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Deierlein AL, Park C, Patel N, Gagnier R, Thorpe M. Mental health outcomes across the reproductive life course among women with disabilities: a systematic review. Arch Womens Ment Health 2024:10.1007/s00737-024-01506-5. [PMID: 39222078 DOI: 10.1007/s00737-024-01506-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2024] [Accepted: 08/14/2024] [Indexed: 09/04/2024]
Abstract
PURPOSE This systematic review examined literature on mental health outcomes among women with disabilities living in high-income countries within the context of reproductive health, spanning menstruation through menopause. METHODS Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, we searched MEDLINE, CINAHL, and PsycINFO databases for studies published through June 2023. Eligible studies were observational, quantitative, and included a comparison group without disabilities. RESULTS A total of 2,520 studies were evaluated and 27 studies met inclusion criteria. These studies assessed mental health during prepregnancy, pregnancy, postpartum, and parenting among women with and without disabilities. None of the studies examined reproductive health time periods related to menstruation, fertility, or menopause. Women of reproductive age with disabilities were more likely to have poor mental health outcomes compared to women without disabilities. During pregnancy and the postpartum, women with disabilities were at greater risk of diagnosed perinatal mental disorders and psychiatric-related healthcare visits. Findings also suggested mental distress and inadequate emotional and social support related to parenting among women with disabilities. The greatest risks of poor mental health outcomes were often observed among women with intellectual and developmental disabilities and among women with multiple types of disabilities, compared to women without disabilities. CONCLUSIONS Routine reproductive healthcare visits provide significant prevention and treatment opportunities for poor mental health among women with disabilities. Further research examining mental health outcomes within the context of reproductive health, especially understudied areas of menstruation, fertility, parenting, and menopause, among women with disabilities is needed.
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Affiliation(s)
| | - Curie Park
- School of Global Public Health, New York University, New York, NY, USA
| | - Nishtha Patel
- School of Global Public Health, New York University, New York, NY, USA
| | - Robin Gagnier
- School of Global Public Health, New York University, New York, NY, USA
| | - Michele Thorpe
- Rory Meyers College of Nursing, New York University, New York, NY, USA
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2
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Lindblad I, Landgren V, Gillberg C, Fernell E. Children born to parents with mild intellectual disability: Register-based follow-up of psychiatric and neurodevelopmental diagnoses and out-of-home placements. Acta Paediatr 2024; 113:1637-1643. [PMID: 38517072 DOI: 10.1111/apa.17218] [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] [Received: 11/03/2023] [Revised: 03/06/2024] [Accepted: 03/14/2024] [Indexed: 03/23/2024]
Abstract
AIM Study the outcomes in terms of registered neurodevelopmental diagnoses and out-of-home placements in children whose parents had been diagnosed with mild intellectual disability (ID) in childhood. METHODS The study groups consist of (1) a population-based sample of 78 individuals, born in 1979-1985, meeting criteria for mild ID during childhood, and (2) their 88 children. From national registers, data on outcomes were retrieved in 2020 regarding psychosocial and psychiatric outcomes for the adults, and neurodevelopmental diagnoses and out-of-home placements for the children. RESULTS Of the 78 adults with mild ID, 31 were parents of 88 children, aged 0-21 . The age-adjusted prevalence of neurodevelopmental disorders among the children was 67%. Of the 27 children aged between 13 and 21 years at follow-up, 16 had at least one registered neurodevelopmental diagnosis; 11 had ADHD and 7 had ID. Nine of these 27 children had experienced out of home placement. CONCLUSION Children of parents with mild ID are at high risk of neurodevelopmental disorders, in particular ADHD and ID, and out-of-home placements. Our findings indicate that individuals with mild ID who become parents routinely should be offered individually tailored parent support and their children offered assessment regard neurodevelopmental disorders.
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Affiliation(s)
- I Lindblad
- Gillberg Neuropsychiatry Centre, Institute of Neuroscience and Physiology, Sahlgren's Academy, Gothenburg University, Gothenburg, Sweden
| | - V Landgren
- Gillberg Neuropsychiatry Centre, Institute of Neuroscience and Physiology, Sahlgren's Academy, Gothenburg University, Gothenburg, Sweden
- Department of Psychiatry, Skaraborg Hospital, Skövde, Sweden
| | - C Gillberg
- Gillberg Neuropsychiatry Centre, Institute of Neuroscience and Physiology, Sahlgren's Academy, Gothenburg University, Gothenburg, Sweden
| | - E Fernell
- Gillberg Neuropsychiatry Centre, Institute of Neuroscience and Physiology, Sahlgren's Academy, Gothenburg University, Gothenburg, Sweden
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3
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Douglass E, Johnson C, Lucas G, Dowling S. "Work with us… to make it more accessible". What women with intellectual disabilities want from infant-feeding health resources: an exploratory study. Int Breastfeed J 2023; 18:67. [PMID: 38066508 PMCID: PMC10704706 DOI: 10.1186/s13006-023-00606-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Accepted: 12/03/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUND More women with intellectual disabilities are becoming mothers but fewer are known to breastfeed compared with other women. Women with intellectual disabilities are entitled to accessible antenatal and infant feeding information, yet are rarely asked for their views on available resources. This article reports on the final stage of a UK project exploring how women with intellectual disabilities are supported to make infant feeding decisions. The wider project includes a scoping review and interviews with healthcare professionals, here we focus on the voices of the women themselves. METHODS Four women with an intellectual disability participated in a focus group where they were asked to give their views on the accessibility of currently available infant feeding resources and on alternative representations of infant feeding. All were interested in women's health issues, including infant feeding. Photo-elicitation was used to gather views on videos, bespoke 'Easy Read' material and several alternative representations of infant feeding. A transcription of the discussion was thematically analysed whilst a critical visual analysis was undertaken of the women's preferred images/resources. The study took place in Bristol, UK, during 2022. RESULTS Two themes were identified from the group discussion: 'The desire for choice' and 'How easy is 'Easy Read'?' The desire for choice was expressed in terms through agreements and disagreements about preferred imagery, differing tastes, and reasons for these preferences. We identified a challenge to 'Easy Read' as a default standard and concerns that some forms of 'Easy Read' can confuse rather than inform. Critical visual analysis identified the importance of the story and social setting of the preferred infant feeding image. CONCLUSIONS Findings suggest a need for a suite of resources, avoiding the one-size-fits-all approach, including people with an intellectual disability at every stage of the design and production process. Resources should recognise and embrace differences in terms of understanding, visual literacy and cultural taste, as well as being freely available to support women with intellectual disabilities to make informed infant feeding decisions. An accessible film was co-produced, to disseminate the findings from all three stages of the completed project.
