Journal of Child and Family Studies, Vol. 6, No. 4, 1997, pp.

471-485

Stress in Mothers with Intellectual Disabilities

Maurice A. Feldman, Ph.D.,1,4 Michele Leger, Hon., B.A.,1 and
Nicole Walton-Allen, Ph.D.2

Both low parental IQ and stress have been shown to be associated with
parenting difficulties and adverse child outcomes. We examined stress in
parents with low IQ as a potential contributor to their documented parenting
problems. Eighty-two mothers with intellectual disabilities (IQ < 80; labelled
as having mental retardation) were given the Parenting Stress Index and they
were found to be enduring very high levels of overall stress (95th percentile),
stress related to child characteristics (95th percentile), and stress related to
other life experiences (90th percentile) as compared to the normative test group.
We divided the 82 mothers with intellectual disabilities into three groups
depending on the age of their children. The mothers with school-age children
reported significantly higher stress than parents of infant/toddler and preschool
children. A hierarchical regression analysis revealed that child age and living
in a crowded environment were significant predictors of parenting stress. The
results confirm that mothers with intellectual disabilities experience extreme
stress that, together with other factors, may hinder adequate parenting.
KEY WORDS: stress; parents with intellectual disabilities; parenting problems.

Stressful life experiences have been shown to affect parental psycho-

logical functioning, parenting behaviors, and child outcomes. Stress is
experienced when the subjective demands of a situation are incompatible
1Associate Professor, Department of Psychology, Queen's University and Chief Psychologist,
Ongwanada Centre, Kingston, Ontario, Canada.
2Student, University of Ottawa, Ottawa, Ontario, Canada.
3Private Practice, Hamilton, Ontario, Canada.
4Correspondence should be directed to Maurice Feldman, Department of Psychology, Queen's
University, Kingston, Ontario, Canada K7L 3N6. Electronic mail may be sent to
feldman@pavlov.psyc.queensu.ca.

471
1062-1024/97/1200-0471$12.50/0 © 1997 Human Sciences Press, Inc.
472 Feldman, Leger, and Walton-Allen

with the response capabilities of the individual (Straus & Kantor, 1987).
From an interactional perspective, the impact of stress on parental emo-
tional functioning and parenting is mediated by characteristics of the
parent, child, and the environment (Belsky, 1984; Dohrenwend & Dohren-
wend, 1969).
Most research in stress and parenting has been conducted with
mothers, who typically take primary responsibility for child-care. Stress is
related to adverse physical and emotional problems in mothers (Bee,
Hammond, Eyres, Barnard, & Snyder, 1986; Ilfeld, 1977). Maternal stress
is associated with negative mother-child interactions (Crnic, Greenberg,
Robinson, & Ragozin, 1984; Forehand, Lautenschlager, Faust, &
Graziano, 1986; Webster-Stratton, 1988; Weinraub & Wolfe, 1983).
Weinraub and Wolfe (1983) found that the frequency of stressors
experienced by mothers tended to correlate negatively with child-rearing
abilities and that increased stress interfered with the mother's ability to
respond appropriately and bond to her infant. Stressful life events, marital
discord, and self-reported depression in mothers were correlated with
more maternal commands, criticisms, and physical punishment of children
(Forehand et al., 1986; Webster-Stratton, 1988). Socially isolated mothers
who reported feeling stressed were negative, confrontational, and
unpredictable with their children (Dumas & Wahler, 1985, Panaccione &
Wahler, 1986).
In addition to its relation to negative maternal behaviors, family
stress places children at an increased risk for developmental and behav-
ioral problems. Maternal stress was associated with low developmental
test scores at 8 months of age (Garcia-Coll, Vohr, Hoffman, & Oh, 1986),
and emotional maladjustment and school problems in older children
(Sandier & Block, 1980). Bee et al. (1986) found that stress is not just
a reaction to but also may precipitate child problems. That is, mothers
experiencing high levels of stress and life change (that adversely affected
maternal health) during the child's first year of life had children with
lower IQ, delayed language, and more problem behavior at 4 years of
age (Bee et al., 1986). In a series of structural equation modelling studies
involving hundreds of boys, Patterson, DeBaryshe, and Ramsey (1989)
have found that parental stressors tend to act indirectly on child behavior
problems by disrupting positive parenting practices that directly affect
child behavior.
Factors correlated with increased risk of maternal stress and related
parenting problems include low socioeconomic status (Brown & Harris,
1979, Garmezy & Rutter, 1983), martial discord (Emery & Tuer, 1993),
single parenting (Weinraub & Wolfe, 1983), social isolation (Dumas & Wa-
hler, 1985; Panaccione & Wahler, 1986), dissatisfaction with supports
Stress in Mothers with Intellectual Disabilities 473

