Caregiver Practices of Families of Children with and Without Physical Disability

  • Mary Gannotti
  • Toko Oshio
  • W. P. Handwerker


Reports suggest children with physical disability are at greater risk than peers for negative caregiver interactions. The environmental, parental, and child characteristics associated with variation in caregiver practices among families of children with (n = 450) and without physical disability (n = 450) in a nationally representative sample from the U.S. Agreement and variation about the shared meaning of “caregiver practices” were measured using consensus analysis. Associated parent, child, and family characteristics were identified using regression analysis. Parents did not spank, hit back, yell, ignore, put to work, or make fun of their children as a punishment. Parents maintained rules set about eating, bedtime, chores, and watching television. They reported playing with children, preparing food for them, going to religious services, reading, singing songs, and telling stories with their children. They reported not being involved in organized exercise and art classes. Child’s socio-emotional skills and behaviors (β = −.331), socio-economic status (β = −.223), the influence of religion on raising child (β = −.180), race/ethnicity of the parent (β = −.071), and physical disability (β = −.104) explained 24 % of the variance in caregiver practices (F = 32.34, p < .000). More negative caregiver practices are associated with families of children with lower levels of socio-emotional skills and behaviors, lower socio-economic status, less religious influence on child rearing practices, who are not Euro-American, or whose children have physical disability. Children’s socio-emotional skills and behaviors explained the largest amount of variance in caregiver practices, not disability status. Health professionals working with children with physical disability should target developing socio-emotional skills to support positive child-parent interactions and promote positive outcomes.


