Cameron L. Neece

Parenting Stress and Child Behavior Problems: A Transactional Relationship Across Time

Parenting stress and child behavior problems have been posited to have a transactional effect on each other across development. However, few studies have tested this model empirically. The authors investigated the relationship between parenting stress and child behavior problems from ages 3 to 9 years old among 237 children, 144 of whom were typically developing and 93 who were identified as developmentally delayed. Behavior problems and parenting stress covaried significantly across time for both groups of children. Cross-lagged panel analyses generally supported a bidirectional relationship between parenting stress and child behavior problems for mothers and fathers.

Families and intellectual disability.

Purpose of review This review includes recent research pertaining to family functioning when there is a child or adult offspring with intellectual disability. The purpose was to broaden the examination of families research from an adjustment/coping perspective to consideration of more contextual factors (environment, culture, service delivery). Recent findings Studies continue to focus on parental well being, with parents of children with intellectual disability still showing evidence of stress and depression. Increasing evidence is accruing, however, that child behavior problems or specific syndrome more directly relate to poorer parental well being. On the other hand, parenting behaviors also contribute to child behaviors, with studies highlighting the importance of parenting context and dynamics. Interventions focus on child behaviors as well as on stress reduction for parents. Finally, the continued involvement of parents across the lifespan of their young adult with intellectual disability is apparent from studies of quality of life and living arrangements. Summary The well being of family members continues to be an area of interest, with special emphasis on siblings and cultural context. Methodological rigor in families research also continues to increase, with diverse methodologies represented. There is still a need, however, for the development of theoretical models within which to frame future research on topics such as siblings, as well as both negative and positive impact on families.

Transition Satisfaction and Family Well Being Among Parents of Young Adults With Severe Intellectual Disability

The transition from high school to adulthood is a critical life stage that entails many changes, especially for youth with severe intellectual disability. The transition period may be especially stressful for the families of these young adults, who often experience a sudden change, or decrease, in services. However, little research has examined what constitutes a successful transition for the families of these individuals. The present study examined parent perspectives of transition for 128 young adults with severe intellectual disability, specifically, parent satisfaction with transition. Results suggested that transition satisfaction is related to young adult, family, and environmental characteristics, with environmental characteristics being the strongest predictors of transition satisfaction. Furthermore, transition satisfaction is related to multiple measures of family well being, indicating the tremendous need for considering the broader family system when planning for a young adults transition. Implications and directions for future research are discussed.

Impact on Siblings of Children With Intellectual Disability: The Role of Child Behavior Problems

The impact on everyday life for siblings of children with intellectual disability or typical development was examined. Participants were families of children with intellectual disability (n=39) or typical development (n=75). Child behavior problems and sibling impact were assessed at child ages 5, 6, 7, and 8. Results indicate that siblings of children with intellectual disability were consistently reported by mothers and fathers to be more negatively impacted compared to siblings of typically developing children. When child behavior problems were accounted for, however, there was no longer a significant relationship between child intellectual status and sibling impact. For both intellectual disability and typical development groups, cross-lagged panel analyses indicate that early child behavior problems lead to increased sibling negative impact over time.

Marital Satisfaction, Parental Stress, and Child Behavior Problems among Parents of Young Children with Developmental Delays

Studies have found that low marital satisfaction, parenting stress, and child behavior problems are linked in families of children with developmental delays (DD). However, previous investigations examining the relationships between parenting stress, child behavior problems, and marital satisfaction rarely examine the interrelationships of these three variables simultaneously, and the samples used are often restricted in terms of age and ethnicity, limiting generalizability. The primary aim of the study was to examine the associations between marital satisfaction, child behavior problems, and parenting stress in a diverse sample of parents of young children with DD. The study included 44 parents of children ages 2.5 to 5 years with DD and high levels of behavior problems who participated in a larger study looking at the impact of Mindfulness-Based Stress Reduction (MBSR) in reducing parenting stress and child behavior problems. Marital satisfaction was significantly related to both parenting stress and child behavior problems, where parents with lower marital satisfaction reported higher parenting stress and child behavior problems. Additionally, preliminary analyses indicated that marital quality significantly moderated changes in child behavior problems from pre- to posttreatment but did not moderate changes in parenting stress as a result of the MBSR intervention.