(Weinraub & Wolfe, 1983), and unemployment (Brown & Harris, 1978).
In addition, high parental stress was associated with having three or more
young children (Brown & Harris, 1978), a child with disabilities (Benedict,
Wulff, & White, 1992; Frey, Greenberg, & Fewell, 1989; Minnes, 1988),
and/or behavior problems (Eyberg, Boggs, & Rodriguez, 1992; Mash &
Johnston, 1983; Quine & Pahl, 1991).
Thus, parental stress has been implicated with adverse consequences
for parents and children. One group of parents who are likely to be at
high risk for stress and parenting incompetency are parents with intellectual
disabilities (ID). Parents with ID are those with IQ less than 80 and many
of them are labelled as having mental retardation. Parents with ID expe-
rience many of the risk factors that may exacerbate their poor parenting
skills.
There have been longstanding concerns about people with mental
retardation becoming parents (Dowdney & Skuse, 1992). As a result of
the community living movement, banning of involuntary sterilization,
repeal of discriminatory marriage laws, and other factors, the number of
adults with mental retardation living in the community and raising children
has steadily increased (Dowdney & Skuse, 1992; Tymchuk & Feldman,
1991). They are overrepresented in child maltreatment cases (Seagull &
Scheurer, 1986; Taylor et al., 1991) and have documented parenting
deficiencies that place their children at-risk for neglect and developmental
and behavior problems (Feldman, 1994, 1997; Feldman, Case, Towns, &
Betel, 1985; Feldman, Case, & Sparks, 1992; Feldman, Sparks, & Case,
1993; Feldman & Walton-Allen, 1997; Gillberg & Geijer-Karlsson, 1983;
Reed & Reed, 1965).
The reasons for parenting inadequacy in parents with ID remain
unclear. While it has been accepted that maternal IQ is not solely asso-
ciated with inadequate parenting unless the parent's IQ is below 55-60
(Dowdney & Skuse, 1992; Tymchuk & Feldman, 1991), there is still a
propensity to attribute incompetent parenting and adverse child out-
comes directly to the parents' cognitive deficiencies (Hayman, 1990, Vo-
gel, 1987). But, because not all children of parents with ID have problems
or the same types of problems (Feldman et al., 1985; Feldman & Wal-
ton-Allen, 1997), other factors besides, or in addition to, low parental
IQ may be involved. For example, it is not certain to what extent parents
with ID endure considerable stress that may contribute to their parenting
problems.
There is reason to believe that having intellectual disabilities may place
a person at increased risk for high levels of stress. Persons with ID may
experience extraordinary stress resulting from a history of abuse (Tymchuk,
1990), low socioeconomic status (Conley, 1973), stigmatization (Abramson,
474 Feldman, Leger, and Walton-Allen

Parker & Weisberg, 1988, Edgerton & Bercovici, 1976), a history of failure
and learned helplessness (Floor & Rosen, 1975), unemployment (Green-
span & Schoultz, 1981), and social isolation (Reiss & Benson, 1985).
Parents with ID may also undergo additional stress due to the constant
threat of child removal by child protection agencies (Hayman, 1990; Tym-
chuk & Feldman, 1991), the lack of support for their parenting role
(Tymchuk, 1992), single parenting and the lack of a supportive, ultimate
partner (Walton-Allen & Feldman, 1991). These risk factors may individu-
ally, collectively, and/or cumulatively create a highly stressful situation
which may impede adequate parenting by persons with ID. Nevertheless,
stress in parents with ID has received little attention.
The purpose of our study was to examine parental stress encoun-
tered by mothers with ID who had children belonging to one of three
age categories: infants/toddlers (age range = 0-2 years), preschool chil-
dren (age range = 2-5 years), and school-age children (age range =
6-12 years). We were interested in determining if stress level is related
to child age. Caring for infants may be less stressful for parents than
caring for older children because babies are well below the parents in-
tellectually. Although parenting a child of any age is complicated, the
basic physical child-care and relatively simple interactions needed for
infants may be easier to provide than the parenting skills required to
address the complex emotional, social, and cognitive needs of older chil-
dren. As children get older, parents may face more complicated parent-
ing problems that require more sophisticated problem-solving skills. We
hypothesized that mothers with ID would report significantly higher
stress levels than a normative sample of parents without disabilities, and
that stress levels will be higher in mothers with older children. In addi-
tion to child age, we also explored other potential stressors, such as liv-
ing in crowded conditions and the threat of child removal by child
protection agencies.

