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Functional limitations and family stressors worsen psychosocial adjustment among disabled school-aged children

Disabled children with learning impairments and family burdens such as poverty or maternal depression are more likely to have poor psychosocial adjustment than other disabled children, according to a study supported in part by the Agency for Healthcare Research and Quality (HS11254 and National Research Service Award training grant T32 HS00063).

Whitney P. Witt, Ph.D., M.P.H., of Northwestern University and formerly of Johns Hopkins University, and colleagues analyzed data from the 1994 and 1995 National Health Interview Surveys, Disability Supplement, which provide data on a nationally representative sample of disabled children aged 6 to 17 years and their mothers. They examined the association between the children's functional status, family stressors, and psychosocial adjustment.

Over one-fifth of disabled children suffered from more than one functional limitation, and 11 percent experienced poor psychosocial adjustment, especially in the areas of peer relations (17 percent) and hostility (13 percent). Nearly one-quarter of the families reported substantial work, sleep, or financial problems as a result of the child's disability.

Physical limitations by themselves were not detrimental to children's psychosocial adjustment. Children with self-care or mobility problems did not have significantly different psychosocial adjustment scores than disabled children without such problems.

On the other hand, children with disabilities who also had limitations in learning or communication were 4 and 1.6 times, respectively, more likely to experience adjustment problems than disabled children without these limitations. Mothers with poor health and distress or depression were 70 and 90 percent more likely, respectively, to have a child who was maladjusted. When mothers reported that the child's disability caused a work, sleep, or financial burden and when families were impoverished, children were about twice as likely to have poor psychosocial adjustment as disabled children without these problems. These findings underscore the need to support the mental health care needs of all family members in order to foster good mental health in children with disabilities.

See "Childhood functional status, family stressors, and psychosocial adjustment among school-aged children with disabilities in the United States," by Dr. Witt, Anne W. Riley, Ph.D., and Mary Jo Coiro, Ph.D., in the July 2003 Archives of Pediatric and Adolescent Medicine 157, pp. 687-695.

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