Support, Communication, and Hardiness in

Families With Children With Disabilities

Susanne Frost Olsen, Ph.D.

Elaine Sorensen Marshall, R.N., Ph.D.
Barbara L. Mandleco, R.N., Ph.D.
Brigham Young University
Keith W. Allred, Ph.D.
Nevada State Department of Education
Tina Taylor Dyches, Ed.D.
Nancy Sansom, M.S.
Brigham Young University

The purpose of this study was to examine how support and communication
are related to hardiness in families who have young children with
disabilities. A sample of 108 parents (54 couples) of preschool-age
children with disabili-ties completed the measures. Among demographic
variables, family income was positively correlated with family hardiness.
Hierarchical regression analyses revealed perceived family support as a
predictor of family hardiness for both parents. Incendiary communication
was negatively related to family hardiness for mothers, whereas income
was positively associated with fathers’ assessments of hardiness. Results
provide family nurses with a foun-dation for exploring constructs
important to help families with children with disabilities.

Address all correspondence to Elaine S. Marshall, #450 SWKT, College of

Nursing, Brigham Young University, Provo, UT 84602; e-mail: elaine_ marshall@
byu.edu. The authors thank the families who participated in this study.

JOURNAL OF FAMILY NURSING, 1999, 5(3), 275-291

© 1999 Sage Publications, Inc.
275

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276 JFN, August 1999, Vol. 5 No. 3

Having a child with disabilities may impose multiple challenges to

families. It is considered a major stressor or crisis in family life. Issues
such as physical and psychological needs, time and care demands,
uncertainty, and general family adaptation offer unique challenges to
nurses involved in health promotion and support of individual and family
growth and development.
When considering issues and needs surrounding children with
disabilities, it is critical that nurses offer care within the context of the
entire family (Anderson & Tomlinson, 1992; Moriarty, 1990). Previ-ous
research has generally drawn data from one family member, usu-ally the
mother (Bristol, Gallagher, & Schopler, 1988; Byrne & Cun-ningham,
1985; Sorensen, 1993). In addition, much past research on families with a
child with disabilities has focused on the child as a source of stress,
maladaptation, or psychopathology for the family (Hodapp, 1995; Ray &
Ritchie, 1993; Singer & Irvin, 1989). However, a growing alternate
approach highlights successful adaptation, resil-iency, and positive
functioning of families where a child has disabili-ties (Bennett, DeLuca, &
Allen, 1996; Boyce, Behl, Mortensen, & Akers, 1991; M. A. McCubbin &
McCubbin, 1991; Stainton & Besser, 1998).
Hardiness of the individual has been conceptualized as a constella-tion
of factors of personal control, challenge, and commitment (Kobasa, 1979).
Hardiness functions as a buffer or mediating factor that may enhance
coping or reduce harmful effects of stress (Failla & Jones, 1991; H. I.
McCubbin, Thompson, & McCubbin, 1996). Family hardiness also has
been explored as a significant factor in health pro-motion, specifically
among families dealing with children with chronic illness (Donnelly,
1994). Clinical and research evidence indi-cates that a variety of factors
may be associated with family hardiness.
This study attempts to address some of the gaps in previous research by
examining family hardiness as a dependent variable and an indicator of
successful adaptation. The purpose of the study was to examine
demographic variables, family support, and family commu-nication as
predictors of family hardiness from the perspective of mothers and fathers
of children with disabilities. Responses of both mothers and fathers were
employed in an effort to investigate per-spectives of multiple family
members.

Funding was provided by a Brigham Young University Alumni Professor-ship and

grants from the College of Nursing and the Family Studies Center at Brigham
Young University and Iota Iota Chapter of Sigma Theta Tau.

