Mothers and Fathers of Children with Cerebral Palsy: Differences in Future Expectations

Parents’ expectations are known to be a central component in children’s development through multiple pathways; however, limited information exists regarding expectations of parents of children with developmental disabilities. The purpose of the current study was to examine future expectations of parents of children with cerebral palsy (CP), as well as the differences in expectations between mothers and fathers. Forty-nine mothers and fathers of children with CP (6–12 years) participated in this study. Parents completed a Parental Future Expectations Questionnaire for Children with Disabilities, and a Perception of Child’s Ability questionnaire, as well as the Pediatric Evaluation Disability Inventory (PEDI). The Gross Motor Function Measure-66 (GMFM-66) was completed by physical therapists. Parental differences in future expectations were analyzed and multiple-stepwise regressions established parental expectations’ predictors. Parents’ expectations correlated with their child’s characteristics. Parents of children with lower levels of functioning reported lower expectations. No differences were found between mothers’ and fathers’ future expectations; however, differences were found between expectations’ predictors. Predictors of mothers’ expectations were their perceptions of their child’s abilities as well as child’s performance. Fathers’ predictors were child’s level of functional impairment and their perceptions of their child’s abilities. The results indicate that parental expectations relate to their child’s functional ability and differ between parents in relation to the child’s level of impairment (fathers) or child’s actual performance (mothers). These differences should be acknowledged by clinicians when they provide specific support for children with chronic physical disabilities and their families.     

Types, availability, and perception of social support among parents of young children with cognitive delays in Vietnam

Parents of young children with disabilities experience increased parenting stress owing to the caregiving demands the children place on them and concern over how they will raise and care for their children in the future. Support or understanding from others can be helpful in relieving the psychological and physical strain that caregivers experience. The project examined the types and availability of social support for Vietnamese parents of young children with cognitive delays, and their perceived social support and parenting stress. Fourteen types of informal support (spouse, wife's father, wife's mother, husband's father, husband's mother, wife's siblings, husband's siblings, sons, daughters, other relatives, friends, neighbors, and parents of other children with disabilities and social helpers) and eight types of professional support (teachers, therapists, doctors, private therapists, home helpers, social agencies, babysitters, and doctors in community health clinics) were available. When the level of intellectual functioning among children was lower, both mothers and fathers reported less availability of support from most types of informal support and teachers. For both mothers and fathers, a larger network of informal and professional support reduced the amount of stress they experienced. Specifically, however, when immediate family members were not available, mothers were more likely to experience parenting stress whereas the unavailability of friends and neighbors increased fathers' parenting stress. While addressing the stigma in society that affects the lives of the families of the children with disabilities in gaining informal support, the need for developing professional services in developing countries is discussed.     

Differences in stress and coping for mothers and fathers of children with Asperger's syndrome and nonverbal learning disorders

Research conducted on families of children with disabilities shows that family cohesion and positive family outcomes are influenced by how mothers and fathers cope with raising their child with disabilities. This study was designed to examine stress and coping differences between mothers and fathers (n = 103) of children with Asperger's syndrome (AS) and nonverbal learning disorders (NLD). A repeated measure design was used to compare how mothers and fathers cope with caring for a particular child to control for differences in the severity and nature of the disability across children. Few studies that compare mothers and fathers do so at the couple level. Responses indicated that mothers had higher rates of stress related to family problems and pessimism about their child's future, higher rates of antidepressant use, and higher rates of therapy use than did fathers. Mothers found some coping strategies more helpful than fathers did. Maternal education and child's age also were related to some stress and coping variables. Implications for nurses and future research are discussed.     

Mothers' and fathers' interactions with children with motor delays.

OBJECTIVE: In early intervention programs, parents are often asked to teach their child new skills. As fathers are increasingly involved in intervention, clinicians need more information on fathers' unique interactive style. This pilot study compared mothers' and fathers' parent-child interactions during a teaching episode to identify similarities and differences in order to better understand parents' strengths. METHODS: The Nursing Child Assessment Teaching Scale was used to observe 10 mothers and 10 fathers interacting with their 10- to 28-month-old children in their homes. The children were receiving early intervention for a motor delay. The Caregiver Scores (parent's contribution to the interaction) of mothers and others were compared using paired t tests. RESULTS: Mothers had more optimal interactions as indicated by significantly higher Caregiver scores than fathers, t (9) = 3.83, p = .004. The subscales with statistically significant differences were Caregiver Contingency and Cognitive Growth Fostering. Children's scores when they interacted with their mothers or fathers did not differ. CONCLUSION: When observing fathers teaching their child new skills, therapists should remember that fathers of children with motor delays (and typically developing children) may use a more task-oriented communication style with less consideration of the child's actions than do mothers.     

