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INACCURATE PARENTAL PERCEPTIONS OP COGNITIVE DISABILITIES:
PREDICTORS AND OUTCOMES ASSOCIATED WITH CHILD AND FAMILY FUNCTIONING

BY

Alan Lance Adams

A THESIS
Submitted to
Michigan State University
in partial fulfillment of the requirements
for the degree of

MASTER OF ARTS

Department of Psychology

1992

ABSTRACT

INACCURATE PARENTAL PERCEPTIONS OF COGNITIVE DISABILITIES:
PREDICTORS AND OUTCOMES ASSOCIATED WITH CHILD AND FAMILY FUNCTIONING

BY

Alan Lance Adams

This study focused on mothers' ability to accurately perceive the
cognitive ability of their children with mental retardation, and the
relationship between perceptual accuracy, socioeconomic status (SES),
severity of mental retardation, mothers' stress or distress, and
children's self-esteem. Subjects were mothers and children with Educable
(n=57) or Trainable Mental Retardation (n=32). Mothers' estimates were
compared to their children's scores on the Peabody Picture Vocabulary
Test-Revised.

Perceptual accuracy was divided into four groups: accurate,
underestimators, overestimators, and ”low estimate/low performance.”
Results indicated that higher SE8 mothers and mothers of children with
moderate mental retardation were most perceptually accurate. Lower 883
mothers tended to overestimate their child's performance. Accurate
estimators experienced less psychological distress. Children of
overestimators tended to report greater feelings of competence in social

interactions than children of accurate estimators.

This achievement is dedicated to my wonderful wife Sandy.
Without her unwavering support and encouragement

the work may never have come to fruition.

iii

ACKNOWLEDGEMENTS

I would like to thank the members of my thesis committee, Dr. Frank
Floyd, Dr. Hiram Fitzgerald, and Dr. Gary Stollak for their guidance,
support and encouragement. In particular, I would like to thank Frank for
his patience and persistence in seeing me through this overlong task, and
for providing a solid foundation for my research skills. I would also
like to thank Dr. Robert Durham, my undergraduate Honors advisor and
mentor for his advice and belief in my abilities.

Finally, I would like to thank my familyu My parents, Ted and Marge
Adams, provided me with the initial striving and curiosity that led me to
pursue an advanced degree. My brothers, Dirk and Scott, provided me with
steadfast interest and encouragement. My mother-in-law Lynn Orne provided

me with proclamations of my certain proficiency as a psychologist.

iv

TABLE OF CONTENTS

Egg;
LIST OF TABLES ...................................................... vii
LIST OF FIGURES ...................................................... viii
INTRODUCTION ......................................................... 1
Literature Review .................................................... 1
Perceptual Accuracy ............................................ 1
Parents' Stress and Distress ................................... 14
Children's Self-esteem ......................................... 20
Model and Hypotheses ........................................... 24
METHOD ................. . ............................ . ................ 29
Subjects ....................................................... 29
Measures ....................................................... 30
Procedure ................. . .................................... 37
RESULTS ......................... . .................................... 38
The Construct of Perceptual Accuracy ........................... 38
Variables Affecting Perceptual Accuracy.. ...... . ............... 43
Variables Affecting Mothers' Stress and Distress ............... 47
Variables Affecting Children's Self-esteem ..................... 61
DISCUSSION.... ...... ..... ....... ...... ............................... 67
Support for the Conceptual Model ............................... 67
Flaws in the Conceptual Model .................................. 68

TABLE OF CONTENTS CONT'D.

Egg;
Mothers' Perceptual Accuracy ................................... 72
The Exogenous Variables and Mothers' Stress and Distress ....... 76
Limitations and Directions for Further Research ................ 78
LIST OF REFERENCES ................................................... 82

vi

LIST OF TABLES

 

Table Page
1 Mothers' Perceptual Accuracy Scores for Separate SES Groups....46
2 Effects of the Severity of Children's Mental Retardation

on Mothers' Stress and Distress ................................ 49
3 Effects of the Family's SE3 on Mothers' Stress and Distress....53
4 Effects of Mothers' Perceptual Accuracy on Their

Stress and Distress ........ . ................................... 59
5 Perceived Competence Scale-Older Version

Item to Scale Correlation ...................................... 63
6 Perceived Competence Scale-Younger Version

Item to Scale Correlation ...................................... 64

vii

LIST OF FIGURES

Em liege
1 The Conceptual Model ...... .... ............ . .................... 25
2 Perceptual Accuracy Group Estimate and Performance

Differences ........ . ...................... . ....... . ............ 42
3 The Relationship Between SES and Mothers' Distress ............. 56

viii

INTRODUCTION

Previous research has shown that the parents of children with mental
retardation often inaccurately perceived either the existence or extent
of their child's retardation (Schulman and Stern, 1959; Barclay and
Vaught, 1964; Gorelick and Sandhu, 1967; and Tew, Laurence, and Samuel,
1974). However, that research has not investigated the possible effects
of this inaccuracy on either the parents or the child. The present study
focuses on the implications of perceptual inaccuracy for stress or
distress in parents and low self-esteem in children. The study also
examines the hypothesis that perceptual inaccuracy is influenced by
socioeconomic status (SES) and the severity of the child's mental
retardation.

LITERATURE REVIEW
Perceptual Accuracy

Perceptual distortions can be traced to the experience of giving
birth to a child with mental retardation. Perceptual distortions of the
child's cognitive ability probably arise from the discrepancy between
parents' idealized expectations and their child's actual abilities, a
discrepancy which is likely to persist until the parents resolve their
grief over the loss of the idealized child. Bentovim (1972) describes
pregnancy as a developmental crisis for both the husband and wife. He

suggests that parents cope with the stress of those preparations by

2

envisioning a "perfect" child who will realize all of their hopes for the
future. However, the birth of a child with mental retardation is
discrepant from parents' expectations. Bentovim further suggests that
parents experience a sudden switch in emotions after the birth of a child
with mental retardation. Rather than the relief experienced after the
completion of a normal, healthy birth, parents feel disbelief, anger, and
an overwhelming sense of helplessness. Many parents feel like they want
to get rid of their child, prompting feelings of guilt or self-blame.
Solnit and Stark (1961) argue that sometdiscrepancy'probably always exists
between parents' expectations and their child's actual ability, but with
the birth of a child with mental retardation, the discrepancy is large
enough to create a trauma situation for the parents. Drotar, Baskiewicz,
Irvin, Rennell, and Klaus (1975) suggest that the grief must be resolved
before the parents can reach the stage of adaptation and reorganization,
where they are able to respond to the child's special needs in an
effective manner.

Recent theories have argued for two modifications of the grief-
resolution process in families of children with mental retardation. First,
iiikler, iiasow, and Hatfield (1981) argued that grief in families of
children with mental retardation is chronic rather than "time-bound", as
discussed in earlier conceptions. Hikler et a1. (1981) used a
questionnaire to measure parents' adjustment to having a child with mental
retardation throughout the family life-span. They administered the
questionnaire to parents and social workers involved with the families.
Both groups reported that, while grief over the diagnosis of the child as

mentally impaired abated somewhat over time, there appeared to be crisis

3
events throughout the child's life which served as reminders of the
child's impairment, and caused re-elevations of the parents' experience
of grief. Hikler et a1. (1981) identified ten such crisis points. The
present study is particulalry concerned with the crisis created when the
child is diagnosed with mental retardation.

Hillner and Crane (1979) noted that the crisis created at the time
of diagnosis was complicated for parents of children with mild handicaps
for whom diagnosis was often delayed. For parents of children with
identifiable, congenital mental retardation, the grieving process occurs
shortly after the birth of the child. However, Hillner and Crane (1979)
found that diagnosis of mild handicaps was often delayed by as many as
five years, and they concluded that resolution of grief was prolonged for
parents by their difficulty in letting go of idealized beliefs and
expectations and establishing expectations based upon the child's actual
capabilities. Prior to diagnosis, parents seemed unaware of the child's
retardation, and they continued to hold idealized expectations based on
the belief that their child is unimpaired. As a result they misperceived
their child's cognitive abilities. ‘Hillner and Crane (1979) further noted
that parents of children with mild handicaps had a more difficult time
resolving the grief they experienced following the diagnosis. They
suggest that, parents of children with mild handicaps have had more time
to stabilize their belief that the child is not impaired, and therefore
these parents have more difficulty adapting their expectations to the
limitations the handicap will place upon the child's capabilities.

McLaren and Bryson's (1987) review' of epidemiological studies

presents further justification for perceptual distortions by parents of

4

children with mild mental retardation. First, they note that 20-40% of
the children with an IQ less than or equal to 50 (approximately TMR or
more severe) in the research investigations were diagnosed with Down
syndrome, which is usually noticeable at birth. Only 4.3—7.8t of the
children with mild mental retardation had Down Syndrome. This suggests
that fewer families of children with mild versus more severe mental
retardation may be given a clear indication of their child's impairment
at birth. This is further supported by McClaren and Bryson‘s (1987)
second finding that a larger percentage of the cases of children with mild
retardation, were of unknown etiology than in the TMR or more severely
retarded group. Thus, mild mental retardation is not only less likely to
be clearly indicated at the child's birth, but its cause is more likely
to remain unclear throughout the child's life. Hillner and Crane (1979)
argue that the parents' difficulty in coping with their child's mild
impairment arises largely from the vague and indeterminate cause of the
impairment itself.

The arguments offered by Willner and Crane (1979), and McLaren and
Bryson (1987) point out the importance of considering both the severity
of the child's mental retardation and the child's age at diagnosis because
both might affect parents' perceptual accuracy. To avoid this potential
confound, the present study will explore the relative importance of both
the child's age at diagnosis, and the severity of his/her mental
retardation.

The child's level of cognitive functioning appears to be associated
both‘with the expectations that parents formulate about the child and with

the accuracy of their perceptions (Jensen and Kogan, 1962; Barclay and

5
Vaught, 1964; and Tew, Laurence, and Samuel, 1974). The level of
functioning of the child seems to be associated with accuracy because it
alters the parents' ability to formulate accurate expectations about the
child's abilities due to the relative ambiguity of the presence and/or
severity of the child's impairment.

Support for this formulation comes from a study addressing parents'
unrealistic expectations conducted by Jensen and Kogan (1962). They
asked 68 parents of children with Cerebral Palsy (CP) to complete a
questionnaire about expectations for their child's future. Their
estimates were compared to those of hospital staff working with the
children. For those children actually functioning in the "dull-normal or
higher” category of cognitive abilities, parents' estimates were nearly
equivalent to the staff estimates. However, the parents' estimates for
the children who were functioning in the "borderline or defective"
category of cognitive abilities considerably exceeded staff estimates.
The authors concluded that the children's cognitive impairment disrupted
the parents' ability to establish realistic expectations for their
children's future. Barclay and Vaught (1964) replicated this study
comparing their own estimates to parents' estimates of the future
achievement of their child with cerebral palsy. The investigators were
clinical psychologists with extensive experience working with children
with cerebral palsy. Unlike Jensen and Hogan's (1962) methods, these
investigators based their estimates upon more quantitative data on the
child's current level of cognitive functioning, derived from the child's
scores on the Stanford-Binet and the Vineland Social Maturity Scale. The

investigators' estimates were compared to parental estimates using Jensen

6

and Hogan's (1962) questionnaire on future expectations. The parents'
estimates uniformly exceeded staff estimates. The extent of the
overestimate depended upon whether or not the child had mental
retardation, but did not depend upon the age of the child or the severity
of the child's cerebral palsy. Thus, mental retardation was associated
with larger errors. Because these studies focused upon future
expectations for the child and did not ask parents to directly assess
their child's current cognitive abilities, the only conclusion that can
be drawn is that parents were more optimistic about their child's future
than hospital staff. Meyerowitz and Farber (1966) compared the future
expectations of parents of normally-functioning children to those of
parents of children with mild mental retardation. They found that parents
of children with mild mental retardation expressed expectations for their
children which were simply unrealistic given the child's capabilities.
They observed that many parents in their sample had not completed high
school, yet they expected their child with Educable Mental Retardation
(EMR) to graduate from college. The authors suggested that these parents
were unaware of the requisite skills necessary for their children to
fulfill these expectations.

Baucom and Epstein (1990) suggest that faulty expectations are
linked to faulty perceptions, both of which derive from a common source,
the individual's long-standing assumptions and beliefs. According to
Baucom and Epstein (1990), perceptions and expectations differ mainly in
their temporal focus. Perceptions are focused on what happens in the
present, and expectations are focused upon what will most likely happen

in the future. As such, perceptions may serve as feedback to assumptions

7
and beliefs, which in turn guide expectations.

