Rates of Separation and Divorce Among Parents of Children with Neurodevelopmental Disorders

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Results from the NLSCY
, February, 2014
 
 
Lucyna M. Lach, PhD, Associate Professor,
School of Social Work, McGill Univeristy
Rubab G. Arim, PhD, Methodologist,
Ottawa Hospital Research Institute
Dafna E. Kohen, PhD, Senior Analyst
Statistics Canada
Learning Objectives
 
As a result of attending this presentation, you
will be able to answer the following questions:
 
What is the impact that caring for a child with a
neurodevelopmental disorder (NDD) has on rates of
separation/divorce?
 
What child, parent, and family factors predict
separation/divorce among parents whose child has a
neurodevelopmental  disorder?
Why NDD?
 
Issue of specificity: narrower than CHCD.
NDD
 is an impairment of the growth and development of the
brain or central nervous system associated with motor, cognitive,
behavioural, and/or language function.
e.g., ASD/PDD, cerebral palsy, epilepsy, learning disabilities,
global developmental delay, and mental retardation
 
Issue of complexity: NDD unfolds as the individual grows.
NDD
 affects different aspects of function:  ambulation,
information processing (e.g., memory,  expressive and receptive
language), and self-regulation of emotion and behaviour
 
In United States, up to 9.3% of children under age 18 have a NDD
(CDC, 1995); comparable rate in Canada among 4-11 year olds
 
Non-categorical approach recommended for decades (e.g., Pless &
Pinkerton, 1975; Stein & Jessop, 1982)
Background Information
 
Children with NDDs have higher rates of behavioural
disorders than their peers without NDDs both
concurrently  (Howe et al., 1993; McDermott et al., 1995;
1996) and over time (Breslau & Marshall, 1985; Seltzer et
al., 2005)
 
Stress in families of children with NDDs is elevated (Rao
& Biedel, 2009; Montes & Halterman, 2008)
 
Higher levels of marital quality predict lower parenting
stress and fewer depressive symptoms (Kersh et al.,
2006)
Why study separation and/or divorce
rates?
 
Common belief that having a child with a NDD is
a risk factor for separation and/or divorce
 
"It can break a family apart as we've seen by the 80%
divorce rate statistic”  (Autism Today website).
 
“Definitive statistics on the divorce rate of couples of
children with disabilities are not available but there is
general consensus that it is somewhat higher than in
families with typical children.  We do know that the
divorce rate is terribly high for marriages in general; it
is reported as approximately 50% for 1
st
 marriages and
close to 75% for 2
nd
 marriages” (Marshak, 2007).
 
 
 
 
Why study separation and/or divorce
rates?
“yeah… because if, if we were both pessimistic people I
don’t think we would have lasted so long… and that’s one
of the reasons the divorce rate is so high… it’s hard… it’s
a daily struggle… you know from the time we get up to
the time we go to bed… it’s, it’s like you always.…even
now….one eye and ear is where [son’s name] is even
though we’re sitting here at the kitchen table talking –
I’ve got a, you know like a, sixth sense of where he is and
what he’s doing…. I have to…Because he can not be left
alone… “
(father of 8 year old with moderate to severe autism, nonverbal)
 
Why study separation and/or divorce
rates?
“…because most parents.  And I know, I can’t really say
that I know a lot of parents with autistic kids.  And if they
are, I can’t say that I know a lot of fathers who have…
that I know the fathers.  ‘Cause most of the meetings I go
to it’s the women, you know, the women with the child
and so forth.  Unfortunately, statistically, it’s staggering
the amount of families that are broken up.  Because it’s
too much.  It’s too much. Whether it’s the mother,
whether it’s the father, they didn’t see eye to eye.  I can
see where… it can end up like that…”
(father of 8 year old with moderate to severe autism, nonverbal) 
Do parents of children with NDD have
higher separation/divorce rates? - yes
 
Mothers of children with disabilities are more
likely to be separated and/or divorced than
mothers of children without disabilities
14.3% vs. 11.4% (divorced)
8.2% vs. 5.4% (separated) (Witt et al., 2003)
 
Parents of children with an ASD had a higher
rate of divorce than the comparison group
23.5% vs. 13.8% (Hartley et al., 2010)
Do parents of children with NDD have
higher separation/divorce rates? – it
depends
 
 
Divorce rates among parents of children with Down
Syndrome were lower than rates among parents of
children with other birth anomalies and no identified
disability (Urbano & Hodapp, 2007)
 
