The relationship between parenting stress and social support in mothers of children with learning disabilities: a Chinese experience

Parent, child, and situational factors associated with parenting stress: a systematic review

Parenting stress has been related to adverse health outcomes in parents, children, and their families. This systematic review aimed to provide an overview of parental, child, and situational factors related to parenting stress in mothers and fathers. We searched Embase, Medline Epub (Ovid), PsychInfo (Ovid), Web of Science, and Google scholar for studies published between January 1980 and May 2021 evaluating the association between at least one factor and parenting stress. Studies were included only if they reported the association in a general population sample of mothers and fathers with children aged 0-12 years. The parent-child relationship model by Abidin guided the data synthesis. Quality of the evidence was assessed using the Standard Quality Assessment Criteria for Evaluating Primary Research Papers from a variety of fields. In total, 29 studies were included with excellent quality (55%), good (31%), and adequate (14%) methodological quality. There was evidence of an association between maternal depression, child overall problems, child externalizing and internalizing problems, social support, maternal educational level and maternal parenting stress. Evidence was inconsistent for an association between maternal anxiety, family income and maternal parenting stress. There was no evidence of an association for maternal age, child sex and maternal parenting stress. Several modifiable factors (i.e., parental depression and social support) were identified that might guide the development of preventive interventions. Future research should employ longitudinal study designs evaluating protective and risk factors and the pathways that lead to parenting stress, among both fathers and mothers.

Development and Validation of a Nomogram for Predicting the Unresolved Risk of Parents of Adolescents With Psychiatric Diagnoses

Evaluating the resolution of parents of ill children can help in taking measures to alleviate their distress in a timely manner and promote children's rehabilitation. This study aims to develop and validate a nomogram for predicting the unresolved risk of parents of adolescents with psychiatric diagnoses. The data for 130 parents (modeling dataset = 90; validation dataset = 40) were collected. A nomogram was first developed to predict the unresolved risk for parents based on the logistic regression analysis in the modeling dataset. The internal and external validation then were conducted through quantifying the performance of the nomogram with respect to discrimination and calibration, respectively, in the modeling and validation datasets. Finally, the clinical use was evaluated through decision curve analyses (DCA) in the overall dataset. In the results, the nomogram consisted of six risk factors and provided a good discrimination with areas under the curve of 0.920 (95% CI, 0.862-0.978) in internal validation and 0.886 (95% CI, 0.786-0.986) in external validation. The calibration with good consistency between the observed probability and predicted probability was also found in both internal and external validation. DCA showed that the nomogram had a good clinical utility. In conclusion, the proposed nomogram exhibited a favorable performance with regard to its predictive accuracy, discrimination capability, and clinical utility, and, thus, can be used as a convenient and reliable tool for predicting the unresolved risk of parents of children with psychiatric diagnoses.

Parental stress, involvement, and family quality of life in mothers and fathers of children with autism spectrum disorder in mainland China: A dyadic analysis

BACKGROUND

Research shows that parents of children with autism spectrum disorder (ASD) are burdened with childcare responsibilities and at increased risk for elevated stress and poor family quality of life (FQOL). Little is known, however, about the dynamic interactions between mothers' and fathers' perceived parenting stress in relating to parental involvement and FQOL, especially in the Chinese cultural context.

AIMS

This study examined the intrapersonal and interpersonal effects of parenting stress on parental involvement and FQOL for families of children with ASD in mainland China.

METHOD

A total of 210 Chinese couples (total N = 420) completed measures of caregiving involvement, perceived parenting stress, and FQOL. The Actor-Partner Interdependence Mediation Model (APIMeM) was employed to examine the dyadic relationships among the variables.

RESULTS

Both parents' parenting stress was negatively associated with their own involvement and FQOL. Moreover, fathers' parenting stress was indirectly related to mothers' perceptions of FQOL through their involvement in the care of their child with ASD.

CONCLUSIONS

The findings highlight the important roles of fathers' parenting stress and involvement in affecting their own and their partners' satisfaction with FQOL within Chinese families raising a child with ASD.

