Parental Perspectives on Eating Disorders of Their School-Age Children with ADHD in Hong Kong: A Qualitative Study

Background: Children with attention deficit hyperactivity disorder (ADHD) frequently encounter eating problems. However, qualitative research on the eating problems of these children and the strategies employed by their parents to manage these issues remains limited. This study aimed to explore the eating problems of school-age children with ADHD and the coping strategies used by parents in urban settings like Hong Kong. Methods: A descriptive qualitative design was utilized, employing semi-structured focus group interviews. Purposive sampling was used to recruit 12 parents who voluntarily participated in five focus group sessions. The interviews were conducted in Cantonese, audio-recorded, and transcribed verbatim. Data were analyzed using template thematic analysis to identify key themes and subthemes. Results: Two major themes emerged: challenges affecting ADHD children's eating behaviors and parental coping strategies in Hong Kong. Children's eating difficulties stemmed from ADHD-specific behaviors, compounded by Hong Kong's demanding educational system and urban environmental constraints. In response, parents developed multifaceted coping approaches, ranging from dietary modifications and behavioral management strategies to healthcare resource utilization, while adapting their urban lifestyle to accommodate their children's needs. Conclusions: Children with ADHD face eating challenges that intersect with Hong Kong's sociocultural environment, where educational pressure, limited living spaces, and parents' work schedules influence their eating patterns. Parents adopt integrated Eastern-Western approaches, supported by Hong Kong's comprehensive healthcare resources spanning professional networks and community programs. Evidence-based dietary guidelines are essential to address ADHD-related nutritional misconceptions.