‘We are dealing with it the best we can’: Exploring parents’ attributions regarding their child’s physical disability using the ‘Four Ws’ framework

Abstract

Background:

When a child has a disability, parents’ adaptation has traditionally been viewed in negative terms (e.g. grief and stress). However, recent research suggests that parents’ adaptation is determined by their appraisals of their situation, both positive and negative. It would be valuable for clinicians to have a conceptual framework for exploring such cognitions.

Aims:

This study aimed, first, to devise an attribution theory–based framework for understanding parental cognitions and, second, to examine its usefulness for analysing the appraisals of parents through a qualitative study.

Methods:

A wide-ranging review of literature on cognitions, particularly attribution theory, was used to devise the ‘Four Ws’ framework: What is the problem? Who is to blame? Why did it happen? When? This was used as a scaffold to organise the data from semi-structured interviews with 36 parents of young children with physical disabilities.

Results:

The framework proved robust, with a range of subthemes emerging through thematic analysis. Additional themes also emerged, for example, about emotions.

Conclusion:

The Four Ws framework provides a potential tool for clinicians working with parents of children with disabilities, both to guide general conversations when the child’s needs are the main focus and for more in-depth clinical work with struggling parents.