The rehabilitation process of children with motor disabilities in the Dutch therapeutic toddler class: main phases and parent involvement.

This study describes the implementation of the main phases of the rehabilitation process of children with motor disabilities who visit Dutch therapeutic toddler classes. Parent involvement, as well as parents' and professionals' satisfaction were also investigated. It was found that in about half of the cases there was no initial assessment of the child, nor a jointly formulated intervention plan. When there was an assessment, several quality standards were not met. In most cases parents were involved in the evaluation phase of the rehabilitation process. However, the proportion of parents involved in the phases of assessment and intervention planning were much lower. The results are discussed within the context of current developments in The Netherlands with respect to team communication and recent research findings.

Service needs of parents with motor or multiply disabled children in Dutch therapeutic toddler classes.

OBJECTIVE: To determine parents' service needs at the start of therapeutic toddler class treatment, to analyse determinants and to investigate received help after a period of 10 months. SUBJECTS: Parents with motor or multiply disabled children in therapeutic toddler classes. SETTING: Sixteen out of 17 Dutch rehabilitation centres. DESIGN: A sample of 84 parents, stratified according to toddler class size. MAIN OUTCOME MEASURES: A questionnaire of 33 items, divided into five categories, was designed to assess parents' needs and to evaluate the amount of received help. Several measures were used to assess child, parent and family characteristics. RESULTS: Based on factor analysis, five need subscales were distinguished which only partially corresponded to the initial categories. The initial category concerning needs for help in family functioning did not come out as a factor. Needs expressed most frequently belonged to the three subscales of needs for information concerning the child. The average level of needs generally did not differ for mothers and fathers across the subscales. However, we found large variation in needs for both mothers and fathers on each subscale. The most important, positively correlated determinant of parents' needs was social isolation of the family. After 10 months a considerable level of unmet needs was found. CONCLUSIONS: A systematic and periodic assessment of individual needs of parents as well as the services offered is recommended. Professionals of the therapeutic toddler classes should especially focus on providing parents with information on their child's disability and therapy, community services and parenting.

Perceived changes in well-being of parents with a child in a therapeutic toddler class.

A 15-item questionnaire was developed to measure the perceived changes in well-being of parents with a motor disabled child during treatment in a Dutch therapeutic toddler class. Eighty-one mothers and 67 fathers completed the questionnaire. Factor analyses showed that two dimensions had to be distinguished in the questionnaire data. Parents perceived a positive change in well-being 10 months after their child started visiting the therapeutic toddler class. Mothers as well as fathers said to have gained more insight in their child's abilities and to feel less that they are all on their own. The impact of the toddler class program on well-being was greater for mothers than for fathers, especially with respect to feeling fit, planning social activities, and having time for their own relaxation. Fathers, however, gained more insight in the abilities of the child than mothers did after ten months. Regression analyses showed some family, parent, and child characteristics to be predictive of mothers' and fathers' perceived change in well-being. Implications of these findings for future research are discussed.

The relationship between mutual family relations and child psychopathology.

The associations of the mutual mother-child, father-child, and mother-father relationship and various patterns of family relations with child psychopathology were investigated in a sample of 137 families referred to outpatient mental health services. Assessment of the relative association of the different family dyads showed that both the mother-child and the mother-father relationship were related to child problem behaviour. However, whereas the mother-child relationship was consistently more related to externalising behaviour, the mother-father relationship was particularly related to internalising behaviour. Our findings gave clear support for the cumulative risk model: having more negatively qualified relationships was associated with more problem behaviour. Furthermore, our results suggested a protective influence of the parent-child relationship: having one or two positive parent-child relationships was associated with less problem behaviour. No support was found for the cross-generational coalition hypothesis. Implications for future research are discussed.