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 Olsen et al. / Families With Children With Disabilities 277

BACKGROUND AND SIGNIFICANCE

Theoretical Foundations

The Resiliency Model of Family Stress, Adjustment, and Adapta-tion

provided a framework for research of families with children with chronic
illness or disability (Bristol, 1987; Donnelly, 1994). The model examines
the relationships among (a) appraisal, schema, and mean-ings; (b) problem
solving and coping; (c) family types and patterns of family functioning;
and (d) resources and social support in the adjust-ment and adaptation to
family stress, such as illness or disability of a family member over time
(M. A. McCubbin & McCubbin, 1989, 1992; H. I. McCubbin, McCubbin,
& Thompson, 1993).
In the model, patterns of family problem solving, such as ways of
communicating, may be linked to family resources, such as support, or
associated with family meaning or appraisal of the stressor. In the
adjustment phase of the model of H. I. McCubbin et al. (1993), family
problem solving, resources, and appraisal may be associated with
maladjustment or bonadjustment to a crisis situation. These same three
factors also contribute (along with newly instituted patterns of
functioning) to subsequent adaptation (H. I. McCubbin et al., 1993). Our
research examined variables from the adjustment phase of the model,
specifically focusing on social support within the family as a type of
family resource and communication as a family problem-solving strategy.
We were particularly interested in the links of such variables to hardiness,
used as an index of adjustment in families with children with disabilities.

Family Hardiness

Hardiness is used to describe people who remain healthy even while

experiencing high amounts of life stress. It is thought to contain three
components: control, commitment, and challenge (Kobasa, 1979). Hardy
individuals exhibit beliefs, attitudes, and behaviors that distinguish them
from those who may become ill (Failla & Jones, 1991; Pollock, 1989).
Although much hardiness research has focused on individuals (Kobasa,
1982; Kobasa, Maddi, & Courington, 1981; Kobasa, Maddi, & Kahn,
1982), a few studies have examined the con-struct of family hardiness
(Failla & Jones, 1991; M. A. McCubbin, McCubbin, & Thompson, 1991).

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278 JFN, August 1999, Vol. 5 No. 3

Family hardiness refers to

the internal strengths and durability of the family unit and is character-ized
by a sense of control over the outcomes of life events and hard-ships, a view
of change as beneficial and growth producing, and an active rather than
passive orientation in adjusting to and managing stressful situations. (M. A.
McCubbin et al., 1991)

It is conceptualized to reflect a we rather than I orientation and is com-

posed of the same three components as individual hardiness: com-
mitment, challenge, and control. Although family hardiness has been
largely studied as an independent variable (Failla & Jones, 1991), the
focus of this study was to examine variables that might predict hardi-ness
in families with a child with disabilities. Relationships between hardiness
and two predictor variables, family support and incendiary
communication, will be discussed in the following sections.

Family Support

A large body of evidence suggests that social support is an impor-tant

factor in personal and family well-being (Dunst, Jenkins, & Trivette,
1988; Koeske & Koeske, 1990). Social support also has been identified as
a significant factor in mediating stress and enhancing coping in families
with children with disabilities, with considerable attention to support
networks outside of the family (Dunst, Trivette, & Cross, 1986; Dyson,
1997; Hadadian, 1994; Kazak, 1986; Stagg & Catron, 1986; Trivette &
Dunst, 1992).
M. A. McCubbin and McCubbin (1992) aptly pointed out that a dis-
tinction should be made between the concepts of social support and
support networks. Social support involves more than contacts with
individuals in a social network and “involves a qualitative exchange of
communication in an atmosphere of mutual trust” (p. 49).
Families with special needs can use two support system networks,
informal social networks and formal support systems. Formal sup-port
systems include agencies as well as professionals that provide help to
families and individuals who need assistance. Informal sup-port networks
refer to a family’s relatives, neighbors, friends, coworkers, or social
groups who may share emotional support, goods and services, or
information (Valentine, 1993). In this research, we examine only informal
sources of social support.

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 Olsen et al. / Families With Children With Disabilities 279

Often parents of children with disabilities receive decreased levels of

social support (Dunst et al., 1986; Stagg & Catron, 1986). Key people in
their support network, such as family members, often do not know how
they can help, so they may withdraw. This occurs at a time of potentially
increased stress on the family due to restricted social con-tacts, additional
expenses, and a need for more assistance with instru-mental activities such
as babysitting, household chores, or shopping. Parents also may
experience loneliness or isolation after the birth of a child with disabilities
(Stagg & Catron, 1986; Valentine, 1993) because they have less time and
energy to make visits outside of the home. In addition, fewer people make
visits to the home, although some research indicates that visiting patterns
of relatives are less affected than those of friends (Stagg & Catron, 1986).

