title: Impact on children of a parent with ALS: a case-control study.
abstract: BACKGROUND
  Numerous studies have explored how patients and their caregivers cope with amyotrophic lateral sclerosis (ALS), but the literature completely lacks research on the psychological impact of the disease on patients' children. The aim of our study was to investigate the emotional and psychological impact of a parent with ALS on school-age children and adolescents in terms of problem behavior, adjustment, and personality characteristics.
  
  
  METHODS
  The study involved 23 children (mean age = 10.62 years, six females) with a parent suffering from ALS, and both their parents. Children were matched for age, gender, and birth-order with a control group of children with healthy parents. They were administered the Youth Self Report (YSR) questionnaire and the Rorschach Comprehensive System, and their healthy parent completed the Child Behavior Checklist (CBCL).
  
  
  RESULTS
  Findings clearly showed that, compared with controls, children with a parent who had ALS had several clinically significant adverse emotional and behavioral consequences, with emotional and behavioral problems, internalizing problems, anxiety and depressive symptoms. Children of a parent with ALS scored higher than controls for the Total Problems, Internalizing Problems, Anxious/Depressed and Withdrawn/Depressed scales in the YSR. A relevant percentage of children fell within the clinical range (42.9%) and borderline range (28.6%) for Internalizing Problems. The Rorschach CS confirmed the substantial impact of ALS in a parent on their offspring in terms of internalizing behavior and depression, with adjustment difficulties, psychological pain, and thought problems.
  
  
  CONCLUSIONS
  Our findings indicate that school-aged children and adolescents with a parent who has ALS are vulnerable and carry a substantially higher risk of internalizing behavior, depressive symptoms, and reactive problems than children with healthy parents. Families affected may need support to cope with such an overwhelming disease.
authors: Department of Philosophy, Sociology, Pedagogy and Applied Psychology, University of Padova Padova, Italy.
authors: Vincenzo
authors: V
authors: Calvo
authors: Department of Philosophy, Sociology, Pedagogy and Applied Psychology, University of Padova Padova, Italy.
authors: Francesca
authors: F
authors: Bianco
authors: Department of Philosophy, Sociology, Pedagogy and Applied Psychology, University of Padova Padova, Italy.
authors: Enrico
authors: E
authors: Benelli
authors: Department of Philosophy, Sociology, Pedagogy and Applied Psychology, University of Padova Padova, Italy.
authors: Marco
authors: M
authors: Sambin
authors: Department of Medical, Surgical, Neurological, Metabolic and Aging Sciences, Second University of Naples Naples, Italy.
authors: Maria R
authors: MR
authors: Monsurrò
authors: Department of Medical, Surgical, Neurological, Metabolic and Aging Sciences, Second University of Naples Naples, Italy.
authors: Cinzia
authors: C
authors: Femiano
authors: Department of Neurosciences, University of Padova Padova, Italy.
authors: Giorgia
authors: G
authors: Querin
authors: Department of Neurosciences, University of Padova Padova, Italy.
authors: Gianni
authors: G
authors: Sorarù
authors: Department of Philosophy, Sociology, Pedagogy and Applied Psychology, University of Padova Padova, Italy.
authors: Arianna
authors: A
authors: Palmieri
keywords: ALS; Rorschach; chronic medical condition (CMC); parents-children; problem behavior