Adaptation in families of children with developmental delay

Family adaptation to child developmental disability is a dynamic transactional process that has yet to be tested in a longitudinal, rigorous fashion. In addition, although children with developmental delays frequently have behavior problems, not enough research has examined possible underlying mechanisms in the relation between child developmental delay, adaptation and behavior problems. In the current study, factor analysis examined how best to conceptualize the construct of family adaptation to developmental delay. Also, longitudinal growth curve modeling tested models in which child behavior problems mediated the relation between developmental risk and indices of family adaptation. Participants included 130 typically developing children and their families (Mental Development Index [MDI] > 85) and 104 children with developmental delays and their families (MDI < 85). Data were collected yearly between the ages of three and eight as part of a multi-site, longitudinal investigation examining the interrelations among children's developmental status, family processes, and the emergence of child psychopathology. Results of the current study indicated that adaptation is best conceptualized as a multi-index construct. Different aspects of adaptation changed in unique ways over time, with some facets of adaptation remaining stable while others fluctuated. Child internalizing and externalizing behavior problems were found to decrease over time for both children with developmental delays and typically developing children. Child behavior problems were also found to mediate the relation between developmental risk and family adaptation for over half of the mediation pathways. Significant mediation results indicated that children with developmental delays showed higher early levels of behavior problems, which in turn was associated with more maladaptive adaptation. These findings provide further evidence that families of children with developmental delays experience both positive and more challenging changes in their families over time. This study implies important next steps for research and clinical practice in the area of developmental disability.