Some Financial Costs of Caring for Children with Down Syndrome at Home

Economic burden on caregivers or parents with Down syndrome children-a systematic review protocol

BACKGROUND

Financial burden is a common phenomenon, often noticed in the caregivers of children with Down syndrome. It echoes adverse effects on the caregiver's mental and physical health. The economic burden covers direct healthcare costs, direct non-health-care costs, and indirect costs and is substantial for the family of a person with Down syndrome, as well as for society. Evidence, in this area, is necessary to reduce mental stress and promote financial well-being among caregivers.

METHODS

In this review, quantitative studies that assess the economic burden on caregivers of children with Down syndrome will be considered. We will perform a systematic literature search conducted from the year 2000 to 2022 on electronic databases CINAHL, EBSCO, EMBASE, PubMed, Scopus, Web of Science, and EconLit. An additional gray literature search will be carried out. Two researchers will independently conduct the screening and data extraction and assess the risk of bias.

DISCUSSIONS

The review attempts to methodically analyze the economic burden among caregivers of children with Down syndrome from the societal perspective and individual perspectives. The current study will provide an evidence base to researchers, academicians, and society in identifying need-based learning to caregivers, and the selection of appropriate therapies for children suffering from Down syndrome.

SYSTEMATIC REVIEW REGISTRATION

PROSPERO CRD42021265312.

MOTHERS AND FATHERS TOGETHER: CONTRASTS IN PARENTING ACROSS PRESCHOOL TO EARLY SCHOOL AGE IN CHILDREN WITH DEVELOPMENTAL DELAYS

Much of our understanding of families and parenting of children with intellectual disabilities (ID) reflects the thoughts, beliefs, attitudes, and behaviors of mothers with relatively little focus on the ways in which fathers contribute to and are affected by this unique context. In this chapter, we address the importance of fathers as a source of critical developmental influence, and contrast fathers and mothers of children with ID along three important dimensions of parent functioning (stress, well-being, and interactive behavior). The contrasts explore the developmental trajectories of these parenting constructs over time from the perspective of an emerging new complexity in conceptual models of family and parent adaptation. Data from the Collaborative Family Study are used to explore paternal and maternal stress, well-being, and behavior across the preschool through transition to school-age developmental period, and findings are discussed within the context of the broader literature in each area.

Parenting Children with Developmental Delays: The Role of Positive Beliefs

Parents of children with developmental delays consistently report higher levels of child behavior problems and also parenting stress than parents of typically developing children. This study examined how mothers' positive beliefs influence the relation between children's behavior problems and mothers' parenting stress among families of children who are developmentally delayed (DD: n = 72) or typically developing (TD: n = 95) and assessed at ages 3, 5, and 7 years. Positive beliefs had a main effect on parenting stress at all ages, which was mediated by child behavior problems for mothers in the DD group at every age and across time. In the TD group, mediation was found at age 3 years. Additionally, support was found for a moderation effect of positive beliefs on the relation between child behavior problems and parenting stress, but only in the DD group at age 3. These findings have implications for interventions drawing on Seligman's (1991) work on learned optimism, the positive counterpart of learned helplessness.

Mothers of young adults with intellectual disability: multiple roles, ethnicity and well-being

BACKGROUND

Two opposing perspectives--role strain and role enhancement--were considered as predictive of women's psychological and physical health. The authors examined the relation between multiple role occupancy (parenting, employment, marriage) and well-being (depression and health) among mothers of young adults with intellectual disability (ID).

METHODS

Participants were 226 mothers aged 35-70 years old caring for a young adult aged 16-26 years old with moderate to severe/profound ID. Mothers were of either Latino ethnicity (n=117) or Anglo (n=109). Mothers' ethnicity and degree of acculturation and young adults' adaptive behaviour and behaviour problems were examined as potential moderators.

RESULTS

Mothers who were employed, married, or both reported better well-being than mothers who were both unemployed and unmarried, especially when their offspring had relatively higher adaptive functioning. This relationship between role occupancy and well-being was fully mediated by socio-economic status (SES) factors. Results did not suggest a role enhancement effect, but instead indicated a role shortage effect; unemployed, unmarried mothers experienced markedly poor well-being, while all other mothers experienced comparable well-being. Well-being scores were higher for Anglo than for Latino mothers; this relationship was entirely accounted for by SES. In Latina mothers, the relation between role occupancy and well-being was moderated by degree of acculturation.

CONCLUSIONS

Findings suggest that multiple roles benefit mothers of young adults with ID primarily through their impact on socio-economic resources. For more acculturated Latina mothers, occupying more roles predicted better well-being even after controlling for SES. Latina mothers who were unemployed and unmarried had lower SES, and this group emerged as at particular risk. The latter group may benefit most from respite assistance and other interventions aimed at addressing their physical and mental health.

Paid employment of mothers and fathers of an adult child with multiple disabilities

Paid employment is increasingly undertaken by mothers as their children age, with the majority of women being in employment by the time their offspring are adult. Opportunities to engage in employment appear to be reduced for mothers of children with disabilities; however, little is known about the employment of mothers or fathers of adults with disabilities. Data were collected regarding the employment decisions of parents of a young adult with multiple disabilities and contrasted with those of parents whose children were all developing normally. Twenty-five mothers and 12 fathers of a young adult with multiple disabilities were interviewed, as were 25 comparison mothers and 19 comparison fathers. Data collected included hours of work, reasons for employment status, attitudes towards work and child care, and psychological well-being. Clear differences were found between the two groups. Mothers and fathers of a child with multiple disabilities showed different engagement patterns with the paid workforce from comparison parents. Hours of work for fathers of a young adult with multiple disabilities showed a bi-modal distribution, with some fathers working fewer hours than usual and others working very long hours. For mothers in both groups, the number of hours in paid employment was negatively associated with reports of psychological problems. Increased attention needs to be given to the employment opportunities of parents of children with disabilities since employment appears to play a protective role for mothers, in particular. Services provided to adults with disabilities will need to change if parents are to have the same life chances as parents without adult offspring with a disability.