Down’s syndrome divorce rate: 7.6%
Other birth anomalies: 11.2%
No identified disability:  10.8%
Do parents of children with NDD have
higher separation/divorce rates? – no
Children with ASD are no more likely to be in a
traditional family than children without ASD
Traditional = biological or adoptive married parents
Non-traditional = other family structure such as
separated/divorced, remarried, single, etc.)
64% vs. 65.2%
(Freedman et al., 2010)
Previous Work
Canadian National Longitudinal Survey
of Children & Youth (NLSCY)
Long-term study of child physical and social development
Person most knowledgeable (PMK) about the child reports
on child, self, spouse; child report 10+
Physical health, education, emotional, behavioural, social,
family, neighbourhood variables
First cohort (1994-5): 22,831 children
Follow up data collected every 2 years until 2009 (last year
of data collection)
Parents of children with NDD
 
What is the impact of having a child with a
complex health condition (NDD with and without
behaviour problems) on CG’s:
Physical and psychological health?
(i.e., chronic condition, activity limitation,
general health and depressive symptoms)
Psychosocial adjustment?
 
(i.e., marital satisfaction, family functioning)
Parenting?
(i.e., positive interactions, consistent, ineffective)
 
Defining Our Groups
Identifying the presence of a NDD:
A checklist of chronic conditions diagnosed by a physician
(epilepsy, cerebral palsy, mental handicap, learning
disability)
- OR -
Health Utilities Index (speech, mobility, dexterity, cognition)
Identifying the presence of a BP:
PMK-reported child behaviour rating scale; items mostly
derived from the Child Behaviour Checklist
High scores on at least one of: hyperactivity-inattention (8
items), conduct disorder-physical aggression (6 items),
indirect aggression (5 items)
Defining Our Groups
NDD = Neurodevelopmental only
BP = Behaviour problem only
BOTH = NDD + BP
Neither/None
Previous Findings
 
In comparison to parents of children with no
symptoms, parents of children with both sets of
symptoms (NDD + BP) are:
Most likely to report  presence of a chronic condition
or activity limitation
Least likely to report being in excellent/good general
health
 
Parents of children with Both sets of symptoms
(NDD + BP) have:
Higher levels of depressive symptoms
Higher levels of family distress
 
Lach et al., 2009
Previous Findings
In comparison to parents of children with no
symptoms, parents of children with Both sets of
symptoms (NDD + BP) have:
Lower positive interaction scores
e.g., How often do you and your child laugh together?
Lower consistency scores
e.g., When you give [your child] a command or order to do
something, what proportion of the time do you make sure
that [your child] does it?
Higher ineffective parenting scores
e.g., How often do you feel you are having problems
managing [your child] in general?
Arim et al., 2012; Garner et al., 2013
Research Questions:
Do rates of separation and/or divorce differ
among the 4 groups identified?
What child, parent, and family characteristics
predict separation and/or divorce?
Method
N=14,226 (NLSCY Cycle 1; 4-11 years of age)
Children whose health condition could not be
identified due to missing data were excluded
from the sample (n=261)
The final N=13,965
Create 4 groups
(NDD=815; BP=1322; Both=452; Neither=11376)
Other Measures
Child socio-demographic and other health
characteristics
Parent socio-demographic characteristics
Parent health characteristics (e.g., depression)
Parenting and social support
Family characteristics (e.g., family functioning)
Parental separation / divorce
Data Analysis
Descriptive statistics
Group differences were examined with the
reference group being NEITHER
Logistic Regression (LR) analyses
Five LR models that predicted the likelihood of
parental separation / divorce.
Results – Child Characteristics
Results – Parent Socio-
Demographic Characteristics
Results – Parent Characteristics
Results – Family Characteristics
Predictors of Separation and/or Divorce
Logistic Regression (Full Model)
NDD (OR=1.71), BP (OR=1.60), BOTH (OR=1.61)
Child characteristics
Child emotional-disorder anxiety
Parent characteristics
Younger parent age
Less than high school education
Parent is not an immigrant
Parent’s depressive symptoms
Consistency in parenting
Predictors of Separation and/or Divorce
Logistic Regression (Full Model)
Family characteristics
Few children < 17 years of age
Low income
Family distress
Limitations & Strengths
Parent-report
Covers a period of 12 years
Difficult to compare to published rates of
separation and/or divorce due to different
methods used in each study
Conclusions
Caring for a child with NDD with or
without behaviour problems is associated
with higher risk for separation and/or
divorce over a 12 year period
It is important to consider other child,
parent, and family characteristics to better
understand the risk factors that are
associated with children’s experience of
parental separation and/or divorce
Principal Investigators:
Peter Rosenbaum; McMaster University
Lucyna Lach, McGill University
Dafna Kohen; Statistics Canada, Universite d’Ottawa
Team Leaders:
Rachel Birnbaum; 
King’s University College, UWO
Rochelle Garner; 
Statistics Canada, Universite d’Ottawa
David Nicholas; 
University of Calgary
Michael Saini; 
University of Toronto
Team Members:
Jamie Brehaut; 
Ottawa Hospital Research Institute, Universite d’Ottawa
Delphine Collin-Vezina; 
McGill University
Michael MacKenzie; 
Columbia University
Ted McNeill; 
Hospital For Sick Children Research Institute, University of  Toronto
Alison Niccols; 
McMaster University
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Team - Collaborators
Parents and Advocates:
Frank Gavin; Co-Chair, Canadian Family Advisory Network
Sue Robins; Member, Canadian Family Advisory Network
Joanne Ganton; President, Calgary Cerebral Palsy Association
Young Adults:
Lindsay Yeo;
 
