Helping parents and children with epilepsy cope successfully: The outcome of a group programme for parents

This paper describes a study to determine the effectiveness of a group programme for parents designed to reduce the psychosocial morbidity among children with epilepsy and their families. The participants were the parents children attending the seizure clinic at a children's hospital. The first part of the project had shown that half of the children and their families had considerable morbidity. Despite the high rate of psychosocial morbidity among these children and thier families, only 35% of the parents expressed an interest in participation in the intervention programme, with only 12% attending any meetings. The latter were mainly the small number of parents whose children had severe intractable epilepsy as well as educational and family problems. Many parents did, however, request more information about epilepsy and for the provision of a counselling service. The latter is likely to be most beneficial in the months following diagnosis.     

Alcohol-related problems within the familiy and global functioning of the children: a population-based study

Summary We carried out a population-based prevalence study to assess the association between the presence of alcohol-related problems within the family and the risk of disorders in the children's global functioning level. We enrolled 394 children attending nursery, primary and secondary schools and their parents living in two municipalities in Central Italy. Alcohol-related problems within the family were reported by registered records obtained from general practitioners and teachers, who were considered as preference raters. The childrens level of functioning was assessed by teachers, who attributed to each school child a score according to the Children Global Assessment Scale (CGAS). The number of reports of alcohol-related problems within the family and the CGAS scores were considered, respectively, as independent and dependent variables in a multiple logistic regression model for ordinal outcome variables. The children's sex and age, and the age of their parents, the duration of the parents' education and family size were considered as covariates. We found a strong association between a poor level of functioning in the children in the social environment and alcohol-related problems within the family. The pravalence odds ratio (and 95% confidence interval) decreased from 0.5 (range 0.2–1.3) for children whose families were reported by one rater to 0.4 (range 0.2–0.8) for children whose families were reported by two raters, the non-reported families being the reference category, suggesting that the level of functioning of the child decreased as reports of alcohol-related problems in the family increased.     

Parental wellbeing of Iranian families with children who have developmental disabilities

To date, most research with families who have a child with developmental disabilities has been undertaken in English speaking countries. Poorer health, allied with increased levels of stress has been commonly reported for mothers but less is known about the impact on fathers and on overall family functioning. This study aimed to document the correlates of these parental impacts with Iranian mothers and fathers who had children with either intellectual disabilities (ID) or with autism spectrum disorders (ASD). In all 121 parents (69 mothers and 52 fathers from 94 families) who had a child with a diagnosis of ADS, along with 115 parents of children with ID (83 mothers and 32 fathers from 101 families) volunteered to take part in the study. Each participant completed through interview standardised rating scales of parenting stress, emotional well-being, family functioning and satisfaction with caring role along with demographic information and details of informal supports. Structural Equation Modeling identified that family functioning was much poorer in families whose child had ASD and both mothers and fathers reported higher levels of stress. Poorer emotional well-being contributed to higher stress and was more frequent among mothers, single parents and those whose children had behaviour problems. Having other dependents living at home and more sources of informal support improved the emotional wellbeing of parents but not their stress or family functioning. Parents who derived greater satisfaction from their caring role tended to have better emotional health and less stress. Although the impact on Iranian parents of having a child with developmental disabilities is broadly similar to those of parents in other cultures, there are indications that children with ASD present distinct challenges to these families. The model derived in this study is a useful guide both for further research as well as family-centred interventions.     

Behavior problems in children with mild intellectual disabilities: An initial step towards prevention

To develop prevention activities, an analysis is conducted of child and parent characteristics that occur significantly more often among children with a mild intellectual disability and behavior problems than among children with a mild intellectual disability and no behavior problems and their families. The sample consisted of 45 children attenting schools for special education. Data were collected from the children, their parents, and their teachers. The instruments used are the Dutch version of the Parenting Stress Index, the Nijmegen Child-Rearing Situation Questionnaire and the Strenghts and Difficulties Questionnaire for parents, teachers and children. On the basis of the results of parents on the Strenghts and Difficulties Questionnaire, the research sample was divided into one group of children with behavior problems and one group without behavior problems. Parents of the children with behavior problems were found to feel less competent, more socially isolated, less satisfied about their relationship with their partner, and indicate more negative life occurrences than the parents of the children without behavior problems. Characteristics in the area of adaptability, mood, distractibility/hyperactivity, demandingness, reinforcement of parents, and acceptability were found to contribute to the total stress in the child–parent relationship for those children with behavior problems and their parents. On the basis of these results prevention activities will be developed and tested on their effectiveness.     