Baucom and Epstein's (1990) analysis suggests that since faulty
expectations about the future emerge from faulty perceptions of present
events, the findings showing that parents hold faulty expectations for
children with mental retardation imply that the parents must actually
misperceive the child's current abilities. Evidence of faulty perceptions
comes from several sources. A study by Tew, Laurence, and Samuel (1974)
asked 57 parents of children with Spina Bifida to estimate their child's
current mental age and that estimate was compared to the child's actual
performance on the Hechsler Intelligence Scales for Children. Overall,
they found that parents overestimated their child's cognitive ability by
an average of nine points. More interesting, the nature of perceptual
distortions differed depending upon the level of the child's cognitive
abilities. For the four children who scored approximately 30 on the HISC,
parents overestimated the cognitive capability of their child, and their
estimates varied.widely despite the fact that all of the children's scores
were nearly identical. The parents' estimates exceeded their child's
score by 5-45 10 points, but in each case the estimate remained in the
impaired range. However, for children scoring between 60 and 100,
parents' overestimates were inversely related to the child's IQ. Thus,
the closer the child's score came to 100, the more accurately parents
estimated the child's ability. Further, because parents were asked to
estimate their child's mental age, a score of 100 reflects a mental age
equal to the child's chronological age. In the case of the children with
more severe mental retardation, parents' estimates seemed to lack an

anchor or norm for developing expectations. In the case of children with

8

mild or no mental retardation, parents seemed strongly directed by the
anchor of normal functioning. Thus, this study suggests that faulty
perceptions occur for parents and that distortions seem dependent upon the
severity, not merely the presence, of the child's retardation. However,
parents' perceptual distortions may have arisen, in part, by asking them
to estimate their child's overall ”mental age", because their responses
probably derived more from their understanding of the constructs of IQ and
mental age than from their perceptions of the child's relevant
capabilities.

Gorelick and Sandhu (1967) noted that earlier studies (e.g. Barclay
and Vaught, 1964; Jensen and.Kogan, 1962) that found a discrepancy between
parents' estimates of their child's cognitive ability and the child's
actual ability used different measures for deriving parents‘ estimates
than for measuring children's actual ability. They questioned whether
differences between the parents' estimates and children's abilities was
an indication of parents' perceptual distortions or an artifact of the
difference between the measures used. In an attempt to avoid this
potential confound, Gorelick and Sandhu (1967) administered the Revised
Stanford-Binet intelligence test to 25 children brought to a clinic for
evaluation of mental retardation, and asked the mothers to respond to the
same test in the same manner they thought their child would answer.
Estimated IQ scores were then calculated from the parents' responses.
These were compared to the child's actual IQ score. The study found that
the children all scored in the mentally impaired range, and that the
parents overestimated their child's actual score by an average of nearly

seven points. Unfortunately, this study did not evaluate the relationship

9

between the severity of the child's mental retardation, and the degree of
the parents' perceptual distortion. For the 17 parents who overestimated
their child's IQ, differences ranged from 1 to 66 points, and only three
estimates fell in the normal range of IQ. These findings indicate that,
similar to parent expectations, parent perceptions tend to exceed their
child's actual cognitive ability. However, in contrast to Tew et al.
(1974), without the availability of an age-related anchor point for
estimating abilities, the parents' estimates were more varied.

Another set of studies has focused on the relationship between
parents' socioeconomic status (SES) and the expectations they held for
their children. In a comprehensive review of this issue in the general
population, Bronfenbrenner (1958) concluded that middle-class mothers
tended to hold higher academic expectations for their children than lower-
class mothers. Similarly, Hendling and Elliott (1968) found that middle-
class parents held higher expectations than lower-class parents for their
normally-achieving children. These studies asked for parents'
expectations about their child's future and thus did not allow for an
evaluation of the accuracy of parents' perceptions.

Other studies have focused upon parents' expectations or
perceptions of their child's current cognitive functioning both for the
general population of children and in families of children with mental
retardation. In the general population, Entwisle and Hayduk (1978) found
that working-class parents reported lower estimates than middle-class
parents for their child's first quarter grades in first grade. In another
study, Marcus and Corsini (1978) studied both parents' expectations for

their preschool child's achievement, and the accuracy of those

10

expectations. They asked 40 parents of preschool children to estimate
their child's abilities on achievement tasks. Half of the parents were
in the middle-class and the remainder were in the lower-class. Parents
were told the tasks had 15 levels, and that average performance on these
tasks ranged from 6-10. Based on that information, parents were asked
what level they thought their child would complete. On the average,
middle-class parents estimated that their child would complete level 8.0,
and lower-class parents predicted their child would complete level 6.8.
The children did not differ in their ability on the tasks. The tasks
actually consisted of only seven levels, and lower-class children scored
an average of 4.60 out of 7, while middle-class children scored an average
of 4.59 out of 7. Thus, Marcus and Corsini (1978) found that, although
the children did not differ in their level of ability, parents differed
by social class in their expectations for the child.

Several studies have looked at how SES affects the relationship
between parents' expectations or perceptions and the current cognitive
functioning of their children with mental retardation. For example, Iano
(1976), looked specifically at families of children with Educable Mental
Retardation (EMR). Because all of the children were classified as EMR,
they did not differ significantly in cognitive ability. Iano asked
parents to estimate their child's intellectual ability, independence and
social ability relative to children in general. Iano hypothesized that,
because parents from lower social classes tended to value achievement
less, they would be less likely to be troubled by their child's slow
educational progress. In addition, Iano hypothesized that children with

EMR from the lower social classes would appear less discrepant from

11

normally-achieving peers from lower social classes because, in general,
children from lower social classes exhibited lower achievement than high
or middle-class children. Iano found support for both hypotheses.
Parents from the highest social class most frequently expressed negative
feelings toward their child (86.4% of the cases), while 90% of the
families from the lowest social class evaluated their child in positive
or mixed terms. That is, lower-SE8 parents did seem less troubled by
their child's slow educational progress. Iano also found that 80% of the
parents from the highest two social classes estimated that their child's
cognitive functioning‘was lower than the cognitive functioning of children
in general, while 98% of the families from the lowest social class
estimated that their child's intellectual ability was higher than other
children's ability. Irt seems that the lower-SE8 child's intellectual
ability'met the standards for what the parents believed their child should
be able to do. In contrast, upper and middle-class parents seemed to
think their child's impaired ability fell below what those parents
believed a child should be able to do. Although this study clearly
indicates different parental expectations by SE3, the results give no
indication of differences in parents' actual perceptual accuracy because
parents were not asked their child's level of cognitive functioning.

A second study, by Ewert and Green (1957), did ask mothers to
estimate their child's current cognitive functioning in terms of mental
age. The authors used those mental age estimates to compute IQ scores,
and they formed two groups based on the accuracy of parents' estimates.
Accurate raters did not differ by more than 15 points from their child's

IQ, while erroneous raters differed by 16 points or more. The authors did

12

not indicate whether or not parents tended to overestimate their child's
cognitive functioning as other studies have found (Jensen and Hogan, 1962;
Barclay and Vaught, 1964; and Tew, et al., 1974). They hypothesized that
parents from higher educational and occupational levels would.more readily
comprehend their child's retardation. ‘They found support for this
hypothesis only with mothers. While 30% of the accurate raters had
attended some college, only 8% of the erroneous raters had attended
college. Similarly, a greater percentage of mothers working in the
professional or managerial fields (the two highest SES categories) were
accurate raters, whereas a much higher percentage of housewives were
erroneous raters. Although these findings show a relationship between
mothers' SES and their perceptual accuracy, the fathers' showed no
difference in perceptual accuracy in relation to either their educational
or occupational levels.

In summary, these findings suggest that parents from higher social
classes hold higher expectations for both children with mental retardation
and children without mental retardation. However, studies have not given
a clear indication of the relationship between parents' SES and their
perceptual accuracy. The higher expectations of higher SES parents may
be accurate perceptions of their child's cognitive ability in the general
population, but for children with mental retardation, those higher
expectations are likely to overestimate the child's capabilities. This
may be particularly true in the EMR group where the child's mental
retardation may not be diagnosed until the child begins school.

Although the effects of the severity of the child's mental

retardation and the parents' SES have been considered separately as

13
predictors of parents' perceptual accuracy, these variables are not
independent from one another. Many studies have noted that mild mental
retardation is more prevalent in the lower social classes (Birch,
Richardson, Baird, Horobin and Illsley, 1970; Edgerton, 1979; Farber,
1959; and Hurley, 1969). In particular, Birch et a1. (1970) conducted an
epidemiologic study to examine that relationship. They found that, in
general, the prevalence of mental retardation correlated negatively with
social class such that, in the lowest social class, the prevalence of
mental retardation was nine times higher than in the highest class.
Further, Birch et al. (1970) found that the prevalence rates across social
classes differed depending on the severity of retardation. For their
analyses, Birch et a1. (1970) divided children into the following three
groups based upon the severity of their mental retardation: 60-74, 50-59,
and <50. For children with an IQ of <59, the prevalence was almost
equally distributed across social classes. However, for children with an
IQ of >60, the prevalence rose steadily from no reported cases in the
highest social class to 24.9 per 1000 in the lowest social class. Thus,
there were very different distributions of the severity of retardation
within each social class. In the upper three social classes, there were
no cases of children in the 60-74 IQ range 11% of the cases in the 50-59
IQ range and 89% of the cases fell in the <50 IQ range. In the lowest
social class, 76% of the cases fell in the 60-74 IQ EMR range, 15% fell
in the 50-59 IQ range, and only 9% fell in the <50 IQ range. Thus
children from lower-SE8 families are more frequently mentally retarded and

that mental retardation is largely the mild type.

14

Parents' Stress and Distress

Byrne and Cunningham (1985) review indicates that parents' stress
and distress have been the primary foci of research on families of
children with mental retardation. Earlier studies of this population
tended to assume families of children with mental retardation comprised
an homogenous group for whom the inevitable outcome was distress.
Generally, parents experience additional stress from raising a child with
mental retardation as compared with parents of normally' developing
children (Abett and Meredith, 1986; Friedrich, 1979; Friedrich and
Friedrich, 1981; Friedrich, Hilturner, and Cohen, 1985; and Kazak and
Marvin, 1984). However, parents of children with mental retardation have
shown great diversity in their experience of stress (Byrne and Cunningham,
1985). The present study attempts to understand factors influencing this
diversity. First, the model assesses the separate contribution of the
severity of the child's mental retardation and parents' SES to parents'
stress and distress. Second the~model assesses the effect of the parents'
perceptual accuracy on parents' stress and distress. Third, drawing from
studies of sociocultural retardation (Birch et al., 1970; Edgerton, 1979;
Farber, 1959; Hurley, 1969) the model assesses the interactive effect of
the severity of the child's mental retardation and the parents' SES on
parents' stress and distress. Models of stress and coping, including
Hill's (1949) and McCubbin, Joy, Cauble, Comeau, Patterson and Needle's
(1980) offer an understanding of the process by which an event becomes
defined as a stressor, the components involved in one's attempts to cope
with stress, and appraisals of the success of the attempts to cope.

However, these models are not entirely applicable for understanding the

15

stress of raising a child with mental retardation because they address
acute stressors, but the presence of a child with mental retardation seems
to present a chronic stressor as families cope with developmental crises
throughout the child's life (Hikler, 1981). In addition, studies of
parents' grief following the identification of their child's retardation
(Solnit and Stark, 1961, and Hillner and Crane, 1979) suggest that
accepting the child's mental retardation may take several years.

In one of the few attempts to explain the effects of chronic stress,
Haan (1977) argues that stress which is not adequately coped with
contributes to physiological symptoms which may become an additional
source of stress. Haan suggests that stress experienced without reprieve
results in outcomes commonly defined as distress (e.g. physiological
camplaints). Hikler, Hasow, and. Hatfield (1981) have attempted to
understand how chronic stress occurs in parents of children with mental
retardation. They suggest that grief in families of children with mental
retardation appears to be chronic, but not continuous. Grief abates after
the initial diagnosis, then recurs in response to specific developmental
events throughout the child's life. Each of these events represents a
stressor to the family. Thus, for these families stress may take on
characteristics of both ongoing stress leading to slow degeneration, and
periods of acute crisis associated with short-term turmoil.

Severity of Mental Retardation.

