Looking at the future and seeing the past: the challenge of the middle years of parenting a child with intellectual disabilities

Expressed Emotion in Families of Children with Neurodevelopmental Disorders: A Mixed-Method Approach

Background

Family interaction plays a pivotal role in the overall well-being of each member of a family unit. It is foreseeable that a family caring for an individual with a mental or physical health condition could experience negative family interactions for various reasons. Expressed emotion refers to the family environment based on the relatives' interaction with the individual diagnosed with a specific illness. Expressed emotion in the families of a person with any form of mental condition could pose potential psychological distress and burden to family members, notably the primary caregivers.

Purpose

The current study intends to explore the expressed emotion of the primary caregivers toward children with neurodevelopmental disorders (NDDs). The association between expressed emotion, stress experienced by the caregiver, and the self-sufficiency of the child diagnosed with neurodevelopmental disorders was examined.

Methods

The Five-Minute Speech Sample (FMSS), Kingston Caregivers' Stress Scale (KCSS), and Waisman Activities of Daily Living (WADL) were used to assess expressed emotion, stress, and a child's self-sufficiency, respectively. The snowball sampling technique was adopted, and data were collected from 35 primary caregivers through telephonic interviews. A mixed-method research design was adopted, and the data were analyzed qualitatively and quantitatively.

Results

The findings reveal that there is a significant association between expressed emotion and caregivers' stress, expressed emotion, and the child's self-sufficiency and a significant relationship between the caregivers' stress and the child's self-sufficiency. The qualitative analysis suggests the influence of factors such as future concerns, family factors, and relationship strains contribute to expressed emotion.

Conclusion

It can be concluded that those primary caregivers who reported extreme caregivers' stress and low self-sufficiency in their child exhibited high negative expressed emotion and diverse individual and systemic factors influenced the display of high expressed emotion within the family.

Juggling between caregiving and self-actualization: Older parents' lifelong experience of caring for an adult child with developmental disabilities

Recently, the number of adults with Developmental Disabilities (DD) who live with their parents has increased. This study aims to explore how parents report retrospectively and interpret their experience in the context of self-actualization in the long-term care of a child with a developmental disability. Four forms of parents' experiences emerged from the analysis: "This child is my whole world"-Total devotion; "I Can Do Both"-Actualizing personal and familial goals as well as caregiving issues; "It's a mission, it's a calling, it's a full-time job"-Self-actualization through caregiving; and "Disability will not stop me"-Emphasizing self-actualization. While prior studies have created a distinct separation between caregiving and self-actualization, the current study focuses on the complex dynamics of lifelong parental caregiving for a child with DD, illustrating the parents' ways of actualizing their life goals in the context of caregiving over the years.

Hospitalized children with intellectual disability: Parents as partners in their care

BACKGROUND

Limited evidence exists of what hospital care is like for parents of children and young people (CYP) with intellectual disability (ID). Effective collaboration is often missing, with parents lacking trust in professionals, with feelings of being expected to care and consequently unable to leave their child. This paper focuses on what parents want from their relationship with healthcare professionals.

METHOD

An ethnographic approach was used, including in-depth interviews and informal discussions with nine parents of CYP with intellectual disability. Researcher voice poems are interspersed with quotations to illustrate key findings.

RESULTS

Parents described the need for a genuine partnership with professionals. They identified seven elements that ideally characterize this partnership: Preparation, Accessibility, Reliability, Trust, Negotiation, Expertise and Respect (PARTNER).

CONCLUSION

Children and young people with intellectual disability and their parents are frequent users of healthcare services. Getting it right from the outset is important to establish their trust in the system.

Lived Experience of the Mother's Caring of Adult Children with Persistent Vegetative State

PURPOSE

The purpose of this study was to deepen understanding the nature of the care experience by the mothers with adult children in persistent vegetative state.

METHODS

Participants were 7 mothers caring for their adult children in persistent vegetative state. Data were collected individually through in-depth interviews on their lived experiences. Also texts were included as data from literary works, novels, movies, essays, and arts containing on patients with persistent vegetative state and their mothers. Data were analyzed by van Manen's phenomenological methodology.