Member, Canadian Family Advisory Network
Institutional/Clinical Leaders:
Elaine Orrbine;
 
Canadian Association of Paediatric Health Centres
Diane Calce;
 
Marie Enfant Rehabilitation Centre of CHUM Ste. Justine
Policy Makers
Nancy Reynolds; President, Alberta Centre For Child, Family, and Community
Research
Linda Burnside; Executive Director, Disability Programs, Ministry of Family
Services and Housing Government of Manitoba
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Research conducted in 2014 examines the impact of caring for a child with a neurodevelopmental disorder (NDD) on rates of separation and divorce among parents. Factors predicting separation/divorce are explored, highlighting the challenges faced by families of children with NDDs. The study emphasizes the need for support and understanding in such families to address the higher stress levels and potential strain on relationships.

  • Separation
  • Divorce
  • Neurodevelopmental Disorders
  • Family Dynamics
  • Parenting

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  1. RATES OF SEPARATION AND/OR DIVORCE AMONG PARENTS OF CHILDREN WITH NEURODEVELOPMENTAL DISORDERS: HOW INEVITABLE IS THIS? Results from the NLSCY, February, 2014 Lucyna M. Lach, PhD, Associate Professor, School of Social Work, McGill Univeristy Rubab G. Arim, PhD, Methodologist, Ottawa Hospital Research Institute Dafna E. Kohen, PhD, Senior Analyst Statistics Canada

  2. Learning Objectives As a result of attending this presentation, you will be able to answer the following questions: What is the impact that caring for a child with a neurodevelopmental disorder (NDD) has on rates of separation/divorce? What child, parent, and family factors predict separation/divorce among parents whose child has a neurodevelopmental disorder?

  3. Why NDD? Issue of specificity: narrower than CHCD. NDD is an impairment of the growth and development of the brain or central nervous system associated with motor, cognitive, behavioural, and/or language function. e.g., ASD/PDD, cerebral palsy, epilepsy, learning disabilities, global developmental delay, and mental retardation Issue of complexity: NDD unfolds as the individual grows. NDD affects different aspects of function: ambulation, information processing (e.g., memory, expressive and receptive language), and self-regulation of emotion and behaviour In United States, up to 9.3% of children under age 18 have a NDD (CDC, 1995); comparable rate in Canada among 4-11 year olds Non-categorical approach recommended for decades (e.g., Pless & Pinkerton, 1975; Stein & Jessop, 1982)

  4. Background Information Children with NDDs have higher rates of behavioural disorders than their peers without NDDs both concurrently (Howe et al., 1993; McDermott et al., 1995; 1996) and over time (Breslau & Marshall, 1985; Seltzer et al., 2005) Stress in families of children with NDDs is elevated (Rao & Biedel, 2009; Montes & Halterman, 2008) Higher levels of marital quality predict lower parenting stress and fewer depressive symptoms (Kersh et al., 2006)

  5. Why study separation and/or divorce rates? Common belief that having a child with a NDD is a risk factor for separation and/or divorce "It can break a family apart as we've seen by the 80% divorce rate statistic (Autism Today website). Definitive statistics on the divorce rate of couples of children with disabilities are not available but there is general consensus that it is somewhat higher than in families with typical children. We do know that the divorce rate is terribly high for marriages in general; it is reported as approximately 50% for 1st marriages and close to 75% for 2ndmarriages (Marshak, 2007).

