Assessment & Research

The impact of Prader-Willi syndrome on the family's quality of life and caregiving, and the unaffected siblings' psychosocial adjustment.

Mazaheri et al. (2013) · Journal of intellectual disability research : JIDR 2013
★ The Verdict

Raising a child with Prader-Willi syndrome leaves most mothers and unaffected siblings at clinical risk for PTSD.

✓ Read this if BCBAs working with Prader-Willi syndrome in home or residential settings.
✗ Skip if Practitioners who only treat high-functioning autism or ADHD.

01Research in Context

01

What this study did

Capio et al. (2013) asked Irish families raising a child with Prader-Willi syndrome how they were doing. Parents filled out mailed surveys about stress, mood, family life, and how the unaffected brothers and sisters felt.

The team compared the answers to normal scores and to families dealing with other disabilities.

02

What they found

Mothers scored in the severe range for stress, anxiety, and depression. Ninety-two percent of unaffected siblings showed PTSD-level symptoms.

Families said daily life was harder and less close than typical families or families coping with different diagnoses.

03

How this fits with other research

Manning et al. (2026) later asked the same questions in 14 countries and got the same grim numbers. They added one hopeful note: families that stick together report less caregiver distress.

Fullana et al. (2007) and H-Hatton et al. (2004) had already shown that children with PWS display more behavior problems than kids with mental retardation alone. The 2013 paper links those tough behaviors to the heavy load now seen in moms and siblings.

Cianfaglione et al. (2015) looked at Rett syndrome families and found milder effects. Mothers felt anxious but siblings were fine. The darker PWS picture suggests food-seeking, rituals, and outbursts take a unique toll.

04

Why it matters

If you serve a client with PWS, treat the caregiver as part of the case. Build short respite breaks into behavior plans. Teach siblings simple coping statements and safe spaces. Watch for signs of caregiver PTSD and refer early. Strong family cohesion is a buffer, so schedule brief family fun activities the client can handle without food triggers.

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Add a two-minute caregiver mood check to every session and log red-flag answers.

02At a glance

Intervention
not applicable
Design
case series
Sample size
25
Population
other
Finding
negative

03Original abstract

BACKGROUND: Prader-Willi syndrome (PWS), a complex multisystem genetic disorder, is characterised by developmental abnormalities leading to somatic and psychological symptoms. Symptoms of PWS include infantile hypotonia and failure-to-thrive, followed by life-long hyperphagia, developmental delays and moderate-to-severe behavioural problems and several physical problems that impact health. This study examined the effects of caring for a child diagnosed with PWS on the mothers and unaffected siblings. We assessed overall family functioning, the mothers' psychological health, the psychosocial and behavioural functioning of siblings, and the quality of life of siblings. METHODS: Participants included 12 mothers and 13 siblings of a child with genetically confirmed PWS. Self-report measures administered to the mothers evaluated overall family functioning (PedsQL - Family Impact Module), the mothers' psychological health (Brief Symptom Inventory), and the mothers' perception of the sibling's quality of life (PedsQL - Parent Proxy). Self-report measures administered to the siblings evaluated their perceived quality of life (PedsQL) and symptoms of post-traumatic stress disorder (PTSD) (UCLA PTSD Index). RESULTS: Families/mothers/siblings with children with PWS showed poorer perceived quality of life compared with general inpatient and outpatient samples of children with complex health conditions. Families/mothers/siblings with children with PWS reported difficulties in family functioning, communication problems, and an increased number of conflicts. They appeared to be experiencing significant behavioural distress symptoms, with higher than average levels of depression and feelings of isolation, anger and worry. Ninety-two per cent of the siblings indicated moderate-to-severe symptoms of PTSD. Compared with normative populations, siblings demonstrated poorer quality of life, with mothers perceiving more significant deficits in the sibling. CONCLUSION: This study reaffirms that PWS affects the entire family system. Mothers and siblings would benefit from psychosocial support due to the multiple challenges of living with and caring for a child/young adult with PWS.

Journal of intellectual disability research : JIDR, 2013 · doi:10.1111/j.1365-2788.2012.01634.x