especially impulsive and emotional. Two years ago, he had a fit and began punching himself in the face. He has been bullied and suspended from school for fighting.

Justin was diagnosed with Attention Deficit Hyperactivity Disorder (ADHD) in 2012.

“There were many nights when I would just cry,” Hughes says. “I felt hopeless. I didn’t know what to do.”

When Hughes noticed her younger son, Lance, 4, was also becoming defiant and reckless, she turned to Seattle Children’s Hospital for help.

“I didn’t want my children to have to go through everything I went through,” she says.

Putting mothers first

Mark Stein, PhD, ABPP, has been treating and studying ADHD for decades and estimates about 20 percent of children with ADHD have a parent with the same disorder.

Unfortunately, adults who have not been diagnosed as children are more difficult to diagnose, Stein says, because the symptoms are less obvious than in kids. This is especially true for women. When mothers go untreated, Stein says they often become demoralized and struggle with parenting, especially if their child is difficult to manage.

“One of the most common reasons children don’t respond to ADHD treatment is because the parents have ADHD themselves,” Stein says. “If a parent goes untreated, they are more likely to forget their child’s medications, miss appointments, lose behavioral charts or not notice positive behaviors when they occur.”

Stein is leading the “Mother’s First” research study to discover how to effectively treat ADHD when a mother has the disorder and their child is at risk or has ADHD that has not yet been treated. The study is treating mothers with medication, behavior modification, or both. Researchers then assess the effects on the mother, the family and the child.

“We know very little about how to treat families when the parent and the child have ADHD,” Stein says. “This study will help us find out if treating mothers first can delay the onset of ADHD in kids.”

While there has been mounting concern over children being diagnosed with ADHD and prescribed medications at a young age, Stein’s study only prescribes medication to mothers and treats children with parent training, a form of behavior modification.

From past research studies, Stein has found parents treated with stimulant medications were more likely to improve their parenting skills.

That was the case with Hughes. She was enrolled in the “Mother’s First” study two months ago and began taking ADHD medications for the first time in her life. Now, she says she can concentrate better, is less angry and manages her children’s behavior more easily.

“As my frustration has decreased their behavior has improved,” Hughes says. “It’s still not easy, but I know much more about ADHD and feel better prepared to handle them.”

Stein hopes this study will change how ADHD is treated in families.

“If we only emphasize treating the child we miss a crucial opportunity to support the whole family,” he says.

“Mother’s First” is currently enrolling study participants. Mothers and children who both show symptoms of ADHD are encouraged to apply. Participants will receive a free assessment and 16 weeks of treatment. Families must not have been treated with ADHD medications before enrolling in the study. Participants must be willing to accept the course of treatment assigned to them. Mothers cannot be pregnant or nursing.

Parents of children with ADHD, ages 6 to 11, can also enroll their child in Camp Seastar, a summer treatment program Stein created for children with ADHD as well as children with autism. The goal of the treatment program is to promote socialization and self esteem with parent training and sports instruction.

In you’re interested in learning more or participating in this study or Camp Seastar, contact Libby Bliss at (206) 884-1488 or


If you are a member of the media and would like to arrange an interview with Dr. Mark Stein, please contact Seattle Children’s PR team at 206-987-4500 or