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Affiliation(s)
- Emma Douglass
- School of Health and Social Wellbeing, College of Health, Science and Society, University of the West of England, Glenside Campus, Blackberry Hill, Fishponds, Bristol, BS16 1DD, UK
| | - Clare Johnson
- School of Arts, College of Arts, Technology and Environment, University of the West of England Bristol, City Campus, Arnolfini, 6 Narrow Quay, Bristol, BS1 4QA, UK
| | - Geraldine Lucas
- School of Health and Social Wellbeing, College of Health, Science and Society, University of the West of England, Glenside Campus, Blackberry Hill, Fishponds, Bristol, BS16 1DD, UK
| | - Sally Dowling
- Bristol Medical School, Faculty of Health Sciences, University of Bristol, 69 St Michael's Hill, Bristol, BS2 8DZ, UK.
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4
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Hammarlund M, Granqvist P, Forslund T. Experiences of Interpersonal Trauma Among Parents With Intellectual Disabilities: A Systematic Review. TRAUMA, VIOLENCE & ABUSE 2023; 24:2843-2862. [PMID: 36062575 PMCID: PMC10486176 DOI: 10.1177/15248380221119237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Research has suggested highly elevated levels of interpersonal trauma (IPT) among parents with intellectual disabilities (ID), and that such experiences may contribute to the caregiving and child developmental problems often seen in this population. Conflicting results have however been reported, and there is no systematic review on this matter. This study therefore systematically reviewed the empirical evidence concerning (a) prevalence of IPT among parents with ID, and links with (b) caregiving-relevant and (c) child developmental outcomes, in accordance with the PRISMA 2020 guidelines. Searches were conducted in MEDLINE, CINAHL, PsycINFO, and PTSDpubs. Peer-reviewed empirical articles reporting exposure to any form of systematically assessed IPT (unspecified IPT, physical, sexual, and emotional abuse, neglect, prolonged childhood separations from caregivers, witnessing abuse in the family) among parents with ID were included, yielding a final selection of 20 studies. Findings consistently indicated markedly elevated levels of IPT among parents with ID, with a majority (>50%) having experienced some form of IPT. Estimates for both unspecified and specific forms were typically higher than corresponding estimates in other groups at elevated risk, and than meta-analytical general population estimates in comparable countries. Findings regarding caregiving-relevant outcomes were mixed but indicated links with adverse outcomes, particularly regarding parental mental health. Reports pertaining to child developmental outcomes were scant and inconsistent. We highlight important limitations in the extant literature and provide directions for future research and clinical practice.
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Affiliation(s)
| | | | - Tommie Forslund
- Department of Psychology, Stockholm University, Sweden
- SUF Resource Center, Uppsala, Sweden
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5
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Dowling S, Douglass E, Lucas G, Johnson C. Supporting women with learning disabilities in infant feeding decisions: UK health care professionals' experiences. MATERNAL & CHILD NUTRITION 2022; 19:e13432. [PMID: 36147016 PMCID: PMC9749617 DOI: 10.1111/mcn.13432] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/11/2022] [Revised: 07/30/2022] [Accepted: 09/01/2022] [Indexed: 12/15/2022]
Abstract
Women with learning disabilities are less likely to breastfeed than other women. They may find it hard to understand or learn feeding techniques or know that they have infant feeding choices. This population may be supported during their pregnancies by a range of professionals with differing priorities and responsibilities towards both the mother and the baby. This puts considerable pressure on health care professionals including, but not limited to, midwives, infant feeding specialists, health visitors and learning disability nurses. Those who support women with learning disabilities through their journey into motherhood have a responsibility to ensure the women in their care have the information they need to make decisions about a range of issues, including infant feeding. In the absence of dedicated lactation consultants, this is one of many issues to be discussed within time-limited appointments. Little is known about the experience of supporting women with learning disabilities to make infant feeding decisions from the point of view of health professionals. Using a qualitative descriptive research design, we conducted online, semistructured interviews with seven UK health professionals about their experience of supporting women with learning disabilities in infant feeding. Thematic analysis identified three themes: the importance of health professionals' having unconditional, positive regard; the need for an individualised approach to supporting women to make infant-feeding decisions; and being part of the support network. This suggests that women with learning disabilities can make and put into practice infant feeding decisions if they have access to the right support at the right time.
