This study examined the relationship between toileting concerns, behavior problems, and parenting stress in parents of children with special health care needs (CSHCN). Participants included parents of 99 males and 71 females aged 4 to 12 years with neural tube defects (NTD), developmental-behavioral disabilities (DBD), or history of perinatal intraventricular hemorrhage (IVH). Parents completed the Achenbach Child Behavior Checklist (CBCL) and the Parenting Stress Index-Short Form (PSI-SF). Parents expressing toileting concerns on the CBCL reported significantly more personal distress and more externalizing problems versus those with continent children. Variation within subsamples suggested that expectations based on nature of disability may be a factor in parent adjustment. Direct assessment and intervention of toileting issues should be a high priority in secondary stress prevention with CSHCN and their families.
Get full access to this article
View all access options for this article.
References
1.
Kronenberger WG, Thompson RJ.Medical stress, appraised stress, and the psychological adjustment of mothers of children with myelomeningocele. J Dev Behav Pediatr. 1992;13:405-411.
2.
Saylor CF.Psychosocial needs: taking care of the caretaker. In: Macias MM, Saylor CF, eds. Children and Spina Bifida: A Guide for Families. Charleston, SC: Medical University of South Carolina Spina Bifida Clinic; 2001:145-147.
3.
Heaman DJ.Perceived stressors and coping strategies of parents who have children with developmental disabilities: a comparison of mothers with fathers. J Pediatr Nurs. 1995;10:311-320.
4.
Holmbeck GN, Gorey-Ferguson L, Hudson T, et al.Maternal, paternal, and marital functioning in families of preadolescents with spina bifida. J Pediatr Psychol. 1997;22:167-181.
5.
Samuelson JJ, Foltz J, Foxall MJ.Stress and coping in families of children with myelomeningocele. Arch Psychiatr Nurs. 1992;6:287-295.
6.
Tunali B, Power TG.Creating satisfaction: a psychological perspective on stress and coping in families of handicapped children. J Child Psychol Psychiatry. 1992;34:945-957.
7.
Baker DB.Parenting stress and ADHD: a comparison of mothers and fathers. J Emot Behav Disord. 1994;2:46-50.
8.
Baker DB, McCal K.Parenting stress in parents of children with attention deficit hyperactivity disorder and parents of children with learning disabilities. Child Fam Stud. 1995;4:57-68.
9.
Cameron SJ, Dobson LA, Day DM.Stress in parents of developmentally delayed and nondelayed preschool children. Can Ment Health. 1991;39:13-17.
10.
Frey KS, Greenberg MT, Fewell RR.Stress and coping among parents of handicapped children: a multidimensional approach. Am J Ment Retard. 1989;94:240-249.
11.
Harvey EA.Parenting similarity and children with attention-deficit/hyper-activity disorder. Child Fam Behav Ther. 2000;22:39-54.
12.
Jackson AP.Maternal self-efficacy and children’s influence on stress and parenting among single black mothers in poverty. J Fam Issues. 2000;21:3-16.
13.
Mash EJ, Johnston C.Determinants of parenting stress: illustrations from families of hyperactive children and families of physically abused children. J Clin Child Psychol. 1990;19:313-328.
14.
Warfield ME, Krauss MW, Hauser-Cram P, et al.Adaptation during early childhood among mothers of children with disabilities. J Dev Behav Pediatr. 1999;20:9-16.
15.
Bendall RD, Stone WL, Field TM, et al.Children’s effects on parenting stress in a low income, minority population. Top Early Childhood Spec Educ. 1989;8:58-71.
16.
Breen MJ, Barkley RA.Child psychopathology and parenting stress in girls and boys having attention deficit disorder with hyperactivity. J Pediatr Psychol. 1988;13:265-280.
17.
Campbell SB.Hard-to-manage preschool boys: externalizing behavior, social competence, and family context at two-year follow-up. J Abnorm Child Psychol. 1994;22:147-166.
18.
Cuccaro ML, Holmes GR, Wright HH.Behavior problems in preschool children: a pilot study. Psychol Rep. 1993;72:121-122.
19.