Studies have rarely evaluated the severity of the child's
retardation as a differential factor in parents' experience of stress.
Only two studies specifically compared the impact of different severity

levels of retardation on stress, despite persuasive arguments that child

16
characteristics affect parents (Crnic et al. 1983; and, Byrne and
Cunningham, 1985). In the first, Nihira, Meyers, and Mink (1980) compared
the home environment, family adjustment and development of children
diagnosed with TMR and EMR. They reported that children with TMR appeared
to have a greater disruptive impact upon their families than children with
EMR. However, they noted that parents of children with TMR expressed more
positive sentiments about the impact of the child than did parents of
children with EMR. ‘This suggests that an understanding of parents' stress
or distress must take into account both the impact of the demands of
caring for a child with mental retardation, and the parents' attitudes
about their child. In the second study, Blacher, Nihira and Meyers (1987)
directly compared reports of family adjustment and coping between families
of children labelled as EMR, TMR and SMR (Severely Mentally Retarded).
They found that families of children with EMR and TMR reported
significantly better adjustment than families children with SMR. They did
not find a significant difference between children with TMR and children
with EMR on family adjustment. In addition, the investigators found no
difference between the three groups for the child's impact on either
marital adjustment or coping. Overall, this study found no significant
difference between EMR and TMR children's impact on their families, and
SMR children only showed an impact on the family's adjustment. Blacher et
al. (1987) defined the impact on family adjustment as the extent to which
parents felt the child with mental retardation affected the atmosphere in
the home, the relationships among family members, and the parents'
agreement on child discipline. This study suggested that the presence of

children with more severe mental retardation was associated with greater

17

impact on family functioning, but not associated with greater impact on
other presumed indicators of stress or distress. Further, the authors
found that severity of retardation was confounded.with SES. Specifically,
they found that the SES level of parents of children diagnosed as EMR were
significantly lower than those of parents of children diagnosed as SMR.
Thus, severity of retardation and SES may have exerted opposing effects
on these families which obfuscated the association of each with family
functioning. These findings do not suggest a clear relationship between
the severity of the child's mental retardation and parents' stress or
distress. Even though parents of children with SMR reported a greater
impact of the child on family adjustment, the child's impact did not
extend to other areas of marital adjustment or coping ability, which
suggests that parents' stress from raising a child with mental retardation
is not a generalized response. Instead, the stress may be associated with
unique demands of the severity of the mental retardation on the family in
combination with parents' SES and, as suggested in the previous study
(Nihira, et al., 1980), parents' attitudes about their child with mental
retardation.

Socioeconomic Status.

 

Research suggests that stress and psychological distress are linked
to social class. Dohrenwend and Dohrenwend (1969) reviewed studies of the
"true prevalence" of psychological distress in different communities.
They found that the lower one's social class, the higher their reported
psychological distress. Also, they found that people from lower social
classes reported less success in coping with "objective" or environmental

demands. The authors argued that members of lower social classes seemed

18
to resign themselves to their conditions and that this resignation
aggravated the impact of stressors upon thems Rabkin and Streuning (1976)
also found that families from lower-SE3 groups experienced more severe,
though not more frequent stressful events than members of the middle
class.

In families of children with. mental retardation however, the
relationship between stress associated with raising the child and SES
appears to be reversed. For example, Donovan (1988) found that higher-
SES mothers reported more stress than lower-SE8 mothers in raising their
children with autism and/or mental retardation. Higher-SES mothers
reported less marital adjustment, which Donovan used as an indirect
measure of the impact of "child stress" on family functioning. Also,
Blacher, Nihira, and Meyers' (1987) study indicated that, although parents
of children with SMR comprised a significantly higher SES group than
parents of children with TMR or EMR, the former group reported the
greatest amount of stress. In part, the greater stress for high-SES
parents may be due to their childrens' generally more severe forms of
mental retardation, which lead to more strain and demands for care from
the parents. However, this SES difference also supports Farber's (1968)
contention that parents from higher social classes would experience the
most emotional distress in response to the diagnosis of their child's
mental retardation because of the discrepancy between the label of mental
retardation and other labels applied to the family. He argued that mental
retardation would create a crisis for both middle and low-SE8 families,
but the nature of that crisis would differ. For middle-class parents, the

crisis would revolve around the frustration of their expectations and

aspirations for their child. For lower-class parents, the crisis would
center on the lack of the families' organization into domestic roles and
responsibilities to meet the challenges of raising a child with mental
retardation. Iano (1976) found that, for families of children with EMR,
upper and middle-class parents expressed the most negative feelings about
the presence of their child with mental retardation.

Perceptual Accuracy.

Although no studies have evaluated the outcomes of parents'
perceptual accuracy, several studies contributed to guide the hypotheses
of the present study. For example, one potentially important cause of
chronic stress for the parents of children with mental retardation is
ongoing difficulty establishing accurate expectations for the child.
Jensen and Hogan (1962), drawing from their clinical experience in working
with the families of children with mental retardation, observed that
parents' persistent overrating of their child's potential for future
achievement corresponded with the amount of disturbance in the parent-
child relationship. In families of children with mental retardation,
diagnosis of the retardation is a critical event in determining the
parents' experience of stress and eventual distress (Gath, 1977). That
event requires the parents to restructure their beliefs about the child.
When the parents persist in holding beliefs discordant from their child's
actual cognitive abilities, they should also exhibit more perceptual
distortion of the child's ability, and a greater amount of stress and
distress.

This formulation is consistent with Iano's (1976) finding, that

parents of children with EMR who were from higher social classes both

19

20
perceived their child's cognitive functioning as below average and were
more dissatisfied with the child. Kurtz (1977) argues that low-SE8
parents' expectations may be less discordant from their child's actual
cognitive functioning than the expectations of parents from higher social
classes, therefore lower-SE8 parents experience less stress. lKurtz listed
six possible reactions of low SES families to their child labelled as
mentally impaired, all of which might decrease the likelihood that they
would perceive the label as a source of stress. (1) They may consider
the condition unimportant or reject the label outright. (2) They may
react minimally because the disability cannot compete with their other
hardships. C3) They may accept the label as "natural," and as such,
acceptable or believable. (4) The label may be one of several given to
their child or children, making it difficult for them to see the child in
terms of the labels. (5) They may react more to any physical disability
than to mental disability. (6) They may not perceive the mental
retardation as a problem requiring response.
Children's Self-esteem
The construct of4§g1f33§tggmg

For the child, self-esteem is a crucial outcome which reflects the
child's perceptions of him/herself as competent and capable. If, as the
literature on parents' expectations and perceptions suggests, parents
expect more than their child with mental retardation can accomplish, then
to the extent those children are aware of their parents' expectations,
they are likely to be at risk for developing poor self-esteem. In
addition, Fitts (1972) argued that, because children with mental

retardation compare themselves to their non-impaired peers, they are at

21

great risk for developing poor self-esteem. Children's sense of self-
esteem represents the evaluative aspect of their self-concept (Gurney,
1988). Harter (1982) chose to focus upon one aspect of one's self-
evaluation, perceived competence, and her Perceived Competence Scales are
used in the present study.

Perceptual Accuracy

Gurney (1988) states that, when young, the child does not have an
sense of self. The child's sense of self develops through interpreting
others' responses to him/her. In support, Rosenberg and Kaplan (1982)
argue that people see themselves as others see them. That is, we evaluate
ourselves based upon others' responses to our actions. Accordingly,
parents' responses figure prominently in guiding the child's evaluation
of his/her competence (Rosenberg, 1965). Lavelle and Keough (1980) argue
that the parents' attitudes and expectations dictate their behavior toward
the child, and their behavior can either promote or disrupt the child's
sense of self-esteem. .According to Baucom and Epstein's (1990) suggestion
that perceptions may guide expectations, parents' inaccurate perceptions
of their child's cognitive ability may result in unrealistic expectations
for the child's achievement. The child would likely adopt these
expectations he/she cannot fulfill, and as a result, the child would
evaluate him/herself unfavorably.

Socioeconomic status

Two studies of the general population suggest that SES should
predict self-esteem (Housley, Martin, McCoy, Greenhouse, Stigger and
Chapin, 1987; and Kohr, Coldiron, Skiffington, Masters and Blust, 1988).

Housley et a1. (1987) used the Rosenberg Self-esteem Scale to measure the

22

self-esteem of girls between the ages of 14 and 16, and to examine
associations with race, SES and area of residence. The investigators did
not find differences in self-esteem in relation to race or area of
residence, but they did find that girls from the higher SES group had
significantly higher self-esteem than their cohorts from the lower SES
group. Kohr, et al. (1988) studied self-esteem in fifth, eighth and
eleventh graders using a measure of self-descriptive statements regarding
the child's relationship with teachers and peers and the child's academic
self-concept. Both of these studies showed differences between the
highest and lowest SES groups, but in neither case did the middle SES
group differ significantly from either the highest or lowest group. The
findings suggested a linear trend, where self-esteem increases‘with higher
levels of SES.

Severity of mental retardation

Another potential influence on self-esteem is the severity'of mental
retardation of the child. Previous studies comparing children withrmental
retardation to children without mental retardation suggest that mental
retardation is associated with low self-esteem (Fitts, 1972; Ziglar,
Bella, and Hatson, 1972; and Leahy, 1985). Fitts (1972) argued that
children with mental retardation compare themselves to their non-impaired
cohorts, are less likely to see themselves as competent, and are thus at
greater risk for developing poor self-esteem. Leahy (1985) found that
children with.mental retardation also exhibit lower "real" self-image than
non-impaired children, defined as the child's perception of his/her
current functioning, suggesting that these children might be more likely

to display low self-esteem because of their mental retardation. Ziglar,

23
Balla, and Watson (1972) found that children with mental retardation
reported having a lower ideal self-image than non-retarded children.

Although fewer studies have examined self-esteem within samples of
children with different levels of mental retardation, the work of Mink,
Hihira, and Meyers (1983) and Mink, Meyers, and Nihira (1984) allows for
an indirect comparison of children's self-esteem and the severity of their
cognitive impairment. In the first study, Mink et at. gathered
descriptive data, including a measure of self-esteem, on children labelled
as TMR. They asked the children's teachers to complete the Coopersmith
Self-esteem Behavior scale. Teacher ratings averaged 17.8. In the second
study, Mink et al. (1984) gathered similar information from teachers of
children labelled as EMR, and found that teacher ratings of the child's
self-esteem averaged 16.4. Although no statistical tests were performed
to contrast the groups, the two reports provide at least suggestive data
that children with more severe mental retardation may experience higher
self-esteem than children with milder mental retardation.

The relationship between self-esteem and mental retardation appears
to be a complicated one. Although the presence of mental retardation
corresponds with lower self-esteem, more severe mental retardation does
not appear to correspond with still lower self-esteem. In addition, the
relatively greater risk for poor self-esteem in children with EMR may
depend upon the family's SES. Kurtz's (1977 ) argument suggests that
lower-SE8 parents' beliefs about their children may not only be protective
for themselves in terms of reducing stress but may also function to
preserve high levels of self-esteem for the children. Iano (1970) further

suggests that of all children with EMR, those from families in the lower

24
social class would likely report higher self-esteem because their
achievement would more nearly match their parents' expectations.
Model and hypotheses

This study focuses on the relationship between parents' perceptual
inaccuracy about their child's cognitive functioning, parental stress or
distress, and low self-esteem for the children. In addition, this study
examines the effects of the parents' SES and the severity of the child's
mental retardation upon both perceptual accuracy and the outcome
variables.

A model proposing direct and indirect links among these factors is
presented in Figure 1. The model suggests that perceptual inaccuracy will
be associated with stress and distress for the parents and low self-esteem
for the child. The model also proposes that SES and the severity of the
child's retardation will directly affect the outcome measures and will
have indirect links through perceptual accuracy.

Although this model is consistent with the reasoning that advantaged
conditions (i.e., high 3E3, mild mental retardation for the child,
accurate perceptions by the parents) should lead to positive outcomes, the
above review of research suggests that the actual picture will be much
more complex. In some cases, SE3 and the severity of retardation should
exert opposing influences, and in others these factors should serve as
moderators for each other and for the effects of perceptual accuracy on
the outcomes. Thus, the present study will evaluate these more complex
relationships and contrast the findings with the relationships proposed

in Figure 1.

 

i
I
I
i
i
i
i
i
i Macaw Stress or
i Di.trsss
i
i
‘ .

.913 at .iagnosis @
i

i
i
i
|
i

‘ i
r
v

\ Child Salt-esteem
“‘s

 

SES

Figure 1. The Conceptual Model

25

26
The hypotheses for the present study are as follows:

1) The parents' SES and the severity of the child's mental
retardation will be associated with the parents' perceptual accuracy.
Specifically, (a) the relationship between SES and parents' perceptual
accuracy will be moderated by the severity of the child's mental
retardation, (b) the moderational effects will be accounted for by the
child's age at diagnosis such that early diagnosis will be associated with
a strong relationship between SES and perceptual accuracy, whereas, late
diagnosis will be associated with a weak relationship between SES and
perceptual accuracy, and (c) the severity of the child's mental
retardation will be strongly associated with the child's age at diagnosis
such that EMR will be associated with significantly later diagnosis.

The moderational hypothesis draws from the findings of Hillner and
Crane (1979) that, although all parents of children with mental
retardation mourn the loss of their idealized child, because children with
mild handicaps were diagnosed at a later age, the mourning process is
delayed and prolonged for the parents. Accordingly, there will be a
strong relationship between SES and parents' perceptual accuracy when the
child had moderate mental retardation and had been diagnosed at an early
age. However, if the child was diagnosed later, the relationship between
SES and parents' perceptual accuracy will be obscured, or possibly
reversed. The reversal may occur because of the parents' beliefs about
what their child should be accomplishing. High-SE3 parents will hold
higher initial expectations for their child than low-SE3 parents, and the
late diagnosis will prolong the exposure of both the parent and the child

to those unrealistic expectations. Because low-SE3 parents' lower

27
expectations will be more congruent with the child's cognitive
functioning, parents will be more perceptually accurate.

