Comfort provided by parents versus strangers after eliciting stress in children with severe or profound intellectual disabilities: does it make a difference?

ABSTRACT

The relationships between children with severe or profound intellectual disabilities (ID) and their parents may fulfil attachment functions, such as regulating emotional responses to stress. This study examined the extent to which children with severe or profound ID differentiate between their parents and a stranger as a resource for stress-regulation. A home-based experimental paradigm was conducted and video-recorded in 38 families. Children (1–8 years) were exposed to four naturalistic stressors followed by comfort, randomly provided by the parents or the stranger. Emotional behaviour (arousal and valence) and the skin conductance level were simultaneously recorded. With regard to both emotional behaviour and skin conductance, children significantly differentiated between their parents as attachment figures and the stranger during stress and comfort, despite their impairments on various developmental domains. Behavioural observation and physiology show complementary manifestations of parent-child attachment in this population.

KEYWORDS:

• Parent-child attachment
• severe or profound intellectual disability
• significant developmental delay
• behavioural observation
• skin conductance

Acknowledgments

We would like to thank Natasha Bargota and Olga Żejmo for providing double-coding of emotional behaviour for the current study. We also offer our sincerest gratitude to all care organisations and parents for their generous participation.

Disclosure statement

No potential conflict of interest was reported by the authors.

Notes

1. To the best of our knowledge, there are no clear guidelines to identify a severe ID at young age on the basis of a comparison between children’s developmental and chronological age. Hogg, Foxen, and McBrien (1981) associate profound ID with a developmental age lower than a quarter of children’s chronological age. In line with this reasoning, half of the children’s chronological age was used as an upper limit. Because the current study did not include children older than nine years, the children’s developmental age did never exceed four and a half years. This is in accordance with the maximum age associated with severe ID in adults with ID according to Kraijer and Plas (2007). However, for each child multiple sources of information were triangulated to warrant a valid and reliable inclusion of children.

2. Especially for the youngest children with very low cognitive abilities, test results were lacking because reliable IQ-tests and established norms are lacking at the very low end of the spectrum of intellectual functioning (Resing & Blok, 2002; Weis, 2014). Hence, the average cognitive level of 9.60 months is possibly an underestimation.

3. Level 4 and 5 of the Gross Motor Function Classification Scale (GMFCS; Palisano et al., 1997) reflect a severe motor impairment (Palisano, Rosenbaum, Bartlett, & Livingston, 2007). In the current study, 15.8% of the children scored level 4 and 34.2% scored level 5. With regard to fine motor skills (e.g. handling objects), 47.4% of the children reached level 4 and 26.3% reached level 5 on the Manual Ability Classification System (MACS; Eliasson et al., 2006, 2017).

4. A number is added to these letters in the remaining text to identify whether the first (A1) or the second (A2) performance of “situation A” was implied. The same applies for “situation B”.

Additional information

Funding

This work was supported by the FWO Flanders (Fonds Wetenschappelijk Onderzoek) under Grant [1174917N].