Goldberg S, Janus M, Washington J, et al.Prediction preschool behavioral problems in healthy and pediatric samples. J Dev Behav Pediatr. 1997; 18:304-313.
20.
Kobe FH, Hammer D.Parenting stress and depression in children with mental retardation and developmental disabilities. Res Dev Disabil. 1994;15:209-221.
21.
Mash EJ, Johnston C.Parental perceptions of child behavior problems, parenting self esteem, and mother’s reported stress in younger and older hyperactive and normal children. J Consult Clin Psychol. 1983;51:86-99.
22.
Baker BL, Heller TL, Henker B.Expressed emotion, parenting stress, and adjustment in mothers of young children with behavior problems. J Child Psychol Psychiatry. 2000;41:907-915.
23.
Creasey GL, Jarvis PA.Relationships between parenting stress and developmental functioning among 2 year olds. Infant Behav Dev. 1994;17:423-429.
24.
Donenberg G, Baker BL.The impact of young children with externalizing behaviors on their families.J Abnorm Child Psychol. 1993;21:179-198.
25.
Eyberg SM, Boggs SR, Rodriquez CM.Relationships between maternal parenting stress and child disruptive behavior. Child Fam Behav Ther. 1992;14:1-9.
26.
Heller TL, Baker BL, Henker B, et al.Externalizing behavior and cognitive functioning from preschool to first grade: stability and predictors. J Clin Child Psychol. 1996;25:376-387.
27.
Mesman J, Koot HM.Common and specific correlates of preadolescent internalizing and externalizing psychopathology.J Abnorm Child Psychol. 2000;109:428-437.
28.
Cuskelly M, Chant D, Hayes A.Behavior problems in the siblings of children with Down syndrome: associations with family responsibilities and parental stress. Int J Disabil Dev Edu. 1998;45:295-311.
29.
Mobarak R, Khan NZ, Munir S, et al.Predictors of stress in mothers of children with cerebral palsy in Bangladesh. J Pediatr Psychol. 2000;25:427-433.
30.
Ross CM, Blanc HM, McNeil CB, et al.Parenting stress in mothers of young children with oppositional defiant disorder and other severe behavior problems. Child Stud J. 1998;28:93-110.
31.
American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 4th ed.Washington, DC: American Psychiatric Association; 1994.
32.
Schroeder CS, Gordon BN.Assessment and Treatment of Childhood Problems: A Clinicians Guide. New York: Guilford Press; 1991.
33.
Walker CE.Elimination disorders: enuresis and encopresis. In: Roberts MC, ed. Handbook of Pediatric Psychology. 2nd ed.New York: Guilford Press; 1995:537-557.
34.
Achenbach TM.Manual for the Child Behavior Checklist4-18. Burlington, VT: University of Vermont, Department of Psychiatry; 1991.
35.
Abidin RR.Parenting Stress Index Short Form: Test Manual. Charlottesville, VA: Pediatric Psychology Press; 1990.
36.
Hassink EA, Brugman-Boezeman AT, Robbroeckx LM, et al.Parenting children with anorectoal malfunctions: implications and experiences. Pediatric Surg Int. 1998;13:377-383.
37.
Gabel S, Chandra R, Shindledecker R.Behavior ratings and outcome of medical treatment for encopresis. J Dev Behav Pediatr. 1988;9:129-133.
38.
Gabel S, Hegedus AM, Wald A, et al.Prevalence of behavior problems and mental health utilization among encopretic children: implications for behavioral pediatrics. J Dev Behav Pediatr. 1986;7:293-297.
39.
Liu X, Sun Z, Uchiyama M, et al.Attaining nocturnal urinarycontrol, nocturnal enuresis, and behavioral problems in Chinese children aged 6 through 16 years. J Am Acad Adolesc Psychiatry. 2000;39:1557-1564.
40.
Vivian D, Fischel JE, Liebert RM.Effect of “wet nights” on daytime behavior during concurrent treatment of enuresis and conduct problems. J Behav Ther Exp Psychiatry. 1986;17:301-303.
41.
Young MH, Brennen LC, Baker RD, et al.Functional encopresis: symptom reduction and behavioral improvement. J Dev Behav Pediatr. 1995;16:226-232.