2) SE3, the severity' of the child's mental retardation and
perceptual accuracy will be associated with parents' stress and distress.

Specifically, (a) there will be no main effect of SES on parents' stress
and distress because high-SE3 parents will report stress related to the
disconfirming effect of the child's mental retardation on parents'
expectations, and low-SE3 parents will report stress related to the
demands of caring for their child with mental retardation. (b) The
severity of the child's mental retardation will be directly associated
with parents' stress and distress such that parents of children with TMR
will report more stress and distress than parents of children with EMR.
However, (c) more interesting is the interaction between SES and severity,
which indicates that low-3E3 parents of children with TMR and high-3E3
parents of children with EMR will experience the highest levels of stress
and distress, and (d) there will be a main effect of parents' perceptual
accuracy on their reports of stress and distress such that accurate
perceivers across groups for SES and severity of mental retardation will
report less stress and distress than inaccurate perceivers.

3) 3E3, severity of the child's mental retardation, and perceptual
accuracy will be associated with the child's self-esteem in the following
manner: (a) SES will have a direct effect on self-esteem such that,
higher SES will be associated with higher child self-esteem, (b) SES will
interact with the severity of the child's mental retardation to affect the
child's self-esteem such that, children with TMR from high-SE3 families,

and children with EMR from low-SSS families will report the highest self-

28
esteem, and (c) there will be a main effect of perceptual accuracy on
children's reported self-esteem such that parents who are accurate
perceivers will have children who report higher self-esteem than children
of inaccurate perceivers regardless of SES or the severity of the child's

mental retardation.

mm
Subjects

The subjects were 57 families of children with Educable Mental
Retardation (EMR) and 32 families of children with Trainable Mental
Retardation (TMR) identified by the local school system. Most of the
families were recruited through the school system. A letter describing
the project was sent to the schools involved. Schools agreeing to
participate distributed information to all parents whose children were
classified as EMR or TMR. Families interested in participating in the
study' returned postcards, and ‘were then contacted to schedule data
collection sessions. In addition, some families responded to radio or
newspaper advertisements, or to referral from local agencies working with
families of children with handicaps. All of the children in the sample
were living at home. The sample consisted of 89 children ranging in age
from 7 to 21 years old (M: 12.6, SD: 3.5).

For this study, severity was considered as a discrete rather than
continuous variable, using the two categories: EducableeMental Retardation
(EMR) and Trainable Mental Retardation (TMR). The severity of the child's
mental retardation was reported initially by parents and confirmed by the
diagnosis from the child's Individual Education Plan (IEP) provided by the
child's school. To be diagnosed with mental retardation, a child must
meet two criteria: (a) a score on a standard intelligence test greater
than two standard deviations below the mean, and (b) evidence of below-
average adaptive functioning on a standardized. measure of adaptive
functioning. Thus, the scores of children classified as EMR ranged from

55-69 on intelligence tests and the scores of children diagnosed as TMR

29

30
ranged from 40-54.
Measures

The parents completed questionnaire measures of their stress and
distress, they evaluated the adaptive functioning in their child with
mental retardation, and they were queried in order to obtain an estimate
of the child's receptive language ability. The children were given
measures of self-esteem and receptive language skills.

The parents completed the Questionnaire on Resources and Stress
(QRS) developed by Holroyd (1974) specifically to measure the stressors
and available familial resources for persons caring for and living with
people who are either handicapped or chronically ill. The QRS was
designed as a self-administered test of both the demands and the family
member's response to those demands. This study used 14 of the 15 scales
of the QRS to assess the parents' stress related to the presence of their
child with mental retardation. The Health/Mood scale appears to overlap
with the measure of distress, and thus was removed in order to eliminate
this possible confound. Holroyd found that the reliability of the whole
285-item QRS was .96 using the Kuder-Richardson test.

The parents completed the Symptom Checklist-90 (SCL-90; Derogatis,
1983), a measure of psychological distress. The SOL-90 is composed of 90
symptoms of distress which subjects rate on a four-point scale from 0-3.
The symptoms cluster into nine scales representing different symptom
dimensions. For this study, all nine scales were combined into a
composite score, the Global Severity Index (GSI). Derogatis (1983)
reported a study of concurrent validation of the SCL-90 in which responses

to the SCL-90 were correlated with responses to the Middlesex Hospital

31
Questionnaire (MSQ) another questionnaire to measure distress.
Correlations between similar scales of the two measures ranged from .36
for phobic anxiety to .74 for anxiety. The global scores of the two
measures showed a correlation of .92.

In order to get an estimate of the children's cognitive ability,
they were given the Peabody Picture Vocabulary Test-Revised (PPVT-R; Dunn
& Dunn, 1981), an individually administered test of verbal, receptive
language abilities. The PPVT is highly correlated with intelligence, and
it is often used as a screening device for determining level of
intellectual functioning. The child is shown four pictures on a page and
asked to identify, either verbally or by pointing to the appropriate
picture, which of the pictures best represents a stimulus word. Normative
scores have been developed for children between the ages of 2 and one-half
to 18 years old. The PPVT-R exhibits split-half reliability ranging from
.67 to .88. Although validity studies have not been completed on the
PPVT-R, numerous studies have established the validity of the PPVT by
comparing its scores to vocabulary tests and to measures of overall
intelligence or achievement. Across 55 studies, the PPVT displayed a
median correlation of .71 with other vocabulary tests. Although it is not
presumed to be a measure of overall intelligence or achievement, the PPVT
displayed moderate correlation with measures of IQ between .38 to .71, and
with scholastic achievement tests between .29 to .68. The PPVT showed a
median correlation of .70 with the PPVT-R, thus its authors argue that
validity data for the PPVT can be applied to the PPVT-R.

The children's age in months when they were first diagnosed with

mental retardation was also used in the present study. Parents were asked

32

about the developmental history of their child with mental retardation in
a structured interview. In that interview, parents were asked when their
child was first diagnosed with mental retardation. Age at diagnosis was
divided into three groups: early diagnosis (birth to twelve months), mid-
length diagnosis (twelve months to thirty-six months) and late diagnosis
(longer than thirty-six months) based on Hillner and Stark's (1979) work.
They suggested that children with mild handicaps are often not diagnosed
until they at least three years old. The early group is designed
primarily to include children whose physical appearance is sufficient for
diagnosis, as with Down Syndrome, or for whom development was delayed to
the extent that it was evident through early gross motor or pre-language
deficits. The middle group was not included in analyses because it was
presumed to form an empty set.

In order to measure self-esteem, the children were administered
Harter's (1982) Perceived Competence Scale for Children (PCSC) or a
picture version of the scale, developed by Harter and Pike (1984), which
was constructed for children too young to read. All children from the TMR
group, and children ten years old or younger from the EMR group were given
the picture version, and all children from the EMR group older than ten
were given the questionnaire version. In both versions the children were
first presented with two descriptors of a particular characteristic, which
expressed either competency or lack of competency for that characteristic.
They were asked to choose which was most like them. Next, they were asked
to determine how strongly they endorsed or did not endorse the attitude.

The questionnaire version yields four factors representing academic,

athletic, popularity, and personal appearance scales, as well as a scale

33

of general competence. The picture version also yields four subscales:
cognitive competence, physical competence, peer acceptance, and maternal
acceptance. Silon and Harter (1985) administered the PCSC to 9-12 year-
old children with EMR and found the following two-factors structure of
responses: a competence scale composed of items from the cognitive and
physical subscales of the PCSC, and a popularity scale composed of the
more concrete items about the number of friends the respondent had. No
general factor emerged. Similarly, Harter and Pike (1984) found that a
two-factor solution best accounted for children's style of responding to
the picture version of the PCSC, but the factors (competence and maternal
acceptance) were dissimilar from those found by Silon and Harter (1985).
In order to compare the children's scores across the two versions, the
present study examined the internal consistency and factorial loadings of
the children's responses to the PCSC for this sample. The children's
responses were compared to the three factors found by Harter (1982), the
two factors found by Harter and Pike (1984), and the two factors found by
Silon and Harter (1985) in order to determine which factor strusture best
fit. For each version, the children's scores on the best-fitting factors
were then converted to Z—scores, and the groups were combined for the
analyses.

Harter ( 1982) reported that the PCSC questionnaire version displayed
acceptable reliability, with coefficient alpha's for the domains ranging
from .73 to .83. Test-retest reliability for three months range from .70
to .87, and for nine months from .69 to .80. She reported that the
factors are stable across development in children in grades three through

nine. Harter argued for the convergent validity of her measure in three

34

ways. First, she asked children to complete the scales and then their
teachers rated them for children's self-esteem, and she found a
correlation of .40 between the child and teacher ratings. In addition,
she found that the correlations between the students' reported self—esteem
and their teachers' ratings increased over grades 3-9 from .28 to .55.
Further, she found that the scales correlated between .27 and .45 with
children's scores on the Iowa Basic Skills Test. Finally, she
hypothesized that the self-esteem scores were connected to intrinsic
motivation, and found that scale scores correlated .57 with preference for
mastery, .54 with independence mastery, and .33 with curiosity. For the
picture version, Harter and Pike (1984) reported that subscale
reliabilities ranged from .50 to .85, and they estimated the overall
reliability to be in the mid- to high .808. In addition, they asked
children how they knew they were good at or not good at activities to
which they had responded on the PCSC. Children showed they ability to
report reasons for their responses in over 90% of the cases. As a test
of the measure's discriminant validity, Harter and Pike (1984) found that
children held.back a grade reported significantly lower competence scores.

The parent that completed the Adaptive Behavior Scales on the child
with mental retardation, collected as part of the larger study, was also
asked to complete the PPVT Hordlist, a.measure derived for this study from
the Peabody Picture Vocabulary Test (PPVT). PPVT Hordlist was designed
to generate a parent-estimate score of the child's cognitive abilities
based on the child's receptive language ability. Similar to the procedure
with the children, the parents were shown the PPVT stimulus materials with

four pictures for each probe. On the PPVT, the child's task was to select

35

the correct picture that best matched each probe word. The items are
arranged in order of increasing difficulty. The parents were asked
whether or not they thought their child could correctly identify which
picture best represented the probe. Similar to the procedure with the
child, a starting point was selected based on the chronological age of the
child. Items were administered in ascending order until a "ceiling" was
reached, which was a total of six of eight words judged to be too
difficult for the child. From the parents' estimates of words the child
would answer correctly and incorrectly two scores were calculated” First,
an overall estimated verbal IQ score was calculated to compare with the
child's actual score in order to create nominal groups of parents who
accurately versus inaccurately perceived the child's abilities on the
PPVT. Mothers' perceptual accuracy was calculated by subtracting the
children's actual standardized scores on the PPVT-R from the standardized
scores calculated from the mothers' estimates. Thus, mothers who
overestimated the number of correct items for their children had positive
scores, while mothers who underestimated had negative scores. Similar to
the procedure used by Ewert and Green (1957), the parents whose estimates
were within one-half of a standard deviation of the child's actual overall
score on the PPVT-R scales formed the group of accurate raters, and those
whose estimates diverged from the child's ability by more than one-half
of a standard deviation formed the inaccurate raters' group.

A socioeconomic status (SES) score was derived using a modification
of Hollingshead's Four-Factor Index of Social Status (1975). Parents
provided information on their current occupation and their highest level

of schooling completed. From these data, the Four-Factor Index, combines

36
the level of schooling completed and the occupational rating for both
parents and takes their average to attain an SES score for the family.
However, this method differentially affects families with one versus two
wage-earners. In families with only one spouse employed, the SES score
is fully determined by that spouse's occupation and educational level.
In families with two wage-earners, combining a second spouse's
occupational and educational levels to the SES score of the first will,
at best, equal the score of the single spouse, and that will only occur
where both spouses attain equal scores. Any difference between spouses'
scores will result in a lowering of the family's average SES. In an
attempt to allow for the full range of difference in scores, the present
study computed scores for both parents and used the higher of their scores
as the family's level of SES. Hollingshead and Redlich (1958) divided the
range of SES scores into five classes, while other studies have collapsed
SE3 classes into two to four SES-groups in an attempt to form more
appreciably different groups (Entwisle and Hayduk, 1978; Ewert and Green,
1957; Flynt and Head, 1989; Iano, 1970; and, Marcus and Corsini, 1978).
Considering the relationship between SES and mental retardation, studies
have identified a lower-SE3 group presumed to represent a socioculturally
deprived environment (Flynt and Hood, 1989; Iano, 1970, and Meyerowitz and
Farber, 1966). That group is contrasted with higher-SE3 groups which are
Presumed to afford sufficient environmental stimulation for normal
development. The present study first employed the five-group method for
diViding SES. The SES scores, as measured by Hollingshead (1975), were
divided into the following five groups: (1) 8-19, (II) 20-29, (III) 30-

39, (IV) 40-48, (V) 49-66. A comparison of parents' years of education

37

across SE3 groups was significant, E(4,91)= 9.21, p<.001. The parents in
group I had significantly fewer years of education than the parents in
groups III, IV, and V, and the parents in group II reported significantly
fewer years of education than the parents in group V.