Important in understanding social support is a recognition that family

members may not always regard social support as helpful but, instead,
perceive it as stressful. Valentine (1993) reported that in a clinical study of
families, the majority (19) of families fell into the cate-gory of well-
supported. These families had six to nine connections outside of their
home, and 14 families reported more supportive rela-tionships than
stressful ones. When these families identified sources of support, the
extended maternal family was ranked most often as an important source of
support, followed by father’s work, and the extended paternal family.

Other categories of families identified in Valentine’s (1993) research

included stressed families (n = 5, those who reported more stressful than
supportive relationships with others), isolated families (n = 3, families
with five or fewer connections), and overextended families (n = 3, families
who had so many interactions with others out-side of the family that time
and energy became scarce, resulting in family members feeling
overwhelmed and tired). Such findings underscore the notion that the
perception of family members regard-ing support is an important area of
investigation.
Mothers’ perceptions of the quality of social support also may dif-fer
according to the age of the child with special needs, even though families
experience comparable number and types of stressors. In Stagg and
Catron’s (1986) study of 31 mothers of mentally retarded children,
compared to mothers who did not have a child with mental retardation,
mothers of younger retarded children were less satisfied with a number of
areas of social support (e.g., feedback and guidance, emotional support,
tangible assistance, and information and advice). On the other hand,
mothers of teenage children with mental retarda-

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280 JFN, August 1999, Vol. 5 No. 3

tion reported more satisfaction with social support than mothers of

nonretarded children in these same areas of social support. It may be that
although the number of stressors experienced by families was comparable,
the nature of the stressors differed, and mothers of younger children felt
overwhelmed, resulting in less satisfaction with social support received.

Other research has found positive relationships among social sup-port

and personal, family, and child adaptation (Dunst et al., 1986). For
example, in families of children with developmental disabilities, Failla and
Jones (1991) found that loss of social support was linked to lower levels of
family hardiness, whereas total functional social sup-port (consisting of
affect, aid, and affirmation) was related to higher levels of family
hardiness. Loss of social support was related to lower levels of family
functioning and higher levels of family stress. In addi-tion, functional
support and the support network (size, frequency of contact, etc.) also
were associated with higher family functioning. Other research (Dunst et
al., 1986) has shown that social support was related to frequency of
parent-child interactions and that family func-tioning was almost always
related to intrafamily support rather than support from outside of the
family.

Family Communication

Family communication has been long recognized as a significant

variable in family adaptation and functioning. The interpersonal
environment of the family is a potential source of stress or a resource for
coping (Breresford, 1994). During challenging times, such as when
families are adjusting to a child with a disability, families manifest
specific patterns of communication. Included among these patterns of
interaction may be positive or negative styles of conflict resolution and
problem solving. Styles that include expressiveness, cohesion, and
cooperation among family members have been linked to positive
adjustment, whereas conflict is negatively associated with individual
adjustment among persons with disabilities (Alston & McCowan, 1995).

M. A. McCubbin, McCubbin, and Thompson (1996) identified two

types of family communication: affirming and incendiary. Affirming
communication is “supportive, caring, and calming in nature,” and
incendiary communication is “inflammatory in nature and tends to
exacerbate stressful situations” (p. 1). Incendiary communication may
contribute to unsuccessful adaptation in families. For example,

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 Olsen et al. / Families With Children With Disabilities 281

research on individual adaptation by Quine and Pahl (1991) showed that a

“tense home atmosphere” was positively related to poor mater-nal
physical and mental health.
Affirming and incendiary communication are highly negatively
correlated with each other (in this study, for mothers, r = –.64, p < .001;
for fathers, r = –.75, p < .001). To avoid problems with multicollinear-ity
of the independent variables, only incendiary communication was used as
a predictor in this research because incendiary communica-tion has been
most predictive of family functioning, associated with family system
distress, and negatively correlated with family hardi-ness (H. McCubbin &
Thompson, 1989a, 1989b).