Time use of mothers with school-age children: a continuing impact of a child's disability.

OBJECTIVE: The purpose of this study was to compare the time use of mothers of children with disabilities with the time use of mothers of children without disabilities. METHOD: Sixty mothers with children 3 to 14 years of age (30 mothers with children with disabilities and 30 mothers with children without disabilities) completed time diaries over seven 24-hour days. RESULTS: Significant differences were found between the two groups when comparing mean hours spent per week by mothers in occupations involving child-care activities and recreational activities. Mothers of children with disabilities spent significantly more time in child-care activities and significantly less time in recreational activities. In addition, mothers of children with disabilities reported fewer typical days and rated the quality of days as poorer. As children got older, the gap between the time mothers devoted to child care increased between the two groups. CONCLUSION: The type of occupations a mother participates in varies significantly dependent upon whether a child in the family has a disability and the age of the child. Professionals need to work collaboratively with families to assist parents to meet the family's daily needs particularly in light of the time demands of the mother.     

Mothers and Fathers at Play with their Children with Down Syndrome: Influence on Child Exploratory and Symbolic Activity

Background Through play children exercise their emerging mental abilities, and for their part, when in collaborative play, caregivers often adjust their behaviours to assist their children’s progress. In this study, we focused on comparisons between play of Down Syndrome (DS) children with their two parents as well as on comparisons between the two parents’ play behaviours. Method Altogether 40 parent–child dyads participated: 20 children with DS (M age = 36.14 months) with their mothers and separately with their fathers. We coded participants’ play behaviours during child solitary and mother–child and father–child collaborative sessions. Results Although children increased exploratory play from solitary to collaborative sessions with both parents, symbolic play increased only during joint play with fathers. Fathers displayed less symbolic and more exploratory activity compared to mothers. Mothers and fathers alike were attuned to their children, although fathers showed a higher degree of attunement. Conclusions This study shows that maternal and paternal contributions to DS child play skills are positive but different. During collaborative play children received specific and nonoverlapping scaffolding from their two parents, and fathers’ contributions were unique.     

The family dynamics of childbearing and childrearing families in Finland

Within the context of an international comparative family dynamics project, this study had two chief goals to describe the family dynamics of childbearing and childrearing families in Finland, and to study changes in family dynamics after childbirth The sample consisted of families expecting ( n = 118) and rearing ( n = 94) their first or second child in Finland Two instruments were used in data collection, i e the Family Dynamics Questionnaire and the Family Dynamics Measure, both these tools have been developed in the USA According to the results, childbearing and childrearing families were thought to function quite well Pregnant mothers described their family dynamics in more positive terms than fathers, reporting greater flexibility and clearer communication Similarly, mothers reported more individuation and mutuality than their partners First-time expectant families reported more mutuality than families expecting their second child Childrearing mothers reported more individuation, but also more role conflict than did fathers Communication in families rearing their first child was clearer than in families rearing their second child The birth of a child affected family dynamics by bringing about various changes such as role conflict, isolation and distorted communication     

Maternal perceptions of family-provider relationships and well-being in families of children with Down syndrome.

The purpose of this study was twofold: (a) to describe parental perceptions of family-provider relationships, and (b) to explore links between parental perceptions of family-provider relationships and well-being in families with children who have Down syndrome. Mailed questionnaires were used to collect data from 94 families that include a child with Down syndrome. Data from 89 mothers are the focus of this report. The results indicate that when mothers of children with Down syndrome believe that their family's relationship with health care providers is positive and family-centered, they feel more satisfied with the care that their child is receiving and they are more likely to seek help from health care providers. In addition, when a discrepancy exists between what mothers want the family-provider relationship to be and what they believe the relationship is, mothers feel less satisfied with the care that their child is receiving. Finally, higher levels of individual and family well-being are reported by mothers who (a) want, and believe they have, positive family-centered relationships with providers, and (b) feel more satisfied with care received. Results of this study contribute to a better understanding of the role that health care providers play in individual and family adaptation to chronic conditions.     

The impact of maternal depression on children with asthma

This integrative literature review focuses on the impact of maternal depression on children with asthma. Maternal depression has a negative impact on a child's growth, development, behavior, mental health, safety, and health care utilization. Mothers of children with chronic conditions such as asthma have higher rates of depression compared to mothers of children without a chronic condition. Research has shown that maternal depression has the potential to increase asthma morbidity and health care utilization. In addition, mothers with depressive symptoms report lower self-efficacy in their ability to care for their children with asthma, which can affect their ability to manage their child's asthma with the prescribed medication regimen. To provide optimal care for children with asthma and their families, pediatric care providers must perform periodic depression screening to mothers or caregivers. Depressed mothers or caregivers of children with asthma require care coordination and management that consists of increased education on asthma and depression, and more frequent follow up than families without maternal/caregiver depression. These additional care measures have numerous positive benefits, including enhancing the quality of life in both the child and caregiver by improving asthma management in the child and depressive symptoms in the mother, as well as decreasing costs imposed on the economy through reduced emergency department visits, hospitalizations, missed work days, and missed school days.     

