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Children's Medical Services - Special services for children with special needs
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Infant Toddler Development Training
Module 5, Lesson 1

Family Stress

mother holding babyThe stress that may accompany raising a child with disabilities can be greater on those families than in the general population (Hendriks, DeMoor, Oud, & Savelberg, 2001; Smith, Oliver, & Innocenti, 2001). Many variables impact family stress. The age at diagnosis, specific disability and culture are among these variables. Some children are diagnosed at birth, others when they are one or two years old and occasionally, even older. Some disabilities require intense medical intervention and support, others require adaptive equipment and/or accommodations, while still others need intensive behavioral interventions (Lessenberry & Rehfeldt, 2004). Cultural views of disabilities can also add to stress.

Whatever the disability, the impact on the family occurs on a daily basis with differing degrees of intensity. It is important to be aware of the implications, not only of disabilities' affects on development and learning, but also potential limitations in life style and options for these families. For example, consider some of the following questions:

  1. How does having a child who is medically fragile and confined to a wheelchair affect family outings and vacations?
  2. How does having a child with severe emotional disturbance affect the family interactions among all of its members?
  3. How does the stress families experience in raising a child with disabilities affect the child's development and sense of self?
  4. How does having a child with any disability that is covered by insurance affect the degree of mobility parents have to leave current positions and pursue new work with different employers?
  5. What challenges do families who have children with disabilities face when looking for child care?

Hierarchy of Needs

The stress a family is under may have nothing to do with the disability. Whatever its source, stress may get in the way of what a professional hopes to achieve. Many times, the source of the stress must be dealt with before interventions can begin. For instance, if the mother is concerned about her ability to pay her electric bill due to medical expenses, she may not be receptive to the latest technology her service provider brings to her house to try with her son. Even if the provider tells her it will help with her son's ability to communicate, her attention is focused elsewhere.

It is good to think about Maslow's Hierarchy of Needs when we are trying to understand what is important for families when they don't seem to be open to our suggestions. Maslow theorized that human beings have needs for certain things and these needs are hierarchical in nature. In other words, basic needs must be met before we can pay attention to higher order needs. The model he used was a pyramid. At the base are physiological needs (food, water, shelter, warmth), followed by needs for safety (security, stability, freedom from fear), then needs for belonging/love (friends, family, spouse, lover), self-esteem needs (achievement, recognition, mastery, respect) , and finally at the top, needs for self-actualization (pursuing inner ability, fulfillment, creativity).

mother reading to childFamilies may be stressed because they are focusing on the physiological and safety levels in their lives, while we are suggesting an intervention or service that they can't begin to think about until more pressing needs are dealt with. Families are at different places for a variety of reasons.

What do parents share as their concerns or worries and how is this affected by culture and values? What does understanding Maslow's Hierarchy of Needs tell us about families' competing needs, concerns and priorities?


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