Psychological Reports, 1994, 75, 1363-1368.

O Psychological Reports 1994

PARENTAL RESPONSE TO THEIR CHILD'S

HEARING IMPAIRMENT '

HAND& J. BRAND AND MARIE A. COETZER

Universily of Stellenbosch

Summary.-The differential patterns of behaviour of hearing parents (30 married

couples) who cope with the reality of parenting a hearing-impaired child were studied.
Responses on the Questionnaire on Resources and Stress indicated no significant dif-
ferences between mothers and fathers for pessimism, child characteristics, and physical
incapacitation. Mothers obtained a significantly higher stress-response on their percep-
tion of difficulties for themselves, other family members, and the family as a whole.
Parents with more education reported less stress than those with less education. Moth-
ers perceived the emotional support they received from their spouses as insufficient
and the amount of free time they had for themselves as inadequate.

Although the psychological effects of a hearing-impaired child on the

family dynamics has been discussed in the literature (Fellendorf & Harrow,
1970; Meadow & Trybus, 1979), it is not clear how and to what extent the
effect is observable (Bodner-Johnson, 1985). Parents are the single most im-
portant source of identification of children with auditory impairments. In a
study by Barringer, Strong, Blair, Clark, and Watkins (1993) parental suspi-
cion and referral were the procedures of identification for 80% of the
children (N = 1404) studied. When parents suspect a significant hearing loss
in a young child, a unique and complex interpersonal situation often devel-
ops (Freeman, Malkin, & Hastings, 1975; Friedrich, 1977).
The complexity of parental response to a child's hearing disability is il-
lustrated by conflicting research results. Noveas (1986) reported that low-in-
come mothers of hearing-impaired children in Brazil did not perceive them-
selves as primarily responsible for their children's progress. Whitson (1986)
found high parental acceptance and trust scores and positive evaluation by
parents of their hearing-impaired children. Both mothers and fathers of hear-
ing-impaired youths rated their adolescents' friendships as higher in aggres-
sion than did parents of hearing adolescents (Henggeler, Watson, & Whelan,
1990). In a case study (Lartz & McCollum, 1990), a mother, while reading,
asked the hearing twin twice as many questions as she asked the deaf twin.
She asked the hearing twin primarily conventional questions but the deaf
twin more gestural questions.
Caring for children with auditory impairments may not be the main
issue for parents. I t is rather the process of seeing a child in discomfort and

'The authors extend their ratitude towards Jurgens D. M. Hanekom for his valuable advice
during the initial stages of A s study. Re uest reprints from Handre J. Brand, Director, Unit for
Counselling Psychology, University of staenbosch, Stellenbosch 7600, South Africa.
1364 H. J. BRAND & M A . COETZER

not being able to remove the distress (Brooks, 1987). Further, it has been
assumed that involvement in multiple roles (a phenomenon particularly rele-
vant to women) is primarily a source of conflict and stress for mothers of
exceptional children (Baruch & Barnett, 1980).
Hamner and Turner (1990) suggested that attachment bonds may be
weaker between deaf children and their mothers than between hearing chil-
dren and their mothers, and deaf parents may be better able to establish
more positive relationships with their deaf children than are hearing parents.
O n the other hand, Greenberg and Marvin (1979) found that attachment
patterns in 28 profoundly deaf preschool children were significantly related
to the communication style between mother and child. Total communicators
showed relaxed social behaviour when the mother returned after separation,
while more oral children showed resistant and ignoring behaviour patterns.
Parents normally turn to their physicians to provide a prompt and accu-
rate diagnosis. The invisibility of the condition unfortunately often leads to
misdiagnosis or even no diagnosis at all. Researchers (Haas & Crowley, 1982;
Kroth, 1987; Phillips, 1987; Williams & Darbyshire, 1982) have pointed out
the importance of early intervention, supportive counselling, and didactic
education of parents in leading to meaningful, mutually satisfying communi-
cation between the hearing-impaired child and the parents. Barringer, et al.
(1993) recommended that public-service announcements should be developed
for radio, television, and newspapers to explain the importance of early iden-
tification.
The primary aim of this study was to obtain more understanding of the
differential patterns of behaviour of hearing parents having to cope with the
reality of parenting a young hearing-impaired child. Specific questions were
formulated and included matters such as, Do mothers of hearing-impaired
children score significantly higher on a stress questionnaire than the fathers?
Is there any meaningful relationship between the amount of stress experi-
enced by parents and their chronological age? Is the stress-response in par-
ents related to the parent's education and to the extent of the child's hearing-
loss? This study was designed to address the complex issue of gender differ-
ences and emotional experiences surrounding the effects of an auditorily
impaired child on parental attitudes.