Parenting stress in families of children with Prader-Willi syndrome

Prader-Willi syndrome (PWS) is a neurodevelopmental disorder characterized by multiple endocrine, metabolic, respiratory, cognitive, and behavioral/psychiatric symptoms that may lead to severe emotional strain in their caregivers. In this study, we evaluated parenting stress by the Parenting Stress Index-short form (PSI/SF) and parent-reported behavioral symptoms by the Child Behavior Checklist (CBCL/6-18) in families of children with PWS. Sixty-seven home-resident PWS patients and their families were recruited in this study. The patients' mean age was 14.9 ± 8.3 years, and 33 (50.8%) were male. High parenting stress was reported by 41.5% families, as determined by high total stress scores of PSI/SF. The patients in high stress families were significantly older than those in low stress families (18.2 ± 8.0 vs. 12.6 ± 7.8 years, p = .007). CBCL/6-18 was used to evaluate the somatic and neuropsychiatric symptoms of PWS patients aged between 6 and 18 in the subgroup of the 35 families. In this subgroup, 37.1% of families reported high parenting stress. High stress families reported a higher T-score in anxiety/depression, withdrawn behavior, somatic complaints, thought problems, attention problems, and delinquent and aggressive behavior of their children with PWS. After multivariate stepwise logistic regression analysis, the T-score of somatic complaints was the only factor related to high parenting stress, with an odds ratio of 1.279. Our data demonstrated the high care burden of families with PWS and highlighted the importance of having dedicated medical care for both somatic and neuropsychiatric symptoms.

The Mediating Role of Parenting Stress in the Relations Between Parental Emotion Regulation and Parenting Behaviors in Chinese Families of Children with Autism Spectrum Disorders: A Dyadic Analysis

Little is known regarding the dynamic interactions between fathers and mothers in families of children with autism spectrum disorder (ASD) during the parenting process. This study used an actor–partner interdependence mediation (APIMeM) model to investigate the intrapersonal and interpersonal effects of emotion dysregulation and parenting stress on parenting behaviors among 211 pairs (total N = 422) of Chinese parents of children with ASD. The results indicated that for both fathers and mothers, there were significant indirect actor effects of parental emotion dysregulation on parents’ own parenting behaviors through their own parenting stress. However, no significant direct or indirect partner effect was found in the analyses. These findings suggest that the emotional parenting dynamics occurred on the individual rather than the dyadic level in these families.

Refining the Parenting Stress Index-Short Form (PSI-SF) in Chinese Parents

The Parenting Stress Index-Short Form (PSI-SF) is a popular brief assessment of parenting stress. However, its latent structure and psychometric properties have not been extensively addressed, in particular in non-Western cultures. The present study is the first to examine the factor structure and psychometric properties of the PSI-SF in parents from Mainland China (683 mother-father dyads; mean age of mothers = 37.10 years, SD = 3.68; mean age of fathers = 39.81 years, SD = 4.13). Initial analyses revealed that previously proposed factor structure of the PSI-SF did not fit the data well. Exploratory and confirmatory factor analyses were then conducted to develop a psychometrically sound and efficient abbreviated version of the PSI-SF. In this new version of 15 items (PSI-SF-15), there are three factors (i.e., parental distress, parent-child dysfunctional interaction, and difficult child). This abbreviated scale showed strict measurement invariance across sex of parent and satisfactory internal consistency. The convergent validity of the PSI-SF-15 were supported by its expected relations with the original PSF-SF measures, the multitrait-multimethod procedure, and its expected relations with scores on parenting behavior, parental depressiveness, and children's conduct problems. In conclusion, these results suggest that the PSI-SF-15 is a valid measure of parenting stress in Chinese parents, and that it holds promise as an informative and reliable alternative to the original PSI-SF when administration time is limited.

Neuropsychiatric Symptoms, Parenting Stress and Social Support in Chinese Mothers of Children with Autism Spectrum Disorder

