Parental Intellectual Disability Research Articles

Parental Mental Illness and the Likelihood of Child Out-of-Home Care: A Cohort Study.

To detail the relationship between parental mental illness and the likelihood of out-of-home care (OHC) among their children, and to identify factors which modify this relationship. Using Swedish national registers, children born in 2000 to 2011 (n = 1 249 463) were linked to their parents. Time-dependent parental mental illness (nonaffective and affective psychosis, substance misuse, depression, anxiety and stress, eating disorders, personality disorders, attention deficit hyperactivity disorder, autism, and intellectual disability), was identified through International Classification of Diseases codes. After adjustment for socioeconomic factors, children living with mentally ill parents were 4 times as likely to be placed in OHC than children without (95% confidence interval [CI] 4.24-4.61). The highest hazard ratio (HR) was in the youngest children aged 0 to 1 year (5.77, 95% CI 5.42-6.14), exposed to maternal illness (HR 4.56, 95% CI 4.37-4.76), and parental intellectual disability (HR 4.73, 95% CI 4.09-5.46). Children with parental mental illness with multiple risk factors were at particularly high risk. Compared with children without parental mental illness, and those with university-educated parents, children whose parents had mental illness and only had education to age 16 had a 15 times higher risk of OHC (95% CI 13.75-16.54). Children with parental mental illness are considerably more likely to be removed from home into care during childhood, particularly during the first year of life and if they are from socially disadvantaged families. Greater knowledge of these risks should lead to increased support for vulnerable new families.

Screening for parental intellectual disability: a first step in planning and delivering equitable support services?

ABSTRACT Parents with intellectual disability, like all parents, need support with childrearing. Early identification of parental intellectual disability may be key to the planning and delivery of appropriately adapted, inclusive family supports and services. The purpose of this study was to investigate the performance of a brief screener for parental intellectual disability. A total of 185 parents, including 91 parents in receipt of specialist intellectual disability services and 94 parents utilizing generic family support services, completed an interview/survey which incorporated candidate screening questions. The results of logistic regression and ROC curve analysis showed that a simple four-item screener performed well (accuracy 90.44%, sensitivity 92.31%, specificity 90.43%, AUC .96). The potential benefits of screening have to be weighed up against the risks of potential misuse. We therefore suggest that screening be introduced in the context of continuing professional education and initiatives to build system’s capacity to support parents with intellectual disability and their families.

Brief report: Follow-up outcomes of multisystemic therapy for adolescents with an intellectual disability and the relation with parental intellectual disability.

Research on follow‐up outcomes of systemic interventions for family members with an intellectual disability is scarce. In this study, short‐term and long‐term follow‐up outcomes of multisystemic therapy for adolescents with antisocial or delinquent behaviour and an intellectual disability (MST‐ID) are reported. In addition, the role of parental intellectual disability was examined.Outcomes of 55 families who had received MST‐ID were assessed at the end of treatment and at 6‐month, 12‐month and 18‐month follow‐up. Parental intellectual disability was used as a predictor of treatment outcomes. Missing data were handled using multiple imputation.Rule‐breaking behaviour of adolescents declined during treatment and stabilized until 18 months post‐treatment. The presence or absence of parental intellectual disability did not predict treatment outcomes.This study was the first to report long‐term outcomes of MST‐ID. The intervention achieved similar results in families with and without parents with an intellectual disability.

A Factorial Survey Investigating the Effect of Disclosing Parental Intellectual Disability on Risk Assessments by Children's Social Workers in Child Safeguarding Scenarios

A Factorial Survey Investigating the Effect of Disclosing Parental Intellectual Disability on Risk Assessments by Children's Social Workers in Child Safeguarding Scenarios

A Factorial Survey Investigating the Effect of Disclosing Parental Intellectual Disability on Risk Assessments by Children's Social Workers in Child Safeguarding Scenarios.

Literature suggests that, as parents, people with intellectual disabilities experience disproportionately high rates of child removal compared to other groups. A factorial survey of 191 children’s social workers investigated the effect of disclosing parental intellectual disability (ID) upon risk assessments in a range of hypothetical child safeguarding scenarios. The case scenarios depicted a range of child safeguarding situations and parents’ ID status was randomly included as an additional item of information. The data were fitted into a generalised ordinal logistic regression model. Findings indicate that when presented with scenarios considered to be less risky, the parental ID disclosure contributed significantly to a higher risk assessment score. However, when presented with scenarios that were considered more risky, the additional parental ID disclosure did not significantly contribute to a higher score. These findings indicate that the risk associated with parental ID is not fixed but relative to the situation in which it is encountered. The research concludes that in cases of low risk, the effect of parental ID is identified as a support need, whereas the lesser contribution of the disclosure to assessments of higher risk cases may indicate that parental ID is overlooked.