PURPOSE AND RESEARCH QUESTIONS

The purpose of this research was to examine how family support and
perceptions of family incendiary communication are related to hardiness
in families where there is a child with disabilities. We obtained data from
both parents on all variables. We asked two spe-cific research questions:
(a) How are demographic control variables, family communication, and
family support linked to family hardi-ness in families where there is a
young child with disabilities? and (b) Are the patterns of relationships
different for fathers and mothers?

METHOD

Design

The study followed a descriptive correlational design to examine

demographic variables, family support, and incendiary communica-tion as
predictors of family hardiness. This project was part of a larger effort
exploring adaptation in families with children with disabilities.

Participants

Participants were recruited from among volunteer parents who had a

child enrolled in an early intervention program for children with
disabilities sponsored by three local school districts in an urban area of the
western United States. The purposive sample consisted of 54 sets of
parents who had a child or children with disabilities. Dis-

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282 JFN, August 1999, Vol. 5 No. 3

abilities were defined as any condition that qualified the child for services
of federally mandated early intervention educational pro-grams in the
United States. A variety of disabilities was represented, including speech
disorders, visual and hearing impairments, cerebral palsy, autistic
disorders, developmental delays, Down syndrome, and other types of
mental retardation. Most of the children had multi-ple disabilities.
Approval was obtained from review boards of all agencies involved.

The majority of families were Caucasian (91%). All families who

volunteered to participate were two-parent families, although during the
course of the study, one couple divorced. Families had an average of 3.91
children (range of 1-11). The average age of the child with dis-abilities
was 3.52 years (range of < 1 year to 6 years); 38% were female, and 62%
were male. All children were referred to early intervention programs
within a few months of birth. The mean age of mothers was 32.55, and the
fathers’ average age was 34.75. Mothers had completed an average of
13.73 years of education (SD = 1.57), and fathers aver-aged 15.53 years of
schooling (SD = 2.28). All of the fathers and 30% of the mothers were
employed full- or part-time. More than half of the families had an income
greater than $35,000 per year.

Procedures

Following an initial personal interview, where procedures were

explained and informed consent obtained, each parent received the
instruments by mail, completed the instruments independently, and
returned their responses by mail. Follow-up telephone reminders and/or
personal visits were made to families to encourage return. Families were
paid $25 for their participation in the entire project.

Instruments

Demographic variables. Parents in the family completed a written

demographic questionnaire. The instrument included the number of years
of education completed by both fathers and mothers and the number of
children in the family. Level of income was assessed using ratings ranging
from 1 (less than $7,000) to 6 (more than $50,000).

Family support. The perceived helpfulness of sources of family sup-

port was assessed by the Family Support Scale (Dunst et al., 1988). The

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 Olsen et al. / Families With Children With Disabilities 283

reported coefficient alpha for the entire scale was .77. Test-retest reli-
ability, taken 1 month apart, was .75. Criterion validity was sup-ported in
a number of studies that examined relationships between the total scale
score and subscales and family, parent, and parent-child outcome
measures. For this study, mothers and fathers evalu-ated their perceptions
of helpfulness of different sources of support using a 5-point Likert scale
anchored by 1 (not helpful at all) and 5 (extremely helpful). Mean scores
for the immediate family and formal kinship subscales (measuring the
helpfulness of spouses, parents, and relatives) were summed. Cronbach’s
alpha for this measure was .86 for fathers and .77 for mothers.

Family incendiary communication. The incendiary communication

subscale of the Family Problem Solving and Communication Index (M. A.
McCubbin et al., 1996) was used to measure how family mem-bers
communicate when struggling with problems or conflicts that upset them.
The subscale assessed perceptions of family communica-tion that are
inflammatory in nature and tend to exacerbate a stressful situation. Parents
rated statements concerning communication pat-terns using a scale that
ranged from 0 (false) to 3 (true). The 5-item subscale was summed, and a
mean score was calculated. Reported reliability for the subscale is .78 (H.
I. McCubbin et al., 1996). Our reli-ability measures were .70 for fathers
and .69 for mothers.