METHOD

Participants

The participants were 82 mothers who were intellectually disabled (IQ

< 80), with no known biological reasons for their cognitive deficiencies. All
mothers had been previously independently diagnosed as having mental re-
tardation (usually when in school), although some did not meet all the
DSM-IV diagnostic criteria for mental retardation — IQ < 70-75 (Ameri-
can Psychiatric Association, 1994). The parents continued to be eligible for,
Stress in Mothers with Intellectual Disabilities 475

and received, specialized services and funding reserved for people with
mental retardation (e.g., a disability pension, an advocate, community living
skills training). Sixty parents had recent WAIS-R scores with a range of
57-80; 62% of update IQs were 75 or below. Participants were referred by
community agencies providing services to adults with mental retardation,
child protection agencies, advocates, nurses, physicians, hospital social
workers, and family members. All mothers were welfare recipients and, in
addition to being eligible for benefits and services for persons with mental
retardation, they were also able to access services for economically disad-
vantaged families (e.g., public health nurse, early intervention, parent
education, and community drop-in centers). All participants gave consent
to allow the information collected about them to be used in a confidential
manner for research purposes.
Mothers were placed in one of three groups depending on the age of
the target child: (a) the Infant/toddler Group consisting of 30 mothers who
had children less man 2 years of age; (b) the Preschool Group consisting
of the 19 mothers who had children aged 2 to 5 years; and (c) the School-
Age Group consisting of the 33 mothers who had children older than 5
years of age. Demographic data on the three groups of mothers and their
children are presented in Table 1. For those mothers who had more than
one child, the mother's youngest child was the target child in our study.
None of the children in our study had any known biological disabilities
which could affect their development.

Table 1. Means and Standard Deviations of Demographic Variables for Three Groups of
Mothers
Infant Group Preschool Group School-age Group
Variables (n = 30) (n = 19) (« = 33)

Mean Mat. IQ 71.64 (6.29) 71.69 (7.09) 65.85 (7.03)*

Mean Mat. Age (years) 26.33 (5.40) 29.89 (6.64) 35.36 (4.67)*
Mean No. of Children 1.29 (0.54) 1.41 (0.51) 1.94 (0.79)*
Mean Crowding Ratioa 0.73 (0.92) 0.64 (0.56) 1.21 (0.59)*
Mean No. of Services 2.57 (0.94) 1.74 (2.88) 2.27 (1.44)
% Single 40% 32% 15%
% Subsidized housing 75% 82%** 67%
% Child Protect. Involv. 89% 77% 27%
Mean Child Age (months) 10.80 (5.41) 36.74 (11.23) 117.24 (25.89)***
Notes: numbers in parentheses are standard deviations; *Mothers of School-age children were
significantly different from mothers in both the Infant/toddler and Preschool Groups (p <
.05); **PreschooI Group significantly different from both the Infant/toddler and School-Age
Groups (p < .05); ***A11 groups are significantly different from one another (p < .05);
Group comparisons based on one-way ANOVAs and Scheffe post-hoc tests; acrowding ratio
= no. of persons living in house (apartment) divided by the ro. of rooms.
476 Feldman, Leger, and Walton-Allen

Measures

Demographics

The demographics questionnaire asked questions about: (a) historical

information (e.g., upbringing, medical history, institutional history, educa-
tion, employment, previous marriages and children); (b) maternal and
paternal characteristics (e.g., age, race, current health, marital, and em-
ployment status); (c) family variables (e.g., income, number of children at
home and in care, child protection agency and social services involvement);
and (d) living accommodations (e.g., type, size, total number of people liv-
ing in the house, subsidized). Much of the demographic data were
corroborated by direct observation and/or interviews of family members and
workers who knew the family well. The paternal information that was col-
lected was not used in this study because there was too much missing data
due primarily to an insufficient number of fathers being available to give
consent for their participation and confirm details about them given by the
mother.

Parenting Stress Index

The Parenting Stress Index (PSI; Abidin, 1990) is a 101-item self-re-

port questionnaire designed to measure stress in the parent-child
relationship. Participants respond to each item on a 5 point Likert-type
scale, where high scores indicate high levels of stress. This instrument yields
a Total Stress score and two subscale scores: a Child Domain score and a
Parent Domain score. The Child Domain measures six different areas of
stress associated with child characteristics including adaptability, accept-
ability, demandingness, mood, distractibility/hyperactivity, and reinforces
parent. The Parent Domain measures seven areas of stress related to parent
characteristics including depression, attachment, restriction of role, sense
of competence, social isolation, relationship with spouse, and parent health.
The PSI has acceptable internal consistency, construct validity and test-re-
test reliability (Wantz, 1989).

