Document Type : Original Articles
Department of Occupational Therapy, faculty of Rehabilitation, Semnan University of Medical Sciences, Semnan, Iran
Neuromuscular Rehabilitation Research Center, Semnan University of Medical Sciences, Semnan, Iran
Department of Occupational Therapy, School of Rehabilitation, Semnan University of Medical Sciences, Semnan, Iran
University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
Background: Cerebral palsy (CP) affects different aspects of children’s development. Some of these negative effects (such as child’s behavioral issues) could be eliminated by teaching mothers –as the main caregivers- to have proper skills. The present study investigated the effectiveness of teaching communication skills to the mothers of children with CP in reducing the children’s behavioral problems.
Methods: Forty-two mothers who had 4-10-year-old children with CP, they were able to read and write, age between 20 and 40, and their children’s mobility score was at or below 3 in Gross Motor Function Classification System were recruited by convenient sampling. In this semi-experimental study, mothers completed the Rutter Children's Behavioral Questionnaire Children’s behavioral problems before and after the training. The experimental group received nine 90-minute training sessions on how to communicate with their children, the control group did not have any intervention regarding children’s behavioral problems. Data were analyzed by Multivariate analysis of covariance (MANCOVA).
Results: Comparing the two groups’ mean scores in five Rutter’s sub-tests showed significant differences (Aggression & hyperactivity, Social incompatibility, Anti-social behaviors, Anxiety & Depression, and General Behavioral problems) before the training indicated differences between groups (p =0.001). After training, the experimental group showed a significant reduction in five subtests of Rutter’s (p = 0.001).
Conclusion: The present study indicated strengthening mothers with proper communication skills may change their interactions with their children with CP, and reduce the occurrence of a child’s behavioral problems. Therefore, rehabilitation team can consider the communication skills training program along with other therapeutic plans to intervene for children with CP.
- Roostaei M, Abedi S, Khazaeli K. The relationship between behavioral problems in 7 to 13 year old children with cerebral palsy and maternal depression: a cross-sectional study. 2016.
- Novak I, Hines M, Goldsmith S, Barclay R. Clinical prognostic messages from a systematic review on cerebral palsy. Pediatrics. 2012;130(5):e1285-e312.
- Doh H-S, Kim M-J, Shin N, Park B-K, Choi M-K. The Effectiveness of a Parent Education Program for Preventing Children's Problem Behaviors: Based on Respected Parents & Respected Children. Korean Journal of Child Studies. 2013;34(3):151-77.
- Parkes J, McCusker C. Common psychological problems in cerebral palsy. Paediatrics and child health. 2008;18(9):427-31.
- Webster RI, Majnemer A, Platt RW, Shevell MI. Child health and parental stress in school-age children with a preschool diagnosis of developmental delay. Journal of child neurology. 2008;23(1):32-8.
- Mitchell D, Hauser‐Cram P. Early childhood predictors of mothers' and fathers' relationships with adolescents with developmental disabilities. Journal of Intellectual Disability Research. 2010;54(6):487-500.
- Ahmadizadeh Z, Rassafiani M, Khalili MA, Mirmohammadkhani M. Factors associated with quality of life in mothers of children with cerebral palsy in Iran. Hong Kong Journal of Occupational Therapy. 2015;25:15-22.
- Davis E, Shelly A, Waters E, Boyd R, Cook K, Davern M. The impact of caring for a child with cerebral palsy: quality of life for mothers and fathers. Child: care, health and development. 2010;36(1):63-73.
- Wayte S, McCaughey E, Holley S, Annaz D, Hill CM. Sleep problems in children with cerebral palsy and their relationship with maternal sleep and depression. Acta Paediatrica. 2012;101(6):618-23.
- Whittingham K, Sanders M, McKinlay L, Boyd R. Interventions to Reduce Behavioral Problems in Children With Cerebral Palsy: An RCT. Pediatrics. 2014;133:e1249-e57.
- Eyberg SM, Nelson MM, Boggs SR. Evidence-based psychosocial treatments for children and adolescents with disruptive behavior. Journal of clinical child & Adolescent psychology. 2008;37(1):215-37.
- Barfoot J, Meredith P, Ziviani J, Whittingham K. Parent‐child interactions and children with cerebral palsy: An exploratory study investigating emotional availability, functional ability, and parent distress. Child: care, health and development. 2017;43(6):812-22.
- Matoso L, Baião R, Baptista J. Beliefs about sensitive parenting among mothers of children with disabilities. Journal of Intellectual Disabilities. 2022;26(1):281-90.
- Weber P, Bolli P, Heimgartner N, Merlo P, Zehnder T, Kätterer C. Behavioral and emotional problems in children and adults with cerebral palsy. European journal of paediatric neurology. 2016;20(2):270-4.
- Jalili N, Akbar Fahimi N, Hosseini SA, Farzi M, Falsafian R. Behavioral problems in children with cerebral palsy. Archives of Rehabilitation. 2012;12:30-7.