Family hardiness. The Family Hardiness Index (M. A. McCubbin et

al., 1991; H. I. McCubbin et al., 1996), measuring the characteristics of
hardiness as a stress resistance and adaptation resource in families, refers
to the internal strength and durability of the family unit. The scale consists
of 20 statements that describe families, and parents are asked to rate them
using a scale anchored at 0 (false) and 3 (true). H. I. McCubbin and
colleagues (1996) reported satisfactory reliability (Cronbach’s alpha = .82)
and construct validity. In this study, the 20 items on the scale were
summed, and a mean score was calculated. Cronbach’s alpha for the scale
was .71 for fathers and .70 for mothers.

Data Analysis

Descriptive statistics for each measure for mothers and fathers were
first calculated. Zero-order correlations and hierarchical regres-sion
analyses were then performed to examine the relationships

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284 JFN, August 1999, Vol. 5 No. 3

Table 1: Means and Standard Deviations of Measures

Mothers Fathers
M SD M SD Possible Range

Hardiness 2.35 .29 2.39 .26

0-3
Income 4.28 1.18 — — 1-6
Family support 6.78 1.53 6.75 1.67
2-10

among demographic variables, family support, family incendiary

communication, and family hardiness.

RESULTS

Descriptive Statistics

Means, standard deviations, and ranges for the predictor and outcome
variables are shown in Table 1. Means for family hardiness (mothers =
2.35, fathers = 2.39) are comparable to the mean of 2.37 reported by H. I.
McCubbin, Thompson, and Pimer (1986) in a sample of 304 parents. The
means of the hardiness scores in this study were higher than those found
by Failla and Jones (1991) in a study of 57 families with children who
have developmental disabilities. H. I. McCubbin and colleagues (1986)
reported a mean for incendiary com-munication of .84, with a standard
deviation of .56. Our sample had lower means and standard deviations
than found in McCubbin’s study, suggesting there were fewer negative
interactions and com-munications. Examination of the social support score
suggests that for both parents, immediate family ties generally ranged
from helpful to very helpful.

Preliminary Analyses

Correlation analyses were first performed to determine if relation-ships

existed among parents’ education, income, or family size and the outcome
variables, mothers’ and fathers’ reports of family hardi-ness, because such
variables frequently reflect sources of family stress. Income was the only
variable significantly related to family

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 Olsen et al. / Families With Children With Disabilities 285

Table 2: Zero-Order Correlations for Mothers and Fathers

Family Incendiary
Hardiness Income Support Communication

Hardiness 1.00
Income .31* (.37**) 1.00
Family support .34* (.51***) .09 (–.01) 1.00
Incendiary
communication –.49*** (–.34**) –.07 (–.26*) –.03 (–.27*) 1.00

Note: Fathers’ values in parentheses.

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

hardiness (mothers: r = .31, p < .05; fathers: r = .37, p < .01). As a result,
that variable was controlled in the multiple regression analyses. In
addition, two unpaired t tests were performed with gender of the child
with a disability as the independent variable and fathers’ and mothers’
hardiness as the dependent variables. There were no signifi-cant
differences between groups on either dependent variable; there-fore,
gender was not used as a control in the multiple regression analyses.

Bivariate Correlations

For mothers and fathers, zero-order correlations among income, family

support, incendiary communication, and hardiness are reported in Table 2.
For mothers, family support was positively related to family hardiness (r =
.34, p < .05). Mothers’ incendiary com-munication was negatively related
to hardiness (r = –.49, p < .001). Fathers’ reports of family support also
were positively correlated with hardiness (r = .51, p < .001), and
incendiary communication was negatively related to hardiness (r = –.34, p
< .01). For fathers only, there were links between the predictor variables,
incendiary commu-nication and income (r = –.26, p < .05), and incendiary
communication and support (r = –.27, p < .05).

