Network Supports and Resiliency among U.S. Military Spouses with Children with Special Health Care Needs

• Author: Danielle C. Swick,Gary L. Bowen,Anne F. Farrell
• Published date: 01 February 2014
• Date: 01 February 2014
• DOI: http://doi.org/10.1111/fare.12045

ANNE F. FARRELL University of Connecticut

GARY L. BOWEN University of North Carolina-Chapel Hill∗

DANIELLE C. SWICK University of North Carolina-Greensboro∗∗

Network Supports and Resiliency among

U.S. Military Spouses with Children with

Special Health Care Needs

Understanding how military families who

have children with special health care needs

(CSHCN) successfully cope in the context of

exceptional demands of the military lifestyle

can inform scholarship, policy, and practice

to the benefit of families. Using data from

775 female civilian parents (mothers serving

as Key Spouses) married to active duty Air

Force members, this study examined differences

on dimensions of network support and spouse

resiliency between mothers who do and do not

have CSHCN, as well as the relative contribution

of formal and informal network support to

variation in self-reports of resiliency among

mothers with CSHCN. Mothers with CSHCN

experience significantly less formal and informal

network support than their counterparts. Despite

Department of Human Development & Family Studies,

University of Connecticut, One University Place, Stamford,

CT 06901 (anne.farrell@uconn.edu).

∗School of Social Work, University of North Carolina-

Chapel Hill, 325 Pittsboro Street, Chapel Hill, NC

27599–3550.

∗∗Department of Social Work, University of North

Carolina-Greensboro, 259 Stone Building, Greensboro, NC

27401–6170.

Key Words: children with special health care needs, disabil-

ities, military families, parenting, community, resiliency,

parent to parent support, social networks.

this, they reported equivalent overall resiliency,

with lower perceived resiliency on only one

of four resiliency outcomes. More formal

and informal network support was generally

associated with higher resilience. Implications

for policy, practice, and research are discussed.

Military families function within a highly

demanding workplace, one in which the readi-

ness and fitness of servicemembers and their

spouses figure prominently. Long duty hours,

family separations, threat of harm, multiple

deployments, and geographic relocations are

common (Bowen, Martin, & Mancini, 2013;

SteelFisher, Zaslavsky, & Blendon, 2008). The

demographic composition of the U.S. mili-

tary parallels its civilian counterpart in many

respects, including the proportion of families

with children in need of special services. As

compared to the civilian population, however,

military families who have children with spe-

cial needs face extraordinary challenges with

potential to threaten their functioning and adap-

tation. Scholars have called for inquiry into the

experiences of military families, spouses, and

children (Booth et al., 2007; Drummet, Coleman,

& Cable, 2003; Palmer, 2008). The underly-

ing assumption of this article is that under-

standing how military families whose children

Family Relations 63 (February 2014): 55–70 55

DOI:10.1111/fare.12045

56 Family Relations

have special needs successfully manage com-

plex circumstances, first, can inform the field’s

understanding of resilience and, second, can

shape military policy and practice (MacDermid

Wadsworth, 2010). The experiences of fam-

ily members are important in their own right

and because family adaptation, support, and

resources affect servicemembers’ performance

and retention (Martin & Sherman, 2012).

With rare exception (Taylor et al., 2005;

Watanabe, Jensen, Rosen, & Newby, 1995),

however, little has been written about family

perceptions of support networks and the role

they play in military life, in particular, parenting

children with special needs. In the context of the

social organization (SO) theory of community

action and change (Mancini & Bowen, 2013),

this investigation begins to address that gap.

We examine the relative contribution of formal

and informal network support to variation in

self-reports of resiliency among a group of

civilian mothers (Key Spouses) who are married

to active duty Air Force (AF) members and

who have children with special health care

needs (CSHCN). We provide an overview of

the military context, discuss the characteristics

of CSHCN, define formal and informal network

supports, review the SO theory of community

action and change, and embed these concepts

within a resilience framework.

MILITARY FAMILIES

The U.S. Armed Forces is the largest U.S.

employer. Currently, approximately 1.4 million

men and women serve in the active-duty

component; another 850,000 serve in the reserve

component (National Guard or other reserves).

The majority of these servicemembers are

married (about 52%), and approximately two

in five have children in the home (Martin &

Sherman, 2012). The typical servicemember

enters parenthood early, has a dual-career

household, and lives off base (Martin &

Sherman, 2009; Segal & Segal, 2004). More

than two million servicemembers have deployed

to war zones since 2001 with longer (more

than 6 months) and repeated deployments being

the norm (Bowen et al., 2013). Increases

in deployment have led to longer and more

frequent family separations and recognition that

nondeployed spouses adopt expanded roles in

parenting and household management (Spera,

2009).

Children with Special Health Care Needs

Definition and Prevalence of CSHCN. The term

special needs is a nonspecific one that has

multiple meanings. Alternatively, the federal

Maternal & Child Health Bureau (MCHB)

defines ‘‘children with special health care

needs’’ as ‘‘those who have or are at increased

risk for a chronic physical, developmental,

behavioral, or emotional condition and who

also require health and related services of

a type or amount beyond that required by

children generally’’ (McPherson et al., 1998,

p. 138). This definition encompasses conditions

from significant disabilities to chronic medical

problems, including developmental concerns,

above-routine use of services, and limited

functional ability. The 2010 national stratified

survey of CSHCN approximated that 13.9%

of children (10.2 million children; 21.8% of

U.S. households) have special health care needs

(Data Resource Center for Child and Adolescent

Health, 2012).

Effects of Special Health Care Needs. The

course of a child’s health condition depends

not only on its origins and implications, but also

on child, family, and community capacity. A

child with developmental plasticity, biological

reserves, coping skills, and ample support may

respond differently to health threats than one

with limited family and community resources

(Halfon, Houtrow, Larson, & Newacheck,

2012). The literature has catalogued largely

deleterious effects of having CSHCN, including

parenting stress, marital distress, and increased

rates of divorce (Boyd, 2002; Hayes & Watson,

2012, Sloper, 2002). Families with CSHCN

are more likely to experience hardship, even

when income, education, family structure, and

race are controlled (Parish, Rose, Grinstein-

Weiss, Richman, & Andrews, 2008). Childhood

health problems have lifetime effects such

as limited educational attainment, reduced

income, and days worked (Stabile & Allin,

2012). Mothers of CSHCN are more likely

to stop or reduce work (Heck & Makuc,

2000; Loprest & Davidoff, 2004). Some authors

have documented ‘‘positive spillover,’’ where

work buffers stresses associated with family

life (Grzwacz & Marks, 2000). No national

data exist on military dependent students, so

their attendance, academic performance, college

enrollment, and work readiness are unknown