Procedure

After giving consent, mothers were visited in their homes by project

staff during which time the demographics questionnaire and the PSI were
administered. Assessors were aware of the nature of the mothers' disabili-
ties, but staff were not privy to the specific hypotheses of this study. The
Stress in Mothers with Intellectual Disabilities 477

assessor would read each item outloud and repeat the five choices for each
question of the PSI. Mothers could read along if they wished, and clarifi-
cations and simpler language were used as needed to increase the mothers'
understanding of questionnaire items. None of the mothers had difficulty
comprehending and answering the questions when presented in this man-
ner.

RESULTS

Table 2 presents the means, standard deviations, percentile rankings,

and z-test results of the PSI Total, Child, and Parent Domains scores of
the entire study sample of mothers with ID compared to the normative
sample of parents provided by the test author. As seen in Table 2, the 82
mothers with ID reported considerable stress and scored significantly
higher than the normative sample (n = 600) on the PSI Total, Child Do-
main, and Parent Domain items.
Table 3 presents the mean PSI Total, Child, and Parent Domains
scores, and z-test comparisons with the normative group for the three age
groups. Individual z-tests showed that all three child age groups had sig-
nificantly higher PSI stress scores than parents in the normative group
(Table 3). One-way analyses of variance accompanied by Scheffe post hoc
tests on the PSI Total, Child, and Parent Domains scores revealed that
mothers in the School-Age Group had significantly higher PSI Total scores
and Child Domain scores than mothers in both the Infant/toddler and Pre-
school groups, F(2, 79) = 11.73, p < .01, and F(2, 79) = 17.89, p < .01,
respectively. Mothers with school-age children also had significantly higher
Parent Domain scores than mothers in the Infant/toddler Group, F(2, 79)
= 5.08, p < .05. No other group differences involving PSI Total, Child and
Parent Domains scores were significant.
Table 4 presents the percentile ranking of each group on each PSI
subscale. According to Abidin (1990), scores >80th percentile are consid-

Table 2. Parenting Stress Index of Mothers with ID Compared to the Normative Sample
Mothers with ID (N = 82) Normative Sample (N = 600)
PSI Scales Mean SD %tile Rank Mean SD z-test

Total 281.7 32.1 95 221.1 38.9 z = 19.00**

Child Domain 128.4 18.1 95 98.4 19.2 z = 14.17**
Parent Domain 153.3 20.3 90 122.7 24.6 z = 11.24**
**p < .001.
478 Feldman, Leger, and Walton-Allen

Table 3. Parenting Stress Index Scores for the Three Age Groups and z-test Comparison
with Normative Group
Infant Group Preschool Group School-age Group
(n = 30) (n = 19) (n = 33)
PSI Scales Mean (SD) z-test Mean (SD) z-test Mean (SD) z-test

Total 266.2 (27.9) 6.36** 270.2 (29.3) 5.51** 302.4 (36.2) 12.00**
Child 120.3 (11.8) 6.26** 119.9 (12.8) 4.88** 140.7 (18.8) 12.66**
Parent 145.9 (19.6) 5.16** 150.4 (20.6) 4.89** 161.7 (20.3) 9.11**
**p < .001.

ered to represent clinically significant stress. As seen in Table 4, out of a

possible 16 PSI total, domain, and subscale scores, the Infant/toddler group
had 13 at or above the clinical threshold, the Preschool group had 12, and
the School-age group had 15. Group statistical comparisons of the 13 PSI
subscales were not conducted to reduce the likelihood of chance significant
findings because of multiple testing
Means and standard deviations for the demographic variables are pre-
sented in Table 1. One-way analyses of variance accompanied by Scheffe
post-hoc tests on the demographic variables revealed that mothers in the
School-Age Group were older, had lower IQs, had more children, lived in
more crowded conditions, and had less child protection agency involvement

Table 4. Percentile Rankings" for Each Age Group on the PSI Subscales
PSI Scales Infant Preschool School-age