Intellectual Disability and Psychotic Disorders in Children: Association With Maternal Severe Mental Illness and Exposure to Obstetric Complications in a Whole-Population Cohort.

Children of mothers with severe mental illness are at significantly increased risk of developing intellectual disability. Obstetric complications are also implicated in the risk for intellectual disability. Moreover, children of mothers with severe mental illness are more likely to be exposed to obstetric complications. The purpose of this study was to examine the independent and joint contributions of familial severe mental illness and obstetric complications to the risk of intellectual disability. Record linkage across Western Australian whole-population psychiatric, inpatient, birth, and midwives' registers identified 15,351 children born between 1980 and 2001 to mothers with severe mental illness and 449,229 children born to mothers with no mental illness. Multivariable models were adjusted for paternal psychiatric status, parental intellectual disability, and other family and sociodemographic covariates. The risk of intellectual disability was increased among children of mothers with severe mental illness compared with children of unaffected mothers. The impact varied across maternal diagnostic groups. For children of mothers with schizophrenia, the unadjusted odds ratio was 3.8 (95% CI=3.0, 4.9) and remained significant after simultaneous adjustment for exposure to obstetric complications and other covariates (odds ratio=1.7, 95% CI=1.3, 2.3). The odds ratio for exposure to obstetric complications also remained significant after adjustment (odds ratio=1.7, 95% CI=1.6, 1.8). For intellectual disability of a genetic basis, the adjusted odds ratio for maternal schizophrenia was elevated but not statistically significant. Among children with intellectual disability, 4.2% later developed a psychotic disorder, compared with 1.1% of children without intellectual disability. Maternal severe mental illness and exposure to obstetric complications contribute separately to the risk of intellectual disability, suggesting potentially different causal pathways.

Mothers with intellectual disability, their experiences of maltreatment, and their children’s attachment representations: a small-group matched comparison study

Maternal intellectual disability (ID) is regarded a risk factor in child development, but there is no scientific evidence on maternal ID in relation to children’s attachment. Using a matched comparison design, a small group (n = 23) of mothers diagnosed with ID was studied to help fill this gap. Besides maternal ID, we examined the role of abuse/trauma/maltreatment (ATM) in the mothers’ biographies, along with potential confounds. Comparison group mothers (n = 25) had normal variations in intelligence and matched mothers with ID on residential area, income, child age, and sex. History of maternal ATM was assessed using a semi-structured interview and was found to be significantly more likely in the ID group mothers’ experience than the comparison group mothers. Children’s (M age = 77 months) attachment representations were assessed with the Separation Anxiety Test. Among children of mothers with ID, a substantial minority (35%) had a secure and the vast majority (>80%) an organized attachment representation. Mothers with ID who had suffered elevated ATM were significantly more likely to have children who were scored high on disorganization and insecurity. We discuss possible implications of our findings for societal considerations regarding parenting and child attachment in the context of parental ID status.

The developmental health of children of parents with intellectual disabilities: Cross sectional study

In a representative population-based sample of 46,025 families caring for a young child, parental intellectual disability (identified in 588 families) was associated with increased risk of child developmental delay, child speech and language problems, child behaviour problems and frequent child accidents and injuries. Parental intellectual disability was also associated with increased risk of exposure to a wide range of environmental adversities such as poverty, poor housing and social isolation. Adjusting for between-group differences in exposure to low socio-economic position reduced the risk of adverse child outcomes by over 50% on each of the four measures of child developmental health. In the final fully adjusted model parental intellectual disability was associated with increased risk of child developmental delay and child speech and language problems. However, there were no significant associations between parental intellectual disability and child behaviour problems or frequent accidents and injuries.

