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Lohiya N, Srivastava L, Lohiya N, Kalrao V. Stress among mothers of children with Autism Spectrum Disorder in comparison to children with & without special health care needs. J Pediatr Rehabil Med 2023; 16:473-481. [PMID: 36776080 DOI: 10.3233/prm-220014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/10/2023] Open
Abstract
PURPOSE Parenting a child with special health care needs (SHCN) is often stressful. This study aimed to measure and compare stress among mothers of children with (a) Autism Spectrum Disorder (ASD) - ASD group, (b) Developmental delay without ASD group, (c) SHCN without developmental delay group, and (d) Typically developing group. To assess factors associated with maternal stress in children with developmental disorders. METHODS A cross-sectional analytical study was performed with children aged 2-12 years and their mothers. The study population was classified into four groups as defined above help of detailed history, developmental & behavioral assessments, psychological assessments, and Child Special Health Care Needs Screener (CSHCN). Parental Stress Scale (PSS) Questionnaire was administered. The main outcome measurement was the PSS and various factors affecting it. RESULTS The mothers of the ASD group reported a high stress score (50.4±11.4) compared to SHCN without developmental delay group (38.2±8.8) and the Typically developing group (22.3±3.3) (p < 0.05) and higher but not significant stress than Developmental delay without ASD group (45.3±9.6, p > 0.05). Maladaptive behavioral issues and irregular interventions were the factors contributing to higher parental stress in the ASD group (p < 0.05). A moderate positive correlation was observed in rewarding and challenging scores of PSS among mothers of the ASD group, Developmental delay without ASD group, and SHCN without developmental delay group. CONCLUSION Mothers of the ASD group perceived higher stress as compared to SHCN without developmental delay group and Typically developing group. Evaluation of stress and stressors is crucial for holistic management of ASD.
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Affiliation(s)
- Nirali Lohiya
- Division of Developmental & Behavioral Pediatrics, Silver Lining Pediatric Super Speciality Center, Nagpur, India
| | - Leena Srivastava
- Department of Pediatrics, Bharati Vidyapeeth Deemed University, Pune, India
| | - Nikhil Lohiya
- Division of Growth & Endocrinology Silver Lining Pediatric Super Speciality Center, Nagpur, India
| | - Vijay Kalrao
- Department of Pediatrics, Bharati Vidyapeeth Deemed University, Pune, India
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Kim KA, Kadyrov RV. Group Schema Therapy for Reducing Parenting Stress in Families with Children with Disabilities. BULLETIN OF KEMEROVO STATE UNIVERSITY 2022. [DOI: 10.21603/2078-8975-2022-24-4-517-524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Parents experience stress that manifests itself as a negative reaction to the situation when the demands of being a parent exceed the expectations of oneself as a parent. Stress level in parents of children with disabilities is significantly higher than in standard families. Schema therapy is an effective psychological intervention for managing this stress. The paper reviews foreign and Russian publications on schema therapy for parents of children with special needs. The comparative analysis showed that schema-therapy approach might have higher efficacy in managing this type of stress than other popular psychotherapeutic approaches, e.g., CBT, MCT, PST, etc. These approaches often focus on teaching specific parenting skills or changing parents' behavior and attitude but leave behind their emotional well-being. Schema therapy develops effective parenting skills and behavioral practices while teaching emotion management strategies. A comprehensive schema therapy program may reduce stress in parents of children with disabilities.
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De Clercq LE, Soenens B, Dieleman LM, Prinzie P, Van der Kaap-Deeder J, Beyers W, De Pauw SSW. Parenting and Child Personality as Modifiers of the Psychosocial Development of Youth with Cerebral Palsy. Child Psychiatry Hum Dev 2022; 53:137-155. [PMID: 33405025 DOI: 10.1007/s10578-020-01106-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/05/2020] [Indexed: 11/26/2022]
Abstract
This two-year longitudinal study addressed the joint contribution of parent-rated parenting behaviors and child personality on psychosocial outcomes in 118 families of children with Cerebral Palsy (M age Time 1 = 10.9 years old, 64.4% boys). Latent change modeling revealed intra-individual changes in children's psychosocial development as internalizing and externalizing behaviors increased from the first to the second assessment and psychosocial strengths increased from the second to the third assessment, whereas externally controlling and autonomy-supportive parenting behavior remained stable over time. Externally controlling parenting related to higher levels of, and increases in behavioral problems, with these associations being most pronounced among children low on Extraversion, Conscientiousness, or Imagination. Autonomy-supportive parenting related to higher levels of psychosocial strengths, with this association being most pronounced among children high on Emotional Stability.
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Affiliation(s)
- Lana E De Clercq
- Department of Special Needs Education, Ghent University, Henri Dunantlaan 1, 9000, Ghent, Belgium.
| | - Bart Soenens
- Department of Developmental, Personality and Social Psychology, Ghent University, Ghent, Belgium
| | - Lisa M Dieleman
- Department of Developmental, Personality and Social Psychology, Ghent University, Ghent, Belgium
| | - Peter Prinzie
- Erasmus School of Social and Behavioral Sciences, Erasmus University Rotterdam, Rotterdam, The Netherlands
| | | | - Wim Beyers
- Department of Developmental, Personality and Social Psychology, Ghent University, Ghent, Belgium
| | - Sarah S W De Pauw
- Department of Special Needs Education, Ghent University, Henri Dunantlaan 1, 9000, Ghent, Belgium
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Kim K, Kadirov R. Parental Stress and Bringing up a Child with Cerebral Palsy: A Foreign Studies Review. КЛИНИЧЕСКАЯ И СПЕЦИАЛЬНАЯ ПСИХОЛОГИЯ 2022. [DOI: 10.17759/cpse.2022110401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
<p style="text-align: justify;">Raising a child with cerebral palsy contains difficult stress, which negatively affects everyone who is involved in this process. In native psychology, this problem is described by I.U. Levchenko, V.V. Tkacheva, V.A. Vishnevsky, T.N. Volkovskaya. However, there is a lack of research on stress for people, who are raising a child with cerebral palsy. The purpose of this review is to learn about foreign studies on stress for people, who are raising children with cerebral palsy. The article describes R. Abidin's current leading model for parental stress. The connection between raising a child with cerebral palsy and parental stress is considered based on R. Abidin's model. Particularly, the results of studies describe specific aspects of parental stress: lack of knowledge on special child care, not an equal assignment for parental responsibilities, separation anxiety, parent's health problems, social isolation, and guilt. Based on the analysis, we can conclude that raising a child with cerebral palsy is associated with a higher level of stress than raising children without disabilities. This information can be used both in similar studies for a domestic sample and in active programs to reduce parental stress.</p>
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Varghese AL, Thomas C, Mohan M, Karuppali S. A Comparative Study of the Communication Profile of Typically Developing Children and Children with Receptive-Expressive Language Disorders: A Parental Perceptive. Clin Pract Epidemiol Ment Health 2021; 17:177-186. [PMID: 35136414 PMCID: PMC8719280 DOI: 10.2174/1745017902117010177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Revised: 08/24/2021] [Accepted: 09/13/2021] [Indexed: 11/24/2022]
Abstract
Background: Parental concerns pertaining to communication abilities are essential as it does aid in the identification of the children at risk of physical and mental health problems. Objectives: The current study followed a cross sectional study design. The study focussed on developing a questionnaire targeting the parental concerns in Typically developing (TD) children and children with Receptive-Expressive Language Disorders (CWRELD) between 3.7 and 6.6 years of age; to administer the developed questionnaire on parents of TD children and CWRELD; and to analyse and compare the concerns faced by parents of TD children and CWRELD across 3.7 and 6.6 years of age. Methods: Fifty-one parents of TD children and 51 parents of CWRELD participated in the study. The study was carried out in three phases- Phase I included the development and validation of questionnaire; Phase II included data collection using the developed questionnaire; and Phase III included performing statistical analysis. Descriptive statistics was done to determine the mean and standard deviation (SD) for both the TD and CWRELD groups. Results: The results revealed that the concerns exhibited by parents of CWRELD were significantly higher than that of parents of TD children. Chi square results indicated statistically significant findings across all the domains between TD children and CWRELD (p<0.05). Conclusion: The developed questionnaire can be used in clinical settings to help track parental concerns which may aid in the early identification of children at risk of various communication disorders. Additionally, this questionnaire may be considered for monitoring parental concerns throughout the course of the intervention program.