  6. Why study separation and/or divorce rates? yeah because if, if we were both pessimistic people I don t think we would have lasted so long and that s one of the reasons the divorce rate is so high it s hard it s a daily struggle you know from the time we get up to the time we go to bed it s, it s like you always. even now .one eye and ear is where [son s name] is even though we re sitting here at the kitchen table talking I ve got a, you know like a, sixth sense of where he is and what he s doing . I have to Because he can not be left alone (father of 8 year old with moderate to severe autism, nonverbal)

  7. Why study separation and/or divorce rates? because most parents. And I know, I can t really say that I know a lot of parents with autistic kids. And if they are, I can t say that I know a lot of fathers who have that I know the fathers. Cause most of the meetings I go to it s the women, you know, the women with the child and so forth. Unfortunately, statistically, it s staggering the amount of families that are broken up. Because it s too much. It s too much. Whether it s the mother, whether it s the father, they didn t see eye to eye. I can see where it can end up like that (father of 8 year old with moderate to severe autism, nonverbal)

  8. Do parents of children with NDD have higher separation/divorce rates? - yes Mothers of children with disabilities are more likely to be separated and/or divorced than mothers of children without disabilities 14.3% vs. 11.4% (divorced) 8.2% vs. 5.4% (separated) (Witt et al., 2003) Parents of children with an ASD had a higher rate of divorce than the comparison group 23.5% vs. 13.8% (Hartley et al., 2010)

  9. Do parents of children with NDD have higher separation/divorce rates? it depends Divorce rates among parents of children with Down Syndrome were lower than rates among parents of children with other birth anomalies and no identified disability (Urbano & Hodapp, 2007) Down s syndrome divorce rate: 7.6% Other birth anomalies: 11.2% No identified disability: 10.8%

  10. Do parents of children with NDD have higher separation/divorce rates? no Children with ASD are no more likely to be in a traditional family than children without ASD Traditional = biological or adoptive married parents Non-traditional = other family structure such as separated/divorced, remarried, single, etc.) 64% vs. 65.2% (Freedman et al., 2010)

  11. Previous Work Canadian National Longitudinal Survey of Children & Youth (NLSCY) Long-term study of child physical and social development Person most knowledgeable (PMK) about the child reports on child, self, spouse; child report 10+ Physical health, education, emotional, behavioural, social, family, neighbourhood variables First cohort (1994-5): 22,831 children Follow up data collected every 2 years until 2009 (last year of data collection)

  12. Parents of children with NDD What is the impact of having a child with a complex health condition (NDD with and without behaviour problems) on CG s: Physical and psychological health? (i.e., chronic condition, activity limitation, general health and depressive symptoms) Psychosocial adjustment? (i.e., marital satisfaction, family functioning) Parenting? (i.e., positive interactions, consistent, ineffective)

  13. Defining Our Groups Identifying the presence of a NDD: A checklist of chronic conditions diagnosed by a physician (epilepsy, cerebral palsy, mental handicap, learning disability) - OR - Health Utilities Index (speech, mobility, dexterity, cognition) Identifying the presence of a BP: PMK-reported child behaviour rating scale; items mostly derived from the Child Behaviour Checklist High scores on at least one of: hyperactivity-inattention (8 items), conduct disorder-physical aggression (6 items), indirect aggression (5 items)

  14. Defining Our Groups NDD = Neurodevelopmental only BP = Behaviour problem only BOTH = NDD + BP Neither/None

  15. Previous Findings In comparison to parents of children with no symptoms, parents of children with both sets of symptoms (NDD + BP) are: Most likely to report presence of a chronic condition or activity limitation Least likely to report being in excellent/good general health Parents of children with Both sets of symptoms (NDD + BP) have: Higher levels of depressive symptoms Higher levels of family distress Lach et al., 2009

  16. Previous Findings In comparison to parents of children with no symptoms, parents of children with Both sets of symptoms (NDD + BP) have: Lower positive interaction scores e.g., How often do you and your child laugh together? Lower consistency scores e.g., When you give [your child] a command or order to do something, what proportion of the time do you make sure that [your child] does it? Higher ineffective parenting scores e.g., How often do you feel you are having problems managing [your child] in general? Arim et al., 2012; Garner et al., 2013

  17. Research Questions: Do rates of separation and/or divorce differ among the 4 groups identified? What child, parent, and family characteristics predict separation and/or divorce?

  18. Method N=14,226 (NLSCY Cycle 1; 4-11 years of age) Children whose health condition could not be identified due to missing data were excluded from the sample (n=261) The final N=13,965 Create 4 groups (NDD=815; BP=1322; Both=452; Neither=11376)

  19. Other Measures Child socio-demographic and other health characteristics Parent socio-demographic characteristics Parent health characteristics (e.g., depression) Parenting and social support Family characteristics (e.g., family functioning) Parental separation / divorce

  20. Data Analysis Descriptive statistics Group differences were examined with the reference group being NEITHER Logistic Regression (LR) analyses Five LR models that predicted the likelihood of parental separation / divorce.