Hierarchical Regression Analyses

Hierarchical multiple regression analyses (Table 3) were per-formed,

entering income only in Model 1; income and family support in Model 2;
and income, family support, and incendiary communica-tion in Model 3.
Mothers’ scores were used to predict mothers’ hardi-

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Table 3: Mothers’ and Fathers’ Family Hardiness Regressed on Income, Family

Support, and Incendiary Communication

Mother’s Hardiness Father’s Hardiness

Standardized Standardized
2 2 2 2
β R Change Total R β R Change Total R

Model 1
Income .31* .10* .10 .37* .14* .14
Model 2
Income .28 .10* .20 .38** .26*** .40
Family support .32* .51***
Model 3
Income .25 .21*** .41 .35** .01 .42
Family support .31* .48***
Incendiary
communication –.46*** –.12
2
Adjusted R .36 .37

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

ness, and fathers’ scores predicted fathers’ hardiness. For mothers, the
final model accounted for 36% of the variance and for fathers, 37% of the
variance.
Specifically, in the final model for mothers, incendiary communi-cation
was the strongest predictor (β = –.46, p < .001), followed by fam-ily
support (β = .31, p < .05). In the final father model, family support was the
strongest predictor (β = .48, p < .001); income also was a sig-nificant
predictor (β = .35, p < .01).

DISCUSSION

Research Implications

The Resiliency Model of Family Stress, Adjustment, and Adapta-tion

assumes that families develop basic capabilities and strengths that foster
the development and growth of family members and pro-tect them from
major disruptions during family changes or transi-tions. These basic and
unique capabilities and strengths may serve to protect the family from
unexpected or nonnormative stressors and may foster the family’s
adaptation following a family crisis (M. A. McCubbin & McCubbin, 1989,
1991). The purpose of this study was to examine variables from the
adjustment phase of the McCubbins

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 Olsen et al. / Families With Children With Disabilities 287

model, exploring links among mothers’ and fathers’ family support,

family communication, and family hardiness in families with a child with
disabilities.
Results showed that perceptions of the helpfulness of family sup-port
were positively related to family hardiness for both fathers and mothers.
Thus, parents in our sample who perceived the support of family
members, such as spouse, parents, and other relatives, as more helpful had
higher levels of family hardiness. Although there is an abundance of
literature on women and social support networks (All-red, 1992; Bristol et
al., 1988), other research on families with children who have disabilities
(Frey, Greenberg, & Fewell, 1989) has demon-strated that increases in
family criticism (lack of support) are related to decreases in fathers’
reported family adjustment.
The importance of family communication also was underscored in this
study. Incendiary, or negative, communication was an important variable
for mothers, serving as a negative predictor of hardiness. For fathers,
although hardiness and incendiary communication also were strongly
linked in the bivariate correlations, this relationship dimin-ished in the
regression equations. This may have occurred because of the correlation
between incendiary communication and both income and family support
for fathers. These findings also support previous research with families
who have experienced different types of family stressors, such as
economic instability (H. McCubbin & Thompson, 1989a, 1989b).

Although the results of this study support findings of previous research,

limitations also should be addressed. First, because this study used cross-
sectional data, the results are correlational in nature. Further longitudinal
work is needed. In addition, our sample was relatively homogeneous in
ethnicity and social status and moderate in size. Nevertheless, these
findings may be useful for nurses plan-ning interventions to assist families
where there is a child with a disability.

Implications for Family Nursing Practice

Information gained from this study provides family nurses with

beginning information regarding constructs important to a better
understanding of viewpoints of parents of children with disabilities. This
knowledge may assist nurses in helping families develop insights and
behaviors associated with hardiness. Hardiness is often viewed as a family
characteristic associated with positive health out-

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288 JFN, August 1999, Vol. 5 No. 3

comes. Our research indicates that by facilitating family support and

helping to diminish negative family communication, hardiness may be
enhanced.
Because families with children with disabilities may experience more
stress than is normative, an important part of any intervention should be
the teaching of effective communication skills and conflict management.
Such interventions may reduce incendiary communi-cation patterns.
Results of the study highlight the importance of sup-portive family
members. Often, health care providers provide infor-mation on external
sources of support, but our findings suggest the additional value of
strