Much of the available literature discusses the problems that parents who have children with special needs (CWSN) report regarding how their child’s condition affect their psychological and emotional functioning. Parenting children with special needs may have an adverse effect on their general well-being (Cummings, Bayley & Rie, 1966; DeMyer, 1979). Plienes (1991) found out that programs which trained parents of children with autism (CWA) demonstrated effectiveness but gave dissimilar effects. The clearest finding that emerged from his study was his analysis between mother-reported stress and child progress level, which he found to have a strong relationship. This study explains that when a child who has special needs does not show much progress, a higher level of stress is perceived by the parents, specifically, the mothers.
Autism is one of the more common disability found among children, and parents of children with autistic spectrum disorders (ASD) are more likely to suffer from psychological distress compared to parents whose children were diagnosed with other developmental disabilities. Raising CWA can present challenges to mothers as reported by Boyd (2002) who examined the relationship between stress and lack of social support in mothers of CWA. He found that the more challenging the child’s condition is, the more that the mother pursues support. If support is not sought, development of depression and anxiety was postulated for these mothers.
Psychiatric disorders, such as anxiety and depression can occur in parents of children who have special needs more than among parent of typically developing children. Anxiety can result from the uncertainty of what the future holds for their child, while depression can come from the parental guilt and frustrations on the child’s condition. Mothers of CWA and children with behavior disorders are at a risk of experiencing dysphoria, which seems to be linked to the stresses brought on by parenting a child with special needs (Dumas, 1991). Parents who have a child with serious mental health problems were seen to have elevated levels of depression and even alcohol symptoms at mid-life (Seltzer, Greenberg, et al., 2003). Inconsistent findings reveal that parents who have CWA were found to have more psychiatric difficulties than among parents who have children with other developmental disabilities (Shaked & Yirmiya, 2004).
Self-efficacy is the perceived capability of the individual to perform in a certain manner to achieve his set goals and manage his current situations (Ormrod, 2006). It has been identified in general parenting literature that self-efficacy is an important factor that affects parental outcomes. Among mothers of children who have CWA, it was found out that the child’s behavior problems contribute to their anxiety and depression thereby mediating effects on maternal self-efficacy (Hastings & Brown, 2002).
Parenting CWA entails increased focus and attention on the child’s behavior and special needs. The daily stress that this issue puts on the shoulder of the parents can create an impact on their executive functions. Relatively poor planning skills and attention flexibility were seen among parents of CWA (Bouvard, Hughes & Leboyer, 1997). This group of parents has been identified to experience statistically and clinically higher levels of parenting stress compared to parents who have children with Down Syndrome, behavior disorders and of normally-developing children. Parents who have children with behavioral disorders report statistically and clinically intense and numerous behavioral difficulties than those of others (Dumas, 1991).
Consistent stress profiles of mothers who have CWA were studied and compared by Koegel (1992) across different geographic environments and children’s ages and children’s level of functioning. The study concludes a characteristic profile that was highly consistent among the subgroups. Stress measure levels were found out to have differed, however, in relation to the different maternal variables (i.e. age, educational level, etc.). This study suggests that the stress of parenting a CWA is felt by all the mothers despite the context, and the disparity lies on the levels of stress caused by individual variable differences.
In literature, studies that explored on parental distress from raising a child with special needs seem to have focused on mothers. The results of the studies also showed that mothers are more likely to be vulnerable than fathers are to the stressful events surrounding their exceptional conditions. Assertion can be made that these gender-based differences can be related to their coping strategies (Gray, 2002).
Focus on understanding the effect of parenting a child with special needs on the fathers has been neglected in the past. In recent years, a number of studies have explored this neglected area. One of them was done by Rodrigue, Morgan and Geffken in 1992 which studied fathers of children who have autism, Down syndrome and those who are normally-developing. On measures of intrapersonal and family functioning, the three subgroups differed significantly, with the fathers of children with special needs reporting an increased use of wish-fulfilling fantasy and information seeking as coping strategies than those of their regular counterparts. Over-all, the authors suggest that fathers adapt relatively well, probably even better than the mothers, with the demands associated with stresses of raising a child with special needs.
Researches on parents of Filipino children with special needs that relate to their psycho-emotional problems, experiences and dynamics have come to surface during the 90’s and have been pursued until the present. Most of these researchers identified the needs of the parents or described coping strategies that these parents employ to cope with the crisis that their family faces (Camara, 2007).
Coping strategies of mothers who have CWA seem to be mediated by the stress they perceived secondary to their socioeconomic status and the level of support these mothers receive from their social system. These findings were true for both working and non-working mothers (Alvares, 2004).
The Philippine public school system has a special education bureau that takes care of the educational needs of children who have special needs. Binoya (2003) undertook a study to describe the coping capacity of parents whose children were enrolled in SPED classes in selected public schools in Manila. The study reveals that parental stress can be due to difficulty of the parents in monitoring their child’s academic performance; the burden of financially supporting their children’s special needs; fear of having another child, the extra effort they have to exert to relate with their special needs child and, the fear that they cannot leave their special child alone. The authors noted how parents of CWA seemed to have coped better than those who have children with Down syndrome.
If parents of children with special needs seem to face a good amount of stress from balancing their family life and taking special care of their child, one could just surmise the stress that single parents take on. Single parents of CWA experience stress related to the characteristics of their CWA along with the stress of everyday living, financial difficulties, concerns for the future, excessive time demands and the apparent lack of community awareness on autism (Foronda, 1998).
