Few studies have examined the impact of parental disability on child mental health and well-being. Of the studies that do exist, most are small and limited to only one set of parental diagnoses such as intellectual disabilities (Findler & Vardi, 2009; Hewitt, 2007) or psychiatric disabilities (Riebschleger, 2004). Some prior studies report only negative impacts of parental disability (Hyatt & Allen, 2005). Yet, others have uncovered a mix of positive and negative impacts (Duvdevany, Moin, & Yahav, 2007; Duvdevany, Yahav, & Moin, 2005; Rehm & Catanzaro, 1998; Riebschleger, 2004). This study uses a large national dataset to ask: Are there adverse impacts of having a parent with a disability on child mental health?
Methods
7116 children participated in this secondary data analysis of the 2006 National Health Interview Survey (NHIS) Person, Family, and Sample Child files. Parental disability was measured using the activity limitation variable in the NHIS. “Activity limitation” includes limitations in work, daily activities, walking, and cognitive functions. We included only children ages four through seventeen because they had data on the dependent variable, the Child Mental Health Brief (CMB).
Missing data patterns were analyzed and missing values were imputed using multiple imputation. Bivariate relationships between parent disability status and other variables were examined. After these preliminary steps, data were analyzed using propensity score matching (PSM). First, propensity scores were estimated using logistic regression with parent group (with or without disability) as the dependent variable and ten independent variables. Second, children of parents with disabilities were matched to children of parents without disabilities using Parsons' (2001) SAS macro for the greedy matching technique. Third, the matched samples were compared on CMB score using a paired samples t-test.
Results
Initial bivariate analyses indicated that children of parents with disabilities were: 1) older, 2) had lower weights at birth, 3) were more likely to be white or African-American, 4) were more likely to be US citizens, 5) were more likely to have health insurance, 6) were more likely to have single parents, 7) lived in lower income families, and 8) were more likely to live in rented homes. Child sex and number of children in the family were retained in the model but not significant.
Prior to PSM, children of parents with disabilities had higher scores on the CMB (t = -7.40, p < .001) and the effect size was moderate (Cohen's d = -.29). After PSM, differences in scores on the CMB were still significant (t = -4.63, p < .001), but the effect size was small compared to pre-match (Cohen's d = -.19).
Implications and Conclusions
Results indicate that children of parents with disabilities are at risk for mental health problems compared to other children, but much of the risk is likely related to co-occurring issues (low income, single parent, etc.) rather than the parent's disability. An interesting finding was that children of parents with disabilities were more likely to have health insurance. This is a possible benefit of having a parent with a disability.