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Stress in Caregivers and Children with a Developmental Disorder Who Receive Rehabilitation. CHILDREN-BASEL 2020; 7:children7090136. [PMID: 32942732 PMCID: PMC7552633 DOI: 10.3390/children7090136] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Revised: 09/01/2020] [Accepted: 09/11/2020] [Indexed: 11/26/2022]
Abstract
This study aimed to evaluate the stress levels of caregivers and children with developmental disorders who were receiving rehabilitation treatment. The relationships between stress levels and factors such as early rehabilitation and home rehabilitation were quantified. Methods: This study was conducted in children with development disorders, aged from 1.5 years to 18 years, who were undergoing rehabilitation. The Korean version of the Child Behavior Checklist (K-CBCL) and the Adult Self-Report (K-ASR) were used to evaluate stress levels in children and caregivers, respectively. Results: Questionnaires were provided to 150 caregivers who agreed to participate. However, only 76 copies of the K-CBCL and 75 copies of the K-ASR were collected. The mean K-CBCL and K-ASR t scores were in the normal range. The K-CBCL score correlated positively with the K-ASR score (p value < 0.5). K-CBCL externalizing problems score correlated positively with the age at the start of rehabilitation, and the K-CBCL and K-ASR externalizing problems scores correlated negatively with home treatment delivered by caregivers. Conclusions: Stress levels of children and caregivers were closely related. Home rehabilitation provided by caregivers reduced stress in both caregivers and children. Early rehabilitation did not impart additional psychological burden on caregivers or children.
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van Gorp M, E Roebroeck M, van Eck M, M Voorman J, Twisk JWR, J Dallmeijer A, van Wely L. Childhood factors predict participation of young adults with cerebral palsy in domestic life and interpersonal relationships: a prospective cohort study. Disabil Rehabil 2019; 42:3162-3171. [PMID: 31060408 DOI: 10.1080/09638288.2019.1585971] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Purpose: To determine childhood predictors of participation in domestic life and interpersonal relationships of young adults with cerebral palsy (CP).Materials and methods: This 13-year follow-up of an existing cohort (baseline age 9-13 years) included 67 young adults with CP (age 21-27 years). The Vineland adaptive behavior scales (VABS) and Life Habits questionnaire were used to assess attendance and difficulty in participation in domestic life and interpersonal relationships. Baseline factors were categorised according to the international classification of functioning, disability, and health. Stepwise multiple linear regression analyses determined significant predictors (p < 0.05).Results: Lower manual ability, intellectual disability (ID), epilepsy and lower motor capacity predicted decreased future participation in domestic life, and/or interpersonal relationships (explained variance R2 = 67-87%), whereas no association was found with environmental and personal factors. Extending models with baseline fine motor skills, communication, and interpersonal relationships increased R2 to 79-90%.Conclusions: Childhood factors account for 79-90% of the variation in young adult participation in domestic life and interpersonal relationships of individuals with CP. Children with limited motor capacity, low manual ability, ID, or epilepsy are at risk for restrictions in participation in young adulthood. Addressing fine motor, communication, and social skills in paediatric rehabilitation might promote young adult participation.Implications for rehabilitationChildhood risk factors for limited participation in domestic life and interpersonal relationships as a young adult with CP are ID, epilepsy, low manual ability, low motor capacity, and low activity & participation levels.In line with current practice, this study confirms the importance of addressing gross and fine motor skills in children with CP for their future participation in domestic life.In addition, results suggest that addressing communication and social skills during paediatric rehabilitation may optimise future participation in interpersonal relationships.
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Affiliation(s)
- Marloes van Gorp
- Department of Rehabilitation Medicine, Amsterdam Movement Sciences, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.,Department of Rehabilitation Medicine, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Marij E Roebroeck
- Department of Rehabilitation Medicine, Erasmus MC University Medical Center, Rotterdam, The Netherlands.,Rijndam Rehabilitation, Rotterdam, The Netherlands
| | - Mirjam van Eck
- Department of Rehabilitation Medicine, Amsterdam Movement Sciences, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.,HU University of Applied Sciences, Utrecht, The Netherlands
| | - Jeanine M Voorman
- Department of Rehabilitation, Physical Therapy Science & Sports, Brain Center Rudolf Magnus, University Medical Center Utrecht, Wilhelmina Children's Hospital, Utrecht University, Utrecht, The Netherlands.,Center of Excellence for Rehabilitation Medicine, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht University, and De Hoogstraat Rehabilitation, Utrecht, the Netherlands
| | - Jos W R Twisk
- Department of Epidemiology and Biostatistics, EMGO Institute for Health and Care Research, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Annet J Dallmeijer
- Department of Rehabilitation Medicine, Amsterdam Movement Sciences, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Leontien van Wely
- Department of Rehabilitation Medicine, Amsterdam Movement Sciences, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.,Department of Rehabilitation Medicine, Erasmus MC University Medical Center, Rotterdam, The Netherlands
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Sleep disturbances and behavioural and emotional problems in preschool children with bilateral cerebral palsy. SOMNOLOGIE 2017. [DOI: 10.1007/s11818-017-0121-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Guyard A, Michelsen SI, Arnaud C, Fauconnier J. Family adaptation to cerebral palsy in adolescents: A European multicenter study. RESEARCH IN DEVELOPMENTAL DISABILITIES 2017; 61:138-150. [PMID: 28087202 PMCID: PMC5667745 DOI: 10.1016/j.ridd.2016.11.010] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/22/2016] [Accepted: 11/19/2016] [Indexed: 05/27/2023]
Abstract
BACKGROUND AND AIM Factors promoting family adaptation to child's disability are poorly studied together. The aim of the study was to describe the family adaptation to disability and to identify determinants associated with using a global theoretical model. MATERIALS AND METHODS 286 families of teenagers [13-17 years] with cerebral palsy (CP) from 4 European disability registers were included and visited at home. Face to face interviews were performed in order to measure parental distress, perceived impact in various dimensions of family life, family resources and stressors. Relationships were modelled with structural equations. RESULTS 31.8% of parents living with an adolescent with CP showed clinically significant high stress requiring professional assistance. The main stressors were the level of motor impairment and behavioural disorders in adolescent. A good family functioning was the best protective factor. Respite in care and a parents' positive attitude were significantly related to less parental distress. Material support, socioeconomical level, marital status or parental qualifications did not appear to be significant protector factors. CONCLUSIONS Particular attention must be paid not only on physical condition but also on adolescent psychological problems to improve family adaptation. Families at risk of experiencing severe distress should be targeted early and proactive caregiver interventions on the whole family should be performed. WHAT THIS PAPER ADDS Family is a dynamic system: facing disability, it tries to recover its balance with available resources and its perception of the situation. Literature highlights potential stressors and protecting factors that could affect the disabled child's family adaptation but few papers study a global model including most of these factors. This study validated a global theoretical model of family adaptation to disability at adolescence. It identified behaviour disorders and motor impairment level as main stressors, family functioning as the largest protecting factors, and equipment and financial support as non significant protective factors.
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Affiliation(s)
- Audrey Guyard
- UGA/CNRS/CHU de Grenoble, TIMC-IMAG UMR 5525, Themas, Grenoble F-38041, France.
| | - Susan I Michelsen
- National Institute of Public Health, University of Southern Denmark, Oster Farimagsgade 5, 1399 Copenhagen, Denmark.
| | - Catherine Arnaud
- INSERM, UMR 1027, Paul Sabatier University, 31000 Toulouse, France.
| | - Jerome Fauconnier
- UGA/CNRS/CHU de Grenoble, TIMC-IMAG UMR 5525, Themas, Grenoble F-38041, France.
