Families with disabled children: Stress and social networks in three samples

Mothers and fathers of 125 handicapped/chronically ill children were compared with parents of 127 matched nondisabled children from three separate samples with respect to personal stress, marital satisfaction, and social network size and density. Only mothers of disabled children experienced higher levels of stress than comparison parents. No differences were found in marital satisfaction. Few group differences were found for social network variables, although mothers of handicapped children had higher-density networks than comparison mothers. A series of ANOVAs examined differences among the three types of families of handicapped children. Significant differences among the groups were found for social network but not family stress variables. The results are discussed in terms of general differences between families with and without a disabled child, and point to the need to identify patterns within different types of family systems in conducting future research in this area.Portions of this paper were presented to the annual meeting of the National Council on Family Relations, Family and Health Section, November 1985, Dallas. This research was supported, in part, by grants from the Temple University Biomedical Research Support Program and the Temple University Grant in Aid of Faculty Research. The author wishes to thank staff and participants from St. Christopher's Hospital for Children, Philadelphia, PA, The Children's Rehabilitation Center of the University of Virginia Medical Center, Charlottesville, VA, and The Woodhaven Center, Philadelphia, PA.     

Race/Ethnic Differences in Social Resources as Cognitive Risk and Protective Factors

Overall social network size, often the sum of common lifetime relationships, including children, family, and friends, has been linked to cognitive impairment and Alzheimer’s Disease. However, little research has examined the association between network size composition and cognitive function in middle-aged and older adults in the context of race/ethnicity. We investigated the associations between the number of close children, family, and friends independently with executive function (EF) and memory across a subsample of non-Hispanic Black, Hispanic, and non-Hispanic White participants who completed the Health and Retirement Study Harmonized Cognitive Assessment Protocol (N = 2,395). We found that network size composition was more closely linked to EF than memory and that these associations varied by race/ethnicity. Specifically, the strongest associations existed between EF and quadratic estimates of the number of close children of non-Hispanic Black participants, and number of close family members for Hispanic participants. Among Black participants, a curvilinear relationship indicated that two close children were associated with greater EF, while a smaller or larger number of close children were associated with lower EF. On the other hand, among Hispanic participants, higher EF was associated with fewer (0–1) and greater (4-5+) numbers of family member contacts. Overall, these results indicate that examining children, family, and friends independently may be more useful than the common practice of aggregation of overall network size, especially in the context of race/ethnicity.     

Attachment relationships within a family system

Insecurity in attachment relationships may promote family interactions that involve (1) “capturing” an attachment figure, (2) turning to an inappropriate attachment figure, (3) inappropriate responding to attachment behavior, and/or (4) anticipating loss, similar to past loss. In a family with two small children, family therapy over all the sessions involved reducing the need to “capture” (point l), with the therapist acting as a secure base for each family member (point 2) and exploring the anticipation of past losses (point 4), so that the parents could become a secure base for each other and their children (point 3). Coding from videotapes focused on a few minutes of intervention concerning the problem child. The interactions formed a pattern suggestive of a pattern of attachment with each parent. How the family contributed to the origins and maintenance of each pattern was illuminated by the above four influences of insecurity.     

Moderators of the Relationship Between Maternal Substance Abuse Symptoms and Preschool Children’s Behavioral Outcomes

While maternal substance use problems increase the likelihood of behavior problems in children, child outcomes are varied, leading to interest in understanding additional family factors that contribute to the development of behavior problems in children impacted by maternal substance abuse. The purpose of this study is to examine harsh parenting and family conflict as potential moderators of the relationship between symptoms of maternal substance use problems and child externalizing behavior problems. The non-clinical sample for this study included 250 low-income parents whose preschool age children were enrolled in Head Start programs in a Southern state. This study utilized data collected during two home visits, an average of 10 months apart, with data on family functioning and maternal symptoms of substance use problems collected at the first time point and child externalizing behavior collected at the second time point. Over one-third of the children (38.1 %) had clinically elevated externalizing behavior scores. We used regression analysis to examine whether harsh parenting or family conflict moderated the relationship between maternal substance use symptoms and child externalizing behavior. In this community sample, we found that in the absence of family risks related to harsh parenting and family conflict, maternal symptoms of substance use problems did not have a significant impact on child externalizing behavior in preschool children. However, when high levels of family conflict or harsh parenting were present, symptoms of maternal substance use problems increased the risk of externalizing behavior problems in children.     

