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Published in: Orphanet Journal of Rare Diseases 1/2017

Open Access 01-12-2017 | Research

Impacts of caring for a child with the CDKL5 disorder on parental wellbeing and family quality of life

Authors: Yuka Mori, Jenny Downs, Kingsley Wong, Barbara Anderson, Amy Epstein, Helen Leonard

Published in: Orphanet Journal of Rare Diseases | Issue 1/2017

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Abstract

Background

Although research in this area remains sparse, raising a child with some genetic disorders has been shown to adversely impact maternal health and family quality of life. The aim of this study was to investigate such impacts in families with a child with the CDKL5 disorder, a newly recognised genetic disorder causing severe neurodevelopmental impairments and refractory epilepsy.

Methods

Data were sourced from the International CDKL5 Disorder Database to which 192 families with a child with a pathogenic CDKL5 mutation had provided data by January 2016. The Short Form 12 Health Survey Version 2, yielding a Physical Component Summary and a Mental Component Summary score, was used to measure primary caregiver’s wellbeing. The Beach Center Family Quality of Life Scale was used to measure family quality of life. Linear regression analyses were used to investigate relationships between child and family factors and the various subscale scores.

Results

The median (range) age of the primary caregivers was 37.0 (24.6–63.7) years and of the children was 5.2 (0.2–34.1) years. The mean (SD) physical and mental component scores were 53.7 (8.6) and 41.9 (11.6), respectively. In mothers aged 25–54 years the mean mental but not the physical component score was lower than population norms. After covariate adjustment, caregivers with a tube-fed child had lower mean physical but higher mean mental component scores than those whose child fed orally (coefficient = −4.80 and 6.79; p = 0.009 and 0.012, respectively). Child sleep disturbances and financial hardship were negatively associated with the mental component score. The mean (SD) Beach Center Family Quality of Life score was 4.06 (0.66) and those who had used respite services had lower scores than those who had not across the subscales.