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Ribeiro MFM, Vandenberghe L, Prudente COM, Vila VDSC, Porto CC. Paralisia cerebral: faixa etária e gravidade do comprometimento do filho modificam o estresse e o enfrentamento materno. CIENCIA & SAUDE COLETIVA 2016; 21:3203-3212. [DOI: 10.1590/1413-812320152110.17352016] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2016] [Accepted: 06/29/2016] [Indexed: 11/22/2022] Open
Abstract
Resumo Estudo com objetivo de compreender de que forma a faixa etária e a gravidade do comprometimento motor dos filhos modificam o significado que mulheres, mães de filhos com paralisia cerebral, atribuem ao estresse e conhecer as estratégias de enfrentamento utilizadas por elas. Abordagem qualitativa com referencial metodológico na Teoria Fundamentada nos Dados. Dezenove mulheres, mães de crianças e de adolescentes com diferentes graus de comprometimento motor participaram de entrevistas individuais e semiestruturadas. A falta de apoio, a expansão do tempo e do esforço investido no papel de mãe, em detrimento de outras áreas da vida, prejudicam a saúde física e emocional das participantes. Mulheres com filhos que apresentam leve comprometimento sofrem com o desafio de lidar com os problemas emocionais, a agressividade e as dificuldades de aprendizado dos filhos. Para mães de filhos com grave comprometimento, o mais difícil é lidar com as complicações de saúde e as limitações funcionais. Mães de crianças, relatam fontes de estresse diversificadas e escassez de recursos; já as mães de adolescentes acumulam experiências e retomam os planos de vida. As experiências, o conhecimento e o apoio recebido são decisivos para a adaptação.
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Klein B. Mental health problems in children with neuromotor disabilities. Paediatr Child Health 2016; 21:93-100. [PMID: 27095886 DOI: 10.1093/pch/21.2.93] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Mental health in children with neuromotor disorders is part of a dynamic system, including medical and developmental domains, family, school and community. Presentations are often complex and multifactorial, requiring a broad, individualized approach. A narrative overview of mental health symptoms in children with neuromotor disabilities is provided, along with recommendations for their assessment and management using the WHO's International Classification of Functioning framework.
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Klein B. Les problèmes de santé mentale chez les enfants ayant des troubles neuromoteurs. Paediatr Child Health 2016. [DOI: 10.1093/pch/21.2.97] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Behavioral and emotional problems in children and adults with cerebral palsy. Eur J Paediatr Neurol 2016; 20:270-274. [PMID: 26748599 DOI: 10.1016/j.ejpn.2015.12.003] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2015] [Revised: 11/14/2015] [Accepted: 12/06/2015] [Indexed: 11/20/2022]
Abstract
OBJECTIVE In patients with cerebral palsy (CP), psychological problems influence their participation in society. Little is known about the persistence of behavioral and social problems into adulthood. MATERIALS AND METHODS In a two-center cross-sectional study, caregivers of 121 adults and 88 children were ask to assess behavior of the patients through the parent/caregiver forms of the Child Behavior Checklist (CBCL), the Strengths and Difficulties Questionnaire (SDQ), and the Vineland Adaptive Behavior Scale II (VABS). Questionnaires were returned from 43 adults and 39 children. RESULTS In both groups we found the same frequency of abnormalities in attention problems (32.4 vs. 36.1%, p = 0.826) and social interaction problems (32.3 vs. 33.3%; p = 0.926) in the CBCL, and peer problems (38.9 vs. 75.7%; p = 0.115) in the SDQ. Children show a lower percentage of abnormal prosocial behavior (41.7 vs. 16.2%, p = 0.016) and lower abnormal rates of communication (88.2 vs. 61.5; p = 0.01) and daily living skills (90.0 vs. 71.8; p = 0.041), whereas the level of abnormalities in both groups in these dimensions of VABS notably high. CONCLUSION The persistence of psychological and social problems from childhood into adulthood underlines the importance of focusing on early intervention.
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Rackauskaite G, Bilenberg N, Bech BH, Uldall P, Østergaard JR. Screening for psychopathology in a national cohort of 8- to 15-year-old children with cerebral palsy. RESEARCH IN DEVELOPMENTAL DISABILITIES 2016; 49-50:171-180. [PMID: 26707927 DOI: 10.1016/j.ridd.2015.11.019] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/19/2015] [Revised: 11/01/2015] [Accepted: 11/19/2015] [Indexed: 06/05/2023]
Abstract
UNLABELLED Cerebral palsy (CP) is often accompanied by psychopathology and learning disability. AIMS (1) to evaluate the prevalence of psychopathology as estimated by the Child Behavior Checklist (CBCL) parental questionnaire in 8- to 15-year-old Danish children with CP and to analyze its association with cognitive ability and families' social characteristics; (2) to examine to what extent children with CP had been evaluated by a child psychiatrist and/or psychologist. METHOD The parents of 462 children with CP answered a questionnaire about their child's treatment and the family's characteristics and 446 the CBCL. The cutoff for psychopathology was the Total CBCL score or DSM-oriented scores above the 93rd percentile in an age- and gender-stratified population. RESULTS The psychopathology screening was positive in 46.2% (CI 41.6-50.8%) against 15.1% in general population. Cognitive disability was associated with an increased prevalence of psychopathology (odds ratio (OR) 2.6, CI 1.4-4.6, for Developmental Quotient of cognitive function (DQ) 50-85 and OR 3.0, CI 1.3-7.0, for DQ<50). Children with CP and a single parent showed increased odds for a positive CBCL screening compared to children living with two parents (OR 2.1, 95% CI 1.1-4.0). Children with DQ 50-85 more often had a psychological evaluation. A positive CBCL screening was strongly associated with a psychiatric assessment (21% vs. 7%, p<0.01). CONCLUSION The high prevalence of emotional and behavioral problems indicates that screening for psychopathology should be a part of multidisciplinary follow-up of CP. The CBCL can be used as a screening instrument in children with CP without severe motor and cognitive disability.
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Affiliation(s)
- Gija Rackauskaite
- Department of Pediatrics, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, 8200 Aarhus N, Denmark.
| | - Niels Bilenberg
- Child and Adolescent Psychiatry, University of Southern Denmark, Campusvej 55, 5230 Odense M, Denmark.
| | - Bodil Hammer Bech
- Department of Public Health, Aarhus University, Bartholins Allé 2, 8000 Aarhus C, Denmark.
| | - Peter Uldall
- the Cerebral Palsy Registry, National Institute of Public Health, University of Southern Denmark, Øster Farimagsgade 5 A, 1353 Copenhagen K, Denmark; Department of Pediatrics and Adolescent Medicine at The Juliane Marie Centre, Rigshospitalet, Copenhagen University Hospital and at The University of Copenhagen, Blegdamsvej 9, 2100 Copenhagen Ø, Denmark.
| | - John Rosendahl Østergaard
- Department of Pediatrics, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, 8200 Aarhus N, Denmark
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Sylvestre A, Brisson J, Lepage C, Nadeau L, Deaudelin I. Social participation of children age 8-12 with SLI. Disabil Rehabil 2015; 38:1146-56. [PMID: 26287388 DOI: 10.3109/09638288.2015.1074730] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
PURPOSE Two objectives are being pursued: (1) to describe the level of social participation of children aged 8-12 presenting a specific language impairment (SLI) and (2) to identify personal and family factors associated with their level of social participation. METHOD This cross-sectional study was conducted among 29 children with SLI and one of their parents. Parental stress and family adversity were measured as risk factors. The measure of life habits (LIFE-H) adapted to children aged 5-3 was used to measure social participation. RESULTS The assumption that social participation of these children is impaired in relation to the communication dimension was generally confirmed. The statements referring to the "communication in the community" and "written communication" are those for which the results are weaker. "Communication at home" is made easier albeit with some difficulties, while "telecommunication" is totally preserved. A high level of parental stress is also confirmed, affecting the willingness of parents to support their child's autonomy. CONCLUSIONS The achievement of a normal lifestyle of children with SLI is upset in many spheres of life. Methods of intervention must better reflect the needs and realities experienced by these children in their various living environments, in order to optimize social participation, and consequently, to improve their well-being and that of their families. The need to develop strategies to develop children's independence and to reduce parental stress must be recognized and all stakeholders need to be engaged in the resolution of this challenge. IMPLICATIONS FOR REHABILITATION The realization of life habits of SLI children is compromised at various levels, especially in the domain related to "communication in the community" and "written communication". Speech-language pathologists must consider providing ongoing support throughout the primary years of these children and during adolescence, to promote and facilitate the continued realization of life habits of SLI persons. Providing ongoing support throughout the primary years and thereafter is needed to facilitate the continuing realization of life habits of SLI persons. Parents of children with SLI experience considerable stress in relation to the exercise of their parental roles. It is important to intervene and to support parents to promote autonomy for their SLI children.