Young children's social networks as a function of age and dysfunction

Social networks provide a larger context than that of the nuclear family in which the child develops. In order to examine the networks of young children, mothers of 75 handicapped children, aged 3 to 6 years, and a matched sample of normal children were surveyed in terms of people in the child's network and frequency of daily contact. The effects of age of subject and handicapping condition on social network composition and contact were of interest. Handicapping condition played a much greater role in the network composition than did chronological age. Handicapped children had larger networks, although they did not have daily contact with network members compared to normal children. Handicapped children thus were not isolated, but appeared to have a large network composed of relatives and adults and, to a lesser extent, peers. Normal children showed a developmental shift, in terms of an increase in the proportion of peers to adults, from 3 to 6 years, whereas handicapped children did not show this change. It is suggested that the handicapped child's developmental delay and caregiving demands may necessitate greater and more prolonged adult contact, which, consequently, constrains the nature of the social network in terms of adult and peer composition. Insufficient peer contact may restrict the handicapped child's opportunity to learn important social skills.     

Family involvement for children with disruptive behaviors: The role of parenting stress and motivational beliefs

Children with disruptive behaviors are at risk for adverse outcomes. Family involvement is a significant predictor of positive child behavior outcomes; however, little research has investigated parent psychological variables that influence family involvement for children with disruptive behaviors. This study investigated the role of parental motivational beliefs (i.e., role construction and efficacy) as a potential mechanism by which parenting stress impacts family involvement for families of children with disruptive behaviors. Results indicated that parent role construction mediated the relation between parenting stress and all aspects of family involvement examined (i.e., home-based involvement, school-based involvement, and home-school communication). Parent efficacy mediated the relation between parenting stress and home-based involvement only. Parents of children with disruptive behaviors reporting stress may experience negative beliefs about their role and efficacy to support their child's education, which may thereby negatively influence their actual involvement. Therefore, parent motivational beliefs may serve as an important point for intervention to support involvement of families of children with disruptive behavior.     

Pathological nurturance: The root of marital discord

Abstract

During the process of Adlerian Family Education, a great deal of attention is given to understanding the dynamics of the family constellation, especially sibling ordinal position and family atmosphere. The first step in interviewing a “teaching-demonstration” family is to diagram the family constellation and make some tentative guesses regarding how the children in the family have “found their place,” gained a sense of belonging, and exhibited possible adjustment problems or misbehavior. Audience participants are encouraged to share in this stochastic process based upon knowledge gained in observing previous family education sessions. Then the parents being interviewed either confirm or revise the guesses presented. At this point the parents generally specify their primary concerns, which typically involve the “misbehavior” of their “problem child.” In helping parents understand children and their misbehavior, the family educators quickly point out that it is necessary for them to understand the whole context of the family and that the Family Education Center program is designed to improve not only the “identified problem” child but the relationships between all members of the family (Dreikurs, et al., 1959, p. 23).     

Resilience and Family Psychosocial Processes Among Children of Parents with Serious Mental Disorders

Resilience involves successful adaptation despite adverse circumstances, and is operationalized in this study as a multidimensional construct which consists of both positive and negative indicators of adaptation. Previous research has emphasized the importance of parental psychopathology in predicting child adaptation among children of parents with serious mental disorders. In contrast, we hypothesized five family psychosocial processes as common sequelae to serious parental mental disorder that are central to child adaptation beyond that predicted by parental psychiatric status. These are diminished family financial resources, social network constriction, impaired performance of parenting tasks, increased familial stress, and disruption of the parent-child bond. We examined the relationship of these processes to child adaptation independently through hierarchical regression analyses after taking into account parental psychiatric symptoms and functioning as well as the child's age and gender. One hundred seventy-seven children of mothers with serious mental disorder, ages 2–17 years old, were assessed on measures of adaptation. Results indicated that family psychosocial processes are a more consistent and powerful predictor of child adaptation than parental psychopathology. Results also indicated that, for these children, adaptation is predicted most consistently by parenting performance, and to lesser extents, by the parent-child bond and familial stress. We discuss our results in terms of their implications for theory and intervention with children of parents with serious mental disorders and for the study of resilience.     

Fathers: The invisible parent

Viewing the family as a system of interdependent roles has frequently led to the assumption that fathers, in comparison with mothers, play highly restricted roles vis-à-vis their children. Much of the literature on fathers, in point of fact, stresses their absence, their disinterest, and lack of competence in child care. Reported here are findings from a sample of 231 families which suggest that this conception of fatherhood does an injustice to the empirical case. The evidence indicates that when the amount of time available to spend with children is considered, the father's involvement with his children is equal to that of the mother's. Under certain conditions, in fact, father-child involvement exceeds the child-related activities performed by mothers.     

