Defining Parenting and the Role That It Plays in the Relationship Between Complexity of the Child's Neurodevelopmental Disorder and Family Impact

Background:

Parenting, a complex concept, with numerous definitions, has been defined as the attributions parents make regarding a child’s behavior. Similarly, another definition centers around parents’ use of certain types of behaviors, such as hostility. Parenting, as defined by both attributions and behaviors, is hypothesized as one factor that leads families to report a positive impact or negative impact in raising their child. For example, the parenting behavior of providing emotional support has consistently been associated with positive developmental outcomes in neurotypical children (Gray & Steinberg, 1999). Mothers of children with disabilities who make higher proportions of positive appraisals throughout their day, have families with higher levels of healthy adjustment (Trute et al., 2010). Whether parenting plays a similar role in families with a child with a neurodevelopmental disability (NDD) was investigated.

Objectives:  To investigate whether parenting could be defined as a concept using a latent variable consisting of both attributions and behaviors; and, to verify whether it partially mediates the relationship between complexity of a child’s neurodevelopment impairment and the family impact of raising a child with a NDD.

Methods:  This study was part of the Parenting Matters! study (PI: Lucy Lach, Ph.D., Dafna Kohen, Ph.D., & Peter Rosenbaum, M.D.). A convenience sample was collected in major health centers servicing families with a child with a neurodevelopmental disorder across Canada. Mothers of 190 children age 4 to 13 years old (M = 8.11 years, SD = 2.41 years), and primarily male participated (62.1%). Children had diagnoses of either cerebral palsy (36.8%), ASD (27.9%), global developmental delay (19.5%), epilepsy (8.9%) or multiple impairment (6.8%). Measures used to collect data, included About My Child – 26 (AMC; Rosenbaum et al., 2008), Parenting Attribution Test (Bugental, 2004), National Longitudinal Study of Children and Youth Parenting Scales - Consistency, Positive Interaction, and Hostile/Ineffective (Strayhorn & Weidman, 1988), and the Family Impact of Child Disability Scale (Trute et al., 2009).

Results:  

A model in which a latent variable for parenting was created from parenting attributions and parenting behaviors was tested with exploratory factor analysis. The goodness of fit indices were poor (e.g., CFI = 0, RMSEA = .38, SRMR = .27).  Subsequently, individual parenting variables were entered as mediators between AMC complexity score and both positive and negative family impact but revealed no significance. The direct effect of AMC complexity score was significant and explained 44.7% of the variance in negative family impact of disability (R² = .195, F (1, 183) = 45.65, p < .001).

Conclusions:  The latent variable of parenting was not established as consisting of both parenting attributions and behaviors. This affirms that defining parenting is complex, and may differ for children with a NDD. The results suggest that measures targeted specifically for the unique situation of parenting a child with a NDD are needed. The relationship between sources of stress such as complexity of the child’s neurodevelopmental impairment and negative family impact suggests the need to address concerns about function in order to improve parents’ appraisal of negative family impact.