title: Indicators of distress in families of children with cerebral palsy.
abstract: OBJECTIVE
  To describe family distress as reported by parents of children with cerebral palsy (CP) and to identify factors associated with distress.
  
  
  METHODS
  In this descriptive, historical cohort study, parents of school-age children (9.2 ± 2.1 years) with CP completed the Parenting Stress Index, the Impact on Family Scale and family-related items on the Child Health Questionnaire. Predictor variables considered were sociodemographic factors, motor, cognitive and behavioral difficulties and functional limitations. These were assessed using the Gross Motor Function Measure, Leiter IQ, Strengths and Difficulties Questionnaire and Vineland Adaptive Behavior Scale.
  
  
  RESULTS
  Parents of 95 children were recruited, of whom 45% were highly stressed and 11% defensive. Half indicated that their child's health impacted on their time, emotional status and family activities. Family distress measures were modestly associated with motor (r = 0.30-0.48) and cognitive abilities (r = 0.29-0.37) but more strongly correlated with particular behavioral difficulties (r = -0.42 to 0.55). Activity limitations across domains were highly associated with measures of distress.
  
  
  CONCLUSIONS
  Parents of school-aged children with CP are likely to experience high stress, increased time constraints and financial and psychological burden. Findings illustrate the need to monitor family functioning intermittently as the child develops and direct appropriate resources to optimize child and family well-being.
authors.affiliation: School of Physical & Occupational Therapy, Department of Neurology and Neurosurgery, Department of Pediatrics, McGill University, 3654 Promenade Sir-William-Osler, Davis House, Montreal, Quebec H3H 1P3, Canada.
authors.forename: Annette
authors.initials: A
authors.lastname: Majnemer
authors.forename: Michael
authors.initials: M
authors.lastname: Shevell
authors.forename: Mary
authors.initials: M
authors.lastname: Law
authors.forename: Chantal
authors.initials: C
authors.lastname: Poulin
authors.forename: Peter
authors.initials: P
authors.lastname: Rosenbaum
mesh_terms: D000223:Adaptation, Psychological; D017028:Caregivers / Q000523:psychology*; D002547:Cerebral Palsy / Q000523:psychology*; D002648:Child; D002653:Child Behavior Disorders / Q000523:psychology; D019988:Children with Disabilities; D005190:Family / Q000523:psychology*; D005192:Family Health; D005260:Female; D006801:Humans; D008297:Male; D051346:Mobility Limitation; D010287:Parent-Child Relations; D016487:Parenting / Q000523:psychology*; D012720:Severity of Illness Index; D012959:Socioeconomic Factors; D013315:Stress, Psychological; D011795:Surveys and Questionnaires