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Clinical Pediatrics
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Toileting Concerns, Parenting Stress, and Behavior Problems in Children with Special Health Care Needs

Michelle M. Macias, MD

Department of Pediatrics, Medical University of South Carolina

Kathryn M. Roberts, MA, EdS

LifeManagement Center, Inc

Conway F. Saylor, PhD

Department of Psychology, The Citadel, Charleston, SC

Jill J. Fussell, MD

Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, AR.

This study examined the relationship between toileting concerns, behavior problems, and parenting stress in parents of children with special health care needs (CSHCN). Participants included parents of 99 males and 71 females aged 4 to 12 years with neural tube defects (NTD), developmental-behavioral disabilities (DBD), or history of perinatal intraventricular hemorrhage (IVH). Parents completed the Achenbach Child Behavior Checklist (CBCL) and the Parenting Stress Index-Short Form (PSI-SF). Parents expressing toileting concerns on the CBCL reported significantly more personal distress and more externalizing problems versus those with continent children. Variation within subsamples suggested that expectations based on nature of disability may be a factor in parent adjustment. Direct assessment and intervention of toileting issues should be a high priority in secondary stress prevention with CSHCN and their families.

Clinical Pediatrics, Vol. 45, No. 5, 415-422 (2006)
DOI: 10.1177/0009922806289616
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