The emotional and behavioural functioning of siblings of children with special health care needs across childhood

This study examined the emotional and behavioural functioning of siblings of children with special health care needs identified in the Longitudinal Study of Australian Children (LSAC). Of the 106 siblings identified, 15–52% had emotional and behavioural difficulties in the at-risk or clinical range on the parent-reported Strengths and Difficulties Questionnaire (SDQ) subscales when aged 4–5 (wave 1), 6–7 (wave 2), 8–9 (wave 3) and 10–11 years (wave 4). After controlling for differences in socio-economic position, siblings had significantly higher difficulties on all subscales than their peers without a brother or sister with a special health care need at most time points. Latent growth modelling revealed little change in emotional and behavioural symptoms for siblings across childhood, while behavioural symptoms decreased for their peers. These findings suggest that some siblings are at heightened risk of emotional and behavioural difficulties across childhood, underscoring the importance of assessing and promoting the wellbeing of all family members when providing services to children with special health care needs.     

The siblings relationship of adolescents with and without intellectual disabilities

The sibling relationship of adolescents with and without intellectual disabilities was examined. Participants were 70 sibling dyads - each dyad was comprised of one 12-year old adolescent with (N = 23) or without intellectual disabilities (N = 47). Sibling relationships, behavior problems, and social skills were assessed using mother reports. Results revealed three findings. First, for typically developing adolescents, mothers reported more warmth in the sibling relationship for opposite sex dyads. For adolescents with intellectual disabilities, mothers reported more warmth in the sibling relationship for same-sex dyads. Second, for typically developing adolescents, mothers reported more status/power differences when the sibling was younger than when the sibling was older. For adolescents with intellectual disabilities, birth order did not affect status/power in the sibling relationship. Third, for typically developing adolescents, conflict was related to internalizing behavior problems. For adolescents with intellectual disabilities, conflict was related to externalizing behavior problems. Implications, limitations, and future directions are discussed.     

Coping of siblings of children with developmental disabilities in the Bedouin community

This is the first study that examines the coping of siblings of children with developmental disabilities in comparison with siblings of children without disabilities in the Bedouin community in Israel. For this purpose, the study examines the components of self-esteem, stress, and growth. Data were collected from 200 adolescents. The findings of this study show that siblings to children with developmental disabilities have a similar degree of self-esteem to those siblings to children without disabilities, whereas siblings to children with developmental disabilities have higher levels of stress perception and growth compared to siblings f children without developmental disabilities. In addition, a negative correlation was found between perception of stress and growth and a positive correlation between self-esteem and growth.     

A controlled trial of the SibworkS group program for siblings of children with special needs

Siblings of children with a disability are an at risk group for emotional and behavioral problems. This study evaluated an intervention to promote the emotional and behavioral functioning of siblings of children with disabilities and chronic health conditions. SibworkS is a six-week manual-based, cognitive–behavioral group support program focussed on strengthening siblings’ perceived social support, self-esteem, problem-solving skills, adaptive coping behaviors and positive sibling relationships. Fifty-six children aged 7–12 were allocated to either the SibworkS program (n = 30) or waitlist control (n = 26) in alternating sequence. The primary outcome was siblings’ emotional and behavioral functioning. Additional outcomes were self-esteem, perceived social support, the sibling relationship and coping behaviors. Siblings were followed-up immediately after the intervention and at 3-months. Siblings participating in the SibworkS intervention were reported to have fewer emotional and behavioral difficulties than siblings in the control group immediately following the intervention and at the 3-month follow-up. Participation in SibworkS was associated with fewer emotional and behavioral difficulties for siblings. Implications for practice and future research include recommendations for improving program participation.     

Emotional and behavioural problems in children and young people with autism spectrum disorder in specialist autism schools

We investigated emotional and behavioural problems in a sample (N = 615) of children and young people with autism spectrum disorders (ASD), most of whom also had intellectual disability (ID), attending specialist autism schools. High rates of parent- and teacher-reported problems were recorded. Teacher-reported levels of hyperactivity were higher in younger children. Teacher- but not parent-reported levels of conduct problems and hyperactivity were highest in children without phrase speech. Greater use of mental health services was associated with higher levels of emotional and behavioural problems, but only a minority of participants had accessed mental health services in the previous 6 months.     

Brief report: Behavioral adjustment of siblings of children with autism

Existing research studies have shown mixed results relating to the impact upon children of having a sibling with a disability. However, siblings of children with autism may be more at risk than siblings of children with other disabilities. In the present study, data were gathered on 22 siblings of children with autism. These children were rated by their mothers as having more behavior problems and fewer prosocial behaviors than a normative sample. Analysis of variables predicting sibling behavioral adjustment revealed that boys with siblings who have autism, and also those younger than their sibling with autism, engaged in fewer prosocial behaviors. Psychological adjustment of mothers (stress) and the child with autism (behavior problems) were not predictive of sibling behavioral adjustment.     