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Affiliation(s)
- Audette Sylvestre
- a Département de réadaptation, Programme de maîtrise en orthophonie , Université Laval , Québec, QC , Canada .,b Centre Interdisciplinaire de Recherche en Réadaptation et Intégration Sociale , Boulevard Hamel, Québec, QC , Canada
| | - Jacinthe Brisson
- b Centre Interdisciplinaire de Recherche en Réadaptation et Intégration Sociale , Boulevard Hamel, Québec, QC , Canada
| | - Céline Lepage
- b Centre Interdisciplinaire de Recherche en Réadaptation et Intégration Sociale , Boulevard Hamel, Québec, QC , Canada .,c Institut de réadaptation en déficience physique de Québec , Québec, QC , Canada , and
| | - Line Nadeau
- b Centre Interdisciplinaire de Recherche en Réadaptation et Intégration Sociale , Boulevard Hamel, Québec, QC , Canada .,d Département de réadaptation, Programme d'ergothérapie , Université Laval , Québec, QC , Canada
| | - Isabelle Deaudelin
- c Institut de réadaptation en déficience physique de Québec , Québec, QC , Canada , and
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Dambi JM, Jelsma J, Mlambo T. Caring for a child with Cerebral Palsy: The experience of Zimbabwean mothers. Afr J Disabil 2015; 4:168. [PMID: 28730030 PMCID: PMC5433478 DOI: 10.4102/ajod.v4i1.168] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2014] [Accepted: 06/15/2015] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND The needs of caregivers of children with disability may not be recognized despite evidence to suggest that they experience increased strain because of their care-giving role. This strain may be exacerbated if they live in under-resourced areas. OBJECTIVES We set out to establish the well-being of caregivers of children with Cerebral Palsy (CP) living in high-density areas of Harare, Zimbabwe. In addition, we wished to identify factors that might be predictive of caregivers' well-being. Finally, we examined the psychometric properties of the Caregiver Strain Index (CSI) within the context of the study. METHOD Caregivers of 46 children with CP were assessed twice, at baseline, and after three months, for perceived burden of care and health-related quality of life (HRQoL) using CSI and EQ-5D respectively. The psychometric properties of the CSI were assessed post hoc. RESULTS The caregivers reported considerable caregiver burden with half of the caregivers reporting CSI scores in the 'clinical distress' range. Many of the caregivers experienced some form of pain, depression and expressed that they were overwhelmed by the care-giving role. No variable was found to be associated with clinical distress. The CSI demonstrated good overall internal consistency (Cronbach's Alpha = 0.8), stability over time (Z = 0.87, p = 0.381) and was significantly and negatively correlated with the EQ-5D VAS (Spearman's rho = -0.33, p = 0.027), demonstrating concurrent validity. CONCLUSION Caregivers must be monitored routinely for their level of distress and there is an urgent need to provide them with support. The CSI is likely to be a valid measure of distress in this population.
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Affiliation(s)
| | - Jennifer Jelsma
- Department of Health and Rehabilitation Sciences, University of Cape Town, South Africa
| | - Tecla Mlambo
- Department of Rehabilitation, University of Zimbabwe, Zimbabwe
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Cantwell J, Muldoon OT, Gallagher S. Social support and mastery influence the association between stress and poor physical health in parents caring for children with developmental disabilities. RESEARCH IN DEVELOPMENTAL DISABILITIES 2014; 35:2215-23. [PMID: 24927515 DOI: 10.1016/j.ridd.2014.05.012] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/24/2014] [Revised: 05/10/2014] [Accepted: 05/16/2014] [Indexed: 05/14/2023]
Abstract
To date, much of the research linking the stress of caring for children with developmental disabilities (e.g. Autism & Down syndrome) with parental health outcomes have tended to concentrate on mental health with less attention paid to the physical health consequences. Thus, this study sought to explore the psychosocial predictors of poor physical health in these caring parents. One hundred and sixty-seven parents (109 caregivers and 58 control parents) completed measures of stress, child problem behaviours, social support, mastery and physical health. Parents of children with developmental disabilities had poorer physical health compared to control parents. Stress and mastery, but not social support and problem behaviours, were significant predictors of poor physical health within caring parents for children with developmental disabilities. However, the association between mastery and physical health was mediated by perceived stress such that those parents who were higher on mastery reported less stress and better physical health; furthermore, the association between stress and physical health was moderated by social support; those parents high on social support and low in stress had better physical health. These results indicate that the paths between psychosocial factors and poor physical health in the caring parents are working synergistically rather than in isolation. They also underscore the importance of providing multi-component interventions that offer a variety of psychosocial resources to meet the precise needs of the parents.
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Affiliation(s)
- Joanne Cantwell
- Department of Psychology, University of Limerick, Limerick, Ireland; Centre for Social Issues Research, University of Limerick, Limerick, Ireland.
| | - Orla T Muldoon
- Department of Psychology, University of Limerick, Limerick, Ireland; Centre for Social Issues Research, University of Limerick, Limerick, Ireland
| | - Stephen Gallagher
- Department of Psychology, University of Limerick, Limerick, Ireland; Centre for Social Issues Research, University of Limerick, Limerick, Ireland
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Peer JW, Hillman SB. Stress and Resilience for Parents of Children With Intellectual and Developmental Disabilities: A Review of Key Factors and Recommendations for Practitioners. JOURNAL OF POLICY AND PRACTICE IN INTELLECTUAL DISABILITIES 2014. [DOI: 10.1111/jppi.12072] [Citation(s) in RCA: 105] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Justin W. Peer
- Behavioral Sciences Department; University of Michigan-Dearborn; Dearborn MI USA
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Working Therapeutically with Parents after the Diagnosis of a Child's Cerebral Palsy: Issues and Practice Guidelines. AUSTRALIAN JOURNAL OF REHABILITATION COUNSELLING 2014. [DOI: 10.1017/jrc.2014.6] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Little is known about the effectiveness of psychoeducational support groups on positive adaptation in parents and families after a child has been diagnosed with cerebral palsy. A systematic literature review adopting the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines was conducted to gain an understanding of the process of adaptation in parents with a child with cerebral palsy and the effects psychoeducational support programs have on this process. The databases searched were psychINFO, Taylor and Francis Online, PsychARTICLES, Medline and ProQuest. A total of 1083 papers were found and 19 of those papers were analysed. A narrative approach was used to synthesise the data extracted. A number of factors that influence adaption within a family after the diagnosis of cerebral palsy in a family member were identified in the review. These factors include, but are not limited to, providing appropriate and relevant information to parents and families, identifying community services and resources available to the family, assisting in the reduction of psychosocial distress, and encouraging the facilitation and collaboration of a strong parent-professional partnership throughout the process. Based on this information guidelines for psychoeducation programs for this client group were proposed.
