Parental Stress, Care Demands, and Use of Support Services for School-Age Children with Disabilities and Behavior Problems

Abstract

Parental Stress, Care Demands, and Use of Support Services for School-Age Children With Disabilities and Behavior Problems* Frank J. Floyd and Erin M. Gallagher** Data were obtained from mothers and fathers of children (N = 231) with mental retardation (MR) or chronic illness (CI), and a nondisabled behavior-problems sample. Mothers identified fewer behavior problems in children with MR and more in children with CI than did teachers. The presence of significant behavior problems was more important than disability type in determining most forms of parental stress, and predicted mental health services use. MR group parents worried most about providing ongoing care into adulthood. Single mothers were not more stressed, but used more services than two-parent families. The results call for a wider array of community and family support services that target children with disabilities who have behavior problems. Key Words: child behavior problems, chronic illness, family adaptation, family stress, mental retardation. Previous research documents that the special child care demands faced by the parents of children with disabilities can cause significant stress for the parents and significant disruption in family relationships (e.g., Farber, 1960; Gath, 1973; Turnbull, Brotherson, & Summers, 1986). These demands persist throughout childhood and into the adult years, and require continuous adaptation by the parents to both ongoing stressors and frequent crises (Wikler, 1986). Previous longitudinal research indicates that, in turn, the psychosocial climate of the home affects the social development of children with disabilities (Nihira, Mink, & Meyers, 1985). Thus, models of family adaptation propose that when families are able to cope well with special childcare demands they may be able to enhance social and cognitive adjustment for the child, and may also avoid distress and disruption for other family members (Crnic, Friedrich, & Greenberg, 1983; Landesman, Jaccard, & Gunderson, 1989). One key to successful adaptation lies in the ability of families to access appropriate support services that both help families cope with the child's needs, and also reduce disability-related problems for the child and family (Singer, et al., 1993). Although some services are provided in school-settings, parents typically must make active efforts to seek additional and sometimes highly necessary services (Wilgosh, Waggoner, & Adams, 1988). Thus, service utilization is highly dependent on the parents' own motivation to obtain assistance. Of course, the types of services used by families will often depend on the nature of the child's disability (i.e., cognitive deficits as opposed to chronic illness), which influences the type of care demands placed on the family. However, motivation to seek and use services may also stem from other characteristics of the child and family that affect perceived needs and the family's ability to benefit from services (Dunst, Trivette, Hamby, & Pollack, 1990; Friedrich, Cohen, & Wilturner, 1988). For example, the ABC-X model of stress and coping suggests that families will make relatively greater use of support services when the child's problems exceed the family's own coping resources (Hill, 1958; McCubbin & Patterson, 1983; Orr, Cameron, & Day, 1991). Additionally, parents' use of services may be influenced by their optimism that the child and family can profit from the services (Margalit, Raviv, & Ankonina, 1992; Rimmerman & Portowicz, 1987; Sloper & Turner, 1992). Although considerable research documents that parents of children with disabilities experience stress associated with the disability that distinguishes them from the parents of children without disabilities, there is relatively little research that examines differences among disability groups. Comparison of selected groups can control for theoretically relevant conditions of child adjustment and family life, and can thus help to specify the processes by which characteristics of the child and characteristics of the family influence each other (Stoneman, 1989). …