Conclusions

Emotional wellbeing was considerably impaired in this caregiver population, and was particularly associated with increased severity of child sleep problems and family financial difficulties. Family quality of life was generally rated lowest in those using respite care extensively, suggesting that these families may be more burdened by daily caregiving.
Literature
1.
go back to reference Weaving L, Christodoulou J, Williamson S, Friend K, McKenzie O, Archer H, et al. Mutations of CDKL5 cause a severe neurodevelopmental disorder with infantile spasms and mental retardation. Am J Hum Genet. 2004;75:1079–93.CrossRefPubMedPubMedCentral Weaving L, Christodoulou J, Williamson S, Friend K, McKenzie O, Archer H, et al. Mutations of CDKL5 cause a severe neurodevelopmental disorder with infantile spasms and mental retardation. Am J Hum Genet. 2004;75:1079–93.CrossRefPubMedPubMedCentral
2.
go back to reference Kalsheuer V, Tao J, Donnelly A, Hollway G, Schwinger E, Kubart S, et al. Disruption of the serine/threonine kinase 9 gene causes Dever X-linked infantile spasms and mental retardation. Am J Hum Genet. 2003;72:1401–11.CrossRef Kalsheuer V, Tao J, Donnelly A, Hollway G, Schwinger E, Kubart S, et al. Disruption of the serine/threonine kinase 9 gene causes Dever X-linked infantile spasms and mental retardation. Am J Hum Genet. 2003;72:1401–11.CrossRef
3.
go back to reference Evans J, Archer H, Colley J, Ravn K, Nielsen J, Kerr A, et al. Early onset seizures and Rett-like features associated with mutations in CDKL5. Eur J Hum Genet. 2005;13:1113–20.CrossRefPubMed Evans J, Archer H, Colley J, Ravn K, Nielsen J, Kerr A, et al. Early onset seizures and Rett-like features associated with mutations in CDKL5. Eur J Hum Genet. 2005;13:1113–20.CrossRefPubMed
4.
go back to reference Fehr S, Wilson M, Downs J, Williams S, Murgia A, Sartori S, et al. The CDKL5 disorder is an independent clinical entity associated with early-onset encephalopathy. Eur J Hum Genet. 2013;21:266–73. Fehr S, Wilson M, Downs J, Williams S, Murgia A, Sartori S, et al. The CDKL5 disorder is an independent clinical entity associated with early-onset encephalopathy. Eur J Hum Genet. 2013;21:266–73.
5.
go back to reference Guerrini R, Parrini E. Epilepsy in Rett syndrome, and CDKL5- and FOXG1-gene-related encephalopathies. Epilepsia. 2012;53(12):2067–78.CrossRefPubMed Guerrini R, Parrini E. Epilepsy in Rett syndrome, and CDKL5- and FOXG1-gene-related encephalopathies. Epilepsia. 2012;53(12):2067–78.CrossRefPubMed
6.
go back to reference Mangatt M, Wong K, Anderson B, Epstein A, Hodgetts S, Leonard H, et al. Prevalence and onset of comorbidities in the CDKL5 disorder differ from Rett syndrome. Orphanet J Rare Dis. 2016;11:39. Mangatt M, Wong K, Anderson B, Epstein A, Hodgetts S, Leonard H, et al. Prevalence and onset of comorbidities in the CDKL5 disorder differ from Rett syndrome. Orphanet J Rare Dis. 2016;11:39.
7.
go back to reference Fehr S, Wong K, Chin R, Williams S, de Klerk N, Forbes D, et al. Seizure variabiles and their relationship to genotype and functional abilities in the CDKL5 disorder. Neurology. 2016;87:2206–13.CrossRefPubMed Fehr S, Wong K, Chin R, Williams S, de Klerk N, Forbes D, et al. Seizure variabiles and their relationship to genotype and functional abilities in the CDKL5 disorder. Neurology. 2016;87:2206–13.CrossRefPubMed
8.
go back to reference Fehr S, Leonard H, Ho G, Williams S, Klerk N, Forbes D, et al. There is variability in the attainment of developmental milestones in the CDKL5 disorder. J Neurodev Disord. 2015;7:2.CrossRefPubMedPubMedCentral Fehr S, Leonard H, Ho G, Williams S, Klerk N, Forbes D, et al. There is variability in the attainment of developmental milestones in the CDKL5 disorder. J Neurodev Disord. 2015;7:2.CrossRefPubMedPubMedCentral
9.
go back to reference Totsika V, Hastings R, Emerson E, Lancaster G, Berridge D. A population-based investigation of behavioural and emotional problems and maternal mental stress: associations with autism spectrum disorder and intellectual disability. J Child Psychol Psychiatry. 2011;52(1):91–9.CrossRefPubMed Totsika V, Hastings R, Emerson E, Lancaster G, Berridge D. A population-based investigation of behavioural and emotional problems and maternal mental stress: associations with autism spectrum disorder and intellectual disability. J Child Psychol Psychiatry. 2011;52(1):91–9.CrossRefPubMed