Disability Children Parenting Culture 


  1. Andreassen, C., & Fletcher, P. (2005). Early childhood longitudinal study, birth cohort (ECLS–B), psychometric characteristics. Volume 1 of the ECLS-B methodology report for the nine-month data collection (NCES 2005–100). Washington, DC: U.S. Department of Education, National Center for Education Statistics.Google Scholar
  2. Arcia, E., Keyes, L., & Gallagher, J. J. (1994). Indicators of developmental and functional status of Mexican-American and Puerto Rican children. Journal of Developmental and Behavioral Pediatrics, 15(1), 27–33.PubMedCrossRefGoogle Scholar
  3. Baumrind, D. (1966). Effects of authoritative parental control on child behavior. Child Development, 37(4), 887–907.CrossRefGoogle Scholar
  4. Bernheimer, L., Gallimore, R., & Weisner, T. (1990). Eco-cultural theory as a context for the individual family service plan. Journal of Early Intervention, 14(3), 219–233.CrossRefGoogle Scholar
  5. Bornstien, M. (2002). Handbook of parenting: Children and parenting (Second ed., Vol. 1). New York: Routledge.Google Scholar
  6. Bronfenbrenner, U. (2005). Making human being human: Bioecological perspectives on human development. Thousand Oaks, CA: Sage.Google Scholar
  7. Button, S., Pianta, R., & Marvin, R. (2001). Partner support and maternal stress in families raising young children with cerebral palsy. Journal of Developmental and Physical Disabilities, 13(1), 61–81.CrossRefGoogle Scholar
  8. Cintas, H. L. (1995). Cross-cultural similarities and differences in development and the impact of parental expectations on motor behavior. Pediatric Physical Therapy, 7(3), 103–111.CrossRefGoogle Scholar
  9. Cunningham, S. D., Warschausky, S., & Thomas, P. D. (2009). Parenting and social functioning of children with and without cerebral palsy. [Research support, N.I.H., extramural research support, U.S. Gov’t, Non-P.H.S.]. Rehabilitation Psychology, 54(1), 109–115.PubMedCrossRefGoogle Scholar
  10. D’Andrade, R. (1995). The development of cognitive anthropology. Cambridge: Cambridge University Press.CrossRefGoogle Scholar
  11. Dressler, W. W., Balieiro, M. C., Ribeiro, R. P., & Dos Santos, J. E. (2009). Cultural consonance, a 5HT2A receptor polymorphism, and depressive symptoms: a longitudinal study of gene x culture interaction in urban Brazil. [Research support, Non-U.S. Gov’t research support, U.S. Gov’t, Non-P.H.S.]. American Journal of Human Biology, 21(1), 91–97. doi: 10.1002/ajhb.20823.PubMedCrossRefGoogle Scholar
  12. Gallimore, R., Weisner, T., Kaufman, S., & Bernheimer, L. (1989). The social construction of ecological niches: family accommodation of developmentally delayed children. American Journal on Mental Retardation, 94(3), 216–230.PubMedGoogle Scholar
  13. Gannotti, M. E., Handwerker, W. P., Groce, N. E., & Cruz, C. (2001). Sociocultural influences on disability status in Puerto Rican children. [Research support, Non-U.S. Gov’t]. Physical Therapy, 81(9), 1512–1523.PubMedGoogle Scholar
  14. Green, P. J., Hoogstra, L. A., Ingels, S. J., Greene, H. N., & Marnell, P. K. (1997). Formulating a design for the ECLS: Review of longitudinal studies (Working paper no. 97-24). Washington, DC: U.S. Department of Education, National Center for Education Statistics.Google Scholar
  15. Gresham, F. M., & Elliott, S. N. (1990). Social skills rating system manual. Circle Pines, MN: American Guidance Service.Google Scholar
  16. Handwerker, W. P. (2001). Quick ethnography: A guide to rapid multi-method research. Walnut Creek, CA: Altamira Press.Google Scholar
  17. Harwood, R., Miller, J., & Izzarry, N. (1997). Culture and attatchment: The child in context. New York: Guilford Press.Google Scholar
  18. Iverson, M., Shimmel, J., Ciacera, S., & Prabhakar, M. (2003). Creating a family-centered approach to early intervention services: perceptions of parents and professionals. Pediatric Physical Therapy, 15, 15–31.Google Scholar
  19. Ketelaar, M., Volman, M. J., Gorter, J. W., & Vermeer, A. (2008). Stress in caregivers of children with cerebral palsy: what sources of stress are we talking about? [Research support, Non-U.S. Gov’t]. Child: Care, Health and Development, 34(6), 825–829. doi: 10.1111/j.1365-2214.2008.00876.x.CrossRefGoogle Scholar
  20. Maccoby, E. E., & Martin, J. A. (1983). Socialization in the context of the family: Parent-child interaction. In P. H. Mussen & E. M. Hetherington (Eds.), Handbook of child psychology: Vol. 4 socialization, personality, and social development (4th ed., pp. 1–101). New York: Wiley.Google Scholar
  21. Majnemer, A., Shevell, M., Law, M., Poulin, C., & Rosenbaum, P. (2012). Indicators of distress in families of children with cerebral palsy. Disability and Rehabilitation, 34(14), 1202–1207. doi: 10.3109/09638288.2011.638035.PubMedCrossRefGoogle Scholar
  22. McCubbin, H. L., & Patterson, J. M. (1983). The family stress process: The double ABCX model of family adjustment and adaptation. In H. L. McCubbin, M. Sussman, & J. Patterson (Eds.), Social stress and the family: Advances and developments in family stress theory and research (pp. 7–37). New York: Haworth.Google Scholar
  23. Merrell, K. M. (2003). Preschool and kindergarten behavior scales. Second Edition (PKBS-2). Accessed October 27 2006.
  24. Murphy, N., Caplin, D. A., Christian, B. J., Luther, B. L., Holobkov, R., & Young, P. C. (2011). The function of parents and their children with cerebral palsy. The Journal of Injury, Function, and Rehabilitation, 3(2), 98–104. doi: 10.1016/j.pmrj.2010.11.006.CrossRefGoogle Scholar
