FIRST DIAGNOSIS OF SEVERE HANDICAP: A STUDY OF PARENTAL REACTIONS

This paper reports the results of interviews with 190 parents of severely mentally handicapped children. Questions were asked about parents' satisfaction with the way they were first informed of the child's impairment. Most parents were informed by a doctor, and almost two-thirds were dissatisfied with the first information given. Satisfaction was associated with being told early in the child's life. There was a significant association between the time of telling and the diagnostic condition of the child: parents of children with handicap of no known pathology were more likely to be told during or after the second year of the child's life, while parents of children with Down's syndrome were most likely to be told at birth. The authors discuss ways in which parents can be helped through this difficult time and suggest procedures for breaking the news to parents in a sensitive way.     

Asian American parents' attributions of children with Down syndrome: connections with child characteristics and culture

This study explores cultural differences between European American (n = 26) and Asian American (n = 17) parents' attributional ratings of children with Down syndrome. Links were examined among parents' attributions, reactions, and behaviors regarding their child's jigsaw-puzzle performance. Although the children's puzzle abilities did not differ, compared with European American parents, Asian American parents judged their child as less successful and had lower expectations for future success. Asian American parents also attributed the child's performance to lower ability and lower effort. Affectively, they indicated less sympathy and more anger and blame toward the child. Despite striking ethnic differences, parents in both groups judged their older children as more successful and reported offering them less encouragement and help. Implications of these findings are discussed.     

Help-seeking process of parents for psychopathology in youth with moderate to borderline intellectual disabilities

OBJECTIVE: To study the help-seeking process of parents for emotional or behavioral problems in their child with borderline to moderate intellectual disabilities. METHOD: In 2003, in a special education-based sample of 522 youths (ages 10-18 years, response = 77.9%), we studied the parents' perception of their child's problems, their subsequent felt need for professional help, actual help-seeking, and the factors possibly related to taking these steps. RESULTS: Even when parents indicated their child's emotional or behavioral functioning as "neither good nor bad," in about 70%, these problems were present according to standardized measures. Of the 213 parents (40.8%) who perceived problems, 70.6% felt a need, and 55.2% of these parents subsequently sought professional help. Parents more often sought help when their child had problems of anxiety and depression, experienced negative life events, and when parents perceived child psychopathology before the past year. Reported barriers to seeking help predominantly related to parents' evaluation of the severity of these problems and wanting to solve the problems themselves. CONCLUSIONS: Clinicians and other service providers should address parents' concerns regarding their child's emotional/behavioral functioning and treatment seeking. Also, they should provide information on treatment options and on signs and potential negative prospects of their child's problems.     

Issues in the therapy of hearing children with deaf parents

The psychiatric literature on deaf children is sparse. Even less attention has been paid to the more common situation of the hearing child raised by deaf parents. Such a child is deprived of the parents' hearing and often the parents' speech. The oldest hearing child in the family often takes on the role of family interpreter which may be a source of both pride and resentment. This can contribute to role reversal leading to a frustration of the child's dependency needs and bitter sibling rivalry. Other problems may result from the parents' ambivalence towards their child. The available literature is surveyed and case illustrations are provided. Suggestions to therapists working with similar families are made.     

Parental speech to young Down's syndrome children: an intervention study.

Parents with Down's syndrome children who were at the one-two word stage of expressive language development were given a language objective to work towards with their child, but no instructions on how to attain this goal. The parents spontaneously altered their language strategies in their attempts. Some parents were more successful and differed in their strategies, using more target words in shorter "statement" utterances. Parents who used a questioning or imitating strategy were less successful. The less successful parents were then shown how to alter their language strategies more appropriately to produce a greater improvement in their child's use of the target words.     

Assessing the diagnostic experiences of a small sample of parents of children with autism spectrum disorders

Although no Canadian studies have been conducted, studies suggest parents of children with autism experience difficulties obtaining a diagnosis for their child. Fifty-six parents of children with autism completed three questionnaires providing information on the families' demographics, parents' experiences throughout the diagnostic process, and their child's autistic symptomatology. These parents experienced significant difficulties obtaining a diagnosis for their child. Parents saw an average of 4.5 professionals, and waited almost 3 years to receive a diagnosis following their first visit to a professional regarding their child's development. The impact of autistic symptomatology on the diagnostic process is discussed.     