10.
go back to reference Zablotsky B, Bradshaw C, Stuart E. The association between mental health, stress, and coping supports in mothers of children with autism spectrum disorders. J Autism Dev Disord. 2013;43:1380–93.CrossRefPubMed Zablotsky B, Bradshaw C, Stuart E. The association between mental health, stress, and coping supports in mothers of children with autism spectrum disorders. J Autism Dev Disord. 2013;43:1380–93.CrossRefPubMed
11.
go back to reference Bourke J, Ricciardo B, Bebbington A, Aiberti K, Jacoby P, Dyke P, et al. Physical and mental health in mothers of children with Down syndrome. J Pediatr. 2008;153:320–6. Bourke J, Ricciardo B, Bebbington A, Aiberti K, Jacoby P, Dyke P, et al. Physical and mental health in mothers of children with Down syndrome. J Pediatr. 2008;153:320–6.
12.
go back to reference Laurvick C, Msall M, Silburn S, Bower C, de Klerk N, Leonard H. Physical and mental health of mothers caring for a child with Rett syndrome. Pediatrics. 2006;118:e1152–64.CrossRefPubMed Laurvick C, Msall M, Silburn S, Bower C, de Klerk N, Leonard H. Physical and mental health of mothers caring for a child with Rett syndrome. Pediatrics. 2006;118:e1152–64.CrossRefPubMed
13.
go back to reference Cianfaglione R, Hastings R, Felce D, Clarke A, Kerr M. Psychological well-being of mothers and siblings in families of girls and women with Rett syndrome. J Autism Dev Disord. 2015;45:2939–46.CrossRefPubMed Cianfaglione R, Hastings R, Felce D, Clarke A, Kerr M. Psychological well-being of mothers and siblings in families of girls and women with Rett syndrome. J Autism Dev Disord. 2015;45:2939–46.CrossRefPubMed
14.
go back to reference Tvrdik T, Mason D, Dent K, Thornton L, Hornton S, Viskochil D, et al. Stress and coping in parents of children with Prader-Willi syndrome: assessment of the impact of a structured plan of care. Am J Med Genet. 2014;167A:974–82. Tvrdik T, Mason D, Dent K, Thornton L, Hornton S, Viskochil D, et al. Stress and coping in parents of children with Prader-Willi syndrome: assessment of the impact of a structured plan of care. Am J Med Genet. 2014;167A:974–82.
15.
go back to reference Gardiner E, Iarocci G. Unhappy (and happy) in their own way: a developmental psychopathology perspective on quality of life for families living with developmental disability with and without autism. Res Dev Disabil. 2012;33:2177–92.CrossRefPubMed Gardiner E, Iarocci G. Unhappy (and happy) in their own way: a developmental psychopathology perspective on quality of life for families living with developmental disability with and without autism. Res Dev Disabil. 2012;33:2177–92.CrossRefPubMed
16.
go back to reference Zuna N, Brown I, Brown R. Family quality of life in intellectual and developmental disabilities: a support-based framework. Int J Public Health. 2014;6(2):161–84. Zuna N, Brown I, Brown R. Family quality of life in intellectual and developmental disabilities: a support-based framework. Int J Public Health. 2014;6(2):161–84.
17.
go back to reference Tibben A. Obtaining a genetic diagnosis in a child with disability: impact on parental quality of life. Clin Genet. 2016;89:258–66.CrossRef Tibben A. Obtaining a genetic diagnosis in a child with disability: impact on parental quality of life. Clin Genet. 2016;89:258–66.CrossRef
18.
go back to reference Louise S, Fyfe S, Bebbington A, Bahi-Buisson N, Anderson A, Pineda M, et al. InterRett, a model for international data collection in a rare genetic disorder. Res Autism Spect Dis. 2009;3:639–59.CrossRef Louise S, Fyfe S, Bebbington A, Bahi-Buisson N, Anderson A, Pineda M, et al. InterRett, a model for international data collection in a rare genetic disorder. Res Autism Spect Dis. 2009;3:639–59.CrossRef
19.
go back to reference Bruni O, Ottaviano S, Guidetti V, Romoli M, Innocenzi M, Cortesi F, et al. The sleep disturbance scale for children (SDSC) construction and validation of an instrument to evaluate sleep disturbances in childhood and adolescence. J Sleep Res. 1996;5:251–61.CrossRefPubMed Bruni O, Ottaviano S, Guidetti V, Romoli M, Innocenzi M, Cortesi F, et al. The sleep disturbance scale for children (SDSC) construction and validation of an instrument to evaluate sleep disturbances in childhood and adolescence. J Sleep Res. 1996;5:251–61.CrossRefPubMed