Although little is known about the current situation regarding autism spectrum disorder (ASD) in mainland China, psychiatric disorders are common among Chinese mothers of preschool children with ASD. Previous studies showed ASD child's behavioral symptoms, maternal anxiety, and maternal depressive symptoms were associated with overall parenting stress in northern China. In the present study, we retrospectively analyzed medical records at the hospital related to neuropsychiatric symptoms, parenting stress and social support in mothers of children with ASD from southern China. A total of 80 mothers of children with ASD were screened. Among them, 34 mothers were in low-functioning ASD group (L-ASD group) and 46 mothers were in high-functioning ASD group (H-ASD group). Identification of the ASD cases was confirmed with a Revised Autism Diagnostic Inventory. Neuropsychiatric symptoms, parenting stress and social support were measured by neuropsychiatric inventory (NPI), parenting stress index short form (PSI-SF), and multi-dimensional scale of perceived social support (MSPSS). Total mean score of the NPI in the L-ASD group was significantly higher than that in the H-ASD group (P<0.01). The subscale scores of NPI, including depression, anxiety, apathy, irritability, agitation, night time behavior disturbances and change in appetite were significantly higher in the L-ASD group than those in the H-ASD group (P<0.01 or P<0.05). Meanwhile, the total PSI-SF scores and the scores of parental distress (PD), parental-child dysfunctional interaction (PCDI) and difficult child (DC) in the L-ASD group were significantly higher than those in the H-ASD group (P<0.01 or P<0.05). The total score of MSPSS was also higher in the L-ASD group than in the H-ASD group (P<0.01). This study goes further to show the neuropsychiatric symptoms and parenting stress are significantly higher in mothers of children with ASD, and more social supports are needed for mothers of children with ASD from southern China, especially for mothers of children with low-functioning ASD.

Parenting stress in Chinese mothers of children with autism spectrum disorders

OBJECTIVE

Elevated parenting stress has been observed among mothers of children with autism spectrum disorders (ASDs) in western countries, but little is known about mothers of Han Chinese children. The aim of the current study was to further the knowledge about stress experienced by Chinese mothers of children with ASD by examining maternal parenting stress in Heilongjiang province of China.

METHODS

In this cross-sectional study, data about participants' demographic characteristics, parenting stress, anxiety, depression, child's behavioral problems, coping strategies, and social support were collected though a questionnaire survey. The participants included 150 families with ASD children, who were consecutively admitted to the clinics of the Children Development and Behavior Research Center in Harbin Medical University, Heilongjiang Disabled Persons Federation, and Mudanjiang Child Welfare Home.

RESULTS

The participants reported elevated parenting stress. Mothers' parenting stress was associated with levels of depression and anxiety, and child's behavioral symptoms. Child's behavioral symptoms, maternal anxiety, maternal depressive symptoms, and lack of governmental financial support were associated with overall parenting stress.

CONCLUSIONS

Government support may play an important role in reducing parenting stress in this population.

Caring for a child with severe intellectual disability in China: the example of Rett syndrome

PURPOSE

Rett syndrome is one of several genetic disorders known to cause severe intellectual and physical disability, mostly in girls. Girls affected by Rett syndrome appear to develop normally in the first 6 months of life, after which the usual clinical presentation comprises regression of communication and hand skills, the appearance of hand stereotypies and impaired gait. Intellectual disability affects more than 1.5% of the population of children in developing countries yet we know little about the daily lives and support services available for them and their caregivers.

METHOD

This qualitative study explored the daily experiences of 14 mothers and one grandmother caring for a child with Rett syndrome in China via telephone interviews.

RESULTS

Participants reported a lack of education, rehabilitation and support services available to them. Limited access to information reduced families' capacity to adequately meet the needs of their child. These gaps were further exacerbated by discrimination and perceived stigma from some members of the community.

CONCLUSIONS

Additional support services and educational programs at the governmental level can improve the quality of life of persons with an intellectual disability and their families and programs involving community participation in the care of people with disabilities may help to address discrimination.

Parenting stress in parents of children with cerebral palsy and its association with physical function

This study was carried out to determine parenting stress levels in the parents of children with cerebral palsy (CP) and to examine the factors that contribute to the parenting stress score. Parenting stress levels were assessed in 101 parents of children with CP (mean age 8.8 years, SD 2.1) using the parenting stress index (PSI). The extent of involvement, gross motor function classification system, and pediatric outcomes data collection instrument were collected for patients' information. The responding parent, parents' age, percentage of involvement in the parenting role, employment, socioeconomic status, educational level, other children, and age were obtained for parents' information. Normative percentile scores were calculated for each subscale, each domain, and the total PSI score. Multiple regression analysis was carried out to determine the significant factors contributing to the PSI score. The mean total PSI score was 97.7 (SD 4.6). The global function score of pediatric outcomes data collection instrument (P=0.004) and ambulatory states (gross motor function classification system, P=0.002) were found to be the significant factors contributing to the total PSI score, where parents of children with a more favorable function showed a higher PSI score. Parents of children with CP showed a high level of parenting stress. Clinicians should keep in mind that psychological support and intervention might be needed for parents of children with CP.