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Affiliation(s)
- Sally Dowling
- School of Health and Social Wellbeing, Centre for Public Health and Wellbeing, University of the West of EnglandGlenside CampusBristolUK,Bristol Medical School, Faculty of Health SciencesUniversity of BristolBristolUK
| | - Emma Douglass
- School of Health and Social Wellbeing, University of the West of EnglandGlenside CampusBristolUK
| | - Geraldine Lucas
- School of Health and Social Wellbeing, University of the West of EnglandGlenside CampusBristolUK
| | - Clare Johnson
- Faculty of Arts, Creative Industries and EducationUniversity of the West of England, ArnolfiniBristolUK
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6
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West AL, Dibble KE. Evidence-Based Early Home Visiting for Mothers and Parents With Intellectual Disability: Home Visitor Perceptions and Practices. INTELLECTUAL AND DEVELOPMENTAL DISABILITIES 2022; 60:288-302. [PMID: 35868304 DOI: 10.1352/1934-9556-60.4.288] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Accepted: 11/17/2021] [Indexed: 06/15/2023]
Abstract
Evidence-based maternal, infant, and early home visiting (EBHV) is a potential strategy to support parent and child health and well-being among families headed by a parent with an intellectual disability (ID). Little is known about the capacity of EBHV programs to meet the needs of parents with ID effectively. This study examined home visitor practices and perceptions of services for parents with ID. Home visiting staff recruited from a national practice-based research network participated in web-based surveys. Practices and perceptions varied widely across sites and were associated with home visitor knowledge and self-efficacy and site implementation supports, such as policies, curricula, and community collaboration. More work is needed to understand and strengthen EBHV services for parents with ID.
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Affiliation(s)
- Allison L West
- Allison L. West and Kate E. Dibble, Johns Hopkins University Bloomberg School of Public Health
| | - Kate E Dibble
- Allison L. West and Kate E. Dibble, Johns Hopkins University Bloomberg School of Public Health
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7
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Johnson C, Douglass E, Lucas G, Dowling S. Supporting women with learning disabilities in infant feeding decisions: A scoping review. MATERNAL & CHILD NUTRITION 2022; 18:e13318. [PMID: 35090089 PMCID: PMC8932700 DOI: 10.1111/mcn.13318] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 11/28/2021] [Accepted: 12/22/2021] [Indexed: 11/30/2022]
Abstract
Mothers with learning disabilities face many challenges during the perinatal period including preparing for and establishing infant feeding. Evidence shows that women with learning disabilities are less likely to breastfeed than other mothers. A scoping review was undertaken using Arksey and O'Malley's methodology to understand what is known about how women with learning disabilities can be supported to make infant feeding decisions, particularly in relation to the use of appropriate and accessible images. An additional aim was to understand what further research is needed to achieve sustainable improvements to policy and practice in this area. A comprehensive search of fourteen electronic databases was undertaken to look for both published and grey literature. Initial searches, after removal of duplicates, resulted in 467 primary research articles plus 22 items of grey literature. Following a systematic process, three published papers and six items of grey literature were identified which met inclusion and exclusion criteria, five of which were resources. Little is known about the acceptability of existing resources, specifically in relation to the use of visual images. A synthesis of the grey literature and a thematic analysis of published literature was conducted and confirmed that women with learning disabilities need tailored support with infant feeding, including accessible resources and that there is a need for more in-depth research in this area. There is a high level of agreement about the importance of using easily read visual images within these resources, but little evaluation of the types of imagery used or their aesthetic histories.
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Affiliation(s)
- Clare Johnson
- School of Art and Design, Faculty of Arts, Creative Industries and EducationUniversity of the West of EnglandBristolUK
| | - Emma Douglass
- School of Health and Social Wellbeing, Faculty of Health and Applied SciencesUniversity of the West of EnglandBristolUK
| | - Geraldine Lucas
- School of Health and Social Wellbeing, Faculty of Health and Applied SciencesUniversity of the West of EnglandBristolUK
| | - Sally Dowling
- School of Health and Social Wellbeing, Faculty of Health and Applied SciencesUniversity of the West of EnglandBristolUK
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8
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Hammarlund M, Granqvist P, Forslund T. Mothers With Mild Levels of Intellectual Disability: Emotion-Interpretation, Traumatization, and Child Attachment Representations. AMERICAN JOURNAL ON INTELLECTUAL AND DEVELOPMENTAL DISABILITIES 2021; 126:341-356. [PMID: 34161561 DOI: 10.1352/1944-7558-126.4.341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Accepted: 01/31/2021] [Indexed: 06/13/2023]
Abstract
Prior research indicates links between parents' experiences of interpersonal trauma and emotion-interpretation difficulties, and between such difficulties and child attachment insecurity and disorganization. Although mothers with mild levels of intellectual disability (ID) are at heightened risk for trauma and emotion-interpretation difficulties, and their children for attachment insecurity, corresponding links in this population have not been examined. We therefore investigated emotional interpretations among mothers with mild levels of ID (n = 23) and matched comparison mothers without ID (n = 25), in relation to mothers' experiences of trauma and their children's attachment representations. Mothers with mild levels of ID were not less accurate than comparison mothers with regard to general positive and negative emotion-interpretation accuracy, but they were significantly more likely to misinterpret shame and anger. Among mothers with mild levels of ID, misinterpretations of shame were positively related to maternal experiences of trauma, and to child attachment insecurity and disorganization.