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20
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Pfeifer LI, Silva DBR, Lopes PB, Matsukura TS, Santos JLF, Pinto MPP. Social support provided to caregivers of children with cerebral palsy. Child Care Health Dev 2014; 40:363-9. [PMID: 23734935 DOI: 10.1111/cch.12077] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/14/2013] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To describe the perception of caregivers of children with cerebral palsy (CP) concerning social support received and to verify how the characteristics of the children (i.e. type of CP and severity of motor impairment) and those of their caregivers (i.e. age, level of education, occupation, income and number of children) are significantly related to this perception. METHOD A total of 50 children with CP aged between 3 and 12 years and their respective caregivers participated in this study. Children were grouped in terms of type of CP and according to the severity of motor impairment through the Gross Motor Function Classification System (GMFCS). The Social Support Questionnaire (SSQ) was used to evaluate the perception of caregivers concerning the social support they receive (number of people offering support - SSQ-N index, and level of satisfaction concerning such support - SSQ-S index). RESULTS The caregivers reported receiving support from a mean of 1.67 people. Core and extended family members (i.e. husband, mother, siblings) and friends are the most common providers of support. In regard to level of satisfaction, caregivers considered the support they received to be positive, obtaining a mean of 5.52 out of a total of six points. Children's and caregivers' characteristics were not significantly related to the SSQ-N and SSQ-S indexes. CONCLUSION Family members are the caregivers' primary source of social support and caregivers reported being satisfied with the support they received.
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Affiliation(s)
- L I Pfeifer
- Department of Neurosciences and Behavioral Sciences, Division of Occupational Therapy, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, S.P., Brazil
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21
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Ribeiro MFM, Sousa ALL, Vandenberghe L, Porto CC. Parental stress in mothers of children and adolescents with cerebral palsy. Rev Lat Am Enfermagem 2014; 22:440-7. [PMID: 25029055 PMCID: PMC4292615 DOI: 10.1590/0104-1169.3409.2435] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2013] [Accepted: 03/11/2014] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVES to evaluate parental stress of mothers of children and adolescents with cerebral palsy; to verify whether parental stress undergoes variations according to the level of motor compromise, the child's phase of life, and sociodemographic variables. METHOD a cross-sectional, descriptive study, with 223 mothers of children and adolescents with cerebral palsy. RESULTS 45.3% of the mothers presented high levels of stress; there were differences in stress between mothers of children with mild and severe motor impairment; mothers of older children were more stressed than mothers of younger children and of adolescents; paid work and leisure activities reduced the stress. CONCLUSION mothers of children and adolescents with cerebral palsy, whose children present mild to severe motor impairment are vulnerable to parental stress. Paid work and leisure activities were the factors that contributed most to reducing the stress.
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Affiliation(s)
- Maysa Ferreira Martins Ribeiro
- Doctoral student, Universidade Federal de Goiás, Goiânia, GO,
Brasil. Assistant Professor, Pontifícia Universidade Católica de Goiás, Goiânia, GO,
Brazil. Scholarship holder from Fundação de Amparo à Pesquisa do Estado de Goiás
(FAPEG)
| | - Ana Luiza Lima Sousa
- PhD, Associate Professor, Faculdade de Enfermagem, Universidade
Federal de Goiás, Goiânia, GO, Brazil
| | - Luc Vandenberghe
- PhD, Adjunct Professor, Pontifícia Universidade Católica de Goiás,
Goiânia, GO, Brazil
| | - Celmo Celeno Porto
- PhD, Emeritus Professor, Faculdade de Medicina, Universidade
Federal de Goiás, Goiânia, GO, Brazil
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Abstract
OBJECTIVE This paper explores possible connections among existing literature on parental stress, augmentative and alternative communication (AAC), and use of mobile technology for persons with autism spectrum disorder (ASD). METHODS A narrative review of the literature. RESULTS Parental support contributes to positive outcomes for children who use AAC. Parents identify communication as a high priority, but describe the process as challenging. AAC is often used with children with ASD, a population in which parental stress is especially high. Though there is research evidence that mobile technology is a promising tool for individuals with ASD, potentially misleading media anecdotes exist, and the effects on parental expectations and stress remain unstudied questions. CONCLUSION Increased understanding of the connections in these research areas should help clarify the potential impact of mobile technologies on parental stress level, help to define appropriate future research directions, and contribute to development of appropriate caregiver training.
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Affiliation(s)
- Anna A Allen
- Department of Communication Sciences and Disorders, MGH Institute of Health Professions , Charlestown Navy Yard, Boston, MA , USA and
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23
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Levy-Zaks A, Pollak Y, Ben-Pazi H. Cerebral palsy risk factors and their impact on psychopathology. Neurol Res 2014; 36:92-4. [DOI: 10.1179/1743132813y.0000000290] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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24
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van Schie PEM, Siebes RC, Dallmeijer AJ, Schuengel C, Smits DW, Gorter JW, Becher JG. Development of social functioning and communication in school-aged (5-9 years) children with cerebral palsy. RESEARCH IN DEVELOPMENTAL DISABILITIES 2013; 34:4485-4494. [PMID: 24139717 DOI: 10.1016/j.ridd.2013.09.033] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/19/2013] [Revised: 09/15/2013] [Accepted: 09/19/2013] [Indexed: 06/02/2023]
Abstract
The aim of this study was to examine determinants of the course and level of social functioning and communication in school-aged children with cerebral palsy (CP) over a 2-year period. A clinic-based sample of 5 and 7 years old children with CP (n=108; 72 males; mean age 6 y 3 mo, SD 12 mo; Gross Motor Function Classification System (GFMCS) level I-V) was followed longitudinally in three yearly assessments. Social functioning and communication were measured with the Vineland Adaptive Behavior Scales (VABS). Data were analyzed with generalized estimated equations. The results showed that social function followed a course of progressive restrictions over time in non-ambulatory children with CP aged 5-9 compared to children who could walk with or without walking aids. Overall lower levels of social functioning were found in children with GMFCS V, epilepsy, speech problems, lower intellectual capacity and older age at baseline. For communication more restrictions over time were found in children with lower intellectual capacity. Children with GMFCS V, speech problems and older age at baseline had overall greater restrictions in communication. It was concluded that motor functioning and intellectual ability can be used to identify children at risk for progressive restrictions in social functioning and communication. For children with CP and social and communicative restrictions, multidisciplinary assessment and treatment may be indicated to counteract an unfavorable development.
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Affiliation(s)
- Petra E M van Schie
- VU University Medical Center, Department of Rehabilitation Medicine and EMGO Institute for Health and Care Research, Amsterdam, The Netherlands.
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25
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Bøttcher L, Dammeyer J. Disability as a risk factor? Development of psychopathology in children with disabilities. RESEARCH IN DEVELOPMENTAL DISABILITIES 2013; 34:3607-3617. [PMID: 23962606 DOI: 10.1016/j.ridd.2013.07.022] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/21/2013] [Revised: 07/15/2013] [Accepted: 07/15/2013] [Indexed: 06/02/2023]
Abstract
Empirical research has established that children with disabilities are more likely to develop psychopathology than children without disabilities. But too little is known about the association between disability and psychopathology. The aim of this article is to discuss developmental psychopathological models that conceptualise the connection between childhood disability and psychopathology. Empirical studies of psychopathology among children with a congenital hearing impairment and children with cerebral palsy will be reviewed, representing in-depth examples of association between disability and psychopathology. Both a congenital hearing impairment and cerebral palsy were found to be dominating risk factors for all types of psychopathology, but no relationship was identified between degree of disability and risk of psychopathology. The higher risk cannot be explained by biological impairments alone. To explain the contradictory findings, developmental models of disability and psychopathology are applied. Within a multi-factorial developmental psychopathological perspective and a dialectical model of disability (Vygotsky, 1993), it is suggested that disability can be understood as an incongruence between the individual development of the child and demands and expectations in the specific relations and institutions in which the child participates. This incongruence creates and strengthens negative factors for the child with disability and results in a higher risk of psychopathology.
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Affiliation(s)
- Louise Bøttcher
- Aarhus University, Department of Education, Tuborgvej 164, 2400 Copenhagen NV, Denmark.
