Characterizing the systems of support for families of children with disabilities: A review of the literature

ABSTRACT

During early childhood, children require major support that is tailored toward their specific needs. For children with disabilities, families play a crucial part in providing the needed services. However, families often lack the knowledge, resources, and skills that would help them in overcoming challenges that arise while raising a child with disability. Although much research has focused on defining the needs of families with children with disabilities and the impact of disability on the family system, many questions remain. A comprehensive perspective is needed to identify the types of support families provide to the child with a disability, the impact of providing that support on family members, the support systems that are available to families, and the impact of support on society. This review consolidates the empirical research to date on family support during early childhood and outlines areas of research that need further exploration.     

“I'll Give You the World”: Socioeconomic Differences in Parental Support of Adult Children

Research has shown that parents with higher socioeconomic status provide more resources to their children during childhood and adolescence. The authors asked whether similar effects associated with parental socioeconomic position are extended to adult children. Middle‐aged parents (N = 633) from the Family Exchanges Study reported support they provided to their grown children and coresidence with grown children (N = 1,384). Parents with higher income provided more emotional and material support to the average children. Grown children of parents with less education were more likely to coreside with them. Parental resources (e.g., being married) and demands (e.g., family size) explained these patterns. Of interest is that lower income parents provided more total support to all children (except total financial support). Lower income families may experience a double jeopardy; each grown child receives less support on average, but parents exert greater efforts providing more total support to all their children.     

Chapter 11. Caregivers of Children with Cancer

SUMMARY

When a child is diagnosed with cancer, families experience a devastating life event with immediate and long-term impact on quality of life, actvities of daily living, family dynamics, self identity, parental role, and sense of meaning in the world. However, despite the trauma, more recent studies are highlighting the resilience and functioning of families facing cancer in childhood. This chapter explores these family dynamics.     

Daily Spillover of Low‐Income Mothers' Perceived Workload to Mood and Mother–Child Interactions

This study investigated associations of low‐income working mothers' daily perceived workload and their reports of their own mood and their interactions with their young children. Sixty‐one mothers were asked to report on their workload, mood, and interactions with their preschool‐age children every day for 2 weeks (N = 520 work days). Low‐income mothers reported significant day‐to‐day variability in workload. The results revealed a curvilinear pattern of negative work‐to‐family spillover: Both lower‐than‐average and higher‐than‐average workload days were associated with increased negative and tired mood, decreased positive mood, and increased harsh mother–child interactions. Although both younger and older mothers experienced a curvilinear pattern of spillover to daily mood, younger mothers in the period of emerging adulthood also experienced spillover to mother–child interactions, perhaps because they are still learning how to balance work and family demands. Both high and low workload are salient stressors in the daily lives of low‐wage working mothers.     

Marital satisfaction and social learning family therapy for child conduct problems: generalization of treatment effects

Successful treatment outcome and maintenance for families with aggressive children by means of social learning family therapy were reported by Sayger, Horne, Walker, and Passmore (1988). The present study examined the generalization of treatment effects to the child's classroom, the parental level of marital satisfaction, the general family relationship environment, and the parental level of depression. Results of this study show that teachers reported improved child behavior following treatment. Parental level of marital satisfaction was increased and sustained for those parents who were experiencing low levels of marital satisfaction prior to treatment. The participating families also became more cohesive and expressive, and less conflictual. Although pretreatment levels of parental depression were moderately low, these levels were alleviated.     

Sibling caring roles and responsibilities when a child suffers from a chronic illness

Siblings' lives and well-being are potentially affected in profound ways when their brother or sister suffers from a chronic illness in childhood. The shift in the care of chronically ill children from the hospital to the home in recent years has had an impact on family relationships and interactions. Whilst studies on caregiving have focused on the parental care of children who are chronically ill; siblings may nevertheless take on some caring roles and responsibilities. This article intends to make a novel contribution to the sociological literature on siblings, caring, and chronic illness by presenting a review of the literature addressing siblings' caring roles and responsibilities in families of children with a chronic illness. Knowing about the caring roles and responsibilities undertaken by siblings when a brother or sister has a chronic illness, may be beneficial to healthcare professionals and influence their caring practice. In addition, this work may contribute to a better understanding of family relationships and further improve healthcare policies.     