When the analyses involving the five SES groups required collapsing,
SE3 was divided into high and low groups using a median split at a score
of 32 on the Hollingshead Index, which ranges from 8-66.
Procedure

This study was conducted as part of a larger study of families of
children with mental retardation. In the larger study, each family was
seen for two sessions which were spaced at least one week apart, each
approximately two hours long. Families were paid $50 for participating
in the study. During the first session, the mothers were given a battery
of questionnaires, including the SCL-90, the childrenmwas administered the
Harter scale, and the PPVT-R was administered to the children in a room
separate from the mothers. The mothers completed the QRS independently
during the week between sessions. During the second session, the mothers
were asked to complete the PPVT Hordlist. The children were removed from
the room while the mothers completed the PPVT Hordlist so that they were

unable to provide feedback on their actual performance on items.

RESULTS
Th§:;on§truct ofgperceptual accuracy

The children obtained standardized scores on the PPVT-R ranging from
40 to 110 with a.mean of 57.1 (SD: 16.8). As expected their PPVT-R scores
differed significantly, ;(1,87)= -5.12, p<.001. The children classified
as EMR scored higher on the PPVT—R (M=63.3, SD: 16.1) than the children
classified as TMR (M=46.6, SD: 12.1). Their mothers' estimated scores
ranged from 40 to 118 with a mean of 58.3 (SD: 20.5). The mothers'
estimates ranged from 41 points below to 76 points above their children's
standard score. Previous studies have found that most parents
overestimated their child's cognitive ability, but the current study found
that the number of mothers who overestimated (n=34) was only slightly
greater than the number who underestimated (n=29).

For most analyses the absolute value of the difference score was the
dependent variable. Specifically, this difference score was used when
examining the effects of the child's age at diagnosis, the severity of
his/her mental retardation, and the family's SES on the mothers'
perceptual accuracy. The mean absolute value of the difference between
the child's performance and the mother's estimate for the sample was 13.65
(SD=14.53).

Other analyses used perceptual accuracy as an independent variable
and examined its effects on the mothers' stress and distress and on the
children's self-esteem. For these analyses, perceptual accuracy was
separated into the following four groups of subjects: (a) low
.performance/low estimate (p=16) were the mothers whose estimates exactly

thatched their children's performance because of a floor effect on the

38

39

PPVT-R, (b) underestimators (p=20) were the mothers whose estimates were
below the child's obtained score by greater than or equal to one-half of
a standard deviation, (c) accurate estimators (3:25) were the mothers
whose estimate fell within one-half of a standard deviation above or below
the child's obtained score and, (d) overestimators (p=19) were the mothers
whose estimate exceeded the child's obtained score by one-half of a
standard deviation or greater. ANOVA's were also run for more extreme
cases of under and overestimation in which the mothers' estimates and the
children's performance differed by more than one standard deviation from
one another. The results of these analyses did not differ appreciably
from the analyses run using one-half of a standard deviation differences
as the criterion, so only the analyses of the less extreme groups are
reported in the present study. The formation of the low performance/low
estimate group is unique to the present study and requires more
explanation.

Previous studies found that parents' estimates rarely corresponded
exactly with their child's obtained intelligence score, yet the present
study yielded 17 such cases. This phenomenon can be accounted for by a
floor effect on the PPVT-R. On that measure, a standardized score of 40
is awarded regardless of how few items the respondent correctly
identifies. As the age of the respondent increases, more items must be
correctly identified in order to exceed that minimum score. Sixteen of
the exact matches occurred because both the number of words the children
identified correctly and the number that the mothers estimated their
children would know were not sufficient, given the children's ages, to

«exceed the minimum score of the PPVT-R. These cases were combined to

40
create the low performance/low estimate group. Analyses were run to
determine whether the exact match between children's performance and
mothers' estimates in this group indicated accurate perceptions or merely
an artifact of the PPVT-R. Because the floor effect, which created the
exact correspondence between the mothers' estimates and the children's
performance in this group, occurred as a result of using standardized
scores, the raw scores of the PPVT-R were used to calculate mothers'
perceptual accuracy for this set of analyses. A one-way ANOVA was run
using the raw scores for mothers' perceptual accuracy as the dependent
variable and the four perceptual accuracy groups as the independent
variable to determine whether or not the group differences exhibited for
the standardized scores existed when looking at raw scores for the PPVT-
R. The ANOVA indicated significant group differences, £(3,76)= 13.65,
p<.0001. Post-hoc comparisons using Tukey HSD indicated more specifically
that mothers from both the accurate and the low performance/low estimate
groups held significantly more accurate perceptions of their child's
performance on the PPVT-R than mothers from the overestimate and
underestimate groups. In addition, a planned comparison indicated that
the low performance/low estimate group did not differ significantly from
the accurate group in perceptual accuracy, 3(1, 76): -1.17, pg. These
analyses indicated that the perceptual accuracy of mothers from the low
performance/low estimate group was not just a function of the
standardization of scores on the PPVT-R, and the low/low group was
retained in all further analyses in which perceptual accuracy served as

an independent variable.

41

The four perceptual accuracy groups were compared on the children's
age and on the mothers' estimates and the children's performance on the
PPVT-R using one-way ANOVA's. The children's age differed significantly
across the four groups, £(3,79)= 3.31, p<.05. On the average, the
children in the low/low group were the oldest (M: 14.1, SD: 3.9), followed
by the accurate group (M: 14.0, SD: 3.5), the underestimators (M: 13.0,
SD: 3.4), and overestimators (M: 11.1, SD: 2.7). A post-hoc test using
Tukey's HSD revealed that the children in the accurate group ‘were
significantly older than the children in the overestimator group.
Although the children in the low/low group were the oldest, the difference
between the children in that group and the children in the overestimator
group was not significant. That may be due to the small number of
children in the low/low group and by the relatively large variation in
their ages. The groups differed significantly for both the mothers'
predictions, F(3,79)= 27.29, p<.001, and the children's performance on the
PPVT-R, {(3,79)= 21.74, p<.001 as shown in Figure 2. More interestingly,
post hoc comparisons using Tukey's HSD revealed the underestimator group
was composed primarily of children whose scores were significantly higher
than those from any other group (M=74), while the overestimator group was
composed primarily of children whose mothers' estimates were significantly
higher than those of any other group. In addition, both the children's
performance and the mothers' estimates for the accurate group were

significantly higher than those of the low/low group.

42

Mothers' Estimates and Children's Periormance on the PPVT-R

 

100

 

 

 

 

 

(D

(D

L

O

0

U)

“U

(T! Perceptual Accuracy
'0

E * Mother
5

+ .

0,3 Chlld
D.

D.

20 ................................

 

 

 

0
Low/Low Underest.Accurate Overest.

Perceptual Accuracy Group

Figure 2. Perceptual Accuracy Group Estimate and Performance Differences

43
Variables affecting perceptual accuracy

Mpderator hypothesis.

Two sets of analyses were conducted to understand the relationship
of the mothers' perceptual accuracy with the severity of the child's
mental retardation, and with the family's socioeconomic status. 'The first
set of analyses tested Hypothesis 1, which proposed that the relationship
between SES and the mothers' perceptual accuracy would be moderated by the
age at which the child was diagnosed with mental retardation. In the
current sample, children's age at diagnosis ranged from birth to 120
months (M=28.5 months, S.D.=28.8). Age at diagnosis was separated into
the following three groups: (a) diagnosis in the first year (p=40), (b)
diagnosis between the first and third years (p=17), and (c) diagnosis
after three years (9:34). Hypothesis 1 proposed that when the diagnosis
of mental retardation was made within the first year, there would be a
strong positive correlation between the family's SES and the mother's
perceptual accuracy. Hhen diagnosis was made after the third year, the
correlation between the family's SES and the mother's perceptual accuracy
would be weak. The data failed to support the hypothesis. There was no
significant difference in the correlation between SES and perceptual
accuracy across the three conditions of the child's age at diagnosis:
r(30)= -.15, pg when the child was identified within the first year,
{(15): -.15, p§_*when the child was identified between the first and third
‘years, and ;(29)= -.17, pg, when the child was identified after the third
year.

This moderator hypothesis was based on the assumption that a strong

correlation existed between the child's age at diagnosis and the severity

44

of the child's mental retardation because both presumably indicated mental
retardation that was more easily detected. However, the low correlation
;(76)= .24, p< .05 between those two variables was inconsistent with this
assumption. Since the hypothesis had already been unsuccessfully tested
for the child's age at diagnosis, the possible role of the severity of the
child's mental retardation as a moderator of the relationship between the
family's SES and the mothers' perceptual accuracy was tested. That
hypothesis was also not supported. The correlation between the family's
SES and the mother's perceptual accuracy was 1(76)= -.18, pg when the
child was classified as moderately mentally retarded, and r(76)= -.04, pg
when the child was classified as mildly mentally retarded. The two
correlations didi not differ significantly when tested using Fisher's r
to z computation, g(76)= -1.205. pg. Thus, the moderator hypothesis was
not supported for either variable presumed to indicate the clarity of the
child's mental retardation.

SES and severity of mental retardation._

Hypothesis 1 also proposed that the mothers would more accurately
perceive their child's ability on the PPVT-R when the family's SES was
higher, or when the child's mental retardation was less severe. Two, one-
way ANOVA's were conducted to test these proposals.

The one-way ANOVA contrasting the EMR and TMR groups, based on the
mothers' perceptual accuracy scores, was significant, {(1.76) = 9.15,
,p<.01. As hypothesized, the mothers of children with moderate mental
retardation (M: 6.4, SD: 8.62) more accurately perceived their children's
ability on the PPVT-R than the mothers of children with mild mental

:retardation (M: 17.0, SD: 15.5).

45
However, the proposed difference in the mother's perceptual accuracy
as a function of the family's SE3 did not occur, {(4.68) = .33, pp. As
shown in Table 1 and consistent with the hypothesis, mothers in the two
lowest 3E3 groups had mean inaccuracy scores that appeared larger than
those for the mothers in the three highest groups. However, the SES group

differences failed to achieve significance because of the large variance

within each of the SES groups and in the sample as a whole.

46
Table 1

Mothers' Perceptual Accurpcy Scorgp for Separate SES Groups

 

 

SES GROUP ACCURACY
R H §2

I (8-19) 9 9.7 10.7
II (20-29) 22 18.9 14.9
III (30-39) 17 11.8 10.4
IV (40-48) 10 8.8 16.0

V (49-66) 19 10.2 9.1
To... 7. I; (I;

 

Note. The SE3 group scores in parentheses represent the parents' score

on the Four Factor Index of Social Status (Hollingshead, 1975).

47

Because there was large variability among the scores within the five
SES groups, the groups were collapsed into larger groups for the purpose
of detecting possible SE3 differences. SES was divided into high and low
conditions using a median split at a score of 32 on the Hollingshead Four
Factor Index. A one-way ANOVA was conducted and, consistent with the
hypothesis, the mothers from the higher SES group (p: 9.4, SD: 11.3 ) more
accurately perceived their child's performance on the PPVT-R than the
mothers from the lower SE3 group (M: 17.1, SD: 16.1), {(1,78) = 5.90,
p<.05.
Variables affecting Mothgpp' Stress and Distress

Interaction of the Exogenous Variables.

 

Hypothesis 2 proposed main effects and interaction effects of the
severity of the children's mental retardation and the families' SE3 on the
mothers' reported stress and distress. First, the interaction hypothesis
that the lower SE3 mothers of children classified as EMR, and higher SES
mothers of children classified as TMR would report the least amount of
stress and distress, was tested using a series of two-way ANOVA's. Due
to the unequal distribution of the subjects into cells however, analysis
could not be conducted on the full 5x2 model of SES (five groups) by
severity' of mental retardation (two groups). The SES groups were
collapsed into high and low SES groups using the median split as described
above. A series of 2X2 ANOVA's was conducted with SE3 (high-low) and the
severity of the child's mental retardation (EMR-TMR) as independent
variables. The dependent variables were the three factor scores for
parent, family, and child problems on the QRS, and the global distress and

depression scales of the SCL-90. None of the proposed interactions were

48
significant: parent problems, {(1,84)= 0.12, pp, family problems, {(1,84)=
0.06, pp, child problems, {(1,84)= 0.41. pp, and total problems, {(1,84)=
0.23, p§,or for global distress {(1,89)= 0.80, pp, and depression {(1,89)=
0.87, pp.

Severity of Mentpl Retardation.