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26
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Ribeiro MFM, Porto CC, Vandenberghe L. Estresse parental em famílias de crianças com paralisia cerebral: revisão integrativa. CIENCIA & SAUDE COLETIVA 2013. [DOI: 10.1590/s1413-81232013000600022] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
O objetivo deste artigo é selecionar, avaliar e interpretar criticamente as publicações que tiveram como foco principal o estresse vivenciado pelos pais/cuidadores de crianças com paralisia cerebral. Revisão integrativa da literatura. A busca foi conduzida na Biblioteca Virtual em Saúde (BVS), no United States National Library of Medicine (PubMED) e busca manual de referências nos estudos selecionados. Optou-se por selecionar aqueles publicados no período de 1998 a 2011. Integraram a amostra 13 artigos. Pais de crianças com paralisia cerebral apresentam níveis de estresse maiores do que os de sem deficiência. Os problemas de comportamento, os distúrbios psicológicos e emocionais das crianças foram os fatores mais comumente associados aos maiores níveis de estresse. A satisfação com apoio social, satisfação com o papel de pai/mãe, o bom funcionamento familiar, o vínculo afetivo pai/mãe-filho, o apoio do cônjuge e o sentimento de participar ativamente da vida social contribuem para reduzir os níveis de estresse. A saúde dos pais de crianças com paralisia cerebral está comprometida pelos maiores níveis de estresse. Desta forma, profissionais da saúde devem oferecer uma atenção especial a eles.
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27
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Guillamón N, Nieto R, Pousada M, Redolar D, Muñoz E, Hernández E, Boixadós M, Gómez-Zúñiga B. Quality of life and mental health among parents of children with cerebral palsy: the influence of self-efficacy and coping strategies. J Clin Nurs 2013; 22:1579-90. [PMID: 23461414 DOI: 10.1111/jocn.12124] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/03/2012] [Indexed: 11/29/2022]
Abstract
AIMS AND OBJECTIVES To explore the quality of life and mental health of caregivers of children with cerebral palsy and to examine the impact of self-efficacy and coping strategies on these outcomes. BACKGROUND Few studies analyse the impact of caring for a child with cerebral palsy on the caregivers' quality of life besides mental health. Also, less attention has been paid to the influence of caregiver's personal resources like self-efficacy or coping strategies on how they adjust to the child's illness and the care situation. DESIGN Cross-section correlational design. METHODS Sixty two parents of children with cerebral palsy completed measures to assess the quality of life (i.e. physical, environmental and social relationships), mental health (i.e. general mental health, depression and anxiety), self-efficacy and coping strategies. RESULTS Parents of children with cerebral palsy had, in general terms, low levels of quality of life and mental health. Self-efficacy was related to most of the outcomes, whereas any of the coping strategies assessed was significantly related to the outcomes. CONCLUSIONS Quality of life and mental health can be affected in caregivers of children with CP. Personal resources like self-efficacy also need attention as they can help in the understanding of the differences in these outcomes and the design of effective interventions. RELEVANCE OF CLINICAL PRACTICE: Self-efficacy should be a key element in interventions addressed to parents of children with CP to elicit a process of empowerment that can improve the well-being of the family as a whole.
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Affiliation(s)
- Noemí Guillamón
- PSiNET research Group, Internet Interdisciplinary Institute, Universitat Oberta de Catalunya, Barcelona, Spain.
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28
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Andrijic V, Bayer J, Bretherton L. Validity of the Children's Moods, Fears and Worries Questionnaire in a clinical setting. Child Adolesc Ment Health 2013; 18:11-17. [PMID: 32847258 DOI: 10.1111/j.1475-3588.2012.00655.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/03/2012] [Indexed: 11/28/2022]
Abstract
BACKGROUND The Children's Moods, Fears and Worries Questionnaire (CMFWQ) is a recently developed parent-report measure for detecting young children's internalising difficulties. This study evaluated construct and criterion-related validity with a clinical sample. METHOD The measure was completed by 30 mothers of children aged between 18 months and 7 years referred to hospital clinical psychology services. RESULTS The CMFWQ demonstrated sound convergent and discriminant validity and a clinical cut-point was established, which optimally discriminated between children with internalising problems and those within the normal range. CONCLUSION The CMFWQ has potential value for identifying young children in need of intervention for internalising problems.
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Affiliation(s)
- Vanessa Andrijic
- Psychology Department, The University of Melbourne, Victoria, 3010, Australia
| | - Jordana Bayer
- Murdoch Children's Research Institute, The Royal Children's Hospital, Parkville, Victoria, Australia
| | - Lesley Bretherton
- Psychology Department, The Royal Children's Hospital, Parkville, Victoria, Australia
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29
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Alyanak B, Kılınçaslan A, Kutlu L, Bozkurt H, Aydın A. Psychological adjustment, maternal distress, and family functioning in children with obstetrical brachial plexus palsy. J Hand Surg Am 2013; 38:137-42. [PMID: 23218557 DOI: 10.1016/j.jhsa.2012.09.036] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2012] [Revised: 09/27/2012] [Accepted: 09/28/2012] [Indexed: 02/02/2023]
Abstract
PURPOSE To examine emotional and behavioral characteristics of children with obstetrical brachial plexus palsy (OBPP), psychological distress of their mothers and their family functioning, and compare them with healthy peers. METHODS Participants included 42 children with OBPP (22 boys, 20 girls; age range, 4-16 y; mean, 7 y 0 mo; SD, 3 y 3 mo) and 43 healthy controls (24 boys, 19 girls; age range, 4-15 y; mean, 8 y 0 m; SD, 3 y 0 mo). Childhood Behavior Checklist, Symptom Checklist 90, and Family Assessment Device were filled in by the mothers. RESULTS Participants with OBPP displayed higher problem scores than the comparison children in most of the domains, including internalizing and externalizing problems. Maternal distress was higher in the OBPP group, and few differences in family functioning were noted. Maternal distress and having the diagnosis of OBPP were the strongest predictors of children's total problem scores and explained 26% of the variance when the effect of age, sex, and family functioning were controlled. CONCLUSIONS Children with OBPP and their mothers are at increased risk for a variety of psychological problems. Professionals should be aware of these children's and their caregivers' psychological adjustment and refer them for further psychological support when needed. TYPE OF STUDY/LEVEL OF EVIDENCE Prognostic II.
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Affiliation(s)
- Behiye Alyanak
- Department of Child and Adolescent Psychiatry, Istanbul Faculty of Medicine, Istanbul University, Fatih, Istanbul, Turkey
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30
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Hall HR, Neely-Barnes SL, Graff JC, Krcek TE, Roberts RJ, Hankins JS. Parental stress in families of children with a genetic disorder/disability and the resiliency model of family stress, adjustment, and adaptation. ACTA ACUST UNITED AC 2012; 35:24-44. [PMID: 22250965 DOI: 10.3109/01460862.2012.646479] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Research suggests that parents of children with disabilities endure increased amounts of stress but also experience positive outcomes. PURPOSE To further investigate findings from focus group interviews that explored parental stress in families of children with disabilities using a sequential mixed methods design. METHOD This study sought to model parental stress using the McCubbin and McCubbin (1993) Resiliency Model of Stress, Adjustment, and Adaptation using qualitative and quantitative data collected sequentially. Twenty-five parents of children with autism spectrum disorder, cerebral palsy, Down syndrome, and sickle cell disease participated in a 2-step study that encompassed qualitative followed by quantitative data ascertainment. RESULTS Parents who quantitatively experienced high stress or low stress used different behavioral themes to describe their experience qualitatively. Positive appraisals, resources, and ability to engage in problem solving and coping were associated with family resiliency.
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Affiliation(s)
- Heather R Hall
- Maternal Child Nursing Department, University of South Alabama, Mobile, Alabama 36688, USA.