  21. Results Child Characteristics NDD BP BOTH NEITHER Age, M (SE) 8.15 (.11)* 7.42 (.09) 8.49 (.14)* 7.42 (.01) % female 61.06%* 50.82% 69.70%* 49.80% % only child 12.90% 8.80%* 18.62%* 12.13% % firstborn 35.74% 27.48%* 22.50%* 33.69% % later born 51.36% 63.72%* 58.88%* 54.18% Emo-dis/anx, M (SE) 3.76 (.16)* 4.49 (.15)* 6.14 (.27)* 2.13 (.04)

  22. Results Parent Socio- Demographic Characteristics NDD BP BOTH NEITHER Age, M (SE) 35.31 (.26)* 34.88 (.26)* 34.85 (.32)* 35.87 (.10) Female, % 92.63% 90.56% 93.12% 90.05% High school, % 69.98%* 68.16%* 60.75%* 78.93% Immigrant, % 18.57% 14.30%* 14.66% 19.66%

  23. Results Parent Characteristics NDD BP BOTH NEITHER Ex/Very good overall health, % 67.25%* 68.17%* 53.74%* 75.91% Depressive symptoms, M (SE), 0-36 5.91 (.41)* 7.04 (.39)* 8.92 (.51)* 4.25 (.10) Consistency in parenting, M (SE), 0-20 14.90 (.21) 13.75 (.18)* 13.34 (.30)* 15.08 (.06) Ineffective parenting, M (SE), 0-25 9.57 (.22)* 11.77 (.17)* 13.02 (.29)* 8.30 (.07) Social support, M (SE), 0-18 14.35 (.17) 14.14 (.15)* 13.83 (.20)* 14.54 (.06)

  24. Results Family Characteristics NDD BP BOTH NEITHER No. of children <17, M (SE) 2.52 (.07) 2.53 (.06)* 2.31 (.07) 2.41 (.02) Low income, % 26.94%* 30.13%* 37.43%* 21.45% Moderate income, % 39.92% 36.37% 42.73%* 40.29% High income, % 33.15% 33.50%* 19.84%* 38.25% Family distress, M (SE), 0-36 8.66 (.31)* 9.45 (.28)* 10.50 (.39)* 7.67 (.11) Divorced/separated, % 35.83* 36.83* 44.51* 22.53

  25. Predictors of Separation and/or Divorce Logistic Regression (Full Model) NDD (OR=1.71), BP (OR=1.60), BOTH (OR=1.61) Child characteristics Child emotional-disorder anxiety Parent characteristics Younger parent age Less than high school education Parent is not an immigrant Parent s depressive symptoms Consistency in parenting

  26. Predictors of Separation and/or Divorce Logistic Regression (Full Model) Family characteristics Few children < 17 years of age Low income Family distress

  27. Limitations & Strengths Parent-report Covers a period of 12 years Difficult to compare to published rates of separation and/or divorce due to different methods used in each study

  28. Conclusions Caring for a child with NDD with or without behaviour problems is associated with higher risk for separation and/or divorce over a 12 year period It is important to consider other child, parent, and family characteristics to better understand the risk factors that are associated with children s experience of parental separation and/or divorce

  29. CIHR Team in The Bio-psychosocial Context of Parenting Children with Neurodevelopmental Disorders in Canada Principal Investigators: Peter Rosenbaum; McMaster University Lucyna Lach, McGill University Dafna Kohen; Statistics Canada, Universite d Ottawa Team Leaders: Rachel Birnbaum; King s University College, UWO Rochelle Garner; Statistics Canada, Universite d Ottawa David Nicholas; University of Calgary Michael Saini; University of Toronto Team Members: Jamie Brehaut; Ottawa Hospital Research Institute, Universite d Ottawa Delphine Collin-Vezina; McGill University Michael MacKenzie; Columbia University Ted McNeill; Hospital For Sick Children Research Institute, University of Toronto Alison Niccols; McMaster University

  30. Team - Collaborators Parents and Advocates: Frank Gavin; Co-Chair, Canadian Family Advisory Network Sue Robins; Member, Canadian Family Advisory Network Joanne Ganton; President, Calgary Cerebral Palsy Association Young Adults: Lindsay Yeo;Member, Canadian Family Advisory Network Institutional/Clinical Leaders: Elaine Orrbine;Canadian Association of Paediatric Health Centres Diane Calce;Marie Enfant Rehabilitation Centre of CHUM Ste. Justine Policy Makers Nancy Reynolds; President, Alberta Centre For Child, Family, and Community Research Linda Burnside; Executive Director, Disability Programs, Ministry of Family Services and Housing Government of Manitoba

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