Academic journal article Exceptional Children

Coping and Adaptation in Families of Children with Cerebral Palsy

Academic journal article Exceptional Children

Coping and Adaptation in Families of Children with Cerebral Palsy

Article excerpt

The family is the major influence affecting the growth and development of children. When families have a member with very special needs, all family members will be affected (Fewell, 1986). Cerebral palsy (CP) is a complex condition (Schleichkorn, 1983) that may cause a variety of challenges for children and their families. Depending on its location and severity, the brain injury that causes a child's movement disorders may also cause other problems (Gersh, 1991a; Miller et al., 1995; Schleichkorn) that need special care (Gersh, 1991b). Families that provide the lifetime care of a child with CP face unique stressors and demands over the life cycle (Cowan, 1991; M. A. McCubbin & Huang, 1989; Orelove & Sobsey, 1991; Thompson, Rubin, & Bilenker, 1983). Family ability to adjust to such long-term disabilities may be exhausted over time as changes occur in the situation (Cleveland, 1989; Johnson, 1985; Leventhal, Leventhal, & Van Nguyen, 1985).

In the past, most of the literature focused on the negative impact or outcomes for these families. More recently, concerns and efforts have shifted to explore how families manage the demands or situations resulting from the long-term care of members with disabilities (H. I. McCubbin et al., 1982). This shift emphasizes the examination of how families cope with and adapt to a difficult situation when their family members have chronic illnesses or disabilities (e.g., Kosciulek, 1993, 1994; H. I. McCubbin et al.). The present study also reflects this trend.

Some current research has shown that positive coping strategies can predict or facilitate family adaptation. The results of Middlebrook's (1987) study indicated that family coping was related to the outcome, and that coping strategies varied depending upon the source of stress encountered. When compared with other variables (e.g., pile-up of life stressors, marital satisfaction, socioeconomic status), coping strategies were found to significantly predict the family outcome. The results of Failla and Jones' (1991) study also revealed that the variance in family functioning could be predicted by the following four variables: (a) family hardiness, (b) total functional support, (c) parental age, and (d) family stressors. Further, Bristol (1987) found that adaptation could be positively predicted by adequate social support and coping strategies. This finding was supported by the Kosciulek (1993/1994) study. Kosciulek's study showed that the variance in family adaptation to head injury situation was explained by the joint prediction of two of the family coping variables: (a) positive appraisal and (b) family tension management.

Although research on children with disabilities and their families is abundant in the literature, few studies are based on explicit conceptual frameworks designed to explain how family coping behaviors might contribute to general outcomes (i.e., adaptation) in the family of persons with CP. To provide appropriate contextual information relating to the potential plausibility for this study, its theoretical framework was drawn from the Resiliency Model of Family Stress, Adjustment, and Adaptation (M. A. McCubbin & H. I. McCubbin, 1993/1996) and the family life cycle theory (Duvall, 1962; Turnbull & Turnbull, 1997).

The most important proposition of the Resiliency Model of Family Stress, Adjustment, and Adaptation (see Figure 1) is that effective family coping strategies can facilitate positive family adaptation (Kosciulek, 1993/1994; M. A. McCubbin & H. I. McCubbin, 1993/1996). In this Model, family coping is defined by M. A. McCubbin and H. I. McCubbin (1993) as "a specific effort (covert or overt) by which individual members in the family or the family function as a whole" to decrease or handle a demand on the family and to acquire resources to manage the situation associated with the demand (p. 55). Family adaptation is further defined as "the outcome of family efforts to bring a new level of balance, harmony and functioning to family crisis situations" (M. …

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