20.
go back to reference Ware J, Kosinski M, Turner-Bowker D, Gandek B. How to score version 2 of the SF-12 health survey (with a supplement documenting version 1). Licoln, Rhode Island: QualityMetric Incorporated; 2004. Ware J, Kosinski M, Turner-Bowker D, Gandek B. How to score version 2 of the SF-12 health survey (with a supplement documenting version 1). Licoln, Rhode Island: QualityMetric Incorporated; 2004.
21.
go back to reference Samuel P, Rillotta F, Brown I. Review: the development of family quality of life concepts and measures. J Intellect Disabil Res. 2012;56(1):1–16.CrossRefPubMed Samuel P, Rillotta F, Brown I. Review: the development of family quality of life concepts and measures. J Intellect Disabil Res. 2012;56(1):1–16.CrossRefPubMed
22.
go back to reference Hoffman L, Marquis J, Poston D, Summers J, Turnbull A. Assessing family outcomes: psychometric evaluation of the beach center family quality of life scale. J Marriage Fam. 2006;68:1069–83.CrossRef Hoffman L, Marquis J, Poston D, Summers J, Turnbull A. Assessing family outcomes: psychometric evaluation of the beach center family quality of life scale. J Marriage Fam. 2006;68:1069–83.CrossRef
23.
go back to reference Bourke-Taylor H, Pallant J, Law M, Howie L. Predicting mental health among mothers of school-aged children with developmental disabilities: the relative contribution of child, maternal and environmental factors. Res Dev Disabil. 2012;33:1732–40.CrossRefPubMed Bourke-Taylor H, Pallant J, Law M, Howie L. Predicting mental health among mothers of school-aged children with developmental disabilities: the relative contribution of child, maternal and environmental factors. Res Dev Disabil. 2012;33:1732–40.CrossRefPubMed
24.
go back to reference Lee J. Maternal stress, well-being, and impaired sleep in mothers of children with developmental disabilities: a liternature review. Res Dev Disabil. 2013;34:4255–73.CrossRefPubMed Lee J. Maternal stress, well-being, and impaired sleep in mothers of children with developmental disabilities: a liternature review. Res Dev Disabil. 2013;34:4255–73.CrossRefPubMed
25.
go back to reference Chu J, Richdale A. Sleep quality and psychological wellbeing in mothers of children with developmental disabilities. Res Dev Disabil. 2009;30:1512–22.CrossRefPubMed Chu J, Richdale A. Sleep quality and psychological wellbeing in mothers of children with developmental disabilities. Res Dev Disabil. 2009;30:1512–22.CrossRefPubMed
26.
go back to reference Bourke-Taylor H, Pallant J, Law M, Howie L. Relationships between sleep disruptions, health and care responsibilities among mothers of school-aged children with disabilities. J Paediatr Child Health. 2013;49:775–82.CrossRefPubMed Bourke-Taylor H, Pallant J, Law M, Howie L. Relationships between sleep disruptions, health and care responsibilities among mothers of school-aged children with disabilities. J Paediatr Child Health. 2013;49:775–82.CrossRefPubMed
27.
go back to reference Hodge D, Hoffman C, Sweeney D, Riggs M. Relationship between children’s sleep and mental health in mothers with and without autism. J Autism Dev Disord. 2013;43:956–63.CrossRefPubMed Hodge D, Hoffman C, Sweeney D, Riggs M. Relationship between children’s sleep and mental health in mothers with and without autism. J Autism Dev Disord. 2013;43:956–63.CrossRefPubMed
28.
go back to reference Wayte S, McCaughey E, Holley S, Annaz D, Hill C. Sleep problems in children with cerebral palsy and their relationship with maternal sleep and depression. Acta Paediatr. 2012;101:618–23.CrossRefPubMed Wayte S, McCaughey E, Holley S, Annaz D, Hill C. Sleep problems in children with cerebral palsy and their relationship with maternal sleep and depression. Acta Paediatr. 2012;101:618–23.CrossRefPubMed
29.
go back to reference Minnes P, Perry A, Weiss J. Predictors of distress and well-being in parents of young children with developmental delays and disabilities: the importance of parent perceptions. J Intellect Disabil Res. 2015;59(6):551–60.CrossRefPubMed Minnes P, Perry A, Weiss J. Predictors of distress and well-being in parents of young children with developmental delays and disabilities: the importance of parent perceptions. J Intellect Disabil Res. 2015;59(6):551–60.CrossRefPubMed