Agreement Between Parents and Teachers on Behavioral/Emotional Problems in Japanese School Children Using the Child Behavior Checklist

We investigated the agreement between Japanese parents' and teachers' ratings concerning their children's behavioral/emotional problems. Mothers (n = 276) and teachers (n = 19) assessed each child (n = 316; 6 to 12 years old ) using Japanese parent and teacher version of the Child Behavior Checklist. Parent–teacher agreement were examined through three indices; mean scores, correlations and D scores (generalized distance between item profile). Mean scores rated by parents were significantly higher than those by teachers. The differences of parents' ratings according to sex of the child or parents' occupational level, and those of teachers' ratings according to sex of the child were consistent with previous Western studies. Parent-teacher correlations were in the low to middle range (0.16–0.36). We obtained significant sets of independent variables accounting for the variance of D scores, but the effect size of these variables was small. These results indicated that, as seen in Western studies, Japanese parents and teachers would also assess their child's problems differently and the child's demographics affect their evaluation. For further research, parent and teacher characteristics which may influence on their perspective of the child's problems could be examined.     

The discovery of autism: Indian parents' experiences of caring for their child with an autism spectrum disorder

The current study investigated the lived experience of 12 parents of children with an Autism Spectrum Disorder in everyday cultural contexts in Goa, India. Narratives from parents collected between 2009 and 2010 were analyzed using the procedures of phenomenological psychology. Four temporal phases of parents' experience emerged from these data. Findings showed that the earliest phase of the child's life was a period of relative normalcy and social cohesion. In the second phase, the child's behaviors began to disrupt the everyday social order, but parents viewed these unexpected behaviors as temporary. In the third phase, parents' observations in public situations, along with assessments of others, led to a qualitative shift in which parents began to perceive that there was a persisting problem interfering with their child's social and practical activities. In the fourth phase, parents grappled with developing their child's capacities to meet existing practical opportunities in the local society, while attempting to reshape the social world to accommodate the abilities and limits of children like their own. Parents' fundamental concerns throughout their journey were: learning to meet new and unfamiliar challenges as parents, caring for their child's basic needs, and finding an engaging niche with a sense of belonging for their child in the everyday milieu. Both culture-specific and potentially universal levels of experience are delineated in the overall findings. Implications for culturally sensitive research and practice in India and other low- and middle-income countries are discussed.     

Understanding transference in parent guidance

Much has been written about parent guidance in the treatment of young children. However, a neglected area of study is the parents' transference relationship with the child clinician and the extent to which the clinician uses that transference in the treatment of the parents and the child. A second type of transference altogether is that between parent and child: the issues that the parents transfer onto their relationship with the child, which the clinician may observe in the parent work. Although it is widely accepted that such transference issues are an unavoidable aspect of parent guidance work, it is also generally understood that exploring the parents' transference may hinder the treatment of the child and, in certain instances, may even lead to premature termination. A supportive approach that facilitates a working alliance using a combination of information gathering, parent education, guidance, and advice giving is usually recommended to be the most helpful. The author suggests that although support is essential for effective parent guidance, that supportive interventions alone may actually limit therapeutic progress. At those times when a parent's emotional conflicts have contributed to or continue to exacerbate the child's ongoing difficulties, transference interpretations can facilitate changes in both the parent-child relationship and the child's individual treatment. The author proposes that working with the transference in parent. guidance and working supportively need not be understood as mutually exclusive approaches but should instead be viewed as complementary. Two cases are presented to demonstrate this approach to parent guidance.     