  25. Najarian, M., Snow, K., Lennon, J., & Kinsey, S. (2010). Early childhood longitudinal study, birth cohort (ECLS-B), preschool–kindergarten 2007 psychometric report (NCES 2010-009). Washington, DC: National Center for Education Statistics, Institute of Education Sciences, U.S. Department of Education.Google Scholar
  26. Nihira, K., Weisner, T., & Bernheimer, L. (1994). Ecocultural assessment in families of children with developmental delays: construct and concurrent validities. American Journal on Mental Retardation, 98(5), 551–566.PubMedGoogle Scholar
  27. Olrick, J., Pianta, R., & Marvin, R. (2002). Mother’s and father’s responses to signals of children with cerebral palsy during feeding. Journal of Developmental and Physical Disabilities, 14(1), 1–17.CrossRefGoogle Scholar
  28. Olson, D. H., Sprenkle, D. H., & Russell, C. (1979). Circumplex model of marital and family systems. I: cohesion and adaptability dimension, family types and clinical applications. Family Process, 18, 3–28.PubMedCrossRefGoogle Scholar
  29. O’Neil, M., Palisano, R. J., & Westcott, S. (2001). Relationship of fherapists’ attitudes, children’s motor ability, and parenting stress to mother’s perceptions of therapist’s behaviors during early intervention. Physical Therapy, 81(8), 1412–1424.PubMedGoogle Scholar
  30. Parkes, J., Caravale, B., Marcelli, M., Franco, F., & Colver, A. (2011). Parenting stress and children with cerebral palsy: a European cross-sectional survey. [Research support, Non-U.S. Gov’t]. Developmental Medicine and Child Neurology, 53(9), 815–821. doi: 10.1111/j.1469-8749.2011.04014.x.PubMedCrossRefGoogle Scholar
  31. Radloff, L. (1977). The CES-D scale: a self-report depression scale for research in the general population. Applied Psychological Measures, 1, 385–401.CrossRefGoogle Scholar
  32. Raina, P., O’Donnell, M., Rosenbaum, P., Brehaut, J., Walter, S. D., Russell, D., et al. (2005). The health and well-being of caregivers of children with cerebral palsy. [Multicenter study research support, Non-U.S. Gov’t]. Pediatrics, 115(6), e626–e636. doi: 10.1542/peds.2004-1689.PubMedCrossRefGoogle Scholar
  33. Resch, J. A., Benz, M. R., & Elliott, T. R. (2012). Evaluating a dynamic process model of wellbeing for parents of children with disabilities: a multi-method analysis. [Research support, U.S. Gov’t, P.H.S.]. Rehabilitation Psychology, 57(1), 61–72. doi: 10.1037/a0027155.PubMedCrossRefGoogle Scholar
  34. Scott, S. (2012). Parenting quality and children’s mental health: biological mechanisms and psychological interventions. Opinion in Psychiatry, 25(4), 301–306. doi: 10.1097/YCO.0b013e328354a1c5.CrossRefGoogle Scholar
  35. Sood, E., Mendez, J., & Kendall, P. (2010). Acculturation, religiosity, and ethnicity predict mothers’ causal beliefs about separation anxiety disorder and preferences for help-seeking. Journal of Cross-Cultural Psychology, 43(3), 393–409.CrossRefGoogle Scholar
  36. Tajima, E., & Harachi, T. (2010). Parenting beliefs and physical discipline practices among Southeast Asian immigrants: parenting in the context of cultural adaption to the United States. Journal of Cross-Cultural Psychology, 41(2), 212–235.CrossRefGoogle Scholar
  37. Turnbull, A. P., Summers, J. A., & Bortherson, M. J. (1986). Family life-cycle: Theoretical and empirical implications and future direction for families with mentally retarded members. In J. J. Gallaher & P. M. Vietze (Eds.), Families of handicapped persons: Research, programs, and policy issues (pp. 45–65). Baltimore: Brookes.Google Scholar
  38. Wasserman, G., Allen, R., & Solomon, C. R. (1986). Limit setting in mothers of toddlers with physical anomalies. Rehabilitation Literature, 47(11–12), 290–294.PubMedGoogle Scholar
  39. Weisner, T. S. (1984). Ecocultural niches of middle childhood: A cross-cultural perspective. In W. A. Collins (Ed.), Development during middle childhood (pp. 335–369). Washington, DC: National Academy of Science Press.Google Scholar
  40. Weller, S., & Baer, R. (2001). Intra- and intercultural variation in the definition of five illness: AIDS, diabetes, the common cold, empacho, and mal de ojo. Cross-Cutural Research, 35(2), 201–226.CrossRefGoogle Scholar
  41. Weller, S., & Romney, A. (1988). Systematic data collection. Newbury Park: Sage Publications.Google Scholar
  42. Werner, E., & Smith, R. (1989). Vulnerable but invincible: A longitudinal study of resilient children and youth (3rd ed.). Adams Banister Cox Publishers.Google Scholar
  43. West, J., Denton, K., & Germino-Hausken, E. (2000). America’s kindergartners (NCES 2000-070). Washington, DC: U.S. Department of Education, National Center for Education Statistics.Google Scholar
  44. Whittingham, K., Wee, D., & Boyd, R. (2011). Systematic review of the efficacy of parenting interventions for children with cerebral palsy. [Research support, Non-U.S. gov’t review]. Child: Care, Health and Development, 37(4), 475–483. doi: 10.1111/j.1365-2214.2011.01212.x.CrossRefGoogle Scholar
  45. World Health Organization (Ed.). (2001). International classification of functioning, disability and health (ICF) (World Health Organization). Geneva: World Health Organization.Google Scholar

Copyright information

© Springer Science+Business Media New York 2012

Authors and Affiliations

  1. 1.Department of Rehabilitation ScienceUniversity of HartfordWest HartfordUSA
  2. 2.Department of EducationUniversity of HartfordWest HartfordUSA
  3. 3.Department of AnthropologyUniversity of ConnecticutStorrsUSA

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