Parent-child interactions and cerebral palsy: An exploratory study

Abstract

Objective: There is growing evidence that positive parent-child interactions contribute to optimal child development; however, less is known about how these interactions are impacted when a child has cerebral palsy. Developmental difficulties associated with cerebral palsy can reduce a child's active exploration and social engagement. In addition, parents are at increased risk of experiencing distress along with additional parenting demands. This study aimed to understand the contribution of the child's functional ability and parent distress to parent-child emotional availability when the child has cerebral palsy. Design: A cross-sectional exploratory study. Method: Twenty three mothers (mean age 37.3±5.7y) and their children (n=16 boys, n=7 girls; mean age 4.9±3.3y) with cerebral palsy were included. A 20 minute interaction, including free-play and structured activities (part of a larger study), was video recorded. Interactions were scored by a blinded coder using the Emotional Availability Scales. Parents also completed the Depression Anxiety Stress Scale and Pediatric Evaluation of Disability Inventory. Correlation analyses were conducted using SPSS (Version 22). Qualitative observations of video footage were made. Results: Parent depression was negatively associated with all aspects of parent-child emotional availability. Specifically, parent sensitivity (p=0.001), parent structuring (p=0.003), parent non-intrusiveness (p=0.50), non-hostility (p=0.001), child responsiveness (p<0.0001), and child involvement (p=0.006). Parent anxiety was found to be negatively associated with parent non-hostility (p=0.015) and child responsiveness (p=0.025). Parent stress was found to be negatively associated with parent structuring (p=0.051), parent non-hostility (p=0.039) and child responsiveness (p=0.031). There was no significant association between child functional ability and parent distress, or between parent-child emotional availability and child functional abilities. Qualitative differences in the way emotionally available parents implemented therapy strategies were observed. Conclusion: This study's results are consistent with wide literature showing a link between parental depression and the parent- child relationship, and extend this link to the cerebral palsy population. The importance of routine screening for parental mental health problems in early childhood intervention is highlighted by these findings. In addition, this study emphasises the need to better understand how therapists provide parent education relating to application of therapeutic strategies to ensure these do not impact on the developing parent-child relationship. A larger study is required to increase confidence in these preliminary exploratory findings.L6148362042017-03-21 <br />