Griffith, GM

Halstead, EJ

Hastings, RP

English

UCL Discovery

Protective factors of support, coping and positive perceptions for mothers of children with intellectual and developmental disabilities   There is mixed evidence about how well parents adapt to having a child with Intellectual and Developmental Disabilities (IDD). The positive psychological outcomes of having a child with IDD are increasingly being recognised in the literature1,2,3 . However, other researchers report a low level of wellbeing among such parents4,5.  To further establish these relationships, moderators of change need to be explored. It is important to establish protective factors which may interact with risk and therefore lead to better parental outcomes.  In families of children with IDD, child behavioural problems have been widely reported to affect parental stress and are considered a risk factor in parental wellbeing6,7,8,9  •Coping has been studied among parents of children with disabilities10,11 being linked to child behavioural problems and positive and negative parental wellbeing outcomes.   •Social support is linked to wellbeing in parents of children with IDD, and Smith, Greenberg, and Seltzer (2012) found perceived social support predicted changes in wellbeing of mothers of young adults with ASD.  •Positive perceptions about having a child with IDD have been found to act as a protective factor among parents and caregivers12.    Therefore, in this study, three potential protective factors (social support, coping mechanisms, and positive perceptions of mothers of children with IDD) are explored as moderators. The sample included 138 mothers  of school-age children with IDD. Eight measures plus a demographic questionnaire were utilised in the present study. The families were recruited through local Special Educational Needs schools.  Measure of stress/risk:  Behaviour and mental health of the child with IDD was measured using the Reiss Scales for Children’s Dual Diagnosis13.  Measures of parental outcomes:  The Hospital Anxiety and Depression scale (HADS)14. The Positive Affect Scale (PAS) was used to measure maternal well-being.  The PAS is a 10 item subscale from the Positive and Negative Affect Schedule (PANAS)15 .The outcome of life satisfaction was measured using the Satisfaction with Life Short Scale16 Measures explored as moderators: Mothers’ perceived support was measured using the Short Support Functions Scale17 .Maternal coping was measured using the Shortened Ways of Coping questionnaire18.Mother’s perception of the positive contributions their child with IDD has made was measured using The Positive Contributions Scale from the Kansas Inventory of Parental Perceptions (KIPP).19 Four separate moderated multiple regression analysis were conducted for each of the four individual level wellbeing outcomes (anxiety, depression, life satisfaction, positive emotions) to assess the three chosen moderators (social support, coping- wishful thinking and practical, and positive perceptions).   For each regression model, the demographic variables which were significantly correlated (p<.05) with each individual parental outcome (HADS- anxiety, depression, life satisfaction, positive emotions) were entered as predictor variables, to control for their possible effects, this was specific to each outcome and therefore each model. The PROCESS custom dialogue box20 was installed into SPSS for the moderated multiple regression analyses. Following the recommendation by Aitkin and West (1991) a simple slope analysis was conducted to explore any significant interactions and to aid interpretation of the direction of significant interactions.  e.halstead@bangor.ac.uk This study found evidence for social support as a moderator variable between poor child behaviour and maternal outcomes of life satisfaction and positive emotions, but not with anxiety or depression outcomes. Parental coping style subscales and positive perceptions were not found to act as moderators in any of the analyses. The two subscales of coping were explored separately 1) wishful thinking and 2) practical coping.   This study found under conditions of high stress or risk (high Reiss score), high levels of social support led to positive outcomes (life satisfaction and positive emotions in mothers) comparable with low risk (low Reiss score) conditions. This suggests that there is evidence for perceived social support to be a protective factor against negative outcomes of mothers of children with IDD when stress is high. A limitation of this study is it was dependent on mothers’ self-report data and did not have any objective assessments.  This is important as mothers’ perception of their family best reflects their experience; however, for example, the perception of child behaviour may vary from a self-report measure depending on mothers’ interpretation.  Future research could also explore the differences between mothers and fathers. Mothers of children with ASD often report higher levels of stress than fathers in the same family.21,22,23,24 These findings can be used in clinical settings and when working with families of children with IDD, it is useful when helping and providing guidance to families to be aware of their social support networks and that a lack of these could have a negative influence on parents wellbeing.  Figure 1 shows a Simple Slope interpretation which included support as a moderator for behaviour and positive emotions.  When support is low there is a significant negative relationship between child behaviour and parental positive emotions, b= -.18, 95% CI [-.31, -.05], t = -2.73, p=.01. At the mean value of support, there is a non-significant negative relationship between child behaviour and parental positive emotions, b= -.08, 95% CI [-.16, .00], t = -1.92, p=.06. When support is high there is a non-significant positive relationship between child behaviour and parental positive emotions, b= .02, 95% CI [-.08, .13], t = .43, p=.67.    Figure 2 shows a Simple Slope interpretation of support as a moderator for behaviour and life satisfaction.   When support is low there is a significant negative relationship between child behaviour and parental life satisfaction, b= -.15, 95% CI [-.25, -.06], t = -3.27, p <.001.  At the mean value of support, there is a non-significant negative relationship between child behaviour and parental life satisfaction, b= -.08, 95% CI [-.15, -.01, t = -2.24, p=.03 (p<.05).  When support is high there is a non-significant negative relationship between child behaviour and parental life satisfaction, b= -.01, 95% CI [-.12, .10], t = -.14, p=.89.  References: Hastings, R. P., & Taunt, H. M. (2002). Positive perceptions in families of children with developmental disabilities. Journal Information, 107(2) Trute, B., Benzies, K. M., Worthington, C., Reddon, J. R., & Moore, M. (2010). Accentuate the positive to mitigate the negative: Mother psychological coping resources and family adjustment in childhood disability. Journal of Intellectual and Developmental Disability, 35(1), 36-43. Ruiz-Robledillo, N., De Andrés-García, S., Pérez-Blasco, J., González-Bono, E., & Moya-Albiol, L. (2014). Highly resilient coping entails better perceived health, high social support and low morning cortisol levels in parents of children with autism spectrum disorder. Research in developmental disabilities, 35(3), 686-695. Emerson, E., Hatton, C., Llewellyn, G., Blacker, J., & Graham, H. (2006). Socio‐economic position, household composition, health status and indicators of the well‐being of mothers of children with and without intellectual disabilities.Journal of Intellectual Disability Research, 50(12), 862-873. Olsson, M. B., & Hwang, C. P. (2008). Socioeconomic and psychological variables as risk and protective factors for parental well‐being in families of children with intellectual disabilities. Journal of Intellectual Disability Research,52(12), 1102-1113. Blacher, J., & McIntyre, L. L. (2006). Syndrome specificity and behavioural disorders in young adults with intellectual disability: Cultural differences in family impact. Journal of Intellectual Disability Research, 50(3), 184-198. Emerson, E. (2003). Mothers of children and adolescents with intellectual disability: social and economic situation, mental health status, and the self‐assessed social and psychological impact of the child's difficulties. Journal of Intellectual Disability Research, 47(4‐5), 385-399.  Hastings, R. P. (2003). Child behaviour problems and partner mental health as correlates of stress in mothers and fathers of children with autism. Journal of Intellectual Disability Research, 47(4‐5), 231-237. Lewis, P., Abbeduto, L., Murphy, M., Richmond, E., Giles, N., Bruno, L., & Orsmond, G. (2006). Psychological well‐being of mothers of youth with fragile X syndrome: syndrome specificity and within‐syndrome variability. Journal of Intellectual Disability Research, 50(12), 894-904. Donovan, A. M. (1988). Family stress and ways of coping with adolescents who have handicaps: Maternal perceptions. American Journal on Mental Retardation. 92, 502-509. Abbeduto, L., Seltzer, M. M., Shattuck, P., Krauss, M. W., Orsmond, G., & Murphy, M. M. (2004). Psychological well-being and coping in mothers of youths with autism, down syndrome, or fragile X syndrome. Journal Information,109(3). Smith, L. E., Greenberg, J. S., & Seltzer, M. M. (2012). Social support and well-being at mid-life among mothers of adolescents and adults with autism spectrum disorders. Journal of autism and developmental disorders, 42(9), 1818-1826. Werner, S., & Shulman, C. (2013). Subjective well-being among family caregivers of individuals with developmental disabilities: The role of affiliate stigma and psychosocial moderating variables. Research in developmental disabilities, 34(11), 4103-4114. Reiss, S., & Valenti-Hein, D. (1990). Reiss Scales for children's dual diagnosis.Chicago: IDS.. Zigmond, A. S., & Snaith, R. P. (1983). The hospital anxiety and depression scale. Acta psychiatrica scandinavica, 67(6), 361-370. Watson, D., Clark, L. A., & Tellegen, A. (1988). Development and validation of brief measures of positive and negative affect: the PANAS scales. Journal of personality and social psychology, 54(6), 1063. Diener, E. D., Emmons, R. A., Larsen, R. J., & Griffin, S. (1985). The satisfaction with life scale. Journal of personality assessment, 49(1), 71-75. Dunst, C. J., Trivette, C. M., & Deal, A. G. (1988). Enabling and empowering families: Principles and guidelines for practice. Brookline Books. Hatton, C., & Emerson, E. (1995). The development of a shortened ‘ways of coping’questionnaire for use with direct care staff in learning disability services.Mental Handicap Research, 8(4), 237-251. Behr, S. K., Murphy, D. L., & Summers, J. A. (1992). User's Manual: Kansas Inventory of Parental Perceptions (KIPP): Measures of Perceptions of Parents who Have Children with Special Needs. Beach Center on Families and Disability, University of Kansas. Hayes, A. F. (2012). PROCESS: A versatile computational tool for observed variable mediation, moderation, and conditional process modelling [White paper]. Retrieved from http://www.afhayes.com/public/process2012.pdf Aiken, L. S., & West, S. G. (1991). Multiple regression: Testing and interpreting interactions. Sage Publications, inc. Dumas, J. E., Wolf, L. C., Fisman, S. N., & Culligan, A. (1991). Parenting stress, child behavior problems, and dysphoria in parents of children with autism, Down syndrome, behavior disorders, and normal development.Exceptionality: A Special Education Journal, 2(2), 97-110. Gray, D. E., & Holden, W. J. (1992). Psycho-social well-being among the parents of children with autism. Australia and New Zealand Journal of Developmental Disabilities, 18(2), 83-93. Moes, D. (1995). Parent education and parenting stress. Teaching children with autism: Strategies for initiating positive interactions and improving learning opportunities, 79-93. Dabrowska, A., & Pisula, E. (2010). Parenting stress and coping styles in mothers and fathers of pre‐school children with autism and Down syndrome.Journal of Intellectual Disability Research, 54(3), 266-280.  1 1 2   1.School of Psychology, Bangor University, Bangor, Gwynedd, LL57 2DG  2.CEDAR, Warwick University, Coventry, CV4 7AL  

Protective factors of support, coping and positive perceptions for mothers of children with intellectual and developmental disabilities

https://discovery.ucl.ac.uk/10124787/1/01.03.15%20Poster%20Gatlinburg%202015%20Protective%20factors.pdf

Protective factors of support, coping and positive perceptions for mothers of children with intellectual and developmental disabilities

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