Predictors of parenting stress among Vietnamese mothers of young children with and without cognitive delay

BACKGROUND

The study examined whether Vietnamese mothers of children with cognitive delay experienced more parenting stress compared to mothers of children without delay, and the factors that contribute to the parenting stress.

METHOD

The study sample included 225 mothers of children with and without cognitive delays from Hue City in Vietnam. The study protocol included mothers reporting on the scales of parenting stress and perceived social support, and on demographic questions.

RESULTS

Mothers of children with cognitive delay experienced more stress. They were poorer and less educated, and perceived less social support. More mothers of these children had health issues. Having a child with cognitive delay was the strongest predictor of stress after controlling other demographic and psychosocial variables.

CONCLUSION

Special education and early intervention services should be developed and available to educate the children with cognitive delay and support their mothers in Vietnam. Effective services also need to address their poverty and health care needs.

Parenting stress of mothers and fathers of young children with cognitive delays in Vietnam

BACKGROUND

This research examined the effects of child and family variables on stress experienced by mothers and fathers of young children with cognitive delays in Vietnam.

METHODS

The mothers (n = 106) and fathers (n = 93) whose children (age range = 3-6 years) were identified as having cognitive delays participated in the interview survey. The survey consisted of a set of the standardized questionnaires that were translated into Vietnamese and assessed for the content validity in the Vietnamese context.

RESULTS

Mothers experienced more stress than fathers. Path analyses were conducted for mothers and fathers separately. Mothers with female children, those with children of lower intellectual functioning, and those whose husbands had health conditions experienced more stress than the other mothers. Fathers with lower economic status and a smaller social support network were more stressed than the other fathers. Both mothers and fathers were more stressed when they experienced stronger stigma, although the effects were not significant when other variables were considered together in path analyses.

CONCLUSIONS

The findings revealed traditional gender roles. Mothers were more affected by the child's characteristics and the spouse's functioning; they anticipated future problems related to the child's functioning more than fathers did. Fathers were more affected by concerns about the family's connection to the wider world such as economic issues and the social support network. Longitudinal studies of how social support and stigma affect families would be valuable.

Psychosocial correlates of parenting stress, lack of support and lack of confidence/security

The purpose of the current study was to identify important correlates of parenting stress, frequently conceptualized as a mediator of suboptimal family function, and of social support and confidence/security, often regarded as buffers. Potential correlates of these concepts were assessed in questionnaires at delivery and at one year, in a sample of 16,000 families in Sweden. Predictors (1) of parenting stress were parental dissatisfaction and poor child sleeping patterns; (2) of lack of support included lack of confidence/security, parents born abroad, single motherhood, and maternal health problems; and (3) of lack of confidence/security were lack of support and serious life events. Mothers lacking social support or confidence/security exhibited significantly higher stress. Although parenting stress is a complex phenomenon certain risk factors can be emphasized, such as sleep problems which appear more important than child health problems. These risk factors can be used both in efforts to prevent stress and in studies of stress effects.

Influence of parental stress and social support on the behavioral adjustment of children with transposition of the great arteries

The joint role of parent stress and social support in the emotional adjustment of children was examined prospectively in a group of children with d-transposition of the great arteries (d-TGA). Questionnaires on parent perceptions of stress and social support were administered when children were 1 and 4 years of age (n = 143-153). Parent ratings of child behavior problems were collected at 4 years (n = 152). The findings indicate a favorable outcome for parents and children with congenital heart disease (CHD). Compared with normative samples, parents experienced less stress and more social support, and they rated children as showing fewer behavior problems. Parents with more stress at both ages reported more behavior problems. Families with less social support reported more stress at both 1 and 4 years. Social support, however, did not moderate the relationship between stress and child behavior problems. Early detection of distressed families may assist in alleviating stress and reducing behavior problems.

Stress factors and coping strategies of parents with children treated by hemodialysis: A qualitative study

The purpose of this study was to describe the common stress factors and coping strategies of parents whose children had been treated by hemodialysis. This study was conducted by using focus group interviews. The sample was composed of 31 parents. Five focus groups were made up from these parents. Data were analyzed by using the manifest content analysis method. According to the results, common stress factors of parents included financial and bureaucratic problems, growth and development of ill children, fluid-diet restriction and educational problems of children, lack of social support, and anxiety about losing their children at any moment. Coping strategies of parents were to give their attention to the positive side of matters, to share their feelings with their spouse or other parents, to cry, or pray.