RESULTS

The essential themes of caring experiences of the mothers were as follows. The theme in relation to lived time has shown as back to the past and caring experience related lived body has emerged as locked the body in children. The theme related lived space was getting into the swamp and the theme in lived others was derived as lonely struggle into.

CONCLUSION

The nature of mothers' caring experiences for adult children in persistent vegetative state is summarized as 'Do not off hand of hope in a locked state'. This study suggests long-term supports are necessary for mothers to care persistent vegetative state children.

Parental experiences of caring for a child with intellectual disabilities: A UK perspective

A structured literature search and thematic analysis of six research articles relating to stress and parenting of a child with an intellectual disability in the United Kingdom identified four key themes: impact upon families, service provision and support networks, coping and transition. The findings identified that parenting a child with an intellectual disability is not always a negative role; it is a role that parents find both rewarding and empowering. However, the findings of the literature review primarily related to mothers of children with an intellectual disability with very little focus on the experiences of fathers.

"We are all there silently coping." The hidden experiences of parents of adults with Asperger syndrome

BACKGROUND

The experiences of older parents of adults with Asperger syndrome have not been explored in the research literature.

METHOD

Four families who had middle-aged offspring with Asperger syndrome were interviewed (3 mothers and 1 couple), and the interviews were analysed using interpretative phenomenological analysis (IPA).

RESULTS

Six themes emerged from the analysis: (a) providers of "hidden" support, (b) role of advocate, (c) social isolation, (d) intrafamilial relationships, (e) support for parents, and (f) future concerns.

CONCLUSIONS

The findings of this study offer insight into the experience of parents of adult sons with Asperger syndrome. Implications for future support interventions and research are suggested.

"You have to sit and explain it all, and explain yourself." Mothers' experiences of support services for their offspring with a rare genetic intellectual disability syndrome

The experiences of mothers of adult offspring with Angelman, Cornelia de Lange, or Cri du Chat syndrome have not been previously explored in research. The current study focuses on experiences with social and medical services and the impact the rareness of an adult offspring's syndrome has on the experiences of mothers. Eight mothers of adults with Angelman, Cornelia de Lange, or Cri du Chat syndrome were interviewed. Thematic Content Analysis was used to interpret the interviews. Four themes emerged from the analysis: (i) The rarity of their offspring's syndrome, (ii) Uneven medical and social care service provision, (iii) The inertia of social care services, and (iv) Mothers as advocates. Mothers felt that the rareness of their offspring's syndrome did not affect experiences with social care services, but did affect access to medical services and some aspects of day-to-day living. Accessing appropriate social care services was reported to be a lengthy and complex process. These data may help inform care service providers about how best to support adults with rare genetic syndromes and their families.

Life and death of a child with down syndrome and a congenital heart condition: experiences of six couples

Individuals with Down syndrome are at increased risk of congenital heart conditions (CHCs), and mortality is higher in people with Down syndrome and a CHC than those without (J. C. Vis et al., 2009). As a consequence, parents of children with Down syndrome and a CHC are more likely to outlive their child. In this research, semistructured interviews were used to explore the experiences of 6 couples whose child with Down syndrome and a CHC had died. The interviews were analyzed qualitatively using interpretative phenomenological analysis (IPA), and 4 themes emerged: dilemmas associated with the dual diagnosis; treatment decisions during the life and the death of their child ("We had to make a decision"); ways couples coped when bereaved ("We weren't really going through it together"); and ripples from the child's life. There was a high degree of similarity of experience within couples. Differences between couples existed in their experiences of coping and supporting each other. Practical implications include the importance of considering the specific needs of couples, individuals, and fathers within partnerships.

Time Use of Mothers with Adolescents: A Lasting Impact of a Child's Disability

The purpose of this study was to compare the time use of mothers with adolescents with disabilities and mothers of adolescents without disabilities. Twenty mothers of adolescents (13 to 19 years old) with disabilities and 20 mothers of adolescents without disabilities completed time diaries for a period of seven 24-hour days. Mothers of adolescents with disabilities spent significantly more time in activities related to supervising their adolescents and less time in participation and socialization activities than mothers of adolescents without disabilities. As a child gets older, there is generally a decrease in the amount of time all mothers spend in childcare activities. However, mothers' occupations are impacted by having a child with a disability. Professionals working in partnership with families need to understand that the role of being a mother evolves as a child matures, and that a mother's time demands may impact the occupational engagement of all family members.