Predictors of Age of Diagnosis for Children with Autism Spectrum Disorder: The Role of a Consistent Source of Medical Care, Race, and Condition Severity

Having a consistent source of medical care may facilitate diagnosis of autism spectrum disorders (ASD). This study examined predictors of age of ASD diagnosis using data from the 2011–2012 National Survey of Children’s Health. Using multiple linear regression analysis, age of diagnosis was predicted by race, ASD severity, having a consistent source of care (CSC), and the interaction between these variables after controlling for birth cohort, birth order, poverty level, parental education, and health insurance. While African American children were diagnosed earlier than Caucasians, this effect was moderated by ASD severity and CSC. Having a CSC predicted earlier diagnosis for Caucasian but not African American children. Both physician and parent behaviors may contribute to diagnostic delays in minority children.

Feasibility of Mindfulness-based Stress Reduction Intervention for Parents of Children with Developmental Delays

Mindfulness-based stress reduction (MBSR) interventions are popular as a treatment strategy for myriad diagnoses in various settings, and may be beneficial for parents of children with developmental delays (DD). However, prior research suggests extreme levels of stress and extraordinary demands on time among these parents, making the feasibility of effectively implementing MBSR with this population questionable. This study examined the feasibility of administering standard MBSR to a diverse community-based sample of parents of young children with DD. The potential impact of MBSR interventions includes improvement in parents’ mental health, and collateral benefits for the family environment, including improved child behavior. Nurses may have an integral role in interdisciplinary teams providing MBSR.

Intellectual Disability and Developmental Risk: Promoting Intervention to Improve Child and Family Well‐Being

Initial intervention processes for children with intellectual disabilities (IDs) largely focused on direct efforts to impact core cognitive and academic deficits associated with the diagnosis. Recent research on risk processes in families of children with ID, however, has influenced new developmental system approaches to early intervention. Recent risk and resilience processes are reviewed that connect stress, family process, and the high rates of behavioral problems in children with ID that have substantial influence on child and family outcomes. These models are linked to emerging evidence-based intervention processes that focus on strategic parent skill training and mindfulness interventions that reduce parental stress and create indirect benefits for childrens behavioral competencies. A family-focused developmental systems approach (M. J. Guralnick, 2011) is emphasized.

ADHD among adolescents with intellectual disabilities: Pre-pathway influences

Children and adolescents with intellectual disabilities (ID) are at heightened risk for developing ADHD. However, the validity of ADHD as a diagnosis for youth with ID remains controversial. To advance research on validity, the present study examined the hypothesized precursors to ADHD in typically developing adolescents (TD) and adolescents with ID, specifically with regard to family history of ADHD, molecular genetics, and neuropsychological functioning. Results indicated that youth ADHD symptoms were related to parental ADHD symptoms regardless of the adolescents cognitive functioning. Additionally, findings suggested that the DRD4 genetic variant and adolescent set-shifting abilities were related to adolescent ADHD symptoms independent of cognitive functioning. This study provides an initial investigation of the biological correlates of ADHD among youth with ID.

Developmental level and psychopathology: comparing children with developmental delays to chronological and mental age matched controls.

Children with developmental delays (DD) are at heightened risk for developing clinically significant behavioral and emotional difficulties as compared to children with typical development (TD). However, nearly all studies comparing psychopathology in youth with DD employ TD control groups of the same chronological age (CA). It is unclear, then, whether the heightened symptomology found in age-matched children with DD is beyond what would be expected given their developmental level. The present study assessed rates of behavior problems and mental disorder in 35 children with DD at age 9 years. These were compared with rates from 35 children with TD matched for CA at age 9 and also earlier rates for these same children at age 6, when matched for mental age (MA). Children with DD had significantly more behavior problems in 7 of the 17 scales of the CBCL when compared to TD children matched for CA, and 6 of 17 scales when compared to the MA-matched group. Rates of meeting DSM-IV criteria for a psychiatric disorder were significantly higher in the DD group than both the CA- and MA-matched TD groups for three and four, respectively, of the seven diagnoses examined. Descriptively, the mean ratings for all variables assessed were higher for the DD group than both TD comparison groups, with the exception of the Anxious/Depressed scale of the CBCL. These findings validate the heightened risk for clinically significant behavior problems and mental disorders in youth with DD above and beyond their developmental functioning.