Another area of focus that is worth to mention is the reactions and effects of raising a child with special needs to the fathers. In a recent study conducted by Del Rosario (2008), she states that of the 20 subjects, all of whom are fathers of CWA, experienced emotional distress upon the diagnosis of their child. Emotions of disbelief, denial, sadness and devastation were expressed. It is important to note though that the fathers do not seem blame themselves or other people for their own and their child’s condition. The primary worry of these fathers of CWAs was the uncertainty of what the future holds for their child.
The education of children with special needs is another area that should be considered in analyzing the stress factors that interplay in the dynamics of family life between the parents. Concerns regarding the interventions (Joaquin, 2002) and special education services of CWA (Sandoval, 2001) reveal additional stress brought about by socio-economics and uncertainty of the special child’s future.
Majority of the available literature that dwells on describing the effects of having a child with special needs on parents tackle parental stress. Very few have been found that particularly talk about how such antecedent links to parental health problems. The available literature should also be scrutinized as to whether the health condition experienced by the parents is actually brought on by parenting a child with exceptionality, as some disabilities can be genetic or hereditary.
Stress and health are related (Serafino, 2005). The attack of stress on an individual can induce biologic reactions such as dizziness, tension, loss of sleep and muscle cramps, and all can contribute to health problems. In the long run stress can also affect the individual’s immune, cardiovascular and nervous systems. Therefore, the parental psychological distress discussed previously can be a trigger or an important determinant in an assortment of physical symptoms and disease processes.
The daunting task of caring for a child who has special needs requires special parenting and/or care-giving skills which can be detrimental to the physical health of their parents or caregivers. Raina, O’Donnel, Rosenbaum, Brenhaut, Walter, Russel, Swinton, Zhu & Wood (2005) found that the most important predictors of these children’s caregivers were the behavior of their child, the demands of the task and the family function.
The consequent stresses of parenting CWA can impose physical strains (Wolf, Hoh, & Fisman, 1989). Children who have been diagnosed with autism exhibit symptoms that are physically straining on their parents. Their apparent atypical behavior such as self-injury, self-stimulation, and inability to display the malaise of symptoms of further conditions found in regular children, might prove to be a handful to the mothers and fathers. Scenarios of running around for their CWAs, physically prompting and sleepless nights are pretty common.
Play behavior and skills are other areas affected by the autism. Silver and Sigman’s (2002) study showed that caregivers of CWAs who showed higher levels of synchronization during play interactions could develop the child’s communication skills among the parental subjects he has employed. If this is true, then we could expect their parents trying exert the extra effort in playing with their CWA. Running and jumping around the playground and parks, increased energy levels during dyadic play, louder and livelier voice projections are some behaviors that parents use during play time.
Seltzer, Greenberg, Floyd, Peete & Hong (2005) presents the life course impacts of parenting a child with disability. Their research reveals the physical health of parenting a child with special needs was similar to those of parents who have children without disabilities. Moreover, it is with parents whose child has serious mental health problems that they found elevated levels of physical symptoms.
The practical daily routines and needs of children with cerebral palsy create a big challenge for their parents. Cerebral Palsy in a neurological disorder characterized by motor difficulties and in some cases consequent mental and developmental limitations, brought on by damage to the immature brain. Raina, et al., (2005) proposes a biopsychoscial framework to explain how the condition of the child with cerebral palsy creates physical and psychological distress on the parents, and that a family-centered program based on such model should be created. Such framework should also be examined with the parents and/or caregivers of children with other disabilities.
Murphy, Christian, Caplin & Young (2007) explored the perspectives of caregivers of children with disabilities. Caregivers can be parents, grandparents or other individuals who are primarily in-charge with direct caring for the child who has special needs. The authors stipulate that in order to sustain quality assistance given by the caregivers, knowledge should be gained on their health-related needs. Their findings show that forty-one per cent of the respondent caregivers reported that their health had worsened over the past year due to the consequent lack of time, a lack of control and decreased psychosocial energy brought about by their roles. They also described perceived negative and functional health consequences of long-term, informal care giving of disabled children.
Literature in the Philippines tackling the aforementioned physical health status of parents of children with special needs mirror those of its counterpart; it is limited and unspecific. Filipino parents of CWAs were studied by Foronda (1998) and Liwag (1997) on two separate but related studies. These parents according to their study, majority of them mothers, exhibited stress that affected their physical health. Liwag (1997) reports that half of the mothers she studied had to quit their careers and felt more tensed when compared to the norms. Foronda (1998) on the other hand, relates that the stress the parents felt were due to the characteristics of their CWA, which is parallel to the previous studies in the international scene. Additional stress accounts for the everyday life with their CWA which can be exhausting and tiresome. Excessive demands on time in taking care of the CWA’s daily routines, behavior management, educational matters and emotional needs also proved to be significant factors.
Binoya (2003) expounded on the problems of parents whose children with special needs were enrolled in public schools in Manila. He found that stress arising from difficulty of monitoring their child’s academic performance burdened these parents and affected their state of physical health.
In 2007, Bayle conducted a research among the stress and coping strategies of Filipino parents of children who have attention deficit and hyperactivity disorder (ADHD). The child’s symptoms of over-activity and restlessness were pointed out as stressful factors affecting their parents. It was reported that because of the behavioral characteristics their children manifest, the parents feel a sense of need to look after their children at all times.
Although Filipino fathers seem to exhibit different levels of stress reactions compared to mothers, this does not mean that they do not feel the burden caused by the exceptional needs of their children. Filipino fathers of CWA as studied by Del Rosario (2008) seemed to be more affected psychologically, among other areas, and do not mention the physical health consequence of their situation.