Background.Families of children who have disabilities experience multiple stressors. “Sense of coherence” (SOC) reflects a person's view of life and his or her capacity to respond to stressful situations. Purpose.The purposes of this paper are to (1) introduce the concept of SOC; (2) review the literature on the stresses experienced by parents of children with disabilities; and (3) discuss how SOC can be used to evaluate systematically and to address effectively parents' resiliency against stressors. Key Issues.The literature shows a strong correlation between parental stress, avoidant coping, depression, and low SOC. Preliminary evidence suggests that an early intervention program can help increase parents' SOC. Implications.Occupational therapists can use the SOC as a framework from which to identify the strength of a parents' SOC, and, when deemed to be low, help create a process for enhancing resilience.
AnthonyL. G., AnthonyB. G., GlanvilleD. N., NaimanD. Q., WaandersC., & SchafferS. (2005). The relationships between parenting stress, parenting behaviour and preschoolers' social competence and behaviour problems in the classroom. Infant and Child Development, 14, 133–154. doi: 10.1002/icd.385
2.
AntonovskyA. (1979). Health, stress and coping. San Francisco: Jossey-Bass.
3.
AntonovskyA. (1987). Unraveling the mystery of health. How people manage stress and stay well. San Francisco: Jossey-Bass.
4.
AntonovskyA. (1993). The structure and properties of the sense of coherence scale. Social Science & Medicine, 36, 725–733.
5.
AntonovskyA., & SouraniT. (1988). Family sense of coherence and family adaptation. Journal of Marriage and the Family, 50, 79–92.
6.
BakerB. L., McIntyreL. L., BlancherJ., CrnicK., & LowC. (2003). Pre-school children with and without developmental delay: Behaviour problems and parenting stress over time. Journal of Intellectual Disability Research, 47, 217–230.
7.
BayatM. (2007). Evidence of resilience in families of children with autism. Journal of Intellectual Disability Research, 51, 702–714.
8.
BlancherJ., & BakerB. L. (2007). Positive impact of intellectual disability on families. American Journal of Mental Retardation, 112, 330–348. doi: 10.1352/0895-8017(2007)112[0330:PIOIDO]2.0.CO;2
9.
BranholmI., Fugl-MeyerA. R., & FrolundeA. (1998). Life satisfaction, sense of coherence and locus of control in occupational therapy students. Scandinavian Journal of Occupational Therapy, 5, 39–44. doi: 10.1191/0269215503cr629oa.
10.
CalderonR., & GreenbergM. T. (1993). Considerations in the adaption of families with school-ages deaf children. In MarschukM. & ClarkM. D. (Eds.), Psychological perspectives on deafness (pp. 27–47). Hillsdale, NJ: Lawrence Erlbaum Associates.
11.
Canadian Association of Occupational Terapists. (2002). Enabling occupation: An occupational therapy perspective (Rev. ed.). Ottawa, ON: CAOT Publications ACE.
12.
Case-SmithJ., & CableJ. (1996). Perceptions of occupational therapists regarding service delivery models in school based practice. Occupational Therapy Journal of Research, 16, 23–44. doi: 10.1177/1744629505057584
13.
DunnM. E., BurbineT., BowersC. A., & Tantleff-DunnS. (2001). Moderators of stress in parents of children with autism. Community Mental Health Journal, 37, 39–52.
14.
EkerL., & TuzunS. H. (2004). An evaluation of quality of life of mothers of children with cerebral palsy. Disability and Rehabilitation, 26, 1354–1359. doi: 10.1080/09638280400000187
15.
ErikssonM., & LindstromB. (2006). Antonovsky's sense of coherence scale and the relation with health: A systematic review. Journal of Epidemiology and Community Health, 60, 376–381. doi: 10.1136/jech.2005.041616
16.
FalkdalA. H., EdlundC., & DahlgrenL. (2006). Experiences within the process of sick leave. Scandinavian Journal of Occupational Therapy, 13, 170–182.
17.
FearingV. G., LawM., & ClarkJ. (1997). An occupational performance process model: Fostering client and therapist alliances. Canadian Journal of Occupational Therapy, 64, 7–15.
18.
GuralnickM. J. (2000). Early childhood intervention: Evolution of a system. Focus on Autism and Other Developmental Disabilities, 15, 68–79. doi: 10.1177/108835760001500202
19.
HakanssonC., SvartvikL., LidfeldtJ., & NebrandC. (2003). Self-rated health in middle-aged women: Associations with sense of coherence and socioeconomic and health-related factors. Scandinavian Journal of Occupational Therapy, 10, 99–106.
20.
HassallR., RoseJ., & McDonaldJ. (2005). Parenting stress in mothers of children with an intellectual disability: The effects of parental cognitions in relation to child characteristics and family support. Journal of Intellectual Disability Research, 49, 405–418. doi: 10.1111/j.1365-2788.2005.00673.x
21.
HastingsR. P., & TauntH. M. (2002). Positive perceptions in families of children with developmental disabilities. American Journal of Mental Retardation, 107, 116–127. doi: 10.1352/0895-801 7(2002)107<0116:PPIFOC>2.0.CO;2
22.
HawleyC. A., WardA. B., MagnayA. R., & LongJ. (2003). Parental stress and burden following traumatic brain injury amongst children and adolescents. Brain Injury, 17, 1–23. doi: 10.1080/0269905021000010096
23.
HoareP., HarrisM., JacksonP., & KerleyS. (1998). A community survey of children with severe intellectual disability and their families: Psychological adjustment, carer distress and the effect of respite care. Journal of Intellectual Disability Research, 42, 218–227.
24.
JohnsonM. (2004). Approaching the salutogenesis of sense of coherence: The role of “active” self-esteem and coping. British Journal of Health Psychology, 9, 419–432. doi: 10.1348/1359107041557057
25.