Second, Hypothesis Two proposed that the mothers' of children with
more severe mental retardation would report a greater number of problems
on the QRS and the SCL-90. This proposal was tested by the main effects
of the two-way ANOVA's described above. As shown in Table 2, the results
for the SOL-90 scales: global distress, {(1.88)= 0.41, pp, and depression,
{(1,88)= 0.55, pp, failed to support the hypothesis. The results did
support the hypothesis for two of the three QRS scales. The mothers of
children classified as EMR reported fewer total problems, {(1,84)= 6.48,
p<.05. parent problems, {(1,84)= 6.69,p<.01, and showed a trend to report
fewer child problems, {(1,84)= 3.62, p<.10, but they did not differ in
their reports of family problems, {(1,84)= 1.74, pp. Follow-up ANOVA's
were conducted on the individual subscales which contribute to the parent
and child-oriented stress factors of the QRS. The ANOVA's revealed that
the mothers of children classified as TMR reported significantly greater
time demands from parenting, {(1.83) = 14.39, p<.001, and greater
pessimism about the future for the child {(1.83) = 14.36, p<.001 than the

mothers of children classified as EMR.

49

Table 2

Severity of Mental Retardation_pnd Mothers' Stress and Distress

 

Severity of Mental Retardation

 

 

TMR _ EMR
VARIABLE Mean SD Mean SD
QRS

Parent-oriented Stress 38.12 (11.39) 31.01 (12.41)**
Health/Mood 4.30 (2.81) 3.45 (2.89)
Time Demands 5.93 (2.83) 3.83 (2.47)***
Negative Attitude 9.53 (3.60) 8.19 (2.63)
Overprotect/Depend 5.73 (2.61) 5.44 (2.73)
Lack Social Support 4.17 (1.23) 3.82 (1.52)
Overcommit/Martyr 3.76 (1.19) 3.32 (1.49)
Pessimism 4.68 (2.26) 2.95 (1.77)***

Family-oriented Stress 10.72 (5.17) 9.71 (4.39)
Lack Fam Integration 3.47 (2.54) 2.76 (2.46)
Lack Pam Opportunity 2.23 (1.45) 1.82 (1.25)
Financial Problems 5.02 (3.03) 5.14 (2.30)

(Table continues...)

50

Table 2 (cont'd)

 

Severity of Mental Retardation

 

 

 

TMR EMR
VARIABLE Mean SD Mean SD

Child-oriented Strepp 17.47 (7.45) 13.98 (8.19)a

Phys Incapacitation 2.37 (1.90) 1.91 (1.67)

Lack of Activities 2.07 (1.44) 1.59 (1.75)

Social Obtrusiveness 2.13 (1.55) 1.85 (1.37)

Difficult Personality 10.90 (5.19) 8.63 (5.48)a
SCL-90

Global Distress .42 (.47) .55 (.54)

Depression .57 (.75) .77 (.77)

 

Note. The number of subjects in each group differed for the QRS (TMR =

 

30, EMR = 55) and SCL-90 (TMR = 32, EMR = 58) because more mothers
returned the latter questionnaire completed.
ap<.10, two—tailed

* p<.05 ** p<.01 *** p<.001

51

Socioeconopic Spppp§_

Hypothesis 2 also proposed that the mothers from higher SE3 groups
would report more parent problems on the QRS than mothers from lower SE3
groups, but that the mothers from lower SES groups would report more
problems related to available financial resources to meet child-care
demands, and more global distress and depression from the SCL-90. For
these analyses, a separate series of one-way ANOVA's were run to compare
the full five SE3 groups' responses on the three factors of the QRS, and
on the global distress and depression scales of the SCL-90. Use of the
main effects from the two-way ANOVA's described above would only have
allowed for a comparison between high and low SES groups. As shown in
Table 3, contrary to the hypothesis. the mothers' parent stress scores did
not differ by SES group membership, {(4.83)= 0.90, pp. A follow-up ANOVA
on the individual scales contributing to personal stress revealed no
significant differences between SE3 groups and no consistent direction of
effects across SES groups.

However, consistent with the hypothesis, the SES effect was
significant for mothers' reports of family problems on the QRS, {(4.83)=
7.22, p<.001. A post-hoc comparison of the groups using Tukey's HSD
revealed that the mothers from group V reported fewer family problems than
the mothers from any other group. Differences in the family-oriented
stress factor were further investigated through a series of one-way
ANOVA's conducted on the individual subscales of the factor. The results
indicated that the SES group differences in Financial Problems, {(4,82)=
10.00, p<.001 largely accounted for the effects on family problems. The

other two subscales contributing to family problems did not differ

52
significantLy by SE3 group: family opportunity {(4,82)= 0.99, pp, and
family integration {(4,82)= 1.65, pp. A post-hoc comparison of the
financial problems subscaLe using Tukey's HSD indicated that Group V
reported significantly less stress than Groups 2 and 3 related to

financial problems.

Table 3

Effects of the Fppily's SES on Mothers' Stress and Distresp

 

 

 

SES
Variable ‘ II III IV v
MEANS
QRS
{arent Problep§_ 29.72 35.92 40.76 35.65 31.11
Health/Mood 3.22 4.88 3.50 4.27 2.73
Time Demands 4.89 4.84 4.38 5.46 3.91
Negative Attitude 7.28 8.96 9.06 9.46 8.34
Overprotect/Depend 4.56 5.72 6.19 5.55 5.46
Lack Social Support 3.72 3.88 4.69 4.09 3.46
Overcommit/Martyr 3.33 4.04 3.38 2.91 3.32
Pessimism 2.72 3.60 3.56 3.91 3.89
Family Problems 9.39 12.24 11.50 11.27 6.43
Family Integration 3.11 3.40 3.19 4.00 1.96
Family Opportunity 1.67 2.28 2.00 2.27 1.59
Financial Problems 4.61 6.56 6.31 5.00 2.89***
(5>2 , 3)

(Table continues...)

54

Table 3 (cont'd)

 

 

 

 

SES
Variable I II III IV V
MEANS
Child Problepp 15.44 16.16 15.57 18.28 12.51
Physical Incapac 2.78 2.40 1.69 2.73 1.32a
Lack of Activities 1.11 1.92 2.06 2.09 1.46
Social Obtrusiveness 1.44 2.60 1.88 1.73 1.59a
Difficult Personality 10.11 9.24 9.94 11.73 8.14
SOL-90
Global Distress .70 .81 .38 .38 .29**
(2)5)
Depression .86 1.13 .50 .62 .41**
(2)5)

 

{pp§. The number of subjects in each group differed for the QRS
(SES groups 1:10. II=25, III=16, IV=11, and V=22) and SCL-90
(SES groups 1:11, 11:24, III=16, IV=13, and V=25)

ap<.10, two-tailed

* p<.05 ** p<.01 *** p<.001

55

The proposed SES effect was also significant for the mothers'
reports of global distress, {(4,88)= 3.98, p<.01, and depression. {(4,88)=
3.17. p<.05 on the SCL-90. A post-hoc comparison of the groups using
Tukey's HSD revealed that group 11 reported significantly greater global
distress and depression than group V. The results indicate a generally
linear relationship from groups II through V, as indicated in Figure 4.
However, the mothers in Group I .reported less global distress and
depression. than those in group II, though this difference 'was not

significant.

56

SES and Mothers' Distress Scores on the SOL-90

 

SOL-90 Scale Scores

1.2

 

 

Distress Scales
* Global

+ Depression

 

 

 

 

0.2 ......

 

 

 

I II III IV V

Socioeconomic Status

Figure 3. The Relationship Between SES and Mothers' Distress

57

Mothgpp' Perceptupl Accurgpy.

Finally, Hypothesis 2 proposed that the mothers who accurately
perceived their child's performance on the PPVT-R would report fewer
problems on the QRS and less distress on the SCL-90 than the mothers who
inaccurately perceived their child's performance. A series of one-way
ANOVA's was conducted to detect differences between the four perceptual
accuracy groups on the three factors of the QRS, and on the global
distress and depression scales of the SCL-90. As shown in Table 4, the
hypothesis was supported for distress, but not for problems on the QRS.
The perceptual accuracy groups differed significantly on both the global
distress, {(3,75)= 3.40, p<.05, and depression, {(3,75)= 3.21, p<.05,
scores on the SCL-90. Post-hoc comparisons using Tukey's HSD revealed
that the mothers in the underestimator group reported significantly more
global distress and depression than the mothers in the low estimate/low
performance group. However, analysis of the QRS factors for parent
problems, {(3,72)= 0.93, pp, family problems, {(3,72)= 1.84, pp, and child
problems, {(3,72)= 1.86, pppp, failed to support the hypothesis. The
differences between the perceptual accuracy groups appeared consistent
across the factor scores of the QRS, so an ANOVA was run using perceptual
accuracy group membership as the independent variable and the overall
problem score on the QRS as the dependent variable. The full ANOVA did
not yield significant group differences. {(3,72)= 1.58. pp. However,
analyses contrasting the groups on the individual subscales of the QRS did
reveal significant differences for pessimism, {(3.72)=3.30, p<.05, and
social Obtrusiveness, {(3,72)=3.01, p<.05, as well as a trend for

difficult personality, {(3,72)= 2.23. p<.10. Post-hoc comparisons of

58
these significant findings using Tukey's HSD indicated that: (a) the low
estimate/low performance group of mothers expressed significantly more
pessimism than the mothers who estimated accurately, and (b) the
underestimators saw their children as more socially obtrusive than the
overestimators. Neither of these findings were consistent with the
hypothesis, which only predicted differences between accurate and
inaccurate perceptions. Also, there was a trend for the mothers from the
low/low group to report that their children had the most difficult
personalities, while those from the accurate group reported that their
children had the least difficult personalities of any perceptual accuracy

group.

Table 4

59

{ffectp of Mothers' Perceptupl Accuracy on Their Stress pnd Distress

 

PERCEPTUAL ACCURACY

 

 

1 2 3 4
Variable Low/Low UNDEREST ACCURATE OVEREST
MEANS

QRS
{prent Problepg 35.97 34.55 29.96 31.50
Health/Mood 3.87 4.50 3.25 3.13
Time Demands 4.80 4.00 3.82 4.53
Negative Attitude 9.20 8.35 8.37 8.23
Overprotect/Depend 5.67 6.20 4.86 5.20
Lack Social Support 4.13 4.00 3.68 4.10
Overcommit/Martyr 3.73 3.65 3.27 3.13
Pessimism 4.67 3.85 2.68 3.17*
(1)3)
Family Problems 10.37 11.65 8.61 10.00
Lack Fam Integration 3.27 3.60 2.32 2.73
Lack Fam Opportunity 2.07 2.15 1.64 1.73
Financial Problems 5.03 5.90 4.66 5.53

(Table continues...)

Table 4 (cont'd)

 

PERCEPTUAL ACCURACY

 

 

 

 

Variable LONtLON UNDEREST ACCURATE OVEREST
MEANS
Child Problgp§_ 18.13 16.00 12.36 14.20
Phys Incapacitation 3.07 1.95 1.82 1.80
Lack of Activities 1.87 1.80 1.91 1.73
Social Obtrusiveness 1.80 2.55 1.64 1.33*
(2)4)
Difficult Personality 11.40 9.70 7.00 9.33a
SCL-90
Global Distress .27 .79 .40 .47*
(2)1)
Depression .36 1.08 .59 .55*
(2)1)
Nppg. The number of subjects in each group differed for the QRS

(Perceptual accuracy groups: 1 = 15, 2

SCL-90 (Perceptual accuracy groups: 1
ap<.10, two—tailed
* p<.05 ** p<.01

20, 3 = 22, and 4 = 16) and the

16, 2 = 19, 3 = 24, and 4 = 18).

61
Variables affecting,Children's Self-esteem

{glidity of Self-esteem in this Sample.

Before addressing the relationship between self-esteem and the
independent variables it was necessary to examine the validity of the
Perceived Competence Scales as a measure of self-esteem in children with
mental retardation. These analyses were conducted on the children who
were capable of responding to the PCSC. Overall. a majority of the
children with mental retardation in this sample were able to understand
the PCSC well enough to complete one of the versions of the questionnaire.
In this sample, 75 of the 94 children were able to complete the PCSC.
Fifty-four of 60 (90%) of the children classified as EMR were able to
complete the questionnaire, as compared to 23 of 34 children (67.7%)
classified as TMR. As expected, a higher percentage of the children with
mild versus moderate mental retardation were able to complete the more
difficult, paper-and-pencil version of the PCSC. Within those groups, 34
children classified as EMR completed the paper-and-pencil version of the
PCSC, while only seven of the children classified as TMR completed that
version. The remainder in each group completed the picture version.