- Manuel J, Naughton MJ, Balkrishnan R, Paterson Smith B, Koman LA. Stress and adaptation in mothers of children with cerebral palsy. Journal of Pediatric Psychology. 2003;28(3):197-201.
- Balali R, Agha Yousefi A. The effectiveness of parents intervention programs to reduce children's behavioral problems. Journal of Applied Psychology. 2012;5(4):59-73.
- Reid JB. Prevention of conduct disorder before and after school entry: Relating interventions to developmental findings. Development and psychopathology. 1993;5(1-2):243-62.
- Durisic M. Relations and communication in families of children with externalizing behavior problems. Research in Pedagogy. 2018;8(2):111-20.
- Whittingham K, Wee D, Boyd R. Systematic review of the efficacy of parenting interventions for children with cerebral palsy. Child: care, health and development. 2011;37(4):475-83.
- Mohammadi Z, Hashemi B, Fazel-Dehkordi S. The Effectiveness of Communication Skills Training to Mothers on Reducing Behavioral Problems in Children 4 to 6 Years Old. Quarterly Journal of Child Mental Health. 2017;4(3):60-8.
- Behpazhooh A. Family pathology and family in pursuit of militants: The comprehensive family education teachers, families, and children in preschool. . Tehran: Anjoman-e-Oliya and Morabbiyan Publication2004.
- Behar LB. The preschool behavior questionnaire. Journal of Abnormal Child Psychology. 1977;5(3):265-75.
- Rutter M. A children's behaviour questionnaire for completion by teachers: preliminary findings. Journal of child Psychology and Psychiatry. 1967;8(1):1-11.
- Yousefi F. Rutter standardized questionnaire to assess the behavioral and emotional problems of male and female primary school students in Shiraz. Journal of Social Sciences and Humanities of Shiraz University 1996;25:94-171.
- Sitnikov L, Rohan KJ, Evans M, Mahon JN, Nillni YI. Cognitive predictors and moderators of winter depression treatment outcomes in cognitive-behavioral therapy vs. light therapy. Behaviour research and therapy. 2013;51(12):872-81.
- Li L, Xiong L, Zhang S, Yu Q, Chen M. Cognitive–behavioral therapy for irritable bowel syndrome: A meta-analysis. Journal of psychosomatic research. 2014;77(1):1-12.
- Leahey TM, Crowther JH, Irwin SR. A cognitive-behavioral mindfulness group therapy intervention for the treatment of binge eating in bariatric surgery patients. Cognitive and Behavioral Practice. 2008;15(4):364-75.
- Hedman E, Mörtberg E, Hesser H, Clark DM, Lekander M, Andersson E, et al. Mediators in psychological treatment of social anxiety disorder: Individual cognitive therapy compared to cognitive behavioral group therapy. Behaviour research and therapy. 2013;51(10):696-705.
- Hossein Khanzadeh A-A, Baghban Vahidi M, Nedaee N. The Impact of Training Mothers of Autistic Children for Effective Communication Skills on Family Emotional Conditions, Adaptability and Cohesion. Journal of Exceptional Children. 2017;16(4):39-50.
- Baghban Vahidi M, Hossein Khanzadeh AA, Nedaee N. The Impact of Training Mothers of Autistic Children for Effective Communication Skills on Social Skills Improvement in Autistic Children. Middle Eastern Journal of Disability Studies. 2017;7(0):44-.
- Momen S, Khosravi S, Chinaveh M. The Effect of Communication Skills Training and Enrichment on Social Responsiveness and Social Communication Skills of Adolescents with Autism Spectrum Disorder and their Parents. International Journal of Health Studies. 2021;7(4):1-5.
- Jalili N, Nasr Z, Zare R, Sattari M, Hosseini A. Occupational Performance Priorities of Children With Cerebral Palsy From the Parents’ Perspective. Archives of Rehabilitation. 2019;19(4):370-9.
- Olusanya BO, Gladstone M, Wright SM, Hadders-Algra M, Boo N-Y, Nair MKC, et al. Cerebral palsy and developmental intellectual disability in children younger than 5 years: Findings from the GBD-WHO Rehabilitation Database 2019. Frontiers in Public Health. 2022;10:1-12.
- Thiansaengthong S, Boonyarattanasoontorn J. Rehabilitation guidelines for children with cerebral palsy. Interdisciplinary Research Review. 2019;14(6):43-7.
- Steiner AM. A strength-based approach to parent education for children with autism. Journal of Positive Behavior Interventions. 2011;13(3):178-90.
- Dalsgaard T, Skov MB, Stougaard M, Thomassen B, editors. Mediated intimacy in families: understanding the relation between children and parents. Proceedings of the 2006 conference on Interaction design and children; 2006.
- Draper S. Coping mechanisms used by mothers when caring for their adolescent child with cerebral palsy 2009.
- Roberts C, Mazzucchelli T, Studman L, Sanders MR. Behavioral family intervention for children with developmental disabilities and behavioral problems. Journal of Clinical Child & Adolescent Psychology. 2006;35(2):180-93.