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Affiliation(s)
| | - Pehr Granqvist
- Mårten Hammarlund and Pehr Granqvist, Stockholm University, Sweden
| | - Tommie Forslund
- Tommie Forslund, Stockholm University and the SUF Resource Center, Uppsala, Sweden
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9
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Tarasoff LA, Murtaza F, Carty A, Salaeva D, Hamilton AD, Brown HK. Health of Newborns and Infants Born to Women With Disabilities: A Meta-analysis. Pediatrics 2020; 146:peds.2020-1635. [PMID: 33203648 PMCID: PMC7786829 DOI: 10.1542/peds.2020-1635] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/17/2020] [Indexed: 12/13/2022] Open
Abstract
CONTEXT Women with disabilities are at elevated risk for pregnancy, delivery, and postpartum complications. However, there has not been a synthesis of literature on the neonatal and infant health outcomes of their offspring. OBJECTIVE We examined the association between maternal disability and risk for adverse neonatal and infant health outcomes. DATA SOURCES Cumulative Index to Nursing and Allied Health Literature, Embase, Medline, and PsycINFO were searched from database inception to January 2020. STUDY SELECTION Studies were included if they reported original data on the association between maternal physical, sensory, or intellectual and/or developmental disabilities and neonatal or infant health outcomes; had a referent group of women with no disabilities; were peer-reviewed journal articles or theses; and were written in English. DATA EXTRACTION We used standardized instruments to extract data and assess study quality. DerSimonian and Laird random effects models were used for pooled analyses. RESULTS Thirty-one studies, representing 20 distinct cohorts, met our inclusion criteria. Meta-analyses revealed that newborns of women with physical, sensory, and intellectual and/or developmental disabilities were at elevated risk for low birth weight and preterm birth, with smaller numbers of studies revealing elevated risk for other adverse neonatal and infant outcomes. LIMITATIONS Most studies had moderate (n = 9) or weak quality (n = 17), with lack of control for confounding a common limitation. CONCLUSIONS In future work, researchers should explore the roles of tailored preconception and perinatal care, along with family-centered pediatric care particularly in the newborn period, in mitigating adverse outcomes among offspring of women with disabilities.
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Affiliation(s)
- Lesley A. Tarasoff
- Department of Health and Society and,Azrieli Adult Neurodevelopmental Centre, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; and
| | | | - Adele Carty
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Dinara Salaeva
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | | | - Hilary K. Brown
- Department of Health and Society and,Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
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10
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Salaeva D, Tarasoff LA, Brown HK. Health care utilisation in infants and young children born to women with intellectual and developmental disabilities: A systematic review and meta-analysis. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2020; 64:303-310. [PMID: 31997428 DOI: 10.1111/jir.12720] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/13/2019] [Revised: 11/25/2019] [Accepted: 01/11/2020] [Indexed: 06/10/2023]
Abstract
BACKGROUND Mothers with intellectual and developmental disabilities (IDD) experience socio-economic and health disparities which could impact their offspring's health care utilisation. We systematically reviewed evidence on health care utilisation in infants and young children of women with and without IDD. METHODS MEDLINE, EMBASE, CINAHL, and PsycINFO were searched from inception to October 2019 for studies examining preventive care, immunisations, emergency department visits, and hospitalisations. Data extraction and quality assessment were performed using standardised tools. Pooled odds ratios (ORs) and 95% confidence intervals (CIs) were generated using random effects models for outcomes with data available from ≥3 studies. RESULTS Four articles describing three cohort studies and one cross-sectional study met our criteria. Maternal IDD status was associated with increased neonatal intensive care unit admission rates (pooled OR 2.03; 95% CI 1.31, 3.13). There were no differences in immunisation rates or hospitalisations. CONCLUSIONS Few studies have examined the impact of maternal IDD status on health care utilisation in their infants and young children. More high-quality studies are needed.
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Affiliation(s)
- D Salaeva
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - L A Tarasoff
- Interdisciplinary Centre for Health & Society, University of Toronto Scarborough, Toronto, Ontario, Canada
| | - H K Brown
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- Interdisciplinary Centre for Health & Society, University of Toronto Scarborough, Toronto, Ontario, Canada
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11
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Clements KM, Zhang J, Long-Bellil LM, Mitra M. Emergency department utilization during the first year of life among infants born to women at risk of disability. Disabil Health J 2020; 13:100831. [DOI: 10.1016/j.dhjo.2019.100831] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2018] [Revised: 07/10/2019] [Accepted: 07/24/2019] [Indexed: 11/30/2022]
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Do disability, parenthood, and gender matter for health disparities?: A US population-based study. Disabil Health J 2019; 12:594-601. [PMID: 31231021 DOI: 10.1016/j.dhjo.2019.06.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2019] [Revised: 05/14/2019] [Accepted: 06/11/2019] [Indexed: 11/22/2022]
Abstract
BACKGROUND Existing research has documented adverse health outcomes among parents with disabilities relative to parents without disabilities, but little is known about whether parenthood adds unique stress and health consequences for people with disabilities. Less is known about whether the effects of parenthood differ between mothers and fathers with disabilities. OBJECTIVES This paper examined health-related quality of life, obesity, and health behaviors between US parents and nonparents with and without disabilities. We also explored differences in health outcomes separately for men and women by one's parental and disability status. METHODS An analytic sample of parents and nonparents aged 18-64, with and without disabilities, were derived from the 2016 Behavioral Risk Factor Surveillance System (9,117 parents and 33,961 nonparents with disabilities). Multivariate logistic regression analyses were applied, controlling for individuals' socio-demographic characteristics and their history of chronic conditions. RESULTS Parents with disabilities, compared to parents without disabilities and nonparents with and without disabilities, were at higher risk of reporting frequent physical distress, obesity, smoking, and insufficient sleep. Among those with disabilities, fathers were more likely than nonfathers to report poor or fair health, frequent physical and mental distress, and obesity; these differences were not evident between mothers and nonmothers with disabilities. CONCLUSIONS The findings suggest the urgent need for policies and programs to address the health-related needs of parents with disabilities, as well as the need for targeted programs to support fathers with disabilities.