Parent's perception of social and sexual functions in adolescents with Down's syndrome

ABSTRACT. The authors investigated parental perceptions of social interactions, interest in the opposite sex, sexual functions and issues concerning sex education in young persons with Down's syndrome. The evaluation of the data revealed that more than half of the study population showed interest in the opposite sex and are attending social gatherings. Many of the youngsters had expressed a desire to get married, however, only a few had an interest in sexual relationships. Masturbation was observed in 40% of the young men and in 22% of the young women. About half of the parents feel that their children should be sterilized or should have other forms of birth control if they would be able to reproduce. Only a limited number of adolescents had sex education. More parents who have girls with Down's syndrome than those who have boys are worried that their child may be taken advantage of sexually.     

Identifying children at high somatic risk: possible effects on the parents' views of the child's health and parents' relationship to the pediatric health services

Country-wide neonatal screening for alpha 1-antitrypsin deficiency (ATD) was discontinued due to clinical observations of negative psychological effects on the parents. In a subsequent systematic study, hypotheses of long-term negative effects on the parents' views of the child's health and on the parents' relationship to the pediatric services were tested by comparing these characteristics in parents with a child with ATD versus control parents, studied through interviews in the home. The identification of the ATD was found to have had negatively influenced the parents' view of the child's general health, but no evidence was found of increased parental anxiety regarding the child's current health or emotional dependence on medical personnel, of increased (reported) usage of pediatric services, or of more negative attitudes toward the pediatric services.     

Assessing psychiatric disorders in children. Discrepancies between mothers' and children's reports

Results were compared from independent interviews using the Schedule for Affective Disorders and Schizophrenia for School-aged Children-Epidemiologic Version and DSM-III with 220 subjects (ages 6 to 23 years) and their parent informants. In agreement with results from studies using a variety of structured diagnostic interviews or symptom scales, considerable discrepancies were found between parents' and children's reports on the degree and nature of the child's psychopathology. The children reported more illness about themselves than their parents reported about them. The parents' reports were primarily a subset of the children's reports. Various factors that might affect agreement, including demography, parental clinical status, severity of illness, and treatment, were also explored. The findings that parents under-report psychiatric disorders in their children are comparable with those reported in studies of adults when family informants are used to obtain diagnostic information. Until these parent-child discrepancies can be resolved by longitudinal, family, and other research, diagnostic assessment of children should include direct interviews with them. An independent assessment of the child's diagnosis based on information from multiple informants, including the child, may be the best estimate.     

Instrumental narcissism in parents

Instrumental narcissism is a syndrome manifested by parents who feel compelled to transform their infants and young children into geniuses. The parents' effort devalues the child's own abilities and exaggerates the parents' self-perceived magical powers. Various historical and contemporary examples of instrumental narcissism provide the basis for the author's exploration of the syndrome in the context of contemporary clinical discussions of narcissism.     

Mental retardation and stress on the parents: a contrast between Down's syndrome and childhood autism.

Mothers of autistic, Down's syndrome, and outpatient psychiatric clinic children completed a questionnaire about their attitudes toward the identified child and the effects of the child on themselves and their families. A canonical correlation between the 15 questionnaire scales and three groups revealed a general retardation/social dependency factor separating the mothers of the two retarded groups from the clinic sample. The autism group was differentiated from the Down's syndrome group by scales measuring severity of the child's handicap and family integration problems more than by scales measuring stress on the mother. The hypothesis that mothers of autistic children would report more problems than both other groups was supported; the hypothesis that mothers of Down's syndrome children would report more problems than mothers of outpatient clinic children was not.     

Beliefs regarding child anxiety and parenting competence in parents of children with separation anxiety disorder

BACKGROUND AND OBJECTIVES: Despite the fact that numerous developmental models have highlighted the role of parental cognitive processes in connection with anxiety disorders in children and adolescents, the role of parents' beliefs about their children and parenting remains largely unexplored. This study investigated the specific association between parental beliefs and child separation anxiety. METHOD: Parents of children with a diagnosis of Separation Anxiety Disorder (SAD) reported on beliefs and expectations related to their child's fears and own parenting competence. To study the potential specificity of relationships, a clinical control group of mothers of children with social phobia (SoP) and a group of mothers of children without a mental disorder (healthy controls, HC) were included. RESULTS: Results indicated that parents of anxious children had significantly higher levels of dysfunctional beliefs than the parents in the HC group. Mothers of children with SAD showed lower levels of parenting self-efficacy than mothers of children with SoP. They also demonstrated lower parenting self-efficacy and satisfaction compared to mothers of healthy children. Parental dysfunctional beliefs about child anxiety and paternal parenting self-efficacy were significantly positively associated with child anxiety. The effects remained significant after controlling for parental anxiety and depression. LIMITATIONS: Due to the cross-sectional design of the study, causality of the found effects cannot be inferred. DISCUSSION: Data suggest that children's anxiety and parents' beliefs about their child's anxiety, coping skills and parenting are strongly associated. Further research is needed to investigate whether addressing parental cognitions in addition to parents' anxiety may improve prevention and intervention of child anxiety.     