The network perspective: an integration of attachment and family systems theories

In this article we discuss the network paradigm as a useful base from which to integrate attachment and family systems theories. The network perspective refers to the application of general systems theory to living systems, and provides a framework that conceptualizes the dyadic and family systems as simultaneously distinct and interconnected. Network thinking requires that the clinician holds multiple perspectives in mind, considers each system level as both a part and a whole, and shifts the focus of attention between levels as required. Key epistemological issues that have hindered the integration of the theories are discussed. These include inconsistencies within attachment theory itself and confusion surrounding the theoretical conceptualizations of the relationship between attachment and family systems theories. Detailed information about attachment categories is provided using the Dynamic Maturational model. Case vignettes illustrating work with young children and their families explore the clinical implications of integrating attachment data into family therapy practice.     

Autism Spectrum Symptomatology in Children: The Impact of Family and Peer Relationships

This study examines the potential impact of family conflict and cohesion, and peer support/bullying on children with autism spectrum disorder (ASD). While such impacts have been established for a range of non-ASD childhood disorders, these findings may not generalize to children with ASD because of unique problems in perspective-taking, understanding others’ emotion, cognitive rigidity, and social reasoning. A structural model-building approach was used to test the extent to which family and peer variables directly or indirectly affected ASD via child anxiety/depression. The sample (N = 322) consisted of parents of children with ASD referred to two specialist clinics. The sample contained parents of children with Autistic Disorder (n = 76), Asperger Disorder (n = 188), Pervasive Disorder Not Otherwise Specified (n = 21), and children with a non-ASD or no diagnosis (n = 37). Parents completed questionnaires on-line via a secure website. The key findings were that anxiety/depression and ASD symptomatology were significantly related, and family conflict was more predictive of ASD symptomatology than positive family/peer influences. The results point to the utility of expanding interventions to include conflict management for couples, even when conflict and family distress is low. Further research is needed on the potentially different meanings of family cohesion and conflict for children with ASD relative to children without ASD.     

Counselling in Action: Sexual abuse in an Asian family

This case study concerns a family of three generations of Asians living in London. It involves three children (two boys and a girl) who were sexually abused by one of the members of the extended family, for a period exceeding 5 years. Attempts to deal with the problem within the secrecy of the family conspiracy failed. It led to a breakdown of communications within the family network. Subsequently, the problem came under police investigation. The perpetrator was found guilty and sentenced to a term of imprisonment. Of the three young victims, the girl was extremely traumatized. Initially, she refused to meet with the therapist, but gradually, at the gentle persuasion of her parents, she relented. The case study is an account of the therapist's culturally relevant use of indigenous techniques to successfully deal with the trauma, thus helping in the rehabilitation of the victim.     

Enhancing Family Resilience Through Family Narrative Co-construction

We draw upon family resilience and narrative theory to describe an evidence-based method for intervening with military families who are impacted by multiple wartime deployments and psychological, stress-related, or physical parental injuries. Conceptual models of familial resilience provide a guide for understanding the mechanics of how families respond and recover from exposure to extreme events, and underscore the role of specific family processes and interaction patterns in promoting resilient capabilities. Leading family theorists propose that the family’s ability to make meaning of stressful and traumatic events and nurture protective beliefs are critical aspects of resilient adaptation. We first review general theoretical and empirical research contributions to understanding family resilience, giving special attention to the circumstances, challenges, needs, and strengths of American military families. Therapeutic narrative studies illustrate the processes through which family members acquire meaning-making capacities, and point to the essential role of parents’ in facilitating discussions of stressful experiences and co-constructing coherent and meaningful narratives. This helps children to make sense of these experiences and develop capacities for emotion regulation and coping. Family-based narrative approaches provide a structured opportunity to elicit parents’ and children’s individual narratives, assemble divergent storylines into a shared family narrative, and thereby enhance members’ capacity to make meaning of stressful experiences and adopt beliefs that support adaptation and growth. We discuss how family narratives can help to bridge intra-familial estrangements and re-engage communication and support processes that have been undermined by stress, trauma, or loss. We conclude by describing a family-based narrative intervention currently in use with thousands of military children and families across the USA.     

Links between mothers' and children's social competence and associations with maternal adjustment.

Extended previous research on family factors related to children's social competence by examining links between 3 domains of maternal social competence (social skills, social frames, network size) and 3 domains of children's social competence (social skills, peer-rated social preference, and network size) in a sample of 78 mothers and their kindergarten children (42 girls, 36 boys). The mediational role of maternal social competence in the association between mothers' depression and interpersonal sensitivity symptoms and children's social competence was also tested. Results supported associations between all 3 domains of mothers' and children's social competence, with maternal social skills the most frequent predictor of children's social competence. Gender differences suggested that maternal social competence was more strongly related to sons' peer acceptance and daughters' social skills. A mediational model received preliminary support for girls, with maternal psychological symptoms related to girls' social competence via maternal social skills. Implications include the need for continued study of maternal social competence as a family factor related to children's peer functioning and the development of family-based interventions for young children experiencing peer problems.     