30.
go back to reference Downs J, Wong K, Ravikumara M, Ellaway C, Elliot E, Christodoulou J, et al. Experience of gastrostomy using a quality care framework: the example of Rett syndrome. Medicine. 2014;93(28):e328.CrossRefPubMedPubMedCentral Downs J, Wong K, Ravikumara M, Ellaway C, Elliot E, Christodoulou J, et al. Experience of gastrostomy using a quality care framework: the example of Rett syndrome. Medicine. 2014;93(28):e328.CrossRefPubMedPubMedCentral
31.
go back to reference Wilken M. The impact of child tube feeding on maternal emotional state and identity: a qualitative meta-analysis. J Pediatr Nurs. 2012;27:248–55.CrossRefPubMed Wilken M. The impact of child tube feeding on maternal emotional state and identity: a qualitative meta-analysis. J Pediatr Nurs. 2012;27:248–55.CrossRefPubMed
32.
go back to reference Brotherton A, Abbott J, Aggett P. The impact of percutaneous endoscopic gastrostomy feeding in children; the parental perspective. Child Care Health Dev. 2007;33(5):539–46.CrossRefPubMed Brotherton A, Abbott J, Aggett P. The impact of percutaneous endoscopic gastrostomy feeding in children; the parental perspective. Child Care Health Dev. 2007;33(5):539–46.CrossRefPubMed
33.
go back to reference Mahant S, Jovcevska V, Cohen E. Decision-making around gastrostomy-feeding in children with neurologic disabilities. Pediatrics. 2011;127:e1471.CrossRefPubMed Mahant S, Jovcevska V, Cohen E. Decision-making around gastrostomy-feeding in children with neurologic disabilities. Pediatrics. 2011;127:e1471.CrossRefPubMed
34.
go back to reference Nelson K, Lacombe-Duncan A, Cohen E, Nicholas D, Rosella L, Guttmann A, et al. Family experiences with feeding tubes in neurologic impairment: a systematic review. Pediatrics. 2015;136:e140–51.CrossRefPubMed Nelson K, Lacombe-Duncan A, Cohen E, Nicholas D, Rosella L, Guttmann A, et al. Family experiences with feeding tubes in neurologic impairment: a systematic review. Pediatrics. 2015;136:e140–51.CrossRefPubMed
35.
go back to reference Muller A, Helbig I, Jansen C, Bast T, Guerrini R, Jahn J, et al. Retrospectie evaluation of low long-term efficacy of antiepileptic drugs and ketogenic diet in 39 patients with CDKL5-related epilepsy. Eur J Paediatr Neurol. 2016;20:147–51.CrossRefPubMed Muller A, Helbig I, Jansen C, Bast T, Guerrini R, Jahn J, et al. Retrospectie evaluation of low long-term efficacy of antiepileptic drugs and ketogenic diet in 39 patients with CDKL5-related epilepsy. Eur J Paediatr Neurol. 2016;20:147–51.CrossRefPubMed
36.
go back to reference Sullivan P, Juszczak E, Bachlet A, Lambert B, Vernon-Roberts A, Grant H, et al. Impact of gastrostomy tube feeding on the quality of life of cares of children with cerebral palsy. Dev Med Child Neurol. 2004;46:796–800.CrossRefPubMed Sullivan P, Juszczak E, Bachlet A, Lambert B, Vernon-Roberts A, Grant H, et al. Impact of gastrostomy tube feeding on the quality of life of cares of children with cerebral palsy. Dev Med Child Neurol. 2004;46:796–800.CrossRefPubMed
37.
go back to reference Strunk J. Respite care for families of special needs children: a systematic review. J Dev Phys Disabil. 2010;22:615–30.CrossRef Strunk J. Respite care for families of special needs children: a systematic review. J Dev Phys Disabil. 2010;22:615–30.CrossRef
38.
go back to reference Sawyer M, Bittman M, Greca A, Crettenden A, Harchak T, Martin J. Time demands of caring for children with autism: what are the implications for maternal mental health? J Autism Dev Disord. 2010;40:620–8.CrossRefPubMed Sawyer M, Bittman M, Greca A, Crettenden A, Harchak T, Martin J. Time demands of caring for children with autism: what are the implications for maternal mental health? J Autism Dev Disord. 2010;40:620–8.CrossRefPubMed
39.
go back to reference Carter A, Martinez-Pedraza F, Gray S. Stability and individual change in depressive symptoms among mothers raising young children with ASD: maternal and child correlates. J Clin Psychol. 2009;65(12):1270–80.CrossRefPubMed Carter A, Martinez-Pedraza F, Gray S. Stability and individual change in depressive symptoms among mothers raising young children with ASD: maternal and child correlates. J Clin Psychol. 2009;65(12):1270–80.CrossRefPubMed