Helping parents achieve optimal development for their children

Parenting has first to be learnt and then worked throughout the child's development. The cost of optimal development is the parents' continued loving awareness of all his needs. Parents today are avid for information which will help them to bring up their children so that each child will be given every opportunity to develop his full potential. Consequently, it is the responsibility of all those involved in helping parents care for their children to increase their understanding of child development.     

Eating attitudes in young teenage girls: Parental management of “fussy” eating

A large number of young children are “fussy” about their eating, refusing particular foods. Several behavioral programs have been advanced for making those foods more desirable. However, these programs ignore the function that this fussiness can serve for the child. Children may refuse food as a way of asserting some control over their environment—for example, by changing their parents behavior. It is also not clear to what extent parental efforts to change children's eating patterns may lead to later difficulties associated with eating. This retrospective study examined the possibility that parents' use of behavioral approaches to food refusal might be related to the child's general food fussiness. Associations between recalled parental behaviors, child fussiness, and the child's eating behavior were examined in considering possible causation. In a sample of 92 teenage girls, it was found that positive and negative reinforcement were ineffective, while early reported use of modeling was related to the children's being mted as more fussy in later childhood. Food fissiness showed some association with eating patterns measured by the Bulimic Inueat@tory Test, supporting the clinical utility of investigating “ffirsJiness.” This outcome suggests that food fusiness should be treated not in isolation but in the context of family relations, and that parents should be aduised accordingly. Such treatment of fissiness may play an important role in the development of adult eatingpsychopathology.     

Factors relating to self-sufficiency in children with Down's syndrome

ABSTRACT: An index of self-sufficiency in children with Down's syndrome was developed for use in a study of the process of adaptation in families living in the Greater Manchester area. The children were 6-14 years old, and living at home. Index scores were based on the mothers'responses to a questionnaire covering their children's personal and domestic functioning and community self-sufficiency, and were obtained from 111 of the 117 mothers who took part in the study. A wide range of child- and family-related variables were found to be significantly associated with self-sufficiency scores on a univariate level. Multiple regression analysis was used to identify those variables which best predicted the level of self-sufficiency achieved. After the child's mental age, the most significant variables were excitability, behaviour problems, the extent the mother used practical means of coping, and the level of social activity experienced by the child. Together, these five variables explained 63% of the variance in self-sufficiency scores. The dynamics by which such factors may relate to selfsufficiency in children with Down's syndrome are discussed, and intervention aimed at promoting the use of practical ways of coping by parents is suggested.     

Parental Perspectives on Inclusion: Effects of Autism and Down Syndrome

This study examined the effects of the child's diagnosis (autism vs. Down syndrome), age, and current educational placement on parental perceptions toward inclusion for their child with disabilities. Parents of children with autism and with Down syndrome completed surveys regarding their opinions on their child's current educational placement, their desire for changing the current placement, and their views on inclusive education. Results indicated that diagnosis, age, and current placement influenced parental opinion on the ideal educational placement for their child. Parents of children with Down syndrome were significantly more likely to endorse inclusion (full-time placement in general education) as the ideal educational program for their child whereas parents of children with autism were more likely to endorse mainstreaming (consistent part-time placement with general education students). Parents of younger children and parents whose children were already placed in general education programs were more positive towards inclusion than parents of older children or students currently in special education. Findings are discussed in terms of child characteristics and prevailing educational practices.