What the family brings: gathering evidence for strengths-based work

Families attending child and adolescent mental health (CAMH) services are often assumed to have problems in key areas such as communication, belonging/acceptance and problem-solving. Family therapy is often directed towards addressing these difficulties. With increasing emphasis in family therapy and human services fields over the last decade on identifying and building from strengths, a different starting point has been advocated. This paper describes a large survey of the self-reported pre-therapy functioning of children and families using a public CAMH service (n=416). Before commencing family therapy parents identified family strengths across a range of key areas, despite the burden of caring for children with moderate to severe mental health problems. This evidence supports theoretical and clinical work that advocates a strengths perspective, and highlights how resilience framed in family (and social) rather than individual terms enables a greater appreciation of how strengths may be harnessed in therapeutic work.     

Heredity, Environment, and Personality Change: Evidence From the Texas Adoption Project

Personality changes over time can be analyzed by the same twin and adoption methods used to analyze the genetic and environmental influences on a trait at a given time. Composite parent rating measures of Extra-version, Socialization, and Stability made on two occasions approximately 10 years apart on 229 adopted and 83 nonadopted children from the Texas Adoption Project were used to illustrate this point in two ways. The first was based on correlations among family members, from which it appeared that by far the chief source of individual change was neither the genes nor shared family environment, but individual experience (and/or measurement error). The second was via a path-analytic approach to changes in the means of adopted and natural children, from which it appeared that, nonetheless, the children were tending to change on the average in the direction of their genetic parents' personalities.     

Support Networks of Single Puerto Rican Mothers of Children with Disabilities

The social support networks of 25 Puerto Rican single mothers of young children with disabilities were examined and compared with current models of family support for children with disabilities. This study was designed to assess the support systems of Latino single mothers in light of dominant models of family support. The Family Support Scale, the ECOMAP, and responses to open-ended questions were employed to describe the characteristics of Puerto Rican single mothers’ support systems. Study findings suggest that members of the children’s immediate and extended kinship system, including non-blood relatives (e.g., madrinas), play a strong role in the support network of the mothers interviewed. Implications for early childhood professionals who work with Latino parents of children with disabilities are examined.     

Differential perceptions of and feelings about sibling children: implications for research on parenting stress

Parenting stress is influenced by parents' perceptions of their relationships with their children, which can vary widely for each parent depending on which child in the family is being considered. Because this within‐parent variation is rarely studied, we investigated some of the differential perceptions that arise with respect to children's behaviour problems and parent–child negativity/positivity. Participants included a national sample of adoptive parents of 486 pairs of genetically unrelated siblings. Mothers reported different perceptions of their sibling children, and within the family, the child who was rated higher in behaviour problems also was regarded with more negativity and less positivity. Furthermore, the magnitude of the difference was uncorrelated with various indicators of the family and home environment, including parental education and occupational prestige, type of housing and crowding in the home, and progressive versus traditional childrearing attitudes. This pattern of results was consistent with three previously published sibling studies utilizing similar methods. The results point to the importance of examining child effects and within‐parent differences in subjective aspects of the parenting experience. Copyright © 2005 John Wiley & Sons, Ltd.     

Children of victims of terrorist activities: A family approach to dealing with tragedy

Abstract

The present report deals with the treatment of families of victims of terrorist activities. Such families are subject to an initial crisis situation involving severe stress as well as disruption in family role structure and homeo-stasis. Much of the trauma precipitated by such events is a result of their suddenness, their salience in the public consciousness and the consequent stigma they produce towards survivors and/or relatives of victims. A number of specific issues were common in the two case studies presented in this report as well as in other families affected by terrorism. These included dealing with the need to be a superparent and correcting unrealistic expectations, teaching effective limit setting including giving permission to be a parent, giving permission to be an adult, dealing with guilt and phobic reactions as well as family and network reorganization. Therapy concentrated on promoting family strengths and coping and deemphasized individual pathology. Common to most families treated was the strong desire of the victim's children to be treated as normal and not as psychological casualties. Thus, family therapy proved to be an ideal treatment modality for dealing with the tragic loss. By focusing on the problems of day-to-day living, the mourning work evolved naturally in the course of therapy. Specific therapeutic modalities such as cotherapy and network intervention facilitated family adjustment considerably.