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Review
. 2020 May;24(5):561-574.
doi: 10.1007/s10995-020-02896-5.

The Caregiver Health Effects of Caring for Young Children with Developmental Disabilities: A Meta-analysis

Sarah C Masefield  1 , Stephanie L Prady  2 , Trevor A Sheldon  2 , Neil Small  3 , Stuart Jarvis  2 , Kate E Pickett  2
Affiliations
Review

The Caregiver Health Effects of Caring for Young Children with Developmental Disabilities: A Meta-analysis

Sarah C Masefield et al. Matern Child Health J. 2020 May.

Abstract

Objectives: Mothers of school age and older children with developmental disabilities experience poorer health than mothers of typically developing children. This review assesses the evidence for the effect on mothers' health of caring for young children with developmental disabilities, and the influence of different disability diagnoses and socioeconomic status.

Methods: Medline, EMBASE, PsycINFO and CINAHL were searched. Studies measuring at least one symptom, using a quantitative scale, in mothers of preschool children (0-5 years) with and without a diagnosed developmental disability were selected. Random effects meta-analysis was performed, and predictive intervals reported due to high expected heterogeneity.

Results: The meta-analysis included 23 estimates of association from 14 retrospective studies for the outcomes of stress (n = 11), depressive symptoms (n = 9), general health (n = 2) and fatigue (n = 1). Caring for a child with a developmental disability was associated with greater ill health (standardised mean difference 0.87; 95% predictive interval - 0.47, 2.22). The largest association was for mixed developmental disabilities (1.36; - 0.64, 3.36) and smallest for Down syndrome (0.38; - 2.17, 2.92). There was insufficient socioeconomic information to perform subgroup analysis. The small number of studies and data heterogeneity limited the precision of the estimates of association and generalizability of the findings.

Conclusions for practice: Mothers of young children with developmental disabilities may have poorer health than those with typically developing children. Research is needed to identify whether the relationship is causal and, if so, interventions that could reduce the negative effect of caregiving.

Keywords: Caregiver; Developmental disabilities; Health; Meta-analysis; Systematic review.

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Conflict of interest statement

The authors declare that they have no conflict of interest.

Figures

Fig. 1
Fig. 1
Flow diagram of the process of selection for eligible studies
Fig. 2
Fig. 2
Relationship of caregiving for preschool children with developmental disabilities to ill health by symptom and overall. aPooled estimates and their 95% CIs are depicted as a diamond. The error bars on the diamond illustrate the predictive interval for the pooled estimate. SMD, standardised mean difference (the size of the association). % weight, the contribution of each study to the pooled estimate in the random effects model based on sample size. bThe pooled estimates for fatigue and general health subgroups are not displayed as a minimum of three effect sizes was required for the analysis
Fig. 3
Fig. 3
Funnel plot to assess small study bias in the meta-analysis. Se(SMD), standard error of the standardised mean difference
Fig. 4
Fig. 4
Relationship of child disability diagnosis (mixed disabilities, cerebral palsy, autism and Down syndrome) to caregiver health outcomes. aPooled estimates and their 95% CIs are depicted as a diamond. The error bars on the diamond illustrate the predictive interval for the pooled estimate. SMD, standardised mean difference (the size of the association). % weight, the contribution of each study to the pooled estimate in the random effects model based on sample size
See this image and copyright information in PMC

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