Cognitive, behavioral, and emotional problems among school-age children of alcoholic parents

Sixty-four children from 37 families with an alcoholic parent were compared with 80 children from 45 families that did not have an alcoholic parent on measures of intelligence, cognitive achievement, psychological and physical disorders, impulsivity-hyperactivity, social competence, learning problems, behavior problems, and self-esteem. On nine of 17 tests, the children of alcoholic parents scored less well than did the children of nonalcoholic parents, although both were within normal ranges. Factor analysis yielded significant differences between the two samples in emotional functioning and cognitive abilities and performance; marginally significant differences were found with respect to behavior problems.     

Respite Care for Children with Severe Intellectual Disability and their Families: Who Needs It? Who Receives It?

Need for, and receipt of, respite care services were examined in a representative sample of 103 5–11-year-old children with severe intellectual disability and their families. Children for whom respite care was wanted had significantly more severe disabilities and behaviour problems than those whose parents felt they did not need it; their parents also reported significantly higher levels of stress. However, among those who wanted respite care, none of these factors appeared relevant to whether or not they had received it. The results suggest the need for greater account to be taken of the severity of the child's behaviour problems and intellectual disabilities in the allocation of respite care services, and also for measures to improve the supply of respite care placements capable of managing children with more challenging behaviour.     

The applicability of Webster-Stratton Parenting Programmes to deaf children with emotional and behavioural problems, and autism, and their families: annotation and case report of a child with autistic spectrum disorder

This article describes a pilot project whose objective was to explore whether the Webster-Stratton Parenting Programme may be effective for hearing parents and their deaf children who present with conduct disorders and other emotional, behavioural and developmental problems. Outcome measures aimed at overall impact in decreasing behavioural problems and improving overall family function were used. Participants were hearing parents of deaf children referred to our specialist service whose assessment had recommended a parenting skills group as treatment of choice. The children had been diagnosed with behavioural problems with or without additional comorbidity. This pilot phase focused deliberately on one participant, in order to explore whether the approach justified further, more comprehensive evaluative research. Outcome was positive, suggesting that modified Webster-Stratton approaches may well be of use in deaf children of hearing parents.     

Patterns and Predictors of Anxiety Among Siblings of Children with Autism Spectrum Disorders

The purpose of this study was to examine patterns of anxiety among siblings of children with autism spectrum disorders (ASD), and determine the characteristics of the child with ASD and their parents that predicted anxiety. Data was collected from 1,755 siblings of children with ASD whose families participated in the Simons Simplex Collection; siblings ranged in age from 3 to 18 years (M = 9 years). Male siblings were at increased risk for sub-clinical anxiety problems during middle childhood. Parental history of anxiety disorders, higher maternal pragmatic language, and more proband behavior problems predicted higher anxiety. While siblings overall did not show elevated anxiety symptoms, higher rates of sub-clinical anxiety problems among males and siblings in middle childhood are cause for concern.     

Families of Children with Prader-Willi Syndrome: Stress-Support and Relations to Child Characteristics

This study examined stress-support in 42 families of 3 to 18-year-old children with Prader-Willi syndrome. Parents were asked about themselves and their families, their child with Prader-Willi syndrome, family supports, and family stress. Compared to reported stress levels in families of children with mixed etiologies of retardation, parents of children with Prader-Willi syndrome showed higher levels of parent and family problems, and comparable levels of pessimism. Parents of children with Prader-Willi syndrome listed other family members and friends as their main supporters; often such supporters lived outside of the respondent's town or city. Although the child's age, IQ, and degree of obesity were not related to familial stress, families experienced greater stress when the child showed more behavior problems overall, more externalizing and internalizing problems, and more problems on five of the nine narrow-band domains of Achenbach's Child Behavior Checklist.     

Death of adult children in traffic accidents

The loss of adult children after traffic accidents is relatively common. Bereavement under these circumstances, however, has been little studied. Forty predominantly midlife parents (20 men and 20 women) of predominantly young adult children (27 men and 13 women) who died in traffic accidents were studied 25.6 months after the death. The parents completed the Symptom Checklist 90, the Beck Depression Inventory, and a Bereavement Questionnaire which sought information about the parent, the child, the rest of the family, and the relationship between them. It was found that the parents continued to grieve intensely and had higher than expected levels of psychiatric symptoms as well as increased health complaints. Some parents were more at risk for problems in the bereavement period. Those with unstable families who had ambivalent relationships with their children and whose children were perceived to have had problems at the time of the accident, had more guilt and increased psychiatric symptoms. Parents who had prior bereavement experiences seem to have been protected from higher levels of distress. Additionally, being a mother, losing a daughter, losing children who live at home, losing children born earlier in the birth order, and losing children in single car, single driver accidents seems to portend a more difficult bereavement. This is an important area for further study.