In all families, each member influences others and, in turn, is influenced by family context. One member's disability affects the total family ecology-- parents, siblings, and even extended family members. MR members challenge families by making demands on their time, psychological well-being, social relationships, economic resources, and freedom of movement. Mental retardation, physical or sensory impairment, or chronic illness in a family member can restrict the family's functioning and impinge on the other members' emotional well-being in ways the general public may not experience ( Darling, 1979, 1980; Hoffmaster, 1982; Ursprung, 1990). The parents' decision to have a child was not the decision to have an MR child ( Hauerwas, 1982). Although public perceptions of disability may be altered and the social stigma of disability reduced ( Biklen, 1986; Bogdan, 1988; Gliedman & Roth, 1980; Yuker, 1988), parents inevitably prefer to have healthy, intellectually sound children ( Paul, Porter, & Falk, 1993).
In discussing family response to an MR member, distinctions can be made based on characteristics of the MR individual and the nature of the family. One influence is the degree of impairment and the prognosis for future functioning, such as the likelihood of independence ( Konstantareas & Homatidis, 1992). Another involves financial circumstances, employment status, age, and health of affected family members ( Gerstel & Gallagher , 1993; Paul, Porter, & Falk, 1993). Whether the disability is readily apparent (and intrusive or disruptive) or is mainly concealed in daily life also influences response ( Barnes, 1991; Wright, 1959, 1988).