Szrbjects
The subjects were 30 married couples (N= 60) who were the parents of
30 hearing-impaired children. All subjects were parents of chddren who were
involved in an educational programme at the Carel du Toit Centre for hear-
ing-impaired children at Tygerberg Hospital, Cape Town, South Africa. Sub-
jects included both Afrikaans-speaking (60%) and English-speaking (40%)
 PARENTAL RESPONSE TO IMPAIRED CHILD 1365

parents, and their ages ranged from 26 to 52 years. The mean age of the
fathers was 35.2 yr. and that of the mothers 32.6 yr. With regard to the edu-
cation of the parents, 28% of the sample obtained post-Grade 12 qualifica-
tions while the rest had attained Grade 12 or lower. Most of the parents
(96.6%) were the biological mothers and fathers, while in two cases the bio-
logical mother had remarried and the new spouse had adopted the children.
The children's ages ranged from 11 mo. to 11 yr. (M= 5.0 yr.). Of the
total number, 4 children (13%) were the only children in the family, 7 (23%)
the eldest child, and 13 (43%) the youngest child. Twenty-three children
(77%) had a severe or profound hearing loss and 23% a moderate or d d
loss.
Questionnaires and Interview
A biographical questionnaire was constructed to obtain basic demo-
graphic and attitudinal data. Items referred to crisis-related factors such as
the age of the child when the hearing-impairment was discovered, how the
problem initially was discovered by the parents, the period of time which the
parents experienced as most stressful, the parents' conceptualisation of their
initial reaction to the diagnosis of hearing-impairment in their child and
their reaction after the diagnosis was made known.
The QRS-F is a short-form of the Questionnaire on Resources and
Stress (QRS), a 285-item true-false instrument developed to measure the ef-
fects of a developmentally delayed, handcapped, or chronically ill child on
other family members (Friedrich, Greenberg, & Crnic, 1983). Data from 289
subjects, item-andysed by Friedrich, et al. (1983), resulted in a 52-item scale
which measures four stress-related factors, uix., parent and family problems,
pessimism, child characteristics, and physical incapacitation. The short-form
total score correlated significantly with the QRS total score (r = 0.997, p <
.001) and produced a KR-20 reliability coefficient of 0.93 (p < ,001).
AU couples were interviewed individually over a 3-mo. period. The bio-
graphical questionnaire was used as a framework around which interviews
were conducted. Both parents were interviewed together and the duration of
the interviews ranged from 40 to 150 minutes. Parents were asked to re-
spond to the QRS-F separately.
RESULTS
The Wilcoxon test (Ferguson, 1971) was used to ascertain whether gen-
der differences in responses of couples on the QRS-F were significant ( p ~
.05). The power-efficiency (Siegel, 1956) of the Wilcoxon test for large sam-
ples (N>25) compared with the t test is 95.5 percent. No significant differ-
ences were found between mothers and fathers for the global stress score (z =
.9O, p = .18), pessimism (z = 1.34, p = .09), child characteristics (z = .85, p =
.20), and physical incapacitation ( z = .49, p = .31). Responses on Scale 1 (par-
ent and family problems) yielded a significant z score (z = 2.44, p = .007), in-
dicating higher mean stress response for mothers.
1366 H. J. BRAND & M. A. COETZER

Parents with more education ( 213 yr.) reported significantly (xLZ=

6.03, p<.05) less stress in terms of QRS-F global score than parents who
had less education (12 yr. and below).