The Impact of Parental Remarriage on Children

Abstract

A meta-analysis of 61 studies was undertaken to determine the impact of parental remarriage on the academic achievement and psychological well-being of children, of which the vast majority were adolescents. Separate analyses were done on studies that did and did not use sophisticated controls in their analyses. Comparisons were made between children from remarried versus intact families as well as children from remarried and divorced or widowed single-parent families. Children from remarried family structures achieved academic levels that were generally more than two-tenths of a standard deviation lower than children from intact families. Children from remarried families also achieved somewhat lower levels than children from corresponding single-parent family structures. The difference between children from remarried families and children from intact families was nearly two- tenths of a standard deviation for measures of psychological well-being, for studies that did not use sophisticated controls and was somewhat less for studies that did use sophisticated controls. The significance of these results is discussed, doi: 10.1300/J002v40n04_05     

Examining the Impact of Child Parent Relationship Therapy (CPRT) on Family Functioning

Research supports that child parent relationship therapy (CPRT), a filial therapy approach, has strong effects on participating parents and children. Some speculate that filial therapy improves the family system; however, minimal research exists to support this claim. Using a single‐case design, researchers examined CPRT's impact on the functioning of 8 families. Results revealed that 6 families experienced statistically significant improvements in targeted areas of family functioning. Results from self‐reported measures indicated that 7 families improved in family satisfaction, 4 in cohesion, 3 in communication, and 1 in flexibility. Observational measures also revealed improvements: 5 families in flexibility, 4 families in cohesion, and 4 families in communication. The results support that the benefits of CPRT may extend to the family system.     

HOME-BASED MARITAL THERAPY FOR MULTIPROBLEM FAMILIES*

This paper describes a project designed to reach low-income, multiproblem families, utilizing couples therapy in the home. By targeting a population of young couples under the age of 30 and with children no older than 7 years, the project aimed at prevention of severe family dysfunctioning and child disturbances. The major characteristics noted in the literature on multiproblem families are reviewed here, as are the treatment goals and techniques with such families. Most programs working with multiproblem families have focused primarily on the parental functioning in family therapy, and little has been reported on work with the couple in multiproblem families. The project described here used home visits by a male-female therapist team, including frequent individual and couple sessions. Therapeutic techniques based on modeling, role playing and demonstration were emphasized. In addition, tasks which increased the individual and couple functioning of the spouses were designed and successful completion was reinforced. An attempt was made to integrate the couple into the community and to create a network of support outside of the family, including friends and community services.     

Risk and Resiliency Factors Among Adolescents Who Experience Marital Transitions

Using a resiliency framework, we examined familial and extrafamilial factors associated with adolescent well‐being in intact, blended, and divorced single‐parent families. Hierarchical regression analyses were conducted using a large sample of 7th‐, 9th‐, and 11th‐grade adolescents (N= 2,011) to test the moderating effect of peer support, school attachment, and neighbor support when parental support and monitoring were low. Significant two‐ and three‐way interactions were probed. Findings indicate that divorced and blended families have some of the same forms of resiliency as intact families. For adolescents in a divorced single‐parent family, peer support moderated the effect of low parental support on internalizing symptoms. We discuss the merits of examining divorce from a resiliency perspective.     

The assessment of parent-led prevention programs: a preliminary assessment of impact

This article reports on a preliminary study of the impact of parent-led prevention groups on youthful drug and alcohol use. In addition, the study assessed the extent to which families involved with parent-led prevention programs reported improved family relations and increased parental control of children's social activities--two major mechanisms by which parent-group advocates claim their activities alter youth substance use patterns. Consistent with the claims of parent-group advocates, the study results suggest that the parent groups did have some impact on family relations and on parental control of children's social activities. The evidence for an impact on drug and alcohol use was, however, weak. A somewhat unexpected finding was that parents who become involved in parent-led prevention activities may not be those parents whose children are at highest risk.     

The Child in the Family of a Drug-Using Father: Attachment Styles and Family Characteristics

SUMMARY

The study examined the impact of family characteristics and parental attachment styles on the children of drug-using (DU) fathers in fifty-six families (n = 168) in Israel. Of the DU fathers, 60.7% were characterized by avoidant attachment style. Among the non-DU mothers, 53.6% were characterized by secure attachment style, 42.9% by avoidant style, and 3.6% by anxious/ambivalent style. Surprisingly, family cohesion and adaptability scores were similar to the Israeli norm, perhaps because the DUs had completed detoxification treatment and participated in rehabilitation programs. Of the children, 61.8% were characterized by secure attachment style, 21.8% by avoidant style, and 16.4% by anxious/ambivalent style. Stepwise regression to predict children's attachment styles revealed that maternal security of attachment and paternal anxious/ambivalent style predict similar attachment styles among the children. The important combined effects of spousal attachment styles on the children are discussed.     

Family Structure and Child Well‐Being: The Significance of Parental Cohabitation

Data from the 1999 National Survey of America's Families (N = 35,938) were used to examine the relationship between family structure and child well‐being. I extended prior research by including children in two‐biological‐parent cohabiting families, as well as cohabiting stepfamilies, in an investigation of the roles of economic and parental resources on behavioral and emotional problems and school engagement. Children living in two‐biological‐parent cohabiting families experience worse outcomes, on average, than those residing with two biological married parents, although among children ages 6–11, economic and parental resources attenuate these differences. Among adolescents ages 12–17, parental cohabitation is negatively associated with well‐being, regardless of the levels of these resources. Child well‐being does not significantly differ among those in cohabiting versus married stepfamilies, two‐biological‐parent cohabiting families versus cohabiting stepfamilies, or either type of cohabiting family versus single‐mother families.     