In an attempt to evaluate the validity of using the PCSC with this
sample of children, their pattern of responses to the measure were
compared to standardization samples used by Harter et al. (1982, 1984).
Inter-item correlations of the children's responses on the PCSC were
compared to the existing factors. The correlation matrix shown in Table
5 indicated that the individual items comprising each standard scale all
correlated significantly with their respective scales, and in every case,

the items correlated. highest. with ‘the appropriate scale. Thus. the

62
structure of the responses of children in the current study appeared
similar to the responses of the children in the standardization sample for
this measure. However, also shown on Table 5, the coefficient alpha's
computed as an indication of internal consistency were somewhat lower than
those reported by Harter (1982) in her standardization samples. Table 6
shows a similar pattern on the Picture Version of the PCSC for both the
item-factor correlations and the coefficient alpha's for each factor.
These results also suggested that the two-factor solution reported by
Silon and Harter (1985) for their EMR sample was a worse fit in the
current sample than the original three factor solution reported by Harter

(1982) .

63
Table 5
Perceived Competence Scple- Older Vgrsion ngp to Scale Correlppions
STANDARD SCALES MR SCALES
ITEMS COGNITIVE SOCIAL PHYSICAL COMPETENCE POPULARITY MEAN S.D.

COGNITIVE COMPETENCE (coefficient alpha: .61)

l. .79** .42** .33* .68**a .47** 2.79 1.20
7. .58** .28 .36* .38** .32* 2.77 1.06
13. .53** .34* .16 .27 .25 2.65 1.16
19. .55** .26 .25 .45**a .35* 2.90 1.15
25. .64** .44** .19 .47** .58** 3.35 0.89
31. .45** .13 .34* .49** .05 2.77 1.23

SOCIAL COMPETENCE (coefficient alpha: .53)

2. .33* .45** .12 .21 .54**a 2.83 1.16
8. .45** .81** .27 .43** .79**a 3.04 1.22
14. .25 .54** .05 .15 .31* 2.73 1.14
20. .16 .52** .16 .17 .64**a 2.85 1.22
26. .03 .41** .02 .10 .12 2.88 1.20
32. .50** .56** .21 .51** .60**a 2.98 1.06

PHYSICAL COMPETENCE (coefficient alpha: .53)

 

3. .31* .18 .59** .36* .22 2.83 1.19
9. -.05 -.03 .45** .27a -.04 2.63 1.20
15. .47** .35* .63** .66**a .43** 2.85 1.17
21. .26 .09 .65** .55**a .13 2.83 1.12
27. .16 -.06 .38** .10 -.04 2.48 1.17

33. .40** .32} .61** .61*tp{7 .31 2.73 1.07
a Items from the scales found with an EMR sample (Silon and Harter 1985)
* = p<.05, ts = 2(.01

64
Table 6
{grceived Competence Sgple- Picture Version Item to Scple Correlations
STANDARD SCALES PICTURE-VERSION SCALES
I EM# COGNIT SOCIAL PHYSICAL COMPETENCE ACCEPTANCE MEAN S.D.

COGNITIVE COMPETENCE (coefficient alpha: .67)

1. .56** .35* .36* .52**a .34 3.30 0.88
5. .47** .08 .45** .52**a .08 3.15 1.09
9. .46** .18 .07 .31a .28 2.79 1.17
13. .68** .22 .68** .76**a .32 2.88 1.19
17. .67** .34 .15 .48**a .43** 3.21 0.99
21. .72** .44* .39* .63**a .53** 3.15 1.12

SOCIAL COMPETENCE (coefficient alpha: .76)

2. .39* .55** .12 .30 .43*a 3.46 0.87
6. .21 .60** .23 .25 .47**a 3.03 1.05
10. .43* .74** .47** .50** .72**a 3.41 0.98
14. .37* .74** .26 .36* .67**a 3.49 0.97
18. .13 .68** .00 .08 .61**a 3.09 1.01
22. .20 .73** .17 .21 .67**a 3.15 1.06

PHYSICAL COMPETENCE (coefficient alpha: .57)

 

3. .42* .25 .47** .50**a .22 3.39 0.79

7. .33 .36* .68** .55**a -.04 2.93 1.17
11. .13 .11 .45** .32a .43** 3.39 0.90
15. .68** .22 .68** .76**a .13 3.42 0.75
19. .35* .33 .46** .45**a -.04 2.94 1.14
23. .09 -.13 .58** .36*p_{ .31 2.73 1.07

a Denotes items forming picture-version scales (Harter and Pike, 1984)

t =

p<.05, ** = p<.01

65

Ippepection of the Exogenous Variables.

Using the three factor model of the PCSC as a basis for analyses,
Hypothesis 3 proposed three effects on the self-esteem of the children in
this sample. First, Hypothesis 3 proposed that SES and the severity of
the child's mental retardation would interact in contributing to higher
self-esteem in children with moderate mental retardation from high SE3
families and children with mild mental retardation from low SES families.
This hypothesis was tested using a 2X2 ANOVA with the family's 3E3 (high
versus low) and the severity of the child's mental retardation (EMR.versus
TMR) as independent variables and scores on the PCSC as a dependent
variable» The results failed to support the hypothesized interactions for
any of the three factors of the Perceived Competence Scales: intellectual
{(1,79)= 1.06, pp, social {(1,79)= 0.38, pp, or physical {(1,79)=0.89, pe.
In addition, the main effect of the child's mental retardation upon
his/her self-esteem was not significant for any factor of the PCSC,
intellectual {(1,79)= 0.81, pe. social {(1,79)= 0.47, pp, and physical
{(1,79)= 2.20, pp.

Socioeconomic steppe.

Second, Hypothesis 3 proposed that high as opposed to low family SE3
would be associated with higher self-esteem in the children with mental
retardation. This proposal was tested using a set of one-way ANOVA's
rather than the main effects of the 2x2 ANOVA's described above in order
to examine the effects of all five SE3 groups on each of the three factors
of the Perceived Competence Scales. Again, none of the three factors
supported the hypothesis: intellectual {(4,78)= 1.02, pe, social {(4,78)=

0.61..p§, or physical {(4,78)= 1.58, pp.

66

Mothers' Perceptuel Accureey.

Third, Hypothesis 3 proposed that the children would report higher
self-esteem when their mother's estimates were accurate than when the
estimates were inaccurate. A series of one-way ANOVA's was used to
determine the effect of the four conditions of perceptual accuracy on the
children's reported self-esteem. The mothers' perceptual accuracy group
membership did not affect the children's reports on either the
intellectual {(3.65)= 0.58, pp, or physical {(3.65)= 0.31 factors, but
perceptual accuracy-group membership was significantly related to the
social factor of the Perceived Competence Scales, {(3.65)= 2.79, p<.05.
However, a post-hoc analysis using Tukey's HSD indicated that the effect
was the opposite of the hypothesized relationship between the mothers'
perceptual accuracy and the children's self-esteem. The Z-scores of the
children whose mothers accurately estimated their performance showed that
they reported significantly lower self-esteem (M: -.34, SD: 1.28) than the
children whose mothers overestimated their performance (5: .54. SD: .79).
suggesting that the mothers' overestimation was related to the children's

reports of more positive self-esteem.

67
DISCUSSION

This study focused on contributions to and outcomes of inaccurate
perceptions of children's cognitive abilities in mothers of children with
mental retardation. Previous literature suggested that, unlike parents
of normally-developing children, parents of children with mental
retardation lack guidance for establishing expectations for their child's
development (Bentovim, 1972). As a result, parents of children with
mental retardation would misperceive their child's cognitive abilities.

The present study approaches the study of mothers' perceptual
accuracy in several unique ways. First, the argument in previous studies
has focused solely upon whether or not parents of children with mental
retardation misperceive their children's cognitive abilities. Because
previous studies consistently documented that the parents do tend to
misperceive their children's abilities (Schulman and Stern, 1959; Barclay
and vaught, 1964; Gorelick and Sandhu. 1967; and, Tew, Laurence, and
Samuel, 1974), this study focuses on the outcomes of maternal
misperception for both the mothers and their children with. mental
retardation. Second, previous studies have tended to focus on parents'
overestimation of their child's cognitive ability. The present study
focused upon both overestimation and underestimation, and the outcomes of
each. Third, this study presented a conceptual model for understanding
the contributions to, and outcomes of, mothers' perceptual inaccuracy.
Sppport for the Conceptuel Model

Of the three major hypotheses, two received qualified support, and
the third received very minimal support. Both greater severity of the

child's mental retardation and higher SE3 were associated with greater

68

perceptual accuracy, though the child's age at diagnosis did not moderate
the relationship between SES and the mothers' perceptual accuracy. More
severe forms of mental retardation, lower SES, and less perceptual
accuracy were associated with the mothers' reports of greater stress and
distress. However, neither the child's mental retardation, nor the
family's SE3 were associated with the children's reported self-esteem.
There was a trend toward a relationship between the mothers' perceptual
accuracy and the children's reported self-esteem.

{lepe in the Conceptuel Model

The lack of more consistent support for the conceptual model as a
whole may be attributed, in part, to errors in the formulation of the
hypotheses that guided the analyses. Little previous research has been
conducted on the relationship between cognitive variables and outcomes for
both parents and children. The exploratory nature of this research likely
increased the or error, [discuss how hypos could be wrong, not just
unsupported because of measurement problems]

Megepetor Hypotheeie.

The present data failed to support the hypothesis that when the
child's mental retardation was readily apparent. as suggested by having
been diagnosed earlier in the child's life, mothers with higher SES would
hold more accurate perceptions than the mothers with low SES. When the
diagnosis was made relatively late, the SES groups were not expected to
differ in their ability to accurately perceive their child's cognitive
abilities. Instead, the results indicated that the mothers with higher
SES made significantly more accurate estimates of their child's cognitive

abilities than the mothers with lower SE3 regardless of the child's age

69

at diagnosis. The failure to support the hypothesis may be due to the
fact that most families were studied several years after the child was
diagnosed. Perhaps the child's age at diagnosis is a variable whose
impact decreases over time. Regardless of the length of the delay in
diagnosis, all parents of children with mental retardation are eventually
faced with their child's cognitive limitations, and they all go through
stages of coping with those limitations as suggested by the work of Gath
(1977), Hikler (1981) and Wikler et al. (1981). Because the mothers in
the present sample typically had a long period of time between when their
children were diagnosed with mental retardation and when the current data
were collected (M: 129.9 months ,SD= 45.9), it is possible that most of
them had already adjusted to the diagnosis as well as they were able. As
such, the lack of support for the moderational hypothesis may simply have
reflected the decreased salience of the variable due to the passage of
time since diagnosis.

I_§ues in the Measurement of the Children's Self-Esteem.

The inter-item correlations suggested that the children in this
sample who were able to comprehend and respond to the PCSC did so in a
manner consistent with the three factor structure created by Harter (1982)
for children without mental retardation. The responses of the children
in the present study were not consistent with the two factor structure
found by Silon and Harter (1985) for children classified as EMR, or the
two factor structure found by Harter and Pike (1984). Silon and Harter
(1985) argued that the "mental age" of children with mental retardation
was a good indicator of their response style on the PCSC. That argument

was supported by the data for the children in the EMR group, but not the

70

TMR group. That is, Silon and Harter (1985) stated that, only at eight
years of age do children begin to perceive their self-esteem in terms of
three factors (intellectual. social, and physical). In the present study,
the children in the EMR group had an average mental age of 8.36 years
(SD=2.12), and this produced what appeared to be a three-factor structure
for the PCSC scores. The children in Silon and Harter's (1985) study,
whose responses produced only a two-factor structure, were all below eight
years. However, the children in the TMR group in the present study had
a.mean mental age of 5.66 (SD=1.52), yet their responses also best matched
the three factor structure. This suggests that mental age may not be the
most reliable indicator of children's response style on the PCSC.
Instead, the differences in response style may have related to
discrepancies in chronological age between the children in this study and
those presented by Harter et al. (1984, 1985). The average age of the
children in this study who completed the pencil-and—paper version of the
PCSC was 14.45 (SD: 2.87), as compared to those in Silon and Harter's
(1985) study (M: 11.07). Similarly, the average age of the children in
this study who completed the picture version of the PCSC was 11.56 (SD:
3.46) compared to 5.68 for the children in Harter and Pike's (1984).