Gender differences of parental distress in children with cancer

BACKGROUND

Reports published over the last few decades present contradictory findings about the psychological distress and coping patterns of parents whose children have cancer. Although an increasing number of studies have focused on psychological distress and the adjustment process that parents experience when their children are diagnosed with cancer, few of these studies have been conducted in Taiwan.

AIMS

Gender differences of parental distress experienced by Taiwanese mothers and fathers (164 couples) whose children were undergoing treatment for cancer were investigated.

METHODS

Parenting stress, psychological distress, somatization, as well as marital satisfaction were compared between mothers and fathers whose children had cancer.

RESULTS

Mothers averaged significantly higher levels than fathers for all forms of distress. Mothers and fathers whose children had been diagnosed within the previous 2 months reported higher levels of depression, anxiety, and global stress than those in the other groups. Both mothers and fathers whose children had been diagnosed within the past 2 months reported greater marital dissatisfaction than parents whose children were in the other treatment groups.

CONCLUSIONS

This finding indicates the need for a thorough psychiatric consultation at the time of diagnosis for children who have cancer and their families. Ongoing psychosocial support and education should have been integral components of the treatment program when relapse occurred.

A structural modeling approach to the understanding of parenting stress

Tested and cross-validated a multidimensional model of predictors of parenting stress on data from a population-based sample of Swedish mothers (N = 1,081) with children ages 6 months to 3 years. The study was a cross-sectional questionnaire study, focusing on the explanation of variance in parenting stress. Structural equation modeling procedures permitted disentanglement of total, direct, and indirect effects. A Swedish instrument based on parts of the Parent Domain in the Parenting Stress Index was used as a measure of stress. The results provided general support for the proposed model. High workload, low social support, perception of the child as fussy-difficult, negative life events, child caretaking hassles, more children in the family, and high maternal age related directly to more stress. Child irregularity contributed indirectly to mother's experienced stress. No buffering effects of social support were found. Forty-eight percent of the variance in the parenting stress measure was explained by the model. Implications for interventions were discussed.

Impact on maternal parenting stress of receipt of genetic information regarding risk of diabetes in newborn infants

Our objective was to investigate whether notification of high-risk status for type 1 diabetes in newborn infants results in an increased maternal-parenting stress level when compared with notification of low-risk status for type 1 diabetes. Maternal parenting stress level was assessed at 5-7 weeks postpartum (baseline) and was reassessed 4-5 months after parents were informed of their newborn infants' genetic screening results (follow-up). Parenting stress level was measured using the total stress score (TSS) of the Parenting Stress Index/Short Form. The outcome variable, change in TSS, was calculated by subtracting the baseline TSS from the follow-up TSS. Demographic variables such as maternal race, maternal age, maternal education level, maternal marital status, child's birth order, and total family income were assessed through a structured phone interview at the time of baseline assessment. The risk factor of interest was the child's human leukocyte antigen (HLA) status for type 1 diabetes, i.e., whether child was at a high or moderate (combined into "high") genetic risk or at a low genetic risk for type 1 diabetes. A sample of 88 mothers (23 with a high-risk child and 65 with a low-risk child) was evaluated. Baseline median TSSs were 65 and 74 for mothers of low-risk infants and mothers of high-risk infants, respectively. Both groups' median TSS decreased between baseline and follow-up. No significant differences were found between change in TSS and maternal age, race, education level, marital status, total family income, or child's birth order. Although the median decrease in TSS was smaller in mothers with a high-risk child when compared with mothers of a low-risk child, this difference was not statistically significant. We did not find an association between newborn's HLA status and change in maternal TSS. The results of this study suggest that notification of high-risk status for type 1 diabetes in newborn infants may not result in an increased level of parenting stress among mothers.

Stress experienced by mothers of Malaysian children with mental retardation

OBJECTIVE

To compare parenting stress among Malaysian mothers of children with mental retardation and a control group, and to determine factors associated with stress.

METHODOLOGY

Seventy-five mothers of children with mental retardation aged 4-12 years and 75 controls (those without disabilities who attended the walk-in paediatric clinic) participated in the Parenting Stress Index (PSI). Intelligence quotient (IQ) and Child Behaviour Checklist (CBCL) scores, together with sociodemographic data, were entered into a multiple stepwise regression analysis, using the PSI as the criterion.