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13
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Strnadová I, Collings S, Loblinzk J, Danker J. Parents with intellectual disabilities and their perspective of peer support: "It depends on how they give it". JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2019; 32:879-889. [PMID: 30790398 DOI: 10.1111/jar.12579] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2018] [Revised: 01/24/2019] [Accepted: 01/30/2019] [Indexed: 11/27/2022]
Abstract
BACKGROUND Parents with intellectual disabilities face particular challenges, such as lack of sufficient support with their parenting. Peers can be an important source of support for parents in the general population; however, there is a limited knowledge about peer support for parents with intellectual disabilities. The aim of this study was to explore experiences of parents with intellectual disabilities with social support with a focus on the role of peers. METHOD Twenty-six parents with intellectual disabilities in New South Wales, Australia, took part in a semi-structured interview. RESULTS The inductive content analysis of data revealed three main themes; this article reports on one of them-Developing interdependence. CONCLUSIONS The source of support was less important than the way support was offered. Parents valued support offered by someone who respected them as a person and parent, and was interested in what they wanted and needed.
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Affiliation(s)
- Iva Strnadová
- Faculty of Arts and Social Sciences, School of Education, University of New South Wales Sydney, Sydney, New South Wales, Australia.,Academic Lead Research, UNSW Disability Innovation Institute, University of New South Wales Sydney, Sydney, New South Wales, Australia
| | - Susan Collings
- Faculty of Arts and Social Sciences, School of Education and Social Work, Institute of Open Adoption Studies, The University of Sydney, Sydney, New South Wales, Australia
| | - Julie Loblinzk
- Self Advocacy Sydney, Inc., Sydney, New South Wales, Australia
| | - Joanne Danker
- Faculty of Arts and Social Sciences, School of Education, University of New South Wales Sydney, Sydney, New South Wales, Australia
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14
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Powell RM, Parish SL, Akobirshoev I. The Health and Economic Well-Being of US Mothers with Intellectual Impairments. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2017; 30:456-468. [PMID: 28321970 DOI: 10.1111/jar.12308] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/03/2016] [Indexed: 11/30/2022]
Abstract
BACKGROUND While the United States has seen increased attention by policymakers on the rights of parents with disabilities, there is limited understanding of the health and economic well-being of parents with intellectual impairments. This study compares the health and economic well-being of mothers with and without intellectual impairments. METHODS This descriptive, exploratory study is a secondary analysis of the Fragile Families and Child Wellbeing Study. This study includes a subsample of mothers of three-year-old children (n = 1561), including mothers with intellectual impairments (n = 263) and without intellectual impairments (n = 1298). RESULTS US Mothers with intellectual impairments are more likely to report serious health conditions, have less instrumental support, live in poverty, receive public benefits and experience certain material hardships. CONCLUSION Findings from this study indicate the need for policies and programmes to support parents with intellectual impairments by addressing their health and economic needs.
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Affiliation(s)
- Robyn M Powell
- Lurie Institute for Disability Policy, Brandeis University Heller School for Social Policy and Management, Waltham, MA, USA
| | - Susan L Parish
- Lurie Institute for Disability Policy, Brandeis University Heller School for Social Policy and Management, Waltham, MA, USA
| | - Ilhom Akobirshoev
- Lurie Institute for Disability Policy, Brandeis University Heller School for Social Policy and Management, Waltham, MA, USA
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15
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Wickström M, Höglund B, Larsson M, Lundgren M. Increased risk for mental illness, injuries, and violence in children born to mothers with intellectual disability: A register study in Sweden during 1999-2012. CHILD ABUSE & NEGLECT 2017; 65:124-131. [PMID: 28135626 DOI: 10.1016/j.chiabu.2017.01.003] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/14/2016] [Revised: 12/08/2016] [Accepted: 01/05/2017] [Indexed: 05/27/2023]
Abstract
Several studies have demonstrated that mothers with intellectual disability (ID) have a higher prevalence of mental health illness, lower socio-economic status, and a higher risk of alcohol and drug use compared to mothers without ID. The children of mothers with ID are over-represented in child protection and legal proceedings but are generally a less studied group than the mothers. The aim of this study was to investigate if children born to mothers with ID had an increased risk of being diagnosed with mental illness, injuries, and violence compared with children of mothers without ID. The study comprised a population-based cohort of children born in Sweden between 1999 and 2005. Data were collected from the Medical Birth Register and linked with two other national registers; ICD-10 codes were used for medical diagnoses, including ID. The children were followed from birth to seven years of age. In total, 478,577 children were included, of whom 2749 were born to mothers with ID. Children of mothers with ID were at a greater risk of having mental health problems (adjusted odds ratio (OR)=2.02; 95% confidence interval (CI)=1.74-2.35) and ID (OR=4.14; CI=2.95-5.82) in early childhood. They had an increased risk for injuries due to falls (OR=1.15; Cl 1.04-1.27). The largest risk related to trauma was violence and child abuse (OR=3.11; CI=1.89-5.12). In conclusion, children of mothers with ID had an increased risk for injuries, violence, and child abuse. We therefore suggest that parents with ID should receive evidence based support so that their children receive the best care and protection.
