Applying Findings to Practice

Abstract

Based on the premise that family relationships influence child development and parenting stress influences a child’s behavior, the researchers examined the impact of being diagnosed during preschool years with developmental delays 4 years after diagnosis. Developmental delay was defined as either a global developmental delay or developmental language impairment. An original group of 224 preschool children were contacted to be reassessed between the ages of 7 and 8 years. A total of 65 families participated in the follow-up study. Measures of the child’s overall health and well-being were determined using the Child Health Questionnaire Parent Form 50 looking at physical and psychosocial health. A 36-item Parental Stress Index Short Form was administered to parents to identify parental distress, dysfunctional interaction, and difficult child measures. Motor, cognitive, social, adaptive, and language outcomes were assessed with the full-scale Battelle Developmental Inventory. The Vineland Adaptive Behavior Scale assessed functional capability in communication, activities of daily living, and socialization. The findings of the study indicated that there were no significant differences in parental socioeconomic status from the original cohort group. Of the children who were assessed with the developmental and functional assessment tools, 98% demonstrated evidence of ongoing impairments in at least one area, and 83% were impaired in two or more developmental domains. Those children with a preschool diagnosis of developmental language impairment showed significantly better performance in adaptive behavior and developmental performance than children with global developmental delays. In terms of health-related quality of life, parental report indicated that the children in the study were significantly lower in the psychosocial area and higher in the role/social limitations area, physical functioning, and bodily pain/ discomfort scales of the physical health scales. Parental stress score analysis included only 53 parent responses. Of these, 42% had scores indicating clinically significant elevated stress levels. Parents of children with global developmental delay were significantly more likely to have elevated stress levels than parents of children with developmental language impairment. This difference was also significant for parents of children with moderate or severe delay at the preschool assessment. Families with fathers who had some postsecondary education had significantly lower levels of parenting stress.