TABLE 1
BETWEENINTENSITY
RELATIONSFLIP OF STRESS AND PARENTS'
EDUCATION
Amount of Education Questionnaire on Resources and Stress
>M <M Total
Grade 12 and Lower 27 16 43
Tertiary Education 4 13 17
E 31 29 60

No significant differences were reported between ages of parents and

stress experienced and between intensity of hearing-loss and stress. Low and
insignificant ( p > .05) correlations were found between chronological age of
the child and parental responses on the Questionnaire on Resources and
Stress. No significant differences (X,2 = 2.97, p> .05) were found between
gender of parents and type of emotional reaction, e.g., shock, worry, anger,
at the time when the dagnosis of hearing-impairment was made.

TABLE 2

Emotional Reaction Mother Father Total

Shock 12 15 27
Worry 13 9 22
Relief 1 3 4
Anger 1 1 2
Uncertainty 3 2 5
E 30 30 60

Compared with fathers, mothers perceived the amount of free time they
had for themselves as inadequate (X,2 = 13.86, p< .05) Although no differ-
ences were obtained between spouses in their assessment of which parent
was emotionally most involved with the hearing-impaired child, mothers re-

TABLE 3
BETWEENGENDER
RELATIONSHIP OF PARENTS
AND ASSESSMENT
OF FREETIMEAVAILABLEFORT ~ S E L V E S
Resoonse Mother Father Total
Yes 25 17 42
No 5 13 18
7;: 30 30 60
 PARENTAL RESPONSE TO IMPAIRED CHILD 1367

TABLE 4
OF GENDER
FREQUENCIES OF PARENTS
AND PERCEPTION
OF EMOTIONAL RECEIVED
SSLIPPORT
Amount of Support Mother Father Total
Plenty 26 18 44
Enough 3 8 11
Little 1 4 5
1 30 30 60

ported that they received less emotional support from their spouse than the
fathers did ( X 2 2 = 7.81, p < .05).
D~scuss~o~
The underlying assumption of this study was that mothers of hearing-
impaired children experience more stress than the fathers because they spend
more time with the c M d , especially in teaching language. Although no sig-
nificant differences in global stress response were found between parents,
mothers did experience more stress relating to their perception of difficulties
for themselves, other family members, and the family as a whole. Items on
this scale included statements such as "I get upset with the way my life is
going," "I have given things up that I really wanted to d o in order to care
for my child," "Our family does not agree on important matters," and "The
family does not d o as many things now as we did before."
Mothers of hearing-impaired children were also of the opinion that they
did not have enough free time for themselves and that they received less
emotional support in the situation they had to confront than did husbands.
These findings suggest that a complex situation (Meadow, 1980; Meadow &
Trybus, 1979; Nolan & Tucker, 1981) might arise from bringing up a hear-
ing-impaired child and can be related to personal unhappiness and anxiety
about the effect on the rest of the nuclear family. I t seems that this situation
was complicated by an implicit deficit in communication between the parents
studied.
Effective communication plays a major role in the parent-child relation-
ship and in the hearing-impaired child's social and cognitive development
(Hamner & Turner, 1990). This process should, however, be preceded by pos-
itive and healthy communication between parents. Stress-related attitudes,
like those which emerged in this study, could be treated effectively by in-
volving parents in well-designed training programs as indicated by Thompson
and Rudolph (1992) and Tye-Murray and Kelsay (1993), who described a
program for parents of children with cochlear implants. The psychological
effects of the unique crisis that parents of hearing-impaired children experi-
ence and the required adjustments in attitude and behaviour might be - d e -
viated.
1368 H . J. BRAND & M. A. COETZER

