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Children at home on mechanical assistive devices and their families: a retrospective study
Insights
Caregiver and family interactions significantly impact child development for those using mechanical devices. Stronger social support and positive family dynamics correlate with better child developmental outcomes.
Area of Science:
- Child Development
- Family Studies
- Rehabilitation Medicine
Background:
- Limited research exists on caregiver/family influence on development for children on mechanical assistive devices.
- Children's developmental status is crucial post-discharge, especially with ongoing medical needs.
Purpose of the Study:
- To assess the impact of caregiver and family interactions on the developmental status of children discharged on mechanical assistive devices.
- To identify key factors within family dynamics that influence child development in this population.
Main Methods:
- A study involving 25 children (2-30 months) discharged on mechanical assistive devices.
- Mothers completed six validated questionnaires assessing family functioning, social support, coping, self-esteem, home environment, and child language development.
- Path-analysis was used to determine significant relationships between variables.
Main Results:
- Family adaptability and cohesion varied, with a significant portion of families showing chaotic adaptability or disengaged/enmeshed cohesion.
- Mothers' social support strongly correlated with family adaptability and cohesion.
- Home Observation for Measurement of the Environment (HOME) scores correlated with maternal self-esteem and coping strategies.
- Receptive-Expressive Emergent Language Scale (REEL) scores correlated with social support.
Conclusions:
- Child-mother interactions and maternal help-seeking behaviors are critical pathways influencing developmental status.
- Family dynamics and social support systems play a vital role in the development of children requiring mechanical assistance.
Abstract:
Few assessments have been done of the influence of caregiver and family interactions on the developmental status of children discharged on mechanical assistive devices. The ages of the 25 children in this study ranged from 2-30 months. Seven were on apnea monitors at the time of the home interviews, and 18 had been off the monitors for 18 months or more. Mothers were administered six questionnaires: Family Adaptability and Cohesion Evaluation Scales (FACES III), Duke-UNC Functional Social Support Questionnaire, Families Coping Strategies (FCOPES), Self-Esteem Scale, Home Observation for Measurement of the Environment, and the Receptive-Expressive Emergent Language Scale (REEL). Results on the FACES III revealed that families were not rigid in adaptability; 61% were chaotic, and 33% were balanced. On the cohesion scale, 25% were disengaged, 30% were enmeshed, and 45% were balanced. On the FCOPES, and it's subscales, 36-40% of the respondents scored below the established norms. Social support was strongly correlated with Cohesion and Adaptability (r = .47, .67), HOME scores correlated with Self-Esteem (r = .47) and FCOPES Reframe scale (r = .45), and REEL scores correlated with Social Support (r = .47, .52). Path-analysis revealed two paths: help-seeking behaviors of the mother and the child-mother interactions.