Total Score 90 90 95
Child Domain 90 90 99
Adaptability 85 85 95
Acceptability 85 90 99
Demandingness 75 85 95
Mood 85 75 95
Distract/Hyperactivity 80 75 85
Reinforces Parent 90 90 95
Parent Domain 85 85 90
Depression 80 80 90
Attachment 95 95 95
Restriction of Role 65 65 75
Sense of Competence 85 90 95
Social Isolation 80 80 85
Relationship to Spouse 75 85 90
Parent Health 80 75 80
aPercentile ranking >80 is considered to be clinically significant stress.
Stress in Mothers with Intellectual Disabilities 479

than mothers in the Infant/toddler and Preschool groups. In addition, sig-

nificantly more mothers with preschool children were living in subsidized
housing than participants in the two other groups; as designed, the child
age differences were significant across groups.
Given these group differences in demographic characteristics, hierar-
chical regression analyses were computed to determine which variables
were significant predictors of PSI Total, Child Domain, and Parent Domain
scores. A correlation matrix for the three dependent measures and the
demographic variables was computed to determine which variables should
be included in hierarchical regression analyses. Child age, child protection
agency involvement, and crowding ratio were the only variables that were
significantly correlated with the PSI Total score (rs = .40, .33, .36, respec-
tively), Child Domain score (rs = .41, .37, .40, respectively), and Parent
Domain score (rs = .33, .25, .28). These variables were subsequently en-
tered into hierarchical regression analyses in which both crowding ratio and
child protection agency involvement were entered on Step 1. Child age was
entered by itself on Step 2 to determine whether child age was a significant
predictor after partialling out the variance attributed to the other variables.
Standardized regression weights (betas) of the regression analyses are
presented in Table 5. The analyses revealed that living in crowded condi-
tions and child age were significant predictors of the PSI Total score. The
addition of child age to the equation on Step 2 resulted in an increment
in R2 from .19 to .26. Child age and living in crowded conditions were also
significant predictors of the Child Domain score. The addition of child age
on Step 2 produces an increment in R from .26 to .34. Hierarchical re-
gression analyses further revealed that child age was a significant predictor
of the Parent Domain score. The addition of child age on Step 2 produced
an increment in R from .10 to .15 for the Parent Domain.

DISCUSSION

We found that mothers with ID raising infants/toddlers, preschoolers,

or school-age children endured clinically significant levels of stress and that
maternal stress increased when the child reached school age. Mothers of
school-age children reported stress related to child characteristics in the
99th percentile on the PSI (Abidin, 1990). These mothers reported signifi-
cantly more stress than mothers of infants/toddlers and preschoolers.
Hierarchical regression analyses revealed that crowded living conditions
and child age predicted PSI total stress scores and Child Domain stress
scores (i.e., stress related specifically to child characteristics such as de-
mandingness, adaptability, mood); child age was also a significant predictor
480 Feldman, Leger, and Walton-Allen

Table 5. Standardized Regression Weights (Betas) from Hierarchical Regression Analyses

for Variables Predicting PSI Total, Child Domain and Parent Domain Scores (N = 82)
Dependent Variables
Independent Variables Total Score Child Domain Parent Domain

Step 1
Crowding Ratio 0.26* 0.32** 0.18
Child Protection Agency
Involvement 0.29* 0.33** 0.22
R Square 0.19 0.26 0.10
F 7.56** 11.51** 3.49*
Step 2
Crowding Ratio 0.22* 0.28* 0.14
Child Protection Agency
Involvement 0.14 0.18 0.09
Child Age 0.31* 0.32** 0.26*
R Square 0.26 0.34 0.15
F 7.56** 10.77** 3.67*
Note. *p < .05, and **p < .01.

of Parent Domain stress scores (i.e., stress related to the parent's life and
affect such as depression, marital satisfaction, sense of competency).
Following the interactional model of parenting (Belsky, 1984), differ-
ences in parent, environmental, and child characteristics of families with chil-
dren of different ages may contribute to the findings in our study that
mothers with ID who had school-age children reported more stress than
parents of younger children. Indeed, with respect to parental and environ-
mental variables, demographic information suggested that mothers of
school-age children were older, had lower IQs, lived in more crowded con-
ditions, and had less child protection scrutiny than mothers of infants/tod-
dlers and preschoolers.
One experience that parents of older children have that parents of
younger children do not, is interacting with the school system. Many parents
with ID who have school-age children have told us that they experienced
considerable stress in dealing with the school system. Interacting with teach-
ers and other school personnel may be very stressful for these parents
because of their limited cognitive abilities and ongoing stigmatization of
family members by school staff, other parents, and students. Parents may
feel stressed because of their inability to help their children with school-
work. Just being in the school may revive unpleasant memories about the
parents' own aversive school experiences that often consisted of failures
and put-downs. This feedback from the parents requires further explora-
tion.
Stress in Mothers with Intellectual Disabilities 481