RESULTS

Mothers of children with mental retardation scored significantly higher than control subjects in both the child-related domain (difference between means 26.1, 95% confidence interval 19.6-32.5) and parent-related domain (difference between means 15.0, 95% confidence interval 7.9-22.1) of the PSI. The total child behaviour scores from the CBCL (P < 0.01), IQ scores (P < 0.01) and sibship size (P < 0.01) were associated with child-related domain scores. For the parent-related domain, CBCL (P < 0.01) and IQ scores (P = 0.01) remained important factors but Chinese ethnicity (P < 0.01) and maternal unemployment (P < 0.01) were also significant predictors of stress.

CONCLUSION

A large proportion of mothers of children with mental retardation experienced substantial parenting stress, especially Chinese and unemployed mothers, and this warrants appropriate intervention.

Parenting stress among mothers of Malaysian children with cerebral palsy: predictors of child- and parent-related stress

A hospital study was carried out to compare parenting stress among 87 Malaysian mothers of children with cerebral palsy and a control group (comprising 87 mothers of children without disability who attended the walk-in paediatric clinic), using the Parenting Stress Index (PSI) questionnaire. Multiple regression analysis was used to determine socio-demographic and medical factors associated with child-domain stress (CDS) and parent-domain stress (PDS). Mothers of children with cerebral palsy scored significantly higher than control subjects on all sub-scales of CDS and PDS (p < 0.01), except for the sub-scale of 'role restriction'. The presence of cerebral palsy (p < 0.001) and activities of daily living (ADL) scores (p < 0.001) were significantly associated with CDS. Factors predictive of PDS were ADL scores (p < 0.001), number of hospitalizations over the past year (p = 0.024), level of maternal education (p = 0.018) and Chinese mothers (p < 0.001). Although this study demonstrated that Malaysian mothers of children with cerebral palsy experienced higher levels of stress than controls, the impact of cerebral palsy per se on parenting stress was modified by other factors such as increased care-giving demands, low maternal education and ethnic background. Habilitation should be directed at easing the burden of daily care, minimizing hospital re-admissions and targeting appropriate psychosocial support at specific subgroups to change parental perception and expectations.

The empowering of Hong Kong Chinese families with a brain damaged member: its investigation and measurement

This is an increasing recognition of the influential roles played by the families of brain damaged persons in rehabilitation. Although these families are expected to take up the burden of care, they are usually ill-prepared to face this long-term process. This preliminary study of empowerment is aimed at helping Hong Kong Chinese families with a brain damaged member to regain a sense of mastery over the brain damage, their environment and their lives. The impact of brain damage on families was explored in order to propose a model to guide the development of assessment and intervention, as well as for the justification of practice by health care professionals. A 52-item instrument, the empowerment questionnaire, was developed through explorative factor analysis of responses of 211 families that included a brain damaged member. This analysis yielded four interpretable factors: efficacy: knowledge: support and aspiration and they demonstrated high validity reliability.

The effect of the disaster caused by the great Hanshin earthquake on people with intellectual disability

The vulnerability of people with intellectual disability when services are disrupted by a major earthquake is described. The value of an accessible register and multiple networks of support at the time of a major disaster is emphasized.

Classification, prevalence, prevention and rehabilitation of intellectual disability: an overview of research in the People's Republic of China

The People's Republic of China is a developing country with all the problems and challenges that face such countries all over the world. Progress has been hampered by scarcity of resources, and a lack of relevant information and appropriate skills, as well as by the stigma traditionally attached to people with intellectual disability. The present rapid economic development has made possible further improvement and expansion of educational opportunities, and health and rehabilitation services. According to a recent census and sample surveys conducted in the People's Republic of China, the overall prevalence rate of people with disabilities was estimated to 4.9%. Thus, China has more individuals with disabilities than any other country in the world. According to these figures, the prevalence of intellectual disability in the population is approximately 1%. For children younger than 14 years of age, the prevalence is around 2%, which accounts for 66% of all handicapped children, making it the most frequent childhood disability. Today, the existing medical facilities, and educational and social welfare organizations cannot meet the tremendous need of care and services. The problems of the large number of disabled children and adults are a major challenge for contemporary Chinese society. This paper is devoted to research pertinent to intellectual disability in China. With a few exceptions, only publications in the English language were included in this review, which makes the overview selective rather than comprehensive. Publications on classification systems and diagnostic criteria, screening methods and assessment instruments, prevalence rates, aetiology and risk factors, prevention and intervention efforts, special education, and families with children with intellectual disability are presented.