Although the fact that items showed expected intercorrelations
suggested that the PCSC was valid for the children in this sample, the
hypothesized differences in the children's self-esteem in relation to the
family's SES or the severity of the child's mental retardation did not
occur. In addition, their self-esteem showed only a tendency to differ

in relation to the mothers' perceptual accuracy. which will be discussed

later. The failure to find expected effects may have resulted from

 

71

several problems that arose from using two different versions of the PCSC
with this sample. First, the severity of the child's mental retardation
was confounded with the version of the PCSC used. Most of the children
withrmoderate mental retardation received the picture version of the PCSC,
and most of the children with mild mental retardation received the paper-
and-pencil version. The children's responses were transformed into
Z-scores in order to make comparisons irrespective of which version of the
PCSC was administered. Thus, differences between the EMR and TMR groups
were obscured because the Z-score transformation made the mean and
standard deviation of both groups equal. Nevertheless, analysis of the
children's actual scale scores revealed no significant differences related
to the family's SES, the severity of the child's mental retardation, or
the mothers' perceptual accuracy. This may due to a second problem with
using two versions of the PCSC. The items on each version were developed
to include age-appropriate content. For example, items from the
intellectual factor of the pictorial version questioned children's
competence for specific scholastically-related tasks. The
paper-and-pencil version of the PCSC asked children about more general
capabilities and difficulties, and questions were specifically referenced
to peers' abilities on the same task. Similarly, on the physical factor,
the pictorial version asked about specific skills such as skipping,
running, and jumping rope. The older version asked about ability and
willingness to participate in sports, and some questions asked the
children to compare themselves to their peers. Therefore. even when the
children were responding to the similar items from different versions of

the PCSC, the connotation of the items differed because they were phrased

72

differently. The pictorial version focused more upon the children's
ability to accomplish a task rather than the quality of their performance
on the task compared to other children. Because the children classified
as TMR generally responded to stimuli developed for much younger children,
the fact that scores were not depressed nevertheless suggests that they
see themselves only 8 competent as much younger children. Thus, the
reported self-esteem of the children in the TMR group may have been
inflated because they were compared to children from a younger reference
group.
Mothers' PerceptueleAccppeey

Initially, mothers' perceptual accuracy was conceived of as a
dichotomous variable, and the hypotheses compared accurate to inaccurate
perceptions. The hypotheses were supported in several ways. As in
previous studies (Ewert and Green, 1957; and Iano, 1976), the mothers with
high SES were more perceptually accurate than the mothers with low SES,
although this finding will be qualified below. Additionally, consistent
with the hypotheses The mothers of children with moderate mental
retardation perceived their children's cognitive abilities more accurately
than the mothers of children with mild mental retardation. This may
reflect the greater ambiguity of mild handicaps as Willner and Crane
(1979) suggested. As a result, they suggested that the parents of
children with mild handicaps had more difficulty relinquishing their
”normal" expectations for the child. For the mothers of children with

moderate mental retardation their children's impairments are more evident.

73

 

The four perceptual accuracy groups.

Although the issue of perceptual accuracy versus inaccuracy alone
has important implications for parent and child outcomes, this study's
results indicated that the outcomes of perceptual inaccuracy differed
depending on whether the mothers underestimated or overestimated. Also,
the study uncovered a group of mothers who were accurate due to a floor
effect on the measure, and who differed from other accurate mothers.

The importance of separating overestimation from underestimation can
be seen clearly in the relationship between the family's SES and the
mothers' perceptual accuracy. As stated above, the mothers with low SES
were less perceptually accurate than those with the higher SE3. In
addition, the mothers differed in the manner of their misperceptions. The
estimates of nearly all of the mothers from Group I, the lowest of the
five SE3 groups, matched or exceeded their children's performance. In
contrast, over half of the mothers from Group II, the second lowest SES
group, underestimated their child's performance. The difference between
these two groups may be related to different family standards. Kahl
(1961) identified two family types within the lower-middle class which
contributed to different parental expectations. The first, referred to
as "getting by" families, tended to accept the security of their current
situation rather than striving to improve their social status. The second
were the "getting ahead” families whose educational and achievement
standards were based upon those above them in the work hierarchy and
social strata. The getting ahead families expected their children to
share those standards. Baucom and Epstein (1990) suggest that standards

are what a person thinks should be, and what is perceived may be

74
influenced by those standards. As such, the Group I mothers' tendency to
overestimate may have indicated their optimism that their children could
get by. On the other hand, the tendency for the mothers in Group II to
underestimate their child's performance may have indicated their pessimism
about the children's ability to get ahead.

The results suggest three observations about the relationship
between perceptual accuracy, stress, distress, and the child's self-
esteem. First, perceptual accuracy was not consistently related to less
stress for mothers. .Although thermothers in both the low/low and accurate
groups perceived their children's cognitive abilities accurately, the
mothers in the former group reported significantly more pessimism about
their children's future than the mothers in the latter group. This
difference between groups of accurate estimators suggests that perceptual
accuracy alone is not sufficient to counteract the realistic problems of
raising a child with more severe mental retardation.

Second. the differences in the~mothers' misperceptions may have been
the result of different processes operating for each group. The
underestimators seemed to exhibit a cognitive set for their children that
was consistent with studies of depressed mothers. In previous studies,
mothers who had been identified as clinically depressed (Lee and Gottlib,
1989), and mothers who reported elevated amounts of depression on self-
report measures (Webster-Stratton, 1988; and Webster-Stratton and Hammond,
1988) consistently reported that their children engaged in more problem
behaviors than children of nondepressed mothers (clinical or self-report) ,
even though outsiders' evaluations suggested that the children's behavior

did not differ from other children's behavior. Similarly, the mothers

75

in this study' who reported the greatest amount of depression also
underestimated their children's cognitive abilities. They also reported
that their children were the most socially obtrusive. despite the fact
that, as a group the children had the highest PPVT-R scores (M: 74.0).
In contrast, the mothers who overestimated reported that their children
were the least socially obtrusive. These children were significantly
younger (M: 10.8 years) than those in any other group. It seems that these
mothers exhibited a general optimism.about their children, perhaps because
they had not encountered some of the stressors that confront parents over
the course of raising a child with mental retardation (Nikler et al.,
1981). Nevertheless, the mothers' optimism seems to be related to positive
outcomes for the children. These children reported the greatest amount
of social competence of any perceptual accuracy group. Thus, taken
together these findings suggest that over and underestimation may be
indicative of general well being and outlook of the mothers, which in turn
has implications for the adjustment and well-being of the children.

The third point raised by these analyses is that perceptual accuracy
may actually enhance the mothers' ability to cope with their children's
cognitive impairment, and may thus prevent the mothers from experiencing
distress or depression because of the childcare burden. .Although both the
low/low and the underestimator groups reported relatively high levels of
child problems, the mothers from the low/low group reported significantly
less distress and depression than the underestimator group. Perhaps
recognizing their children's problems in the context of accurately
recognizing the child's cognitive limitations helps to relieve confusion

for the mothers in the low/low group, and thus relieves stress and

76
distress.
Impect of the Exogenous Variables on Mothers' Stress and Distress

The Interection.

The proposed interaction between the severity of the child's mental
retardation and the family's SE3 on the mothers' reported QRS problems was
not supported for either the total problems or the individual factors of
the QRS. These results failed to support Iano's (1970) findings that
parents with higher SES more often reported negative feelings about their
child diagnosed as EMR than parents with low SES. One explanation for the
difference is findings may be the difference in instruments used to
measure parents' attitudes. Iano (1970) used judges ratings of parents
responses to the Adapted Thurston Sentence Completion Form (ATSCF) to
measure their attitude toward their children. The QRS was designed
specifically for measuring parents' experiences of different, and
generally'more objective sources of stress parents encounter while raising
a child with mental retardation. Perhaps. the ATSCF is more sensitive to
the subjective thoughts and opinions parents have about their children
than the QRS.

Family SE3.

The proposed relationship between the family's SES and the mothers'
reports of problems and distress received partial support. As
hypothesized, the motherswith lower SES reported significantly more
family problems on the QRS and more stress and distress on the SCL-90 than
the mothers with higher SES. However there was no significant difference
in parent problems across SE3 groups. The differences on the family

problems factor of the QRS were accounted for by differences in the number

77

of reported financial problems between these groups. Interestingly,
although the number of reported financial problems tend to increase as the
family's SES decreased. this was not the case for the mothers from the
lowest SES group. They reported fewer financial problems than any other
group except the highest SES group. This finding, together with the fact
that family income for these mothers from SE3 group I was actually the
lowest of any SSES group (Floyd and Saitzyk, 1991) suggested that the
mothers from the lowest SES group were denying their financial problems
a response Haan (1977) noted was common in families with low SES, or the
mothers were content with "getting by." as Kahl (1961) observed in his
study.

Severity of the Child'e Mentel Retardation.

As hypothesized, the mothers of children with moderate mental
retardation reported greater amounts of problems for the parent factor and
total problems on the QRS and they showed a trend toward reporting more
child problems than the mothers of children with.mild mental retardation.
However, the mothers' reports did not differ significantly as a function
of the severity of the child's mental retardation for family problems on
the QRS or distress on the SCL-90. Floyd and Saitzyk (1991) note, the
jperent problems factor of the QRS measures both childcare demands and
feelings of stress or distress. The present findings showed significant
EMR/TMR group differences only on the time demands and pessimism subscales
(of the parent problems factor. These findings suggest that although the
mothers of the children classified as TMR recognized more demands related
‘to their children's cognitive limitations. these demands were not

iassociated with greater distress for the mothers. These mothers seemed

78
to recognize that they were faced with raising a more difficult child,
whose condition was not likely to change, but they were able to cope with
those demands.

These findings do not appear to be consistent with previous studies
(Blacher, Nihira, and Meyers, 1987; and Nihira, Meyers. and Mink, 1980)
which found that more severe mental retardation was associated with a
greater number of family problems. However, the differences Blacher et
al. (1987) found were between families of children with severe mental
retardation and those with either mild or moderate mental retardation.
They did not find significant differences in family adjustment between the
parents of children with EMR versus TMR. In addition, Nihira et al.
(1980) found that children classified as TMR had a greater impact on their
family's adjustment than children classified as EMR. However, they also
found that parents of children classified as TMR expressed.a.more positive
attitude about their child than mothers of children with EMR. The family
factor subscales on the QRS do not distinguish between adjustment and
attitudes, which may explain the lack of significant EMR-TMR differences
in the present study.

Limitations and Directions for Further Research

 

Several limitations of this study restrict the conclusions that can
be drawn about the impact of perceptual accuracy, but point out directions
for further research. First, the study was limited by the measures used.
The outcome measures selected for this study may not have been applicable
to the range of cognitive impairment exhibited by the children in this

sample.

79

The design of this study could also have been improved in several
ways. First, a more complete study of the full conceptual model would
require collecting a larger number of subjects, in order to ensure an
adequate distribution of families across SE3 groups and mental retardation
groups. Second, it would also be useful to collect perceptual accuracy
data from parents of children without mental retardation to observe
differences or similarities with the sample of mothers with mental
retardation. Use of a comparison sample might also give a baseline
indication of mothers' perceptual accuracy for mothers who have available
developmental guidelines. Third, the potency of perceptual accuracy and
the child's age at diagnosis would be increased by studying families more
immediately following their child's diagnosis. This is particularly
relevant for detecting expected problems for families of children whose
diagnosis is delayed.

The outcome measures used in this study could also have limited the
results obtained. First, many items on the QRS may have been targeted for
children with more severe handicaps than the children in this sample. For
example. the parent attitudes subscale of the QRS that seems to include
many items that apply to children with more severe mental retardation and
concommitant physical difficulties. There are several items on parents'
thoughts about their child dying, which are more likely to be endorsed
when the child's handicaps are severe and life-threatening. There are
also several items which question parents' response to the child‘s
physical incapacitation. For example, item 89 states, "It is easier for
me to do something for __ than to let him/her do it himself/herself and

make a mess." While these items are likely to be important in

80

differentiating parenting stress across the full range of severity of
mental retardation, many of the items on this subscale may be too extreme
for parents of children with either mild or moderate mental retardation
to endorse, and this seems true of the QRS in general. In an attempt to
include items applicable to the full range of impairment, Holroyd's (1974)
QRS may not address the issues facing parents of children with more mild
or moderate mental retardation. Those issues. such as parents attitudes,
beliefs, may need to be addressed using instruments aimed at parents of
children without mental retardation. The present study may have
benefitted by using both measures of parenting experiences develOped for
families of children without handicaps and the QRS. In that way,
processes and events applicable to parents of children with and without
mental retardation could be measured. Second, the study could have made
a more definite statement about the effects of the three independent
variables on the children's self-esteem if all of the children had been
able to complete the same measure of self-esteem.

The results of this study suggest that mothers' perceptions play a
role in the stress they experience in parenting, and in the development
of their child's self-esteem. However, both of those relationships
presume that mothers act on their perceptions. Based on how they perceive
their child's cognitive abilities. mothers should establish expectations
for their child and they should act to bring about those expectations.
Adding direct observation of mother—child behavior, and more complete
assessment of parents beliefs and standards, would allow for a more
complete understanding of whether this is indeed the case. Future work

should use longitudinal follow-ups in order to better understand the

81
processes by which parents' perceptions of their children's cognitive
abilities are shaped by their beliefs or standards about what their
children should be able to achieve. Presumably parents' perceptions are
both affected by and serve to modify their beliefs or standards about
their children. Furthermore, both parents' perceptions and beliefs or
standards about their children combine to affect parents' expectations for
their children's future and the parents' behavior toward their children.
The relationship between these cognitive and behavioral variables can be

best understood using longitudinal follow-ups.

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