Differences in adjustment by child developmental stage among caregivers of children with disorders of sex development

Stephanie E Hullmann,Larry L Mullins,Amy B Wisniewski,Cortney Wolfe-Christensen,David A Fedele

doi:10.1186/1687-9856-2011-16

Abstract

BackgroundThe current study sought to compare levels of overprotection and parenting stress reported by caregivers of children with disorders of sex development at four different developmental stages.MethodsCaregivers (N = 59) of children with disorders of sex development were recruited from specialty clinics and were asked to complete the Parent Protection Scale and Parenting Stress Index/Short Form as measures of overprotective behaviors and parenting stress, respectively.ResultsAnalyses of covariance (ANCOVAs) were conducted to examine differences between caregiver report of overprotection and parenting stress. Results revealed that caregivers of infants and toddlers exhibited more overprotective behaviors than caregivers of children in the other age groups. Further, caregivers of adolescents experienced significantly more parenting stress than caregivers of school-age children, and this effect was driven by personal distress and problematic parent-child interactions, rather than having a difficult child.ConclusionsThese results suggest that caregivers of children with disorders of sex development may have different psychosocial needs based upon their child's developmental stage and based upon the disorder-related challenges that are most salient at that developmental stage.

Highlights

Disorders of sex development, or DSD, are a group of congenital medical conditions in which affected individuals experience discordance between their genetic, gonadal, and/or phenotypic sex [1]
Preliminary Analyses The sample was first examined to determine the percentage of caregivers meeting criteria for clinically significant levels of parenting stress and overprotective behaviors
Planned post-hoc comparisons revealed that, on average, caregivers of infants and toddlers (M = 40.64, SEM = 1.61, 95% CI [37.42, 43.87]) evidenced significantly higher levels of parental overprotection than caregivers of preschool-age children (M = 32.00, SEM = 1.44, 95% CI [29.11, 34.89], p = .001), school-age children (M = 27.14, SEM = 2.10, 95% CI [22.93, 31.35], p < .001), or adolescents (M = 27.46, SEM = 2.37, 95% CI [22.71, 32.21], p < .001)

Summary

Introduction

DSD, are a group of congenital medical conditions in which affected individuals experience discordance between their genetic, gonadal, and/or phenotypic sex [1]. Child development is often conceptualized as a multifaceted process that occurs in four relatively distinct stages based largely upon physical and mental development and degree of independence from caregivers. These stages include infancy and toddlerhood, preschool age, school age, and adolescence [5]. The major role of the HPG axis during pre- and peri-natal development in boys, and in adolescence for both boys and girls, combined with the development of gender and sexuality at these ages, may make the challenge of caring for a child with a DSD salient to parents at these developmental stages. The current study sought to compare levels of overprotection and parenting stress reported by caregivers of children with disorders of sex development at four different developmental stages

Methods

Results

Conclusion