Respite care for families of special needs children: A systematic review

Study Aim/Purpose: The author sought to identify the common findings of quantitative and qualitative studies of respite care for families of children with disabilities. 

Summary of Methods: A keyword search was conducted to identify studies conducted in the United States, Australia and the United Kingdom. The following electronic databases were searched: Cochrane Database of Systematic Reviews, The Cochrane Clinical Controlled Trials Register, PubMed, PsychInfo, CINAHL, Social Work Abstracts, and the Web of Science. Additionally, the author “checked relevant websites and reference lists of all topic-relevant publications.” The author used the Critical Appraisal Skills Programme system to appraise each article’s methodology. A total of 17 articles were appraised and 15 were considered appropriate for the synthesis. 

Summary of Key Results: Based on the synthesis of findings from 15 articles, the author highlighted six major findings: 1) family characteristics that appear to influence the use of respite include level of family stress, access to informal support networks, family size, and marital status; 2) use of respite care is associated with significant reductions in parental stress; 3) implementing any form of more structured respite appears to have a positive impact compared to no support or the receipt of standard services; 4) respite offers important short-breaks to families caring for children with multiple disabilities; 5) respite care appears to result in reductions in psychological distress among parents of children with developmental disabilities; and 6) respite care may be considered an intervention for child abuse prevention, especially for those children suffering from challenging behaviors. At the same time, the author notes the lack of research in several important areas including: “the influence of respite care upon the families of disabled children and abuse potential”, “the interrelationships between respite care, child abuse potential, family relations, and parenting stress over time”, and “effective models of respite care for individuals with developmental disabilities and severe behavioral problems.” 

Limitations of Studies Reviewed (as cited by the author): “Tools used for testing may not have been tested for validity and reliability. There were small sample sizes and samples represented only groups of parents who were specifically seeking certain types of services, and therefore may not have been representative of the larger population of parents of children with developmental disabilities. Some designs did not allow for the assessment of other mediating or moderating variables that could also potentially contribute to child abuse potential.” Additional limitations included 1) no control groups; 2) lack of longer-term follow-up data; and 3) the lack of inclusion of process measures. 

Authors’ Discussion/Conclusions: The author recommends further research be conducted to assess the impact of respite services including the impacts on child abuse, the impacts specifically for individuals with developmental disabilities and their families, impacts on family members in addition to mothers, and on the longer term benefits of respite care on measures such as stress. She also notes that further research is needed exploring the availability and use of respite care.