KellerD., & HonigA. S. (2004). Maternal and paternal stress in families with school-aged children with disabilities. American Journal of Orthopsychiatry, 74, 337–348.
26.
KendallL., SloperR., LewinJ. P, & ParsonJ. M. (2003). The views of parents concerning the planning of services for rehabilitation of families of children with congenital cardiac disease. Cardiology in the Young, 13, 20–27. doi: 10.1017/S1047951103000052
27.
KingG. A., ZwaigenbaumL., KingS., BaxterD., RosenbaumP., & BatesA. (2006). A qualitative investigation of changes in the belief systems of families of children with autism or Down syndrome. Child: Care, Health & Development, 32, 353–369. doi: 10.1111/j.1365-2214.2006.00571.x
28.
LawM., & KingG. (1993). Parent compliance with therapeutic interventions for children with cerebral palsy. Developmental Medicine and Child Neurology, 35, 983–990. doi: 10.1111/j.1469-8749.1993.tb11580.x
29.
LawsonJ. (2004). Disclosing childhood impairment and the consequences for parent/professional relationships. Practice, 16, 273–281.
30.
LillefjellM., & JakobsenK. (2007). Sense of coherence as a predictor of work re-entry following multidisciplinary rehabilitation for individuals with chronic musculoskeletal pain. Journal of Occupational Health Psychology, 12, 222–231. doi: 10.1037/10768998.12.3.222
31.
LindstromB., & ErikssonM. (2005). Salutogenesis. Journal of Epidemiology and Community Health, 59, 440–442. doi: 10.1136/jech.2005.034777
32.
MargalitM., & KleitmanT. (2006). Mothers' stress, resilience and early intervention. European Journal of Special Needs Education, 21, 269–283.
33.
MargalitM., LeyserY., AnkoninaD. B., & AvrahamY. (1991). Community support in Israeli kibbutz and city families of disabled children: Family climate and parental coherence. Journal of Special Education, 24, 427–440.
34.
MargalitM., RavivA., & AnkoninaD. B. (1992). Coping and coherence among parents with disabled children. Journal of Clinical Child Psychology, 21, 202–209.
35.
McAuleyC., McCurryN., KnappM., BeechamJ., & SleedM. (2006). Young families under stress: Assessing maternal and child well-being using a mixed-methods approach. Child and Family Social Work, 11, 43–54. doi: 10.1111/j.1365-2206.2006.00390.x
36.
MelnykB. M., Alpert-GillisL., FeinsteinN. F., CreanH. F., JohnsonJ., FairbanksE., … Coro-RichertB. (2004). Creating opportunities for parent empowerment: Programme effects on the mental health/coping outcomes of critically ill young children and their mothers. Pediatrics, 113, 597–607.
37.
MontesG., & HaltermanJ. S. (2007). Psychological functioning and coping amoung mothers of children with autism: A population based study. Pediatrics, 119, 1040–1046.
38.
MulliganS. (2003). Occupational therapy evaluation for children: A pocket guide. Philadephia: Lippincott Williams and Wilkins.
39.
OelofsenN., & RichardsonP. (2006). Sense of coherence and parenting stress in mothers and fathers of preschool children with developmental disability. Journal of Intellectual & Developmental Disability, 31, 1–12. doi: 10.1080/13668250500349367
40.
OlssonM. B., & HwangC. P. (2002). Sense of coherence in parents of children with different developmental disabilities. Journal of Intellectual Disability Research, 46, 548–559.
41.
PiggotJ., PatersonJ., & HockingC. (2002). Participation in home therapy programs for children with cerebral palsy: A compelling challenge. Qualitative Health Research, 12, 1112–1129. doi: 10.1177/104973202129120476
42.
QuineL., & RutterD. R. (1994). First diagnosis of severe mental and physical disability: A study of parent-doctor communication. Journal of Child Psychology and Psychiatry, 35, 1273–1287. doi: 10.1111/j.1469-7610.1994.tb01234.x
43.
RichardsonC. G., & RatnerP. (2005). Sense of coherence as a moderator of the effects of stressful life events on health. Journal of Epidemiology & Community Health, 59, 979–984. doi: 10.1136/jech.2005.036756
44.
RimmermanA., & StangerV. (2001). Parental stress, marital satisfaction and responsiveness to children: A comparison between mothers with and without inborn impairment. International Journal of Rehabilitation Research, 24, 317–320.
45.
Rone-AdamsS. A., SternD. F., & WalkerV. (2004). Stress and compliance with a home exercise program among caregivers of children with disabilities. Pediatric Physical Therapy, 16, 140–148.
46.
SandersJ. L., & MorganS. B. (1997). Family stress and adjustment as perceived by parents of children with autism or Down syndrome: Implications for intervention. Child and Family Behaviour Therapy, 19, 15–32.
47.
SchultM., SoderbackI., & JacobsK. (2000). The sense-of-coherence and the capability of performing daily occupations in persons with chronic pain. Work, 15, 189–201.
48.
SloperP., & TurnerS. (1992). Service needs of families of children with severe physical disability. Child: Health, Care and Development, 18, 259–282. doi: 10.1111/j.1365-2214.1992.tb00359.x
49.
VeissonM. (1999). Depression symptoms and emotional states in parents of disabled and non-disabled children. Social Behaviour and Personality, 27, 87–98.
50.
WalshF. (2003). Family resilience: A framework for clinical practice. Family Process, 42, 1–18. doi: 10.1111/j.1545-5300.2003.00001.x
51.
WarfieldM. E. (2005). Family and work predictors of parenting role stress among two-earner families of children with disabilities. Infant and Child Development, 14, 155–176. doi: 10.1002/icd.386