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31
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Vrijmoeth C, Monbaliu E, Lagast E, Prinzie P. Behavioral problems in children with motor and intellectual disabilities: prevalence and associations with maladaptive personality and marital relationship. RESEARCH IN DEVELOPMENTAL DISABILITIES 2012; 33:1027-1038. [PMID: 22502827 DOI: 10.1016/j.ridd.2012.01.010] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/11/2011] [Revised: 01/24/2012] [Accepted: 01/24/2012] [Indexed: 05/31/2023]
Abstract
Prevalence rates of behavioral problems in children with motor disabilities are commonly based on questionnaires developed for a general population (e.g., Child Behavior CheckList). These questionnaires do not take into account lower levels of intellectual functioning. The first aim of this study was to examine the prevalence of parent-reported and daily caretaker-reported behavioral problems in children with motor and intellectual disabilities (MID) using the Developmental Behavior Checklist. Second, we investigated whether behavioral problems were related to sex and age. Our third and fourth aim were to determine whether behavioral problems are related to maladaptive personality traits and to marital stress and conflict. Participants were 101 Flemish children with MID (mean age=14 years 6 months). For total behavioral problems, we found prevalence rates of 18% and 8% based on parent and daily caretaker reports, respectively. Based on parent reports, twenty seven percent of the children with MID exhibited anxiety problems. Behavioral problems were not related to sex. Older children showed fewer behavioral problems than younger children. Multiple hierarchical regression analyses revealed that lower scores on Compulsivity and higher scores on Emotional Instability and Disagreeableness were related to behavioral problems. In addition to personality traits, stress and conflict in the marital relationship was also positively associated with behavioral problems. Given the importance of behavioral problems in children with MID, this study is of theoretical and clinical interest and has the potential to inform targeted clinical interventions.
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Affiliation(s)
- Cis Vrijmoeth
- Department of Child and Adolescent Studies, Utrecht University, The Netherlands
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32
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Ramstad K, Jahnsen R, Skjeldal OH, Diseth TH. Mental health, health related quality of life and recurrent musculoskeletal pain in children with cerebral palsy 8-18 years old. Disabil Rehabil 2012; 34:1589-95. [PMID: 22352294 DOI: 10.3109/09638288.2012.656794] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
PURPOSE To extend knowledge on mental health with children's self-report and explore mental health and health related quality of life (HRQL) in a context of recurrent musculoskeletal pain in cerebral palsy (CP). METHOD Eighty-three participants, mean age 14.2 ± 2.8 years, were assessed with clinical examination, interview and questionnaires. Gross motor function was GMFCS level I 42%, level II 42%, level III 12% and level IV-V 5%. Children self-reported mental health on SDQ (Strengths and Difficulty Questionnaire), HRQL on PedsQL (Pediatric Quality of Life), and pain on CHQ (Child Health Questionnaire). Mothers proxy-reported on the same questionnaires and reported own mental health on GHQ (General Health Questionnaire). RESULTS Both self-reported mental health and HRQL was better than proxy-reported. Recurrent musculoskeletal pain was associated with more mental health problems and reduced HRQL in self-reports, but not in proxy-reports. CONCLUSIONS In CP, the importance of child-report on mental health and HRQL when possible, in addition to parent proxy-report, cannot be overstated. Close co-operation between (re)habilitation and child psychiatry is urgent. Further research on self-reported mental health and impact of mental health problems is warranted together with a focus on the impact of recurrent musculoskeletal pain on participation.
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Affiliation(s)
- Kjersti Ramstad
- Department of Clinical Neuroscience, Division of Women and Children, Oslo University Hospital, Norway.
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Taft TH, Ballou S, Keefer L. Preliminary evaluation of maternal caregiver stress in pediatric eosinophilic gastrointestinal disorders. J Pediatr Psychol 2012; 37:523-32. [PMID: 22271793 DOI: 10.1093/jpepsy/jsr118] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
OBJECTIVE To characterize caregiver stress (CS) in parents of children with Eosinophilic Gastrointestinal Disorders (EGIDs) and understand relationships with psychological functioning and child behavior. METHODS Caregivers with a child (0-17 years) with EGID completed questionnaires for demographics, EGID severity, treatments, CS, psychological distress, self-efficacy, and child behaviors. RESULTS A total of 163 caregivers (98% mother, 94% Caucasian) participated. CS correlated with psychological distress, income, child behavioral problems, treatments, and disease severity. Children were rated higher than age-specific norms for emotional difficulties. Behavioral difficulties associated with gender, age, EGID severity, and duration. Parent psychological distress was most strongly associated with CS. Parental self-efficacy, dietary treatments, and child emotional difficulties were also related to stress. CONCLUSIONS Mothers reported stress and psychological distress from caring for a child with EGID. The relationship between these variables suggests these parents may benefit from supportive psychotherapy interventions. Evaluation of parental self-efficacy and child behavior is also warranted.
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Affiliation(s)
- Tiffany H Taft
- Division of Gastroenterology, Northwestern University Feinberg School of Medicine.
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Wong C, Bartlett DJ, Chiarello LA, Chang HJ, Stoskopf B. Comparison of the prevalence and impact of health problems of pre-school children with and without cerebral palsy. Child Care Health Dev 2012; 38:128-38. [PMID: 21443556 DOI: 10.1111/j.1365-2214.2011.01233.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND The range of health problems associated with children with cerebral palsy (CP) is well documented in the literature; however, the existing data are often either reported for samples of children with all types of CP, or stratified by typology of motor disorder, rather than using the Gross Motor Function Classification System (GMFCS), which has been shown to be the most reliable way of classifying children with CP. Furthermore, availability of research on pre-school-aged children (under 5 years) is sparse. The aim of this study is to compare the prevalence and impact of health problems in pre-school children with and without CP, stratified by the GMFCS. METHODS Parents of 430 pre-school-aged children with CP (243 boys, 187 girls; mean age = 3 years 2 months, SD = 11 months) and 107 typically developing (TD) children (56 boys, 51 girls; mean age = 3 years 4 months, SD = 11 months) participated. Using the consensus definition of CP and the World Health Organization's International Classification of Functioning, Disability and Health, a parent survey was developed to assess the prevalence and impact of 16 health problems. The measure demonstrates good test-retest reliability (ICC > 0.80) and discriminant validity across GMFCS levels (P < 0.001). RESULTS Both the prevalence and impact of health problems is greater in children with CP compared with TD children (P < 0.001). The number and impact of health problems increase with ascending GMFCS level (P ≤ 0.01), except for the impact of health problems between groups GMFCS I and GMFCS II/III (P= 0.19). Children with CP have an average of between 3.4 and 6.7 health problems, compared with fewer than one in TD children. CONCLUSIONS Service providers working with pre-school-aged children with CP need to consider health problems and their impact when planning care.
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Affiliation(s)
- C Wong
- Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
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Brossard-Racine M, Hall N, Majnemer A, Shevell MI, Law M, Poulin C, Rosenbaum P. Behavioural problems in school age children with cerebral palsy. Eur J Paediatr Neurol 2012; 16:35-41. [PMID: 22036311 DOI: 10.1016/j.ejpn.2011.10.001] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2011] [Revised: 09/20/2011] [Accepted: 10/03/2011] [Indexed: 10/15/2022]
Abstract
BACKGROUND Although behavioural problems are frequent in children with Cerebral Palsy (CP), the exact nature of these difficulties and their relationship with intrinsic or extrinsic factors are just beginning to be explored. AIM To describe and characterize behavioural problems in children with CP and to determine the nature of any relationships with child and family characteristics. METHODS In this cross-sectional study, children with CP between 6 and 12 years of age were recruited. Children were assessed using the Leiter Intelligence Test, the Gross Motor Function Measure, the Strengths and Difficulties Questionnaire (SDQ), the Vineland Adaptive Behavior Scales and questionnaires on demographic factors. Parents' level of stress was measured with the Parenting Stress Index. RESULTS Seventy-six parents completed the SDQ. Using the Total Difficulties Scores, 39.4% of the sample scored in the borderline to clinically abnormal range. Peer problems were the most common (55.3%). High parental stress was consistently associated with behavioural difficulties across all domains of the SDQ. Not surprisingly, better socialization skills and a lower parental stress were correlated with more positive behaviours. CONCLUSION Behavioural difficulties are common in children with CP and appear not to be associated with socio-demographic variables and physical and cognitive characteristics. These difficulties are an important correlate of parental distress. This study emphasizes the need to recognize and address behavioural difficulties that may arise so as to optimize the health and well-being of children with CP and their families.
