Parenting stress in families of children with disabilities: Impact of type of disability and assessment of attending paediatricians.

ABSTRACT

BACKGROUND: Parents of children with developmental disorders (DD) or disabilities report greater parenting stress than parents of typically developing children. To minimise this stress, stressful factors need to be known and stress needs to be recognised early. The present cross-sectional study aims to systematically assess and compare parenting stress in families of children with various types of disabilities. In addition, the assessment of parenting stress by attending paediatricians will be evaluated. METHODS: We surveyed 611 parents about their parenting stress at the Children's Development Center (CDC). Three questionnaires, including the German versions of the Parenting Stress Index (PSI) and Impact on Family Scale (IOFS), were used to evaluate parenting stress. Furthermore, attending paediatricians assessed of the child's type of disability and their perception of parenting stress in a separate questionnaire. RESULTS: Fifty-five percent of all parents reported stress at a clinically relevant level, 65% in the child domain and 39% in the parent domain of the PSI. Parenting stress differed significantly across diagnostic categories (p < 0.01) and was associated with childhood disability related issues of behaviour, sleep or feeding issues. Parenting stress was often underestimated by the paediatricians, especially when the children had disabilities perceived as less severe. In one-third of parents with clinically relevant total stress, paediatricians reported low stress levels. Parent-reported financial problems, social isolation, and partnership conflicts were not suspected by paediatricians in ≥85% of cases. CONCLUSIONS: Clinically relevant parenting stress was found more often than in comparable studies. An assessment of parenting stress by paediatricians may be complicated by time constraints in medical appointments, the mainly child-centred consultation, or restricted expression of parents' stress. Paediatricians should move from a purely child-centred to a holistic, family-centred approach to treatment. Routine screening of parenting stress using standardised questionnaires could be helpful to identify affected families.