Factors Related to Positive Perceptions in Mothers of Children with Intellectual Disabilities

Background Existing theoretical and empirical work in the intellectual disability field has paid little attention to parents' positive perceptions of their child and the positive impact that the child may have on the family generally. The main aim of the present study was to explore the factors related to the mothers' positive perceptions of their child with intellectual disability. Methods The mothers of 41 children with intellectual disabilities completed a self‐report questionnaire that measured demographic factors, child demographic variables (including caregiving demand), social support, coping strategies and dimensions of positive perceptions. Results Mothers' perceptions of the child as a source of happiness/fulfilment and as a source of strength and family closeness were positively associated with reframing coping strategies. Mothers' perceptions of the child as a source of personal growth and maturity were also positively associated with reframing coping strategies, the helpfulness and usefulness of support from family and friends, and the caregiving demand. Conclusions The relationship between coping and parental positive perceptions requires more investigation both theoretically and empirically. This relationship may also have important implications for the support of families of children with intellectual disabilities.     

Adolescent reactions to sibling death: perceptions of mothers, fathers, and teenagers

Fourteen families in which a child had died participated in this study; the mother, father, and one teenager from each family were interviewed. All participants completed a sibling bereavement inventory consisting of 109 scaled items that measured self-concept perceptions and grief reactions. The teenagers completed the inventory in terms of their own reactions; the mothers and fathers were instructed to complete the inventory as they anticipated their teenager would answer it. Mothers held significantly different views of their teenagers' self-concept and grief than did the fathers or the teenagers. Fathers' responses resembled those of their teenagers. In addition to accenting the need to study more fully the family dynamics involved when a child dies, the results call into serious question commonly held views regarding the accuracy and reliability of mothers' perceptions of bereaved children. The results suggest that more credence be given to fathers' observations about the phenomena of bereavement engaging their teenage children.     

Impact of Marital Quality and Parent-Infant Interaction on Preschool Behavior Problems

Abstract This study examined the relationships between parent interactions with healthy term and preterm infants at 12 months of age, marital quality, family socioeconomic status, and preschool behavior problems. Eighty mothers and 74 fathers were observed in the home during an interaction with their child (Nursing Child Assessment Teaching Scale). and this group of parents completed the Dyadic Adjustment Scale questionnaire (marital quality) 12 months after the child was discharged from the hospital. Each parent completed the Eyberg Child Behavior Inventory when their child was four years of age. The parent and infant interaction scores were not predictive of later child behavior problems. Maternal perceptions of marital quality at 12 months predicted the frequency (Eyberg Intensity score) and impact (Eyberg Problem score) of the child's problematic behaviors reported by mothers. Marital quality and family socioeconomic status predicted the impact of behavior problems for fathers. There were no significant differences between preterm and term children or between boys and girls in the frequency or impact of problematic behaviors. Mothers reported a significantly greater frequency of behavior problems than fathers of the same children. The implications of these findings for nurses who work with families and young children are discussed.     

Medical equipment use in children with disabilities: A descriptive survey

Objective: To investigate the use of medical equipment by children with disabilities, the reasons for use, and prescribers of equipment. Methods: A convenience sample. Setting: Referral clinic for children with developmental conditions. Participants: Caregivers of children with motor disabilities completed an interview survey for children 0-21 years. Results: 108 parents/caregivers reported 467 (mean=4.3 per patient) pieces of owned equipment. The mean age of children was 7.1 years (± 5.0), and 49% were female. The most common diagnoses were cerebral palsy (45%), 'Other' diagnoses including intellectual disability (19%), genetic abnormality (13%), spina bifida (13%), and neuromuscular diseases (7%). Survey participants described use of the following types of equipment: orthotics (82%), bath chair (37%), seating device (34%), stander (19%), augmentative communication devices (17%), walker (14%), and gait trainer (10%). Reasons for "non-use" of equipment included: outgrown (19%), not useful (14%), and child refusal (15%). Physicians were the sole prescriber for 15% of families, whereas physical or occupational therapists most commonly recommended new equipment (76%).Conclusion: Based on parental report, children with neuromuscular disabilities use most equipment that is medically recommended. The majority of equipment needs are identified by therapists. Pediatricians can benefit from additional expertise in the provision of medical equipment for children.