It is also possible that parents of school-age children experience more

stress because their children have certain characteristics that make them
more difficult to parent than younger children. Some of the older children
may surpass their parents intellectually and their parents could have prob-
lems understanding their child's more sophisticated communication and
abstract reasoning. The brighter children may also take advantage of their
parents and the parents may have trouble enforcing discipline (O'Neill,
1985). Feldman and Walton-Allen (1997) found high rates of behavior dis-
orders in school-age children of mothers with ID and that the more
intelligent children were more likely to have multiple behavior problems.
As child behavior problems are associated with high levels of stress in par-
ents without ID (Eyberg et al., 1992), it is possible that many parents with
ID experience stress related to their inability to control their children's be-
havior. Future research will need to determine if child behavior disorders
increase with age in these families and the extent to which child behavior
problems predict stress in parents with ID.
Another child characteristic that may be related to increased parental
stress is developmental delay (Benedict et al., 1992; Minnes, 1988). Indeed,
cumulative evidence suggests that children of parents with ID are at increased
risk for low IQ, learning disabilities, and academic problems (Feldman et al.,
1985; Feldman & Walton-Allen, 1997, Gillberg & Geijer-Karlsson, 1983;
Reed & Reed, 1965). Research with parents (without ID) of children with
developmental disabilities has shown that raising school-age children may be
more stressful than caring for younger children (Gallagher, Beckman &
Cross, 1983; Orr, Cameron, Dobson, & Day, 1993). Future research will need
to investigate the impact of child developmental and learning disabilities on
the stress of parents with ID raising children of different ages.
Certain limitations of our study should be noted. First, the mothers
in our study were already known to, and referred by, community agencies;
in many cases, concerns were raised about parental competencies. Addi-
tional research is needed to confirm the generalizability of our findings to
all mothers with ID, although it may not be feasible to identify a truly
representative sample (i.e., finding those who have not come to the atten-
tion of the social service and child welfare systems). Second, reliable
information on the fathers was not available for our study. The scores on
the PSI marital satisfaction subscale in our study suggested that the
mother's intimate relationship was a source of stress. Future research in-
vestigating stress in parents with ID should include fathers and explore the
contribution of the spousal relationship on parental and child wellbeing.
Our study also lacked child outcome measures to correlate with the PSI
scores. Future studies should include longitudinal measures of child intel-
lectual development and behavior problems to ascertain the complex
482 Feldman, Leger, and Walton-Allen

relationship between parental stress and child problems (Bee et al., 1986;
Patterson et al., 1989). Psychopathology of the mothers with ID was not
extensively investigated in this study. People with mental retardation are
at-risk for psychiatric disorders (Reiss, 1990; Yu & Atkinson, 1993) and
the PSI depression subscale scores in our study suggested that the mothers
were feeling despondent; further research is needed to delineate the rela-
tionship between stress, parenting, child outcomes, and mental health
problems in mothers with ID.
Parental stress is known to have detrimental effects on parenting and
child outcomes. High levels of maternal stress have been associated not
only with negative mother-child interactions (Crnic et al., 1984; Forehand
et al., 1986), but also with adverse child outcomes such as lower IQ, be-
havior and developmental problems (Bee et al., 1986; Sandier & Block,
1980). Previous research has shown that mothers with ID may have par-
enting problems that seriously threaten their children's health and
well-being (Feldman et al., 1992); their children are also at-risk for signifi-
cant problems in development and social adjustment (Feldman et al., 1985,
1993; Feldman & Walton-Allen, 1997). We see now that mothers with in-
tellectual disabilities also endure extreme stress in their role as parents and
it is likely that stress plays a role in parenting failure.
This is the first study to empirically document heightened stress levels
in mother with ID and to show that their stress is related to child age. The
impact of stress on parenting and child outcomes needs further investiga-
tion. The potential dehabilitating effects of parental stress should be
considered when assessing parenting competency, and designing and pro-
viding interventions for these families.

ACKNOWLEDGMENTS

This research was supported by grants from the Ontario Mental Health
Foundation and Ontario Ministry of Community and Social Services Re-
search Grants Program (administered by the Research and Program Evalu-
ation Unit). We thank Jayne Carnwell, Laurie Case, Amy Cheung, Maria
Garrick, Wanda MacIntyre-Grande, Sylvia Hains, and Bruce Sparks for their
contributions to the collection, organization, and analysis of the data.