Family developmental risk factors among adolescents with disabilities and children of parents with disabilities

This paper investigates how the learning environments and family dynamics differ if households have a child with a disability or a parent with a disability. Using data from the National Longitudinal Survey of Youth 1997, results indicate that children with disabilities experience similar learning environments as other children, but have somewhat weaker relationships with their parents. In two-parent families, maternal disability lowers parents' school involvement and is associated with a less enriching home environment. Paternal disability reduces maternal monitoring and positive family activities possibly because mothers divert care-giving resources from their children to their male partners. Children in mother-headed households experience learning environments and family dynamics that are similar regardless of their own disability status or that of their mothers, but these outcomes are markedly inferior to those of children growing up in two-parent households. Future research on adolescent development should consider the disability status of children and parents, with particular attention to patterns of gendered care-giving in American families.     

Disparities in the use of preventive health care among children with disabilities in Taiwan

Children with disabilities face more barriers accessing preventive health services. Prior research has documented disparities in the receipt of these services. However, most are limited to specific types of disability or care. This study investigates disparities in the use of preventive health care among children with disabilities in Taiwan. Three nationwide databases from the Ministry of the Interior, Bureau of Health Promotion, and National Health Research Institutes were linked to gather related information between 2006 and 2008. A total of 8572 children with disabilities aged 1-7 years were included in this study. Multivariate logistic regression analysis was conducted to adjust for covariates. Nationally, only 37.58% of children with disabilities received preventive health care in 2008. Children with severe and very severe disabilities were less likely to use preventive care than those with mild severity. Children with disabilities from the lowest income family were less likely to have preventive care than other income groups. Urbanization was strongly associated with the receipt of preventive health care. However, surprisingly, urban children with disabilities were less likely to receive preventive care than all others. Under universal health insurance coverage, the overall usage of preventive health care is still low among children with disabilities. The study also identified several disparities in their usage. Potential factors affecting the lack of use deserve additional research. Policymakers should target low socioeconomic brackets and foster education about the importance of preventive care. Mobile health services should be continually provided in those areas in need. Capitation reimbursement and other incentives should be considered in improving the utilization among children with disabilities.     

Peer-relationship difficulties in children with brain injuries: Comparisons with children in mental health services and healthy controls

Positive peer relationships are essential in healthy development. The prevalence of peer-relationship problems in children after acquired brain injury (ABI) has yet to be explored, although ABI does inevitably impact upon peer interactions. We aimed to explore how peer-relationships and emotional distress after ABI may differ from the levels reported by healthy children or mental health controls. Parents of 214 children (137 “healthy” children, 27 children using mental health services and 40 children with ABI) aged 9–15 years participated. A questionnaire measure of peer-relationship functioning and emotional distress was completed. Children with ABI experienced a greater degree of peer-relationship difficulties and emotional distress than healthy controls. No difference was found in reported peer relationship difficulties or emotional distress between ABI children and the children accessing mental health services. We conclude that emotional distress and co-occurring peer-relationship difficulties are as prevalent in a population of children after ABI as may be expected in a population of children under the care of mental health services, yet, unlike the latter group, appropriate intervention services are not commonly available. Interventions that aim to enhance peer relationships after childhood ABI may provide an essential resource to the benefit of outcome.     

Elevated homocysteine level in siblings of patients with schizophrenia

Increased homocysteine plasma levels were reported in patients with schizophrenia and Levine et al. (2002) suggested that such increase characterizes mainly males. In the following study we examined whether such increased levels also characterize male siblings of schizophrenia patients. Forty-four pairs of schizophrenia patients and their corresponding healthy male siblings were recruited and sampled for homocysteine. We also had age-matched controls for each of the sibling. The median homocysteine plasma level for patients was 13.0 µMol/L and 11.7 µMol/L for their male siblings compared with a median of 10.9 µMol/L for the siblings' controls. There was no significant difference between homocysteine plasma level in patients and their siblings. Significant difference was found for homocysteine plasma level between the siblings' group and their matched controls. A partial correlation of Ln plasma homocysteine level between patients and their siblings was found to be close to a zero correlation of −0.089, p=0.57 for the whole study group and −0.15, p=0.38 in the male–male patient-sibling pairs. Our results show that elevated homocysteine plasma level may characterize schizophrenia patients' male siblings, a finding that seems to agree with previous studies suggesting elevated homocysteine level as a risk factor for developing schizophrenia.     

The effects of instructional interventions related to street crossing and individuals with disabilities

Adequate street crossing skills reduce the risk of injury and increase the functional independence of individuals with disabilities. This paper reviews research involving instructional interventions for street crossings with individuals with disabilities. Eight studies were included. There was evidence individuals could be taught street crossings using classroom based interventions, roadside instruction, or virtual reality technology. Classroom based methods were successful when involving strategies which promoted generalization of skills. Task analysis found the steps involved in street crossing included: stopping at the curb, looking left and right, walking quickly, walking within the crosswalk, and continuing to look left and right. A variety of instructional strategies were used, but the small body of literature did not allow clear identification of superior strategies.     

