Parenting Stress and Abuse Potential in Mothers of Children with Developmental Disabilities

Most research on parenting stress and abuse factors in parents of children with developmental disabilities has relied almost exclusively on Caucasian, middle-income, intact families. The current study investigated the generalizability of previous findings, examining the relations among parenting stress, abuse potential, and child's intellectual/adaptive functioning in a sample of low-income African American mothers of children with developmental delays. Thirty-three maternal caregivers completed the Child Abuse Potential Inventory and the Parenting Stress Index. Results indicated significant parenting stress, particularly aspects related to the child, as well as considerable physical abuse potential. Parenting stress was strongly correlated with abuse potential, particularly stress related to parental attributes. Neither parenting stress nor abuse potential were significantly correlated with the child's intellectual or adaptive functioning. Concerns regarding the appropriateness of these measures with this population and the need for controlled studies are discussed. Article: As the mechanisms that contribute to child mal-treatment undergo increasing research scrutiny, specific at-risk populations have been targeted for study. Several literature reviews report an elevated incidence of abuse and neglect in children with disabilities (Ammerman, Van Hasselt, & Hersen, 1988; Starr, Dietrich, Fischhoff, Ceresnie, & Zweier, 1984; Westcott, 1991), although estimates vary widely, largely because of methodological differences. Minimal research with the disability population has examined potential for physical abuse in unidentified perpetrators, Reliance on imperfect reporting and investigatory procedures to detect abuse may lead to distorted estimates of the incidence of maltreatment in children with disabilities because of numerous biases in such procedures. The rationale for studying the potential for abuse in "normal" or "high-risk" parents stems from the belief that the potential to physically abuse children lies on a continuum, with such parents providing valuable insights that may apply to their peers further along the risk continuum. One study that did investigate the potential for physical maltreatment in mothers of children with disabilities found risk scores comparable to the normative sample (Kirkham, Schinke, Schilling, Meltzer, & Nerelius, 1986), leading some to question whether children with disabilities are indeed at risk for abuse. Children with disabilities are generally regarded as at risk for abuse and neglect theoretically because of such factors as early separation and disrupted attachment and disappointment, as well as increased care-taking demands and stress (Ammerman et al., 1988). Characteristics of the child, such as increasing age, type of disability, unusual care-giving demands, and difficult behavior, may exacerbate stress (Gallagher, Beckman, & Cross, 1983). Some have suggested that the degree of disability may also influence parental response (Westcott, 1991). Parental expectations and beliefs as well as contextual factors, such as social support networks, marital status, and income (Gallagher et al., 1983) may also affect parental behavior toward a child with disabilities. Parenting stress has been consistently linked with abusive parenting behaviors in various populations (Chan, 1994; Webster-Stratton, 1988). Webster-Stratton (1990) highlights the need to conceptualize stress in broad terms and to incorporate several contributing factors (e.g,, marital conflict, isolation, health concerns). This point addresses the intrinsic problem in considering individual stressors in isolation from others. Stress arising from the parent-child interaction, including parentas well as child-related factors, has also correlated with physical child abuse potential (Talbott, cited in Milner, 1986). High parenting stress appears especially prevalent in parents of children with disabilities. Compared to a matched sample of parents of a child without disabilities, parents of children with disabilities obtained significantly higher parenting stress scores; these higher scores involved stress associated with both parentand child-related characteristics, with mothers of children with disabilities attaining mean scores at about the 90th percentile (Beckman, 1991), Several studies have found that parenting stress in this population appears in particular to involve child-related, rather than parent-related characteristics (Boyce, Behl, Mortensen, & Alcers, 1991; Cameron, Dobson, & Day, 1991; McKinney & Peterson, 1987; Noh, Dumas, Wolf, & Fisman, 1989). Some researchers suggest that high parenting stress would not place children with disabilities at risk for maltreatment. A study of mothers of children with disabilities found that stress did not account for significant variance in child abuse potential scores (Kirkham et al., 1986). Moreover, families of children with multiple disabilities who had a history of substantiated abuse were compared to nonreported families who had children with disabilities, and no significant differences were found in current stress between the groups (Benedict, Wulff, & White, 1992), Another study reported mean stress scores, both parentand child-related aspects, comparable to the normative sample (Krauss, 1993). Such findings reflect several authors' interpretation that despite significant stressors, families of children with disabilities adapt and accommodate without significant impact on family functioning (Gallimore, Weisner, Bernheimer, Guthrie, & Nihira, 1993; Kazak & Marvin, 1984; Saddler, Hillman, & Benjamins, 1993). However, research on stress and child-abuse-related factors in parents of children with disabilities has relied almost exclusively on homogeneous samples of Caucasian, middle-income, intact families. Several studies neglected to report the ethnic composition of their study samples, apparently not considering race a pertinent issue (Cameron et al., 1991; Kazak & Marvin, 1984; Krauss, 1993), Many studies report predominantly or entirely Caucasian samples (Beckman, 1983, 1991; Boyce et al., 1991; Dyson, 1991, 1993; Kirkham et al., 1986; McKinney & Peterson, 1987), In addition, those studies reporting the socioeconomic status of their samples describe their samples as middle income or above (e.g., Beckman, 1983, 1991; Dyson, 1991, 1993; Gallimore et al., 1993; Saddler et al., 1993). Moreover, studies primarily involve families with two parents present (e.g., Beckman, 1983, 1991; McKinney & Peterson, 1987; Dyson, 1991, 1993; Gallimore et al., 1993; Krauss, 1993; Saddler et al., 1993), Some of these authors acknowledge the limitations of interpreting findings due to their sample characteristics (Beckman, 1991; Boyce et al., 1991; Dyson, 1991, 1993). Understandably, stress in parents of children with disabilities is likely to be intensified by such factors as low socioeconomic status and single-parent status (see Gallagher et al., 1983, for discussion). Indeed, the relationships among stress, socioeconomic status, and family composition may be particularly relevant for families raising children with disabilities. Various environmental factors may contribute to developmental delay, including such variables as poverty and unemployment, single or teenaged parenting, limited parental education, and parental mental health (Bernstein, Hans, & Percansky, 1991; Roth, 1982), Abuse reporting is higher for individuals who are unmarried, unemployed, poorly educated, and with low incomes (Benedict, White, Wulff, & Hall, 1990). A group of parents of children with disabilities reported for maltreatment typically included individuals who were unmarried, had less education, and were more frequently African American (Benedict et al., 1990, Benedict et al., 1992). Another study of predominantly Caucasian mothers reported that single mothers of children with disabilities obtained higher child abuse potential scores than married mothers (Kirkham et al., 1986). Mothers raising children with disabilities on their own also report higher stress than those in two-parent homes (Quine & Pahl, 1985). One study has made an effort to confront some of these issues, exploring stress and family functioning in low-income Mexican mothers of children with physical disabilities (Shapiro & Tittle, 1986). Yet, some studies have concluded that parents raising children with disabilities may not experience higher parenting stress (Krauss, 1993), that stress is unrelated to abuse potential (Kirkham et al., 1986), and that these families adjust despite stressors (Gallimore et al., 1993). Before such interpretations can be offered, more research clearly needs to involve projects with individuals more likely to encounter the stressors that complicate raising a child with disabilities. Because the applicability of prior findings to low-income African American families is unclear, the purpose of the current study was to examine the parenting stress and child abuse potential in a sample of low-income African American mothers of children with developmental disabilities. The relations of child and family characteristics with stress and abuse potential were also investigated.