REFERENCES
BARRINGER, D. G., STRONG, C. J , I~I.,\[R, T. C., & W A T I ~ NS.
S ,(1993) Screenin
C., CLARK,
procedures used to identlly i h d e n with hearin, loss. American Annals of the
138, 420-426.
d
BARUCH, G . K., & BARNETT,R. C. (1980) On the well-being of adult women. In L. A. Bond
& J. C. Rosen (Eds.), Competence and coping during adulthood. Hanover, NH: Univer.
Press of New England. Pp. 240-257.
BODNER-JOHNSON, B. (1985) Families that work for the hearing-impaired child. The Volta Re-
view, 87, 131-137.
BROOKS, J. B. (1987) The process of parenting. Mountain View, CA: Mayfield.
FELLENDORF, G., & HARROW, I. (1970) Parent counselling, 1961-1968. The Volta Review, 72,
51-57.
FERGUSON, G . A. (1971) Statistical analysis in psychology and education. Tokyo: McGraw-Hill
Kogakuska.
FREEMAN,R. D., MALKIN,S. F,, & HAST~NGS, J. 0. (1975) Psychosocial roblerns of deaf chil-
dren and their families: a comparative study. American Annals of tRe Deaf, 80, 391-404.
FREDRICH, W. N. (1979) Predictors of the coping behnv~orlrsof mothers of handicapped chil-
dren. Journal of Consulting and Clinical Psycholoa, 47, 1140-1141.
FEDRICH, W. N., GREENBERG, M. T., & CRNIC,K. (1983) A short-form of the Questionnaire
on Resources and Stress. American Journal of Mental Deficiency, 88, 41-48.
GREENBERG, M. T., & ~ ~ R V R. T NS. ,(1979) Attachment patterns in profoundly deaf preschool
children. Merrill-Palmer Quarterly, 25, 265-279.
HAAS,W. H., & CROWLEY, D. J. (1982) Professional information dissemination to parents of
pre-school hearing-impaired children. The Volta Review, 84, 17-23.
- -

HAMNER,T. J., & TURNER, l? H. (1990) Parenting in contemporary sociery. Englewood Cliffs,
NJ: Prentice Hall.
HENGGELER, S. W., WATSON,S. M., & WHELAN,J. I? (1990) Peer relations of hearing-irn-
paired adolescents. Journal of Pediatric Psychology, 15, 721-731.
KROTH, l? L. (1987) Mixed or missed messages: between parents and professionals. The Volta
Review, 89, 1-9.
LARTZ,M. N., & MCCOLLUM,J. (1990) Maternal questions while reading to deaf and hearing
twins: a case study. American Annak of the Deaf, 135, 235-240.
MEADOW,K. l? (1980) Deafness and child development. London: Edward Arnold.
MEADOW,K. P., & TRYBUS,R. (1979) Behavioral and emotional problems of deaf children: an
overview. New York: Grune & Stratton.
NOLAN,M., & TUCKER,I. G. (1981) The hearing-impaired child and thefamily. London: Sou-
venir Press
Novms, B. C. (1986) Hearing impaired children in Sao Paulo, Brazil: knowledge and attitudes
of mothers rerc!+g hearing impairment and early intervention programs, and the im-
plications for abhtat~on Dzaertation Abstracts International, 47, 2360B.
, L. (1987) Working with parents: a story of personal and professional growth. The
P t ~ n m s A.
Volta Review, 89, 131-143.
SIEGEL,S. (1956) Nonparamehic statistics for the behavioral sciences. New York: McGraw-Hill.
THOMPSON,C. L., & RUDOLPH,L. B. (1992) Counseling children. Pacific Grove, CA: Brooks/
Cole.
TYE-MURRAY, P., & &SAY, D. M. (1993) A communication training program for parents of
cochlear implant users. The Volta Review, 95, 21-31.
WHITSON,L. M. (1986) The relationship between parent attitude and achevement in hearing
impaired students in grades seven to twelve. Dissertation Abstracts International, 47,
504A.
WLLU~MS, D. M. L., & DARBYSHIRE, J. 0. (1982) Diagnosis of deafness: a study of family re-
sponses and needs. The Volta Review, 84, 24-30.

Accepted October 19, 1994.