Pediatric Acquired Disability: Child and Parental Adjustment

Abstract

Pediatric acquired disability challenges children and their parents as they adjust to a new reality of physical impairment. This longitudinal study explored the association between severity of children’s acquired disability and children and parents’ adjustment six weeks after diagnosis (T1) and three-four months later (T2), particularly focusing on parental perception of illness and of parent–child interactions. The participants were 140 parents of children with acquired disability who were hospitalized in pediatric or rehabilitation departments at three major medical centers in Israel. Parents completed questionnaires on background information, parental illness perception, perception of parent–child interactions, and child and parents’ adjustment. Physicians and nurses completed a questionnaire on disability severity indexes. The results revealed that severity of child’s disability correlated positively with parental illness perception and adjustment, but not with parental perception of parent–child interactions. At both time points, parents’ adjustment correlated negatively with illness perceptions and positively with perception of parent–child interactions. Parents’ adjustment was partially associated with children’s adjustment. Children and parents’ adjustment improved over time, as the severity of the child’s disability decreased and parental illness perception eased. Parental perception of parent–child interactions did not change significantly. Parents’ initial adjustment at T1 correlated with their children’s subsequent adjustment, but not vice versa. The study showed that parental adjustment affects children’s adjustment to the acquired disability, and demonstrated the role of parental perception. Early identification of parents at risk might facilitate appropriate professional intervention.