Informal support for the carers of disabled children

Mothers' and Fathers' Interaction with their Young Mentally Handicapped Children

Studies of interaction between parents and their young mentally handicapped children generally lack ecological validity, ignore individual differences, and fail to consider the long-term implications of observed patterns. Such limitations may also be seen to apply to current strategies of early intervention. The paper reports a study of 21 young mentally handicapped children and their mothers and fathers, presenting data on daily patterns of child-care and observed teaching interactions. Predictions of differences between mothers and fathers, taken from literature on nonhandicapped and handicapped children, are confirmed. However, taking into consideration that fathers have less time available, parents do not differ as groups on the proportion which they spend in concentrated interaction with the child. Concentrated interaction time of mothers is related to a tendency to dominate observed teaching interactions; however, for fathers it is positively related to sensitivity in interaction. Possible implications of the results for intervention strategies are outlined.

The needs of families of children with heart disease

The aim of the study was to assess the perceived needs of children with heart disease of their parents and siblings and to determine the support and services that the families were currently receiving. A mailed survey of 447 families of children with congenital or acquired heart disease was conducted. Completed questionnaires were received from 209 (46.8%) families, 124 (59%) of whom had unmet needs in one or more areas. Information was the area in which there was the greatest degree of expressed need. While the majority of families received support from family and friends, community-based statutory services and support were less adequate. However, a number of families who were not receiving support from community professionals did not want any intervention. It is concluded that interventions need to be targeted so that those families needing additional services and support receive them. Implications for the development of an evidence-based children's cardiac liaison nursing service are discussed.

Appreciation of community-based rehabilitation by caregivers of children with a disability

Evaluations of community-based rehabilitation (CBR) programmes generally focus on quantitative data. To gain insight into the determinants of the outcomes, process-oriented data are needed. From the literature six variables have been identified that possibly correlate with the evaluation of CBR by caregivers of children with a disability. These variables are: (1) traditional beliefs, (2) impact of a child with a disability on the caregiver, (3) community involvement, (4) perceived ability to teach the child, (5) attitude towards various health services, and (6) expectations for the future of a disabled child. The study was done in the CBR projects in Zimbabwe. Seventy-five caregivers were interviewed. Background, perceived abilities to teach and expectations of the caregivers were very different. This study revealed a significant correlation between the appreciation of CBR and the attitude towards various health services, and between the perceived ability to teach and the expectations for the future of the child.

Long-term follow-up study of cerebral palsy children and coping behaviour of parents

The purpose of this study was to understand: (a) the feelings, thoughts and actions of parents at the time their children were diagnosed as having cerebral palsy; (b) the crisis periods in raising their children; (c) the important persons who supported the parents during the 'acceptance' phase; and (d) the roles of mothers and fathers in raising the children. The subjects were 28 mothers and fathers who had sons or daughters with cerebral palsy. The latter offspring were aged 22-29 years at the time of this study. They were interviewed at their homes with a semi-structured method retrospectively. The results showed that most parents became aware of their children's disability in infancy and most of their children were diagnosed as having cerebral palsy by around 2 years of age. The mothers' reactions to the diagnosis were emotional and those of the fathers were realistic in coping with the problem. Although crisis periods arose throughout the periods of growth and development of the children, the infancy period was the more critical for mothers and the toddlerhood, school-age and adolescence periods were more critical for fathers. The important support people were the spouses. The mothers took care of the children while the fathers provided an income; however, some fathers withdrew from competing for achievement in their jobs.