Managing Stress Levels of Parents of Children with Developmental Disabilities: A Meta‐Analytic Review of Interventions
| Author | Jessica Frank,Endia J. Lindo,Bertina H. Combes,Karin R. Kliemann |
| Date | 01 February 2016 |
| DOI | http://doi.org/10.1111/fare.12185 |
| Published date | 01 February 2016 |
E J. L, K R. K, B H. C, J F
University of North Texas
Managing Stress Levels of Parents of Children with
Developmental Disabilities: A Meta-Analytic
Review of Interventions
Special Issue Guest Editor’s Note: In this
article the authors examine the impact of inter-
vention programs focused on reducing stress of
parents with children diagnosed with a devel-
opmental disability. The authors’ meta-analysis
of available research found programs that focus
on stress are important in supporting parental
well-being. This article builds from its paired
article by Gouin and colleagues, “Impact of
Formal and Informal Support on Health in
the Context of Caregiving Stress” (this issue,
pp. 191–206) on the health risks experienced by
family caregivers.
A
Parents of children diagnosed with disabili-
ties often experience elevated levels of stress
compared to those parenting children without
disabilities (Baker-Ericzén, Brookman-Frazee,
& Stahmer, 2005; Tomanik, Harris, & Hawkins,
2004). This increase in stress can have a neg-
ative impact on parent well-being (Trute &
Department of Educational Psychology, Universityof North
Texas, 1155 Union Circle, No. 311335, Denton, TX
76203–5017 (endia.lindo@unt.edu).
∗Department of Educational Psychology, University of
North Texas, 1155 Union Circle, No. 311335, Denton, TX
76203–5017; and Arlington Independent School District,
690 E. Lamar Blvd., Arlington, TX 76011.
Key Words: developmental disability, meta-analysis, parent-
ing, parent social support, stress management.
Hiebert-Murphy, 2002) resulting in a stress-
induced dysregulation of the immune system.
In their article in this issue, Gouin, da Estrela,
Desmarais, and Baker found that increased
levels of social support served as protection
against this dysregulation. In the current study,
we examined the nature and benecial com-
ponents of formal support services targeted at
reducing the stress levels of parental caregivers
of children with developmental disabilities. With
this meta-analytic review we attempt to examine
the efcacy of these interventions and potential
moderators to their effects by reviewingcompar-
ison group studies conducted in North America
with parent stress interventions and stress out-
come measures. Six studies were identied that
met this review’s criteria, reporting an overall
effect of d =0.51. In sum, stress management
interventions were found to effectively reduce
the reported stress of parentscaring for children
with developmental disabilities. A signicant
issue identied was the limited number of
comparison group studies that examined stress
management interventions for this population.
Implications of these ndings and need for
further exploration are discussed.
One in six children in the United States between
the ages of 3 and 17 are diagnosed as having
a developmental disability (DD) or delay (Cen-
ters for Disease Control and Prevention [CDC],
2013). According to the CDC, developmental
disabilities comprise groups of conditions (e.g.,
Family Relations 65 (February 2016): 207–224 207
DOI:10.1111/fare.12185
208 Family Relations
autism, intellectual disability) resulting in sig-
nicant disability that affects an individual’s
adaptive behavior skills and general intellec-
tual functioning. Schalock et al. (2010) dened
adaptive behavior as a collection of skills (con-
ceptual, social, practical) learned and performed
in everyday life, whereas intellectual functioning
describes general mental capacity (learning, rea-
soning, problem solving). Typically diagnosed
in early childhood, the conditions associated
with a DD have lifelong implications not only
for the individual but for his or her families and
caretakers as well (CDC, 2013).
I C DD F
Within family systems theory, “family” is
viewed as a dynamic and intricate system of
individuals and interactions (Minuchin, 1985).
Reichman, Corman, and Noonan (2008) noted
that all aspects of family functioning can be
affected by the shared experience of living
with a child with a DD, in both positive and
negative manners. Potential positive outcomes
noted in the literature include an increased
inner strength, resilience, cohesion, and com-
munity connection (Ellingsen, Baker, Blacher,
& Crnic, 2014; Hastings & Taunt, 2002; Reich-
man et al., 2008). Conversely, researchers also
have documented the challenges of parenting
children with DD, including strained marital
relationships (Freedman, Kalb, Zablotsky, &
Stuart, 2012), nancial pressures (Parish, Rose,
Swaine, Dababnah, & Mayra, 2012), sibling
adjustment (Manor-Binyamini & Abu-Ajaj,
2012), and decreased parent efciency (Karst
& Van Hecke, 2012). Such challenges lead
to increased levels of stress experienced by
parents of children with DD (Baker-Ericzén,
Brookman-Frazee, & Stahmer, 2005; Benson,
2006; Brookman-Frazee & Koegel, 2004; Min-
jarez, Mercier, Williams, & Hardan, 2013;
Noh, Dumas, Wolf, & Fisman, 1989; Tomanik,
Harris, & Hawkins, 2004).
P S DD
Abidin’s (1995) theoretical framework views
parent stress as a measure of dysfunction in
the parent–child relationship. Parental stress,
dened by Deater-Deckard (2004) as “a set
of processes that lead to aversive psycholog-
ical and physiological reactions arising from
attempts to adapt to the demands of parent-
hood” (p. 6), can have a pervasive impact on
families of children with a DD. Although par-
enting in general has been documented as a
stress-producing experience (Deater-Deckard &
Scarr, 1996; Kowalkowski, 2012), researchers
estimate that signicantly elevated stress levels
are experienced by up to two thirds of moth-
ers of children who have a DD (Baker-Ericzén
et al., 2005; Tomanik et al., 2004). This ele-
vation in stress has been attributed to greater
nancial responsibilities, physical burdens, mal-
adaptive behaviors in children, feelings of social
isolation, and concern about lifelong care of the
child (Baker-Ericzén et al., 2005; Gammon &
Rose, 1991; Hall & Graff, 2012). Giventhat indi-
viduals with DD frequently experience signif-
icant difculty with cognitive, communicative,
behavioral, and social skills, their parents must
often learn specialized skills and navigate a com-
plex system of services to support their children
(Minjarez et al., 2013). In addition to dealing
with the daily stresses, life cycle events such as
the time of diagnosis, parental and child aging,
and a transition to adulthood services tend to be
especially stressful times for these parents (Hast-
ings & Beck, 2004; Turnbull, Erwin, Soodak, &
Shogren, 2011). Effectively addressing parental
stress is important for the enhancement of the
child’s well-being and functioning within the
family and larger society as well as for the par-
ents’ well-being (i.e., reduced risk for conditions
such as depression, heart disease, and obesity;
Trute & Hiebert-Murphy, 2002).
P E S
Living with the sustained stress often experi-
enced by parents of individuals with DDs may
increase these parents’ tendency to engage in
behaviors that are harmful to their health (e.g.,
failing to get sufcient sleep, smoking) and has
been found to have physiological impacts on
the body, increasing the production of inam-
matory markers such as cortisol and C-reactive
protein (Gouin, da Estrela, Desmarais, & Barker,
2016). Prolonged exposure to elevated levels of
such biomarkers can have a variety of negative
effects on one’s body, including impaired cogni-
tive and thyroid function and raised blood pres-
sure (Ebrecht et al., 2004). Exposure to these
psychological and corresponding physiological
stressors leave parents of individuals with a
DD vulnerable to poorer health outcomes than
To continue reading
Request your trial