Cultural Expectations of Child Behavior and Parental Perspectives in ADHD Care: Disciplinary Decisions and Emotional Burden in East Asian Contexts — Oak Academic Publishing
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Cultural Expectations of Child Behavior and Parental Perspectives in ADHD Care: Disciplinary Decisions and Emotional Burden in East Asian Contexts
Zhejiang Chinese Medical University and Paediatrics, Hangzhou First People’s Hospital, Hangzhou, China
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Department of Pediatrics, Hangzhou First People’s Hospital, Affiliated to Westlake University, Hangzhou, China
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Department of Pediatrics, Hangzhou First People’s Hospital, Affiliated to Westlake University, Hangzhou, China
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Department of Child Rehabilitation, Hangzhou Rehabilitation Hospital, Hangzhou, China
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The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine), Hangzhou, China
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The Fourth Clinical School of Zhejiang University of Traditional Chinese Medicine, Hangzhou, China
1 Zhejiang Chinese Medical University and Paediatrics, Hangzhou First People’s Hospital, Hangzhou, China
2 Department of Pediatrics, Hangzhou First People’s Hospital, Affiliated to Westlake University, Hangzhou, China
3 Department of Pediatrics, Hangzhou First People’s Hospital, Affiliated to Westlake University, Hangzhou, China
4 Department of Child Rehabilitation, Hangzhou Rehabilitation Hospital, Hangzhou, China
5 The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine), Hangzhou, China
6 The Fourth Clinical School of Zhejiang University of Traditional Chinese Medicine, Hangzhou, China
Objective : Attention Deficit Hyperactivity Disorder (ADHD) in children is often viewed as a result of bad parenting, moral failure, or lack of discipline in many societies ( Cueli et al., 2024 ). This raises the question of whether cultural expectations of child behavior in East Asian societies influence how parents respond to their children diagnosed with ADHD. In this study, we predict that culturally embedded expectations of child behavior significantly influence parental perspectives in child ADHD care. Using existing literature ( Lv et al., 2025 ) this study refers to Eastern Asian culturally embedded expectations of child behavior as including being obedient, listening to adults, conforming to group expectations, showing respect for others and developing useful social skills. For the purposes of this study, parental perspectives in child care are simply defined by what parents think and how they feel about disciplining children with ADHD. Method : We performed a comprehensive review with structured analysis to evaluate recent evidence about parental perspectives in ADHD care. The review included studies published from 2021 to 2025 to guarantee contemporary relevance. Eligible research included peer-reviewed journal articles, systematic reviews, meta-analyses, and narrative reviews; however, theses, conference abstracts, editorials, blogs, grey literature, and books were excluded. The search took place from September 3, 2025, to January 3, 2026, and the main database used was PubMed. Results : Cultural behavioral expectations were under examined, with merely 10.8% of studies specifically evaluating this issue. In the majority of studies (64.9%), parenting style was also not explicitly documented, which suggests a lack of uniformity in its measurement and conceptualization. Cultural behavioral expectations were also under examined, with merely 10.8% of studies specifically evaluating this issue. According to our analysis, there was no significant correlation between cultural expectations and ADHD behavior framing, parenting style or parenting stress. However, we noticed a correlation between cultural expectations and a preference for strict or compliance-focused discipline. The results generally suggest that culturally acceptable child behavior may have a limited but specific impact, especially on punishment, whereas the wider relationships between many aspects of parenting remain unclear. Conclusion : Our results indicate that cultural expectations of normal child behavior and parental perspectives on ADHD care are related in a broad and complicated way. We also observed that limited and inconsistent measurement of cultural variables in the literature makes it difficult to draw definitive conclusions, indicating that current research may not adequately reflect the complexity of these influences.
KeywordsCultural Behavioral Expectations
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