Stress Clinical Trial
Official title:
Development of a Resiliency Training Program for Parents of Children With Specific Learning Disabilities
This study has three aims:
Phase I: Through focus group interviews with expert clinicians, leaders of organizations, and
parents with children with special needs, this study aims to identify the psychosocial needs
of parents of children with learning disabilities, specifically a) the types of concerns that
parents find most difficult and stressful b) areas of concern that lack support and
resources, and c) areas of need for education and skill training. This study also aims to
gather feedback on the Benson-Henry Institute's Relaxation Response Resiliency Program (3RP).
Phase II: Informed by Phase I findings, this study aims to develop and determine the
feasibility and acceptability of a virtual 8-session Relaxation Response Resiliency (3RP)
program for parents of children with Specific Learning Disabilities (SPLD).
Phase II: This study also aims to test the effectiveness of a pilot wait-list control trial,
establishing efficacy of a virtual resiliency program.
According to the 2011/12 National Survey of Children's Health, 14.6 million children in the
U.S. have special health care needs (e.g., learning disability, ADD/ADHD, developmental
delays, chronic mental or physical health conditions); CSHCN comprise between 14.4%-25.6% of
the child population in the United States. Having a child with special health care needs
(CSHCN) is associated with an increased risk of problems with emotional and physical health
and social well-being. Parents of CSHCN are also at an increased risk for not being employed,
financial stress, and poor healthrelated quality of life (HRQoL). There is growing literature
on the increased levels of parental stress associated with caring for CSHCN. One study found
that chronic stress, as measured by the duration of having a CSHCN, was associated with an
increase in clinical aging, determined by telomeres (caps at the end of each strand of DNA
that protect chromosomes during aging) sequences. A review article provides a comprehensive
overview of the links between high levels of parental stress among parents of children with
intellectual and developmental disabilities and child health and well-being. Furthermore, a
recent study documented that parents of SSHCN feel socially isolated. Therefore, having a
child with special health care needs (CSHCN) is associated with an increased risk of problems
with emotional and physical health and social well-being. Parents of CSHCN are also at an
increased risk for not being employed, financial stress, and poor health-related quality of
life (HRQoL). There is growing literature on the increased levels of parental stress
associated with caring for CSHCN, and a recent review article provides a comprehensive
overview of the links between high levels of parental stress among parents of children with
intellectual and developmental disabilities and child health and well-being.
Resiliency is a multidimensional construct that refers to the ability to maintain adaptation
and effective functioning when faced with stressors. Resiliency provides a framework for
understanding the adjustment to stress as a dynamic process. Allostasis refers to the
capacity to maintain stability of physiological systems in the face of adversity. When the
exposed to chronic stressors, such as care for a CSHCN, individuals expend a great deal of
energy attempting to maintain allostasis; this can lead to the metabolic wear and tear
described as allostatic load. Evidence is accumulating that this wear and tear is mediated by
changes in basal stress system activity and by effects of these changes on dependent systems.
Allostatic load and resilience can therefore be assessed by measuring basal stress system
activity (HPA axis and salivary alpha-amylase). Thus, research to reduce these parents'
exposure to stress and, moreover, improve parental responses to stress, may improve the
well-being of both parents and their children. Yet, a treatment focused on the psychosocial
needs of parents of CSHCN has not been developed. Thus, research is warranted to examine and
intervene upon parental stress.
Through focus group interviews with expert clinicians, leaders of organizations, and parents
with children with special needs, this study aims to identify the psychosocial needs of
parents of children with learning disabilities, specifically a) the types of concerns that
parents find most difficult and stressful b) areas of concern that lack support and
resources, and c) areas of need for education and skill training. This study also aims to
gather feedback on the Benson-Henry Institute's Relaxation Response Resiliency Program (3RP)
to advance our next objective to develop a resiliency intervention to provide support to
parents of children with learning disabilities. This study aims to evaluate the virtual 3RP
for Parents of SPLD in a wait-list control trial and determine a) its feasibility and
acceptability and b) its effectiveness at decreasing stress and stress reactivity.
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