Polymorbidity of developmental disabilities: Additive effects on child psychosocial functioning and parental distress.
Each extra developmental disability stacks more behavior problems and parent stress—so count the diagnoses and scale your support.
01Research in Context
What this study did
Giesbers et al. (2020) asked parents to fill out surveys about their late-elementary kids. Each child had at least one developmental disability. The team counted how many disabilities each child had and measured child behavior problems and parent stress.
They used simple math to see if each extra disability added more behavior trouble and more parent distress.
What they found
Every added disability meant more emotional and behavior problems in the child. Those extra problems then raised parent stress step by step.
The link was steady: two disabilities hurt more than one, three hurt more than two, and so on.
How this fits with other research
Yorke et al. (2018) pooled 28 studies and found the same upward slope: more autism behavior issues, more parent stress. H et al. extend that pattern to any mix of developmental disabilities.
Gallagher et al. (2014) showed child behavior, not parent health, doubles depression risk. H et al. add the new detail that each extra disability keeps turning that same screw.
Wacker et al. (2009) saw more disabilities raise support needs but not challenging behavior. H et al. disagree: they show behavior problems do rise with each added diagnosis. The gap comes from different yardsticks—Julia counted only adaptive skill deficits, while H asked about everyday emotional and behavior troubles.
Why it matters
When you see a child with more than one diagnosis, expect sharper behavior spikes and hotter parent stress. Screen early, teach coping skills to the child, and give parents their own support plan. One quick win: add a brief parent stress questionnaire to your intake and revisit it each extra diagnosis you identify.
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02At a glance
03Original abstract
BACKGROUND: While parents of children with developmental disabilities show greater parenting burden and distress compared with their counterparts, little is known about to what extent developmental polymorbidity in children escalates and magnifies the risk of parental distress. AIMS: This study investigated the co-occurrence of developmental disabilities among a sample of elementary school children and examined its additive effects on child psychosocial functioning and parental distress. METHODS AND PROCEDURES: A cross-sectional survey among 710 parents of elementary school children in Hong Kong included measures of child psychosocial functioning and parental stress. Structural equation modeling was used to test a hypothesized model in which child psychosocial functioning mediates the effect of developmental polymorbidity on parental distress. OUTCOMES AND RESULTS: About one-fourth of the participants reported their children having two or more developmental disabilities. The number of developmental disabilities was positively related to the severity of emotional and behavioral problems in children, which in turn explained general and parenting distress in parents. CONCLUSIONS AND IMPLICATIONS: Given the heightened vulnerability to distress among parents of children with multiple developmental disabilities, psychological care should particularly target this population. Early identification and intervention strategies are also needed to detect children with multiple co-occurring developmental disabilities, which could potentially alleviate their emotional and behavioral problems and lessen the parenting burden.
Research in developmental disabilities, 2020 · doi:10.1016/j.ridd.2020.103579