Re-referral for Complex Child Abuse and Neglect Concerns: The Influence of Family and Child Factors in a 25 Year Data Set

ObjectiveThe study reviewed a 25-year dataset of child abuse and neglect concerns, examining child and family factors associated with re-referral.MethodsSuspected child abuse and neglect data collated from a variety of sources including child protection, health, police and education by a multidisciplinary Suspected Child Abuse and Neglect team for the 25-year period of 1980 to 2005 was entered for analysis. Case referral criteria for the team included clinician perception of the case as being complex and necessitating multidisciplinary case planning. The dataset contained 6669 cases of child abuse and neglect concerns, relating to 5943 unique children.ResultsThe majority of children (90.5%) experienced only one referral to the team, with the remaining experiencing between 2–6 referrals. Through the utilisation of regression analysis, the factors of number of abuse types present at the initial concern, parental abuse as a child, parental intellectual disability, parental history of violence, perpetrator of intrafamilial origin, disabled children in family, and financial stress in family were found to significantly predict complex case re-referral respectively.ConclusionsChildren within this Australian sample of complex cases experienced rates of re-referral similar to those reported internationally. Family and child factors identified as predictors of re-referral in this 25-year dataset support previous international studies on statutory child protection re-referral, and evidence for the association between previously unstudied variables and re-referral likelihood for complex cases.

The effect of parental intellectual disability status on child protection service worker decision making

There is evidence to suggest that parents with an intellectual disability (ID) constitute a higher proportion of child-protective services (CPS) cases than would be expected based on the prevalence of ID in the general population. Researchers have suggested that the stereotypic assumptions and expectations that CPS workers have about parents with an ID might influence decisions and responses made to such parents. This study examined whether parental ID (having an ID vs. not) had an effect on CPS workers' emotional reactions, attributions and decisions about risk to the child, whether to remove the child and workers' general willingness to help the parent. Two hundred and twelve CPS workers read vignettes describing parents who were labelled as either having or not having an ID. Workers responded to the vignettes by making ratings of their emotional reactions, attributions and decisions regarding risk, removal and helping. CPS workers made significantly higher ratings of pity, willingness to help and risk for parents with an ID than for parents without an ID. Lower ratings of anger and disgust were found for parents with an ID than for parents without an ID. Parents' intellectual status did not have a direct effect on workers' attributions or removal decisions. The results show evidence for the influence of stereotypes regarding parental ID due to its differential effect on CPS workers' emotional reactions and decisions about child risk and their willingness to help.

Mothering with Intellectual Disabilities: Relationship Between Social Support, Health and Well‐Being, Parenting and Child Behaviour Outcomes

Background There is a general agreement in the literature that no systematic correlation exists between parental intellectual disability per se and parenting performance. Yet, a few studies in the field of parents and parenting with intellectual disability have explored other potential determinants of parenting and child outcomes. In this study, we examined the relationship between maternal social support, psychological well‐being, parenting style, quality of the home environment and child problem behaviours.Materials and Methods The sample included 32 mothers recruited through agencies that offer services exclusively to persons with intellectual disabilities and their families, and each mother’s oldest child in the 2‐ to 13‐year age range. In a series of semi‐structured interviews, participating mothers completed a demographic and social support questionnaire, the SF‐36 (health measure), the Parenting Stress Index, the HOME Inventory and the Child Behavior Checklist. Parenting style was assessed using the Canadian National Longitudinal Study on Children and Youth parenting questionnaire.Results On an average, the participating mothers reported poorer physical and mental health compared with population norms. However, a few reported clinically significant levels of parenting stress. Overall, the target children did not have significant problem behaviours, but these were more common in older children. Main findings include a significant correlation between parenting stress, parenting style and perceived child problem behaviours.Conclusion Global assessment, including health status (mental and physical) and level of parenting stress, as well as everyday life and parenting skills is recommended as basis for designing individualized supports and services for mothers with intellectual disabilities.

Prevalence and outcomes for parents with disabilities and their children in an Australian court sample

Objective: The purpose of this study was to obtain sound prevalence and outcomes data on parents with disabilities and their children in statutory child protection proceedings. Method: The court files of all care and protection matters initiated by the statutory child protection authority and finalized in a 9-month period ( n=285) at two Children’s Courts in NSW, Australia were reviewed. Results: Parents with disabilities featured in almost one-third of the cases (29.5%). Parental psychiatric disability was most prevalent at 21.8% followed by parental intellectual disability (mental retardation) at 8.8%. Significant associations were found between parental disability and court outcome with a disproportionately large number of children of parents with intellectual disability being made wards of the state. Conclusions: The findings demonstrate that parents with disabilities are significantly over-represented in statutory child protection proceedings and that the outcomes of these proceedings vary according to disability type.