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Affiliation(s)
- Maria Wickström
- Uppsala University, Department of Women's and Children's Health, SE-751 85 Uppsala, Sweden.
| | - Berit Höglund
- Uppsala University, Department of Women's and Children's Health, SE-751 85 Uppsala, Sweden.
| | - Margareta Larsson
- Uppsala University, Department of Women's and Children's Health, SE-751 85 Uppsala, Sweden.
| | - Maria Lundgren
- Uppsala University, Department of Women's and Children's Health, SE-751 85 Uppsala, Sweden.
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16
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Schuengel C, Kef S, Hodes MW, Meppelder M. Parents with intellectual disability. Curr Opin Psychol 2017; 15:50-54. [PMID: 28813268 DOI: 10.1016/j.copsyc.2017.02.022] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2017] [Accepted: 02/10/2017] [Indexed: 10/20/2022]
Abstract
Questions around parents with intellectual disability have changed according to sociocultural shifts in the position and rights of people with intellectual disability. The early research focus on capacity for parenting has given way to a contextual model of parenting and child outcomes, increasingly tested in population-based samples. Epidemiological research shows that contextual variables such as low income, exposure to violence, and poor mental health partly account for negative outcomes. As theoretical models developed for other at risk populations prove increasingly helpful for understanding the challenges of parenting with intellectual disability, it becomes viable to adapt existing evidence-based parenting interventions and test these for this population. Ultimately, parenting research should become fully inclusive.
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Affiliation(s)
- Carlo Schuengel
- Vrije Universiteit Amsterdam, Faculty of Behavioural and Movement Sciences and Amsterdam Public Health Institute, Van der Boechorststraat 1, 1081 BT Amsterdam, The Netherlands.
| | - Sabina Kef
- Vrije Universiteit Amsterdam, Faculty of Behavioural and Movement Sciences and Amsterdam Public Health Institute, Van der Boechorststraat 1, 1081 BT Amsterdam, The Netherlands
| | - Marja W Hodes
- Vrije Universiteit Amsterdam, Faculty of Behavioural and Movement Sciences and Amsterdam Public Health Institute, Van der Boechorststraat 1, 1081 BT Amsterdam, The Netherlands; ASVZ, Postbus 121, 3360 AC Sliedrecht, The Netherlands
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17
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Wołowicz-Ruszkowska A, McConnell D. The experience of adult children of mothers with intellectual disability: A qualitative retrospective study from Poland. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2017; 30:482-491. [PMID: 28070932 DOI: 10.1111/jar.12322] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/11/2016] [Indexed: 11/27/2022]
Abstract
BACKGROUND Little is known about the experience of growing up with a mother with intellectual disability. The aim of this study was to explore this experience from the perspective of adult children. METHOD In-depth interviews with 23 adult children brought up by mothers with moderate-to-severe intellectual disability. The interview data were analysed using grounded theory methods. RESULTS The childhood experiences of the interviewees and the role their mothers played in their upbringing varied, depending in part on the involvement of extended family. It was the stigma of maternal intellectual disability, rather than their mother's functional limitations, that posed the greatest challenge. CONCLUSION Interviewees characterized their mothers and childhoods as different, yet ordinary. Understanding the social context, including but not limited to the availability of informal support, is critical to understanding the experience of children growing up with mothers with intellectual disability.
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Affiliation(s)
| | - David McConnell
- Department of Occupational Therapy, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB, Canada
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Powell RM, Parish SL. Behavioural and cognitive outcomes in young children of mothers with intellectual impairments. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2017; 61:50-61. [PMID: 27306542 DOI: 10.1111/jir.12308] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/10/2015] [Revised: 04/12/2016] [Accepted: 05/18/2016] [Indexed: 06/06/2023]
Abstract
BACKGROUND Despite an increase in international studies examining the experiences of parents with intellectual impairments and their children, few have utilised population-based data. This study investigated the behavioural and cognitive outcomes of 3-year-old US children of mothers with intellectual impairments compared with children of mothers without intellectual impairments. METHODS This study employed a secondary analysis of the Fragile Families Child and Wellbeing Study, a longitudinal birth cohort study in the US. Our analytic sample included mothers with intellectual impairments (n = 263) and a comparison group of mothers without intellectual impairments (n = 1298), as well as each sampled mother's focal child. When weighted, Fragile Families is representative of all births in US cities with populations over 200 000. RESULTS Children of mothers with intellectual impairments had poorer behavioural and cognitive outcomes in comparison to same-age children of mothers without intellectual impairments. Notably, however, children of mothers with intellectual impairments were not at increased risk of being aggressive unless their family income was below 200% of the federal poverty level. Further, families headed by mothers with intellectual impairments experienced multiple hardships related to socioeconomic factors, limited social supports and poor self-reported health. CONCLUSION Appropriate policies and programmes must be developed and implemented to effectively support these families, such as increased financial benefits.