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Affiliation(s)
- Marie Brossard-Racine
- School of Physical & Occupational Therapy McGill University Health Centre, QC, Canada
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Hattier MA, Matson JL, Belva B, Kozlowski A. The effects of diagnostic group and gender on challenging behaviors in infants and toddlers with cerebral palsy, Down syndrome or seizures. RESEARCH IN DEVELOPMENTAL DISABILITIES 2012; 33:258-264. [PMID: 22093672 DOI: 10.1016/j.ridd.2011.09.014] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/06/2011] [Accepted: 09/02/2011] [Indexed: 05/31/2023]
Abstract
Challenging behaviors are frequently studied in individuals with various developmental disabilities, although specific conditions are rarely compared to one another. Such data would be informative to clinicians who assess and develop treatment plans for children with these disabilities. For that reason, the current study's aim was to analyze problem behavior deficits in infants and toddlers diagnosed with cerebral palsy (CP), Down syndrome (DS), and a history of seizures/seizure disorder. Seventy six children participated in this study and were administered the Baby and Infant Screen for Children with aUtIsm Traits-Part 2 (BISCUIT-Part 2). Inspection of the Tantrum/Conduct Behavior subscale of this measure revealed that children with a history of seizures/seizure disorder exhibited significantly higher scores, indicating greater impairment, than those with CP or DS. Children with DS and those diagnosed with CP did not significantly differ from one another. Additionally, there was no significant main effect by gender. The CP and DS groups also had fewer endorsements on all 18 items of the subscale as compared to the seizures group. Implications of these results are discussed.
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Marx C, Rodrigues EM, Rodrigues MM, Vilanova LCP. Depressão, ansiedade e sonolência diurna em cuidadores primários de crianças com paralisia cerebral. REVISTA PAULISTA DE PEDIATRIA 2011. [DOI: 10.1590/s0103-05822011000400003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
OBJETIVO: Avaliar os níveis de depressão, ansiedade e sonolência diurna excessiva em cuidadores primários de crianças com paralisia cerebral, relacionando-os às condições socioeconômicas do cuidador e às características neurológicas da criança e comparando-os a cuidadores de crianças saudáveis. MÉTODOS: 45 cuidadores de crianças com paralisia cerebral e 50 cuidadores de crianças saudáveis foram aleatoriamente incluídos no estudo e responderam a um questionário semiestruturado. Avaliaram-se os níveis de depressão, ansiedade e sonolência diurna excessiva por meio das escalas de Beck, ansiedade estado-traço e Epworth, respectivamente. RESULTADOS: A maioria dos entrevistados eram mães com baixo nível socioeconômico. Os que se autoavaliaram como ansiosos e depressivos apresentaram resultados comprobatórios de ansiedade e depressão com as escalas de ansiedade estado-traço e Beck para os cuidadores de crianças com paralisia cerebral. Os níveis de sonolência diurna excessiva estiveram relacionados a elevados níveis de depressão. O comprometimento neurológico das crianças não influenciou os resultados sobre os cuidadores. CONCLUSÕES: Depressão, ansiedade e problemas relacionados ao sono foram comuns em cuidadores de crianças com paralisia cerebral. O nível de funcionalidade neurológica da criança não influenciou os resultados.
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Van Wely L, Becher JG, Reinders-Messelink HA, Lindeman E, Verschuren O, Verheijden J, Dallmeijer AJ. LEARN 2 MOVE 7-12 years: a randomized controlled trial on the effects of a physical activity stimulation program in children with cerebral palsy. BMC Pediatr 2010; 10:77. [PMID: 21044314 PMCID: PMC2989952 DOI: 10.1186/1471-2431-10-77] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2010] [Accepted: 11/02/2010] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Regular participation in physical activities is important for all children to stay fit and healthy. Children with cerebral palsy have reduced levels of physical activity, compared to typically developing children. The aim of the LEARN 2 MOVE 7-12 study is to improve physical activity by means of a physical activity stimulation program, consisting of a lifestyle intervention and a fitness training program. METHODS/DESIGN This study will be a 6-month single-blinded randomized controlled trial with a 6-month follow up. Fifty children with spastic cerebral palsy, aged 7 to 12 years, with Gross Motor Function Classification System levels I-III, will be recruited in pediatric physiotherapy practices and special schools for children with disabilities. The children will be randomly assigned to either the intervention group or control group. The children in the control group will continue with their regular pediatric physiotherapy, and the children in the intervention group will participate in a 6-month physical activity stimulation program. The physical activity stimulation program consists of a 6-month lifestyle intervention, in combination with a 4-month fitness training program. The lifestyle intervention includes counseling the child and the parents to adopt an active lifestyle through Motivational Interviewing, and home-based physiotherapy to practise mobility-related activities in the daily situation. Data will be collected just before the start of the intervention (T0), after the 4-month fitness training program (T4), after the 6-month lifestyle intervention (T6), and after six months of follow-up (T12). Primary outcomes are physical activity, measured with the StepWatch Activity Monitor and with self-reports. Secondary outcomes are fitness, capacity of mobility, social participation and health-related quality of life. A random coefficient analysis will be performed to determine differences in treatment effect between the control group and the intervention group, with primary outcomes and secondary outcomes as the dependent variables. DISCUSSION This is the first study that investigates the effect of a combined lifestyle intervention and fitness training on physical activity. Temporary effects of the fitness training are expected to be maintained by changes to an active lifestyle in daily life and in the home situation. TRIAL REGISTRATION This study is registered in the Dutch Trial Register as NTR2099.
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Affiliation(s)
- Leontien Van Wely
- Department of Rehabilitation Medicine, EMGO+ Institute for Health and Care Research, Research Institute MOVE, VU University Medical Center, Amsterdam, The Netherlands.
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Sigurdardottir S, Indredavik MS, Eiriksdottir A, Einarsdottir K, Gudmundsson HS, Vik T. Behavioural and emotional symptoms of preschool children with cerebral palsy: a population-based study. Dev Med Child Neurol 2010; 52:1056-61. [PMID: 20497458 DOI: 10.1111/j.1469-8749.2010.03698.x] [Citation(s) in RCA: 62] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
AIM To describe behavioural and emotional symptoms among Icelandic preschool children with cerebral palsy (CP). METHOD Children with congenital CP, assessed with the Child Behavior Checklist/1½-5 (CBCL/1½-5) and Caregiver-Teacher Report Form (C-TRF), were enrolled in the study. A comparison group was recruited from the general population. Thirty-six children (53% males) with CP were assessed at a mean age of 4 years 11 months (SD 5 mo, range 4-6 y); 26 (72%) had bilateral distribution of symptoms and 32 (89%) had spastic CP. Thirty (83%) were at Gross Motor Function Classification System levels I or II and six at levels III or IV. For comparison, 110 (43% males) and 120 (48% males) children were assessed with the CBCL/1½-5 and the C-TRF respectively, at a mean age of 4 years 6 months (SD 6 mo, range 4-6 y). RESULTS Sixteen children (48%) with CP had high scores on total problems scale of the CBCL/1½-5 and 20 (65%) on the C-TRF compared with 18% of the comparison group, both on the CBCL/1½-5 and the C-TRF (p<0.001). Children with CP had higher scores on all subscales of the CBCL/1½-5 and the C-TRF, except somatic complaints. Attention difficulties, withdrawn, aggressive behaviour, and anxious/depressed symptoms were most pronounced among children with CP. INTERPRETATION A large proportion of preschool children with CP have substantial behavioural and emotional difficulties, which need to be addressed in their treatment.
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Colver A. Why are children with cerebral palsy more likely to have emotional and behavioural difficulties? Dev Med Child Neurol 2010; 52:986. [PMID: 20584049 DOI: 10.1111/j.1469-8749.2010.03721.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
- Allan Colver
- Newcastle University, Institute of Health and Society, Sir James Spence Building, Royal Victoria Infirmary, Newcastle, UK
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