Behavioural and emotional difficulties in students attending schools for children and adolescents with severe intellectual disability

Background   For several decades, researchers and clinicians have been aware of an increased prevalence of psychiatric disorder in children with intellectual disability. However, there are few research studies exploring this issue.
Methods   The parents of 123 children attending schools for children with 'severe learning difficulties' completed the Developmental Behaviour Checklist (DBC) in order to identify those children with clinically significant behavioural and emotional problems. Comparisons were made with norms for the DBC and a range of child variables were investigated as possible correlates of disorder.
Results   Some 50.4% of the children scored above the cut-off on the DBC for psychiatric disorder. The child's severity of physical disability was related most strongly to parental ratings of behavioural and emotional problems. There were also effects for the child's age and the absence of Down's syndrome.
Conclusions   The present study confirms previous research findings of a high prevalence of behavioural and emotional difficulties amongst children with intellectual disability, and identifies a number of correlates of disorder which require further investigation.     

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.     

Sleep quality and psychological wellbeing in mothers of children with developmental disabilities

Sleep and behavioural difficulties are common in children with developmental disabilities. Mothers often wake and tend to their child when their child is having sleep difficulties. Therefore, mothers of children with developmental disabilities can have poor sleep quality due to these disruptions. The present study investigated the impact of sleep and behaviour problems in children with developmental disabilities on mothers’ sleep quality and psychological wellbeing. The sample consisted of 46 mothers and 50 children with developmental disabilities. The results indicated that greater sleep and behaviour problems in children were significantly associated with disturbed sleep and increased depression, anxiety and stress levels in mothers. Mothers’ sleep disturbance was also found to significantly predict poor maternal psychological wellbeing. The research limitations, implications of findings, and directions for future research are also discussed.     

Multimorbidity in older adults with intellectual disabilities

Multimorbidity may be related to the supposed early aging of people with intellectual disabilities (ID). This group may suffer more often from multimorbidity, because of ID-related physical health conditions, unhealthy lifestyle and metabolic effects of antipsychotic drug use. Multimorbidity has been defined as two or more chronic conditions. Data on chronic conditions have been collected through physical assessment, questionnaires, and medical files. Prevalence, associated factors and clusters of multimorbidity have been studied in 1047 older adults (≥50 years) with ID. Multimorbidity was prevalent in 79.8% and associated with age and severe/profound ID. Four or more conditions were prevalent in 46.8% and associated with age, severe/profound ID and Down syndrome. Factor analyses did not reveal a model for disease-clusters with good fit. Multimorbidity is highly prevalent in older adults with ID. Multimorbidity should receive more attention in research and clinical practice for targeted pro-active prevention and treatment.     

The assessment of the likelihood of mammography usage with relevant factors among women with disabilities

Research that identifies the determinants of low mammography use among disabled people is scant. This study examines the determining factors related to the low usage of mammography among women with disabilities. To identify the barriers that prevent women with disabilities from participating in mammography screening can help authorities conceive feasibly useful strategies for avoiding worse suffering. With women aged between 50 and 69 as subjects, this study was conducted using the database of Ministry of the Interior, Taiwan, in 2008, coupled with information gathered between 2006 and 2008 on preventive health care and medical claim data from the Bureau of Health Promotion and the National Health Research Institutes, respectively. This study examined the factors determining the use of mammography with logistic regression analysis. Only 8.49% of the disabled women used mammographies. When women with disabilities were in higher income level, they were more likely to use mammography for breast cancer screening. Similar findings were found for education levels. Moreover, subjects with a more severe form of disability were less likely to use mammography with ORs of 0.84, 0.63, and 0.52. Disabled women with major organ malfunction, chronic mental illness, or mental retardation had a higher likelihood to use mammography services, whereas women with multiple disabilities had the lowest likelihood of usage. Those with experience using other preventive services showed 1.9 times to 7.54 times (95% CI: 1.82-1.98, 7.15-7.95, respectively) increased likelihood of mammography usage. In summary, mammography usage is relatively different for disabled and nondisabled populations. To mitigate the disparities, we can use community healthcare institutions or public health nurses and social workers to provide related preventive health services through community events to implement integrated cancer screening services.     

A longitudinal study of siblings of children with chronic disabilities.

OBJECTIVE: To examine the unaffected siblings of 2 different groups with chronic disabilities, pervasive developmental disorder (PDD) and Down syndrome (DS), over 3 years, comparing their adjustment with each other and with the siblings of a nondisabled group. METHOD: This study examines 137 siblings of children with PDD, children with DS, and developmentally normal children (control group) initially and 127 siblings at follow-up 3 years later. Their adjustment is measured by the Survey Diagnostic Instrument (SDI), completed by caregivers and teachers. Predictor variables include sibling self-perception, social support, and relationship with sibling, as indicated by siblings; caregiver psychosocial factors such as parental stress, caregiver depression, and marital relationship; family systems characteristics as viewed by both caregiver and sibling; and difficulty that disabled child causes as perceived by the primary caregiver. RESULTS: Significantly more adjustment problems are found in the siblings of PDD children at both times when compared with siblings of DS and control children. Caregivers of PDD children report the highest levels of distress and depression, and this persists over time. Parent distress was found, at both times, to be related to sibling adjustment problems, regardless of study group. CONCLUSION: These results have implications for preventive intervention for the unaffected siblings of PDD children.