REFERENCES

Abidin, R. R. (1990). Parenting Stress Index — Manual. Charlottesville, VA: Pediatric

Psychology Press.
 Stress in Mothers with Intellectual Disabilities 483
Abramson, P., Parker, T., & Weisberg, S. (1988). Sexual expression of mentally retarded
people: Educational and legal implications. American Journal on Mental Retardation, 93.
328-334.
American Psychiatric Association (1994). Diagnostic and statistical manual of mental disorders.
Fourth Edition (DSM-IV). Washington, DC: Author.
Bee, H. L., Hammond, M. A., Eyres, S. J., Barnard, K. E., & Snyder, C. (1986). The impact
of parental life change on the early development of children. Research in Nursing and
Health, 9, 65-74.
Belsky, J. (1984). The determinants of parenting: A process model. Child Development, 55,
83-96.
Benedict, M.I., Wulff, L. & White, R. (1992). Current parental stress in maltreating and
nonmaltreating families of children with multiple disabilities. Child Abuse & Neglect, 16,
155-163.
Brown, G. W. & Harris, T. (1978). The social origins of depression: A study of psychiatric
disorder in women. London: Tavistock Publications.
Conley, R. W. (1973). The economics of mental retardation. Baltimore: John Hopkins
University Press.
Crnic, K. A., Greenberg, M. T., Robinson, N. M., & Ragozin, A. S. (1984). Maternal stress
and social support: Effects on the mother-infant relationship from birth to eighteen
months. American Journal of Orthopsychiatry, 54, 224-235.
Dohrenwend, B., & Dohrenwend, B (1969) Social status and psychological disorders, New York:
Wiley.
Dowdney, L., & Skuse, D. (1992). Parenting provided by adults with mental retardation.
Journal of Child Psychology and Psychiatry, 34, 25-47.
Dumas, J., & Wahler, R. (1985). Indiscriminate mothering as a contextual factor in
aggressive-oppositional child behavior. Journal of Abnormal Child Psychology, 13, 1-17.
Edgerton, R. B., & Bercovici, S. M. (1976). The cloak of competence: Years later. American
Journal of Mental Deficiency, 80, 485-497.
Emery, R. E., & Tuer, M. (1993). Parenting and the marital relationship. In T. Luster & L.
Okagaki (Eds.), Parenting: An ecological perspective (pp. 121-148). Hillsdale, NJ: Lawrence
Erlbaum Associates.
Eyberg, S. M., Boggs, S. R., & Rodriguez, C. M. (1992). Relationships between maternal
parenting stress and child disruptive behavior. Child and Family Behavior Therapy, 14,
1-9.
Feldman, M. A. (1994). Parenting education for parents with intellectual disabilities: A review
of outcome studies. Research in Developmental Disabilities, 15, 299-332.
Feldman, M. A. (1997). The effectiveness of early intervention for children of parents with
mental retardation. In M. J. Guralnick (Ed.). The effectiveness of early intervention:
Directions far second generation research (pp. 171-191). Baltimore: Paul H. Brookes.
Feldman, M. A., Case, L., Towns, F., & Betel, J. (1985). Parent education project I:
Development and nurturance of children of mentally retarded parents. American Journal
of Mental Deficiency, 90, 253-258.
Feldman, M. A., Case, L,, & Sparks, B. (1992). Effectiveness of a child-care training program
for parents at-risk for child neglect. Canadian Journal of Behavioural Science, 24, 14-28.
Feldman, M. A., Sparks, B., & Case, L. (1993). Effectiveness of home-based early intervention
on the language development of children of parents with mental retardation. Research
in Developmental Disabilities, 14, 387-408.
Feldman, M. A., & Walton-Allen, N. (1997). Maternal mental retardation and poverty:
Intellectual, academic, and behavioral status of school-age children, American Journal on
Mental Retardation, 101, 352-364.
Floor, L, & Rosen, M. (1975). Investigating the phenomenon of helplessness in mentally
retarded adults. American Journal of Mental Deficiency, 79, 565-572.
Forehand, R., Lautenschlager, G., Faust, J., & Graziano, W. G. (1986). Parent perceptions
and parent-child interactions in clinic referred children: A preliminary investigation of
the effects of maternal depressive moods. Behaviour Research and Therapy, 24, 73-75.
484 Feldman, Leger, and Walton-Allen