Transition for adolescents and young adults with learning disabilities and mental health problems/challenging behaviours: the parent carers' views

The aim of the research was to scope issues of concern at transition for young people with learning disabilities and mental health problems/challenging behaviour from the perspective of parent carers, using a focus group interview consisting of ten participants, including one facilitator and administrative support. The interview was tape‐recorded, transcribed and thematically coded using Microsoft Word and NVivo. Two case vignettes were used to stimulate the discussion. Several themes emerged from analysis of the transcripts: access to information about rights and the services available for their son or daughter, and conflicts between carers and professionals. The experience of parent carers of people with learning disabilities is still not well understood. By understanding the views and experiences of parent carers, transition can be facilitated and concerned parties can work together to achieve better results.

Silenced grief: living with the death of a child with intellectual disabilities

BACKGROUND

This paper examines the bereavement experiences of parents of people with intellectual disabilities (IDs). It is based upon an understanding that there exists little research-based understanding of those experiences or of the support needs of parents after the death of their child.

METHODS

In-depth interviews were held with 13 parents on the deaths of their children with IDs.

RESULTS

The data highlighted the deep sense of loss that these parents experience after the death of their child. The loss was intensely felt. They also show that their loss was a form of compounded loss. To begin with the scale and depth of loss is misrecognized. They also lose contact with a world that they had previously been heavily involved in. There was a sense that ID services and professionals withdrew from the family with too much haste. The data reveal that there exists no adequate supportive emotional community for these parents to express their grief.

CONCLUSIONS

It is argued that the experiences of these parents have much in common with understandings of disenfranchised grief. The implications of these findings for research and practice are briefly discussed.

Families challenged by and accommodating to the adolescent years

BACKGROUND

Informed by Ecocultural theory, this study explores the challenges that families caring for an adolescent with disability face and strategies they apply to sustain a meaningful family routine during the adolescent years.

METHODS

In-depth Ecocultural interviews were conducted with 20 families caring for an adolescent (aged 10-21 years) with severe disabilities, including intellectual disability. Transcripts were analysed using a constant comparative approach. Two types of family level challenges were differentiated--internal and external factors impacting on daily family life.

RESULTS

Two themes representing this distinction between internal and external family challenges are presented in detail. Across both younger adolescent (aged 10-14 years) and older adolescent (aged 16-20 years) groups, families were first challenged by changing family roles and relationships (an internal factor). In response, families used three strategies: dividing up family time, protecting some members from too much involvement and engaging others in family activities. Families were also challenged by service discontinuity (an external factor). Accommodation strategies included advocacy, coordinating multiple services and forfeiting a desired alternative.

CONCLUSIONS

Family routine in the adolescent years is dynamic rather than static, simultaneously challenged by internal and external factors. Families use multiple strategies to accommodate these challenges, which are underpinned by their beliefs, values and resources. Professionals working with families caring for an adolescent with disability need to be aware of these in order to support families effectively to sustain a meaningful family routine during the adolescent years.

Self-concepts of parents with a child of school age with a severe intellectual disability

The self-concepts of Hong Kong Chinese parents with a child of school age with severe intellectual disability were explored. A 20-item Adult Sources of Self-Esteem Inventory (ASSEI) and open-ended questions on self-evaluation and interviewing were adopted as the major procedures to identify the source and basis of their self-conceptions. One hundred and nine parents--35 males and 74 females, aged 31 to 45--participated in this study. The results indicated that the participants showed similar life priorities as the control group (parents of non-handicapped children). However, the participants showed significantly lower concept of self than the control group in most areas of life. An exploratory factor-analytic result showed that the parents' concept of self had a one-dimensional structure, which might indicate the parents' lack variety in their life. An analysis of the contents of the open-ended responses showed that family and work were the most important domains of the concept of self. However, most of the respondents stated that poor family relationships, the health problems of their child, and work and financial problems made them 'feel bad'.