40.
go back to reference Urbanowicz A, Downs J, Bebbington A, Jacoby P, Girder S, Leonard H. Use of equipment and respite services and caregiver health among Australian families living with Rett syndrome. Res Autism Spectr Disord. 2011;5:722–32.CrossRef Urbanowicz A, Downs J, Bebbington A, Jacoby P, Girder S, Leonard H. Use of equipment and respite services and caregiver health among Australian families living with Rett syndrome. Res Autism Spectr Disord. 2011;5:722–32.CrossRef
41.
go back to reference Boehm T, Carter E, Taylor J. Family quality of life during the transition to adulthood for individuals with intellectual difficulty and/or autism spectrum disorders. Am J Intellect Dev Disabil. 2015;120(5):395–411.CrossRefPubMed Boehm T, Carter E, Taylor J. Family quality of life during the transition to adulthood for individuals with intellectual difficulty and/or autism spectrum disorders. Am J Intellect Dev Disabil. 2015;120(5):395–411.CrossRefPubMed
42.
go back to reference Glenn A. Using online health communication to manage chronic sorrow: mothers of children with rare diseases speak. J Pediatr Nurs. 2015;30:17–24.CrossRefPubMed Glenn A. Using online health communication to manage chronic sorrow: mothers of children with rare diseases speak. J Pediatr Nurs. 2015;30:17–24.CrossRefPubMed
43.
go back to reference Moeschler J, Shevell M. Genetics Co. Comprehensive evaluation of the child with intellectual disability or global developmental delays. Pediatrics. 2014;134:e903–18.CrossRefPubMed Moeschler J, Shevell M. Genetics Co. Comprehensive evaluation of the child with intellectual disability or global developmental delays. Pediatrics. 2014;134:e903–18.CrossRefPubMed
44.
go back to reference Lv R, Wu L, Jin L, Lu Q, Wang M, Qu Y, et al. Depression, auxiety and quality of life in parents of children with epilepsy. Acta Neurol Scand. 2009;120:335–41.CrossRefPubMed Lv R, Wu L, Jin L, Lu Q, Wang M, Qu Y, et al. Depression, auxiety and quality of life in parents of children with epilepsy. Acta Neurol Scand. 2009;120:335–41.CrossRefPubMed
45.
go back to reference Akay A, Kurul S, Ozek H, Cengizhan S, Emiroglu N, Ellidokuz H. Maternal reactions to a child with epilepsy: depression, anxiety, parental attitudes and family functions. Epilepsy Res. 2011;95:213–20.CrossRef Akay A, Kurul S, Ozek H, Cengizhan S, Emiroglu N, Ellidokuz H. Maternal reactions to a child with epilepsy: depression, anxiety, parental attitudes and family functions. Epilepsy Res. 2011;95:213–20.CrossRef
46.
go back to reference Young L, Chengye J, Jiong Q. Factors affecting the quality of life in childhood epilepsy in China. Acta Neurol Scand. 2006;113:167–73.CrossRef Young L, Chengye J, Jiong Q. Factors affecting the quality of life in childhood epilepsy in China. Acta Neurol Scand. 2006;113:167–73.CrossRef
47.
go back to reference Kerne V, Chapieski L. Adaptive functioning in pediatric epilepsy: contributions of seizure-related variables and parental anxiety. Epilepsy Behav. 2015;43:48–52.CrossRefPubMed Kerne V, Chapieski L. Adaptive functioning in pediatric epilepsy: contributions of seizure-related variables and parental anxiety. Epilepsy Behav. 2015;43:48–52.CrossRefPubMed
48.
go back to reference Williams J, Steel C, Sharp G, DelosReyes E, Phillips T, Bates S, et al. Parental anxiety and quality of life in children with epilepsy. Epilepsy Behav. 2003;4:483–6.CrossRefPubMed Williams J, Steel C, Sharp G, DelosReyes E, Phillips T, Bates S, et al. Parental anxiety and quality of life in children with epilepsy. Epilepsy Behav. 2003;4:483–6.CrossRefPubMed
Metadata
Title
Impacts of caring for a child with the CDKL5 disorder on parental wellbeing and family quality of life
Authors
Yuka Mori
Jenny Downs
Kingsley Wong
Barbara Anderson
Amy Epstein
Helen Leonard
Publication date
01-12-2017
Publisher
BioMed Central
Published in
Orphanet Journal of Rare Diseases / Issue 1/2017
Electronic ISSN: 1750-1172
DOI
https://doi.org/10.1186/s13023-016-0563-3

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