Frey, K., Greenberg, M., & Fewell, R. (1989). Stress and coping among parents of
handicapped children: A multidimensional approach. American Journal on Mental
Retardation, 94, 240-249.
Gallagher, J., Beckman, P., & Cross, A. (1983). Families of handicapped children: Sources
of stress and its amelioration. Exceptional Children, 50, 10-19.
Garcia-Coll, C, Vohr, B., Hoffman, J., & Oh, W. (1986). Maternal and environmental factors
affecting developmental outcome of infants of adolescent mothers. Developmental
Behavioral Pediatrics, 7, 230-236.
Gammezy, N., & Rutter, M. (1983). Stress, coping and development in children. New York:
McGraw-Hill.
Gillberg, C, & Geijer-Karlsson, M. (1983). Children born to mentally retarded women: A
1-21 year follow-up study of 41 cases. Psychological Medicine, 13, 891-894.
Greenspan, S., & Schoultz, B. (1981). Why mentally retarded adults lose their jobs: social
competence as a factor in work adjustment. Applied Research in Mental Retardation, 2,
23-38.
Hayman, R. L. (1990). Presumptions of justice: Law, politics and the mentally retarded parent.
Harvard Law Review, 103, 1201-1274.
Ilfeld, F. W. (1977). Current social stressors and symptoms of depression. American Journal
of Psychiatry, 134, 161-166.
Mash, E. J., & Johnston, C. (1983). Parental perceptions of child behavior problems, parenting
self-esteem, and mother's reported stress in younger and older hyperactive and normal
children. Journal of Consulting and Clinical Psychology, 51, 86-99.
Minnes, P. M. (1988). Family resources and stress associated with having a mentally retarded
child. American Journal on Mental Retardation, 93, 184-192.
O'Neill, A. M. (1985). Normal and bright children of mentally retarded parents: The Huck
Finn syndrome. Child Psychiatry and Human Development, 15, 255-268.
Orr, R. R., Cameron, S. J., Dobson, L. A., & Day, D. M. (1993). Age-related changes in
stress experienced by families with a child who has developmental delays. Mental
Retardation, 31, 171-176.
Panaccione, V F, & Wahler, R (1986) Child behavior, maternal depression and social coercion
as factors in the quality of child care. Journal of Abnormal Child Psychology, 14, 263-278.
Patterson, G. R., DeBaryshe, B. D., & Ramsey, E. (1989). A developmental perspective on
antisocial behavior. American Psychologist, 44, 329-335.
Quine, L., & Pahl, J. (1991). Stress and coping in mothers caring for a child with severe
learning difficulties: A test of Lazarus' transactional model of coping. Journal of
Community and Applied Social Psychology, 1, 57-70.
Reed, E. W., & Reed, S. C. (1965). Mental retardation: A family study. New York: Saunders.
Reiss, S. A. (1990). Prevalence of dual diagnosis in community-based day programs in the
Chicago metropolitan area. American Journal on Mental Retardation, 94, 578-585.
Reiss, S., & Benson, B. A. (1985). Psychosocial correlates of depression in mentally retarded
adults: I. Minimal social support and stigmatization. American Journal of Mental
Deficiency, 89, 331-337.
Sandier, W., & Block, M. (1980). Life stresses and maladjustment of poor children. American
Journal of Community Psychology, 8, 41-52.
Seagull, E. A., & Scheurer, S. L. (1986). Neglected and abused children of mentally retarded
parents. Child Abuse and Neglect, 10, 493-500.
Straus, M., & Kantor, G. (1987). Stress and child abuse. In R. Heifer & R. Kempe (Eds.),
The battered child (pp 42-59) Chicago: The University of Chicago Press.
Taylor, C. G., Norman, D., Murphy, J., Jellinek, M., Quinn, D., Poitrast, F. & Goshko, M.
(1991). Diagnosed intellectual and emotional impairment among parents who seriously
mistreat their children: Prevalence, type and outcome in a court sample. Child Abuse &
Neglect, 15, 389-401.
Tymchuk, A. J. (1990). Parents with mental retardation: A national strategy. Journal of
Disability Policy Studies, 1, 43-55.
Tymchuk, A. J. (1992). Predicting adequacy of parenting by people with mental retardation.
Child Abuse and Neglect, 16, 165-178.
Stress in Mothers with Intellectual Disabilities 485

Tymchuk, A. J., & Feldman, M. A. (1991). Parents with mental retardation and their children:
A review of research relevant to professional practice. Canadian Psychology/Psychologie
Canadienne, 32, 486-496.
Vogel, P. (1987). The right to parent. Entourage, 2, 33-39.
Walton-Allen, N., & Feldman, M. A. (1991). Perceptions of service needs by parents who are
mentally retarded and their workers. Comprehensive Mental Health Care, 1, 57-67.
Wantz, R. A. (1989). Review of the Parenting Stress Index. In J. C. Conoley & J. J. Kramer
(Eds.), The tenth mental measurements yearbook (pp. 602-603). Lincoln, NE: University
of Nebraska Press.
Webster-Stratton, C (1988). Mother's and father's perceptions of child deviance: Roles of
parent and child behaviors and parent adjustment. Journal of Consulting and Clinical
Psychology, 56, 909-915.
Weinraub, M., & Wolfe, B. M. (1983). Mother-child interactions in single and two-parent
families. Child Development, 54, 1297-1311
Yu, D., & Atkinson, L. (1993). Developmental disability with and without psychiatric
involvement: Prevalence estimates for Ontario. Journal on Developmental Disabilities, 2,
92-97.