Happy Spouses,Happy Parents? Family Relationships Among Finnish and Dutch Dual Earners

In this study links between spousal and parent‐child relationships among Finnish (n = 157 couples) and Dutch (n = 276 couples) dual earners with young children were examined using paired questionnaire data. Variable‐oriented analyses (structural equation modeling with a multigroup procedure) supported the spillover hypothesis, as higher levels of satisfaction in the spousal relationship were related to higher quality in the parent‐child relationship and lower parental role restrictions. These connections did not differ by gender or country. With family typological analyses (mixture modeling), 4 family types were identified: families with satisfying relationships (73.4% of the families), families with unsatisfying parent‐child relationships (13.4%), and families with either dissatisfied men (6.0%) or dissatisfied women (7.2%).     

Negotiating Inequality Among Adult Siblings: Two Case Studies

Qualitative instrumental case study analysis of adult siblings from 2 families explores how socioeconomic inequality among them affects their relationships to one another. Eight middle‐aged siblings’ observations of childhood, parental expectations, work and family history, lifestyle, and current sibling ties indicate that childhood interdependence, parallel parental treatment, similar intergenerational mobility, greater success of the younger rather than older siblings, and economic success due to other than individual effort facilitate smoother negotiations of material inequality and enhance the negotiation of sibling relationships as important sources of support. These new insights on negotiating sibling ties over time are related to various forms of capital, a life course perspective, and ambivalence, and point to fresh avenues for future research and theory.     

Family Change and Economic Well-being in Canada: The Case of Recent Immigrant Families with Children

This paper examines the relationship between family change and economic well‐being among recent immigrant families with children to Canada during the 1977 to 1997 period. Whereas the average income to needs ratio of all Canadian families with children is up modestly over this period, this study documents a substantial decline in the average level of economic well‐being of recent immigrants. In this context, this study draws attention to the relevance of not only structural explanations that emphasize the role of labour markets and/or government policy in shaping the economic conditions of immigrants, but also the potential impact of shifts in the living arrangements and family structure of immigrants. More specifically, an increased incidence of lone parenthood has had a net negative impact on the economic well‐being of immigrants, albeit not to the same extent as among non‐immigrants in Canada. Yet, other changes have had a slight positive impact, including an ongoing decline in the average number of children per family, an upward shift in the age distribution of parents, and a slight increase in the tendency of immigrants to co‐reside with family members beyond the immediate nuclear family.     

Family‐of‐Origin Issues and the Generation of Childhood Illness

Unresolved family‐of‐origin issues can play a powerful but covert role in here‐and‐now family interactions, and can contribute to the generation and maintenance of childhood psychopathology and illness behaviour. This article describes an intervention with a family where the children frequently presented to local health services with a baffling array of psychological and somatic symptoms. The therapist was unable to pinpoint where the problem lay. In a final effort to understand family functioning she used the Adult Attachment Interview (AAI) in order to better understand parental state of mind and how parental anxieties and behaviours contributed to current family functioning. This information was used to plan a treatment intervention.     

Recovery coaches and the stability of reunification for substance abusing families in child welfare

Substance abuse is a long-standing challenge for child welfare systems. Parental substance abuse disrupts family stability, family cohesion, and jeopardizes the well-being of children. In the current study we test an intervention to improve child welfare outcomes for substance abusing families, specifically the probability of families achieving a stable (at least 12 months) reunification. The intervention was an integrated case management model where recovery coaches were appointed to substance abusing parents associated with an open foster care placement. A diverse group of families (n = 1623) were randomly assigned to either a control group (services as usual) or an experimental group (services as usual plus a recovery coach). Multinomial logistic regression indicated that substance abusing parents associated with a recovery coach were significantly more likely to achieve a stable reunification as compared with similar families in the control group.     

The Intergenerational Consequences of Parental Health Limitations

Scholars have theorized interrelationships between family members' health and well‐being. Though prior research demonstrates associations between parents' and children's health, less is known about the relationship between parental health limitations and children's behavioral and academic outcomes. This article uses data from the Fragile Families and Child Well being Study (N = 3,273) to estimate the relationship between parental health limitations and four aspects of children's well‐being. Findings reveal that mothers' health limitations, especially when they occur in middle childhood or chronically, are independently associated with greater internalizing and externalizing behaviors, lower verbal ability, and worse overall health at age 9. Fathers' health limitations are not associated with children's well‐being. Fathers exert influence in other ways, as the relationship between mothers' chronic health limitations and children's internalizing behaviors is concentrated among children not residing with their fathers. These findings support the development of policies and interventions aimed at families.