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Affiliation(s)
- R M Powell
- Brandeis University, Lurie Institute for Disability Policy, Waltham, MA, United States
| | - S L Parish
- Brandeis University, Lurie Institute for Disability Policy, Waltham, MA, United States
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Hindmarsh G, Llewellyn G, Emerson E. The Social-Emotional Well-Being of Children of Mothers with Intellectual Impairment: A Population-Based Analysis. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2016; 30:469-481. [PMID: 27878941 DOI: 10.1111/jar.12306] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/03/2016] [Indexed: 11/29/2022]
Abstract
BACKGROUND Children of parents with intellectual impairment are thought to be at risk for poor social-emotional well-being. This study investigated the relationship between maternal intellectual impairment and poor child social-emotional well-being. METHOD Secondary analysis of data from waves 2-4 of the Millennium Cohort Study (UK). Social-emotional well-being was measured by maternal report at Waves 2-4, with teacher and child self-report at Wave 4. Bivariate and multivariate analyses were conducted. RESULTS Unadjusted, maternal intellectual impairment was associated with an elevated risk of overall poor social-emotional well-being at ages 3 and 5, but not at age 7. After controlling for individual, family and environmental characteristics, no statistically significant association was found between maternal intellectual impairment and poor child social-emotional well-being. CONCLUSIONS Children of mothers with intellectual impairment are more likely than their peers to be exposed to adverse living conditions. These living conditions may explain, at least in part, why these children face a heightened risk of poor social-emotional well-being at ages 3 and 5. Improving the living conditions of mothers with intellectual impairment may offer a pathway to child social-emotional well-being.
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Affiliation(s)
- Gabrielle Hindmarsh
- Centre for Disability Research and Policy, Faculty of Health Sciences, The University of Sydney, Lidcombe, NSW, Australia
| | - Gwynnyth Llewellyn
- Centre for Disability Research and Policy, Faculty of Health Sciences, The University of Sydney, Lidcombe, NSW, Australia
| | - Eric Emerson
- Centre for Disability Research and Policy, Faculty of Health Sciences, The University of Sydney, Lidcombe, NSW, Australia
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20
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Strnadová I, Bernoldová J, Adamčíková Z, Klusáček J. Good Enough Support? Exploring the Attitudes, Knowledge and Experiences of Practitioners in Social Services and Child Welfare Working with Mothers with Intellectual Disability. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2016; 30:563-572. [PMID: 27878930 DOI: 10.1111/jar.12307] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/03/2016] [Indexed: 11/28/2022]
Abstract
BACKGROUND This study examined the attitudes, knowledge and experiences of practitioners in social services and child welfare working with mothers with intellectual disability. METHOD The authors used a national survey, which was completed by 329 participants. Descriptive statistics and frequency tables were generated, and the associations between variables and differences between various subgroups of the sample were made. The open questions were analysed using the processes involved in content analysis. RESULTS The findings indicated that the participants had limited knowledge of available supports and services for mothers with intellectual disability. Furthermore, many participants believed that mothers with intellectual disability should have an abortion should they become pregnant. The findings show practitioners' stereotyped attitudes towards mothers with intellectual disability. CONCLUSIONS Workers in the area of social services and child welfare need access to training and professional development in the area of supporting mothers with intellectual disability.
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Affiliation(s)
- Iva Strnadová
- School of Education, University of New South Wales, Sydney, Australia.,Faculty of Education and Social Work, Honorary staff member at the University of Sydney, Sydney, Australia
| | - Jana Bernoldová
- Department of Special Education, Faculty of Education, Charles University in Prague, Prague, Czech Republic
| | - Zdeňka Adamčíková
- Department of Special Education, Faculty of Education, Charles University in Prague, Prague, Czech Republic
| | - Jan Klusáček
- Department of Public and Social Policy, Faculty of Social Sciences, Charles University in Prague, Prague, Czech Republic
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21
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Guay A, Aunos M, Collin-Vézina D. Mothering with an Intellectual Disability: A Phenomenological Exploration of Making Infant-Feeding Decisions. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2016; 30:511-520. [DOI: 10.1111/jar.12298] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/30/2016] [Indexed: 12/01/2022]
Affiliation(s)
- Amanda Guay
- School of Social Work; McGill University; Montreal QC Canada
- Centre Intégré Universitaire de Santé et de Services Sociaux de l'Ouest-de-l’île-de-Montréal; Lachine QC Canada
| | - Marjorie Aunos
- Centre Intégré Universitaire de Santé et de Services Sociaux de l'Ouest-de-l’île-de-Montréal; Lachine QC Canada
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22
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Lindberg L, Fransson M, Forslund T, Springer L, Granqvist P. Maternal Sensitivity in Mothers with Mild Intellectual Disabilities is Related to Experiences of Maltreatment and Predictive of Child Attachment: A Matched-Comparison Study. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2016; 30:445-455. [PMID: 27878912 DOI: 10.1111/jar.12300] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/26/2016] [Indexed: 11/28/2022]
Abstract
BACKGROUND Scientific knowledge on the quality of caregiving/maternal sensitivity among mothers with mild intellectual disabilities (ID) is limited and subject to many methodological shortcomings, but seems to suggest that these mothers are less sensitive than mothers without intellectual disabilities. METHODS In this matched-comparison study (N = 48), the present authors observed maternal sensitivity for 20 min in four different laboratory play situations. The study also included semi-structured interviews to assess maternal experiences of maltreatment and child attachment. RESULTS The present authors found significantly lower sensitivity among mothers with intellectual disabilities than among a comparison group of mothers without intellectual disabilities. Among mothers with intellectual disabilities, low sensitivity was related to maternal experiences of maltreatment and predictive of disorganized child attachment. In the comparison group, high maternal sensitivity was related to partner presence and social support, and predictive of child intelligence. CONCLUSIONS The present authors highlight the importance of attending to intellectual disabilities mothers' history of receiving care to understand their capacity for giving adequate care.
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Affiliation(s)
- Lene Lindberg
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
| | - Mari Fransson
- Department of Psychology, Uppsala University, Uppsala, Sweden
| | - Tommie Forslund
- Department of Psychology, Uppsala University, Uppsala, Sweden
| | - Lydia Springer
- SUF Resource Center, Uppsala County Council, Uppsala, Sweden
| | - Pehr Granqvist
- Department of Psychology, Stockholm University, Stockholm, Sweden
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23
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Powell RM, Parish SL, Akobirshoev I. Health of Young Children Whose Mothers Have Intellectual Disability. AMERICAN JOURNAL ON INTELLECTUAL AND DEVELOPMENTAL DISABILITIES 2016; 121:281-294. [PMID: 27351697 PMCID: PMC9402285 DOI: 10.1352/1944-7558-121.4.281] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Understanding the needs and experiences of parents with intellectual disability (ID) and their children is critical to ensuring that policies can effectively support these families. This research analyzed data from the Fragile Families and Child Wellbeing Study to examine the health outcomes of U.S. children whose mothers have (n = 263) and do not have ID (n = 1,298). Compared to mothers without ID, mothers with ID experienced worse outcomes related to socioeconomic status, limited support networks, and poor self-reported health. However, after controlling for sociodemographic characteristics, mother's intellectual disability was not associated with a child having fair or poor health, asthma, or being overweight or obese.
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Affiliation(s)
- Robyn M Powell
- Robyn M. Powell, Susan L. Parish, and Ilhom Akobirshoev, Brandeis University, Waltham, MA
| | - Susan L Parish
- Robyn M. Powell, Susan L. Parish, and Ilhom Akobirshoev, Brandeis University, Waltham, MA
| | - Ilhom Akobirshoev
- Robyn M. Powell, Susan L. Parish, and Ilhom Akobirshoev, Brandeis University, Waltham, MA
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24
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Emerson E, Llewellyn G, Hatton C, Hindmarsh G, Robertson J, Man WYN, Baines S. The health of parents with and without intellectual impairment in the UK. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2015; 59:1142-1154. [PMID: 26365876 DOI: 10.1111/jir.12218] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/02/2015] [Revised: 07/24/2015] [Accepted: 07/28/2015] [Indexed: 06/05/2023]
Abstract
BACKGROUND Little is known about the health and well-being of the 'hidden majority' of parents with mild intellectual disability (ID), who are less likely to be in contact with disability services. METHOD We sought to add to knowledge in this area by examining the health and living conditions of parents with and without intellectual impairment in a large contemporary nationally representative sample of UK parents aged between 16 and 49 years old (n = 14 371). RESULTS Our results indicated that, as expected, parents with intellectual impairment were at significantly greater risk than other parents of having poorer self-reported general, mental and physical health. They were also at significantly greater risk of experiencing higher rates of household socio-economic disadvantage and environmental adversities and lower rates of neighbourhood social capital and intergenerational support. Adjusting risk estimates to take account of between group differences in household socio-economic disadvantage eliminated statistically significant differences in health status between parents with and without intellectual impairment on all but one indicator (obesity). Further adjusting risk estimates to take account of between group differences in neighbourhood adversity, neighbourhood social capital and intergenerational support had minimal impact on the results. CONCLUSIONS That controlling for between-group differences in exposure to socio-economic disadvantage largely eliminated evidence of poorer health among parents with intellectual impairment is consistent with the view that a significant proportion of the poorer health of people with IDs may be attributable to their poorer living conditions rather than biological factors associated with ID per se.
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Affiliation(s)
- E Emerson
- Centre for Disability Research and Policy, University of Sydney, Sydney, New South Wales, Australia
- Centre for Disability Research, Lancaster University, Lancaster, UK
| | - G Llewellyn
- Centre for Disability Research and Policy, University of Sydney, Sydney, New South Wales, Australia
| | - C Hatton
- Centre for Disability Research, Lancaster University, Lancaster, UK
| | - G Hindmarsh
- Australian Family & Disability Studies Research Collaboration, Faculty of Health Sciences, University of Sydney, Sydney, New South Wales, Australia
| | - J Robertson
- Institute for Health Research, Lancaster University, Lancaster, UK
| | - W Y N Man
- Australian Family & Disability Studies Research Collaboration, Faculty of Health Sciences, University of Sydney, Sydney, New South Wales, Australia
| | - S Baines
- Centre for Disability Research, Lancaster University, Lancaster, UK
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25
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Abstract
Parenting by people with intellectual disability continues to confront societal sensibilities. On the one hand, parents with intellectual disability engage in the valued social role of raising children; on the other, their parenting attracts (typically negative) attention based on an expectation of their limited capacities to parent. The literature primarily addresses the question of whether or not parents with intellectual disability can be adequate parents or reports on methods for improving their parenting skills. An emerging trend in the literature over the last decade takes a different perspective. Rather than concentrating exclusively on parents with intellectual disability, this perspective focuses on their parenting situation compared to that of other parents more generally. This paper reviews the current state of knowledge about parents and parenting with intellectual disability in this broader population context. The focus of the paper is on the use of larger scale datasets to understand the situation of parents with intellectual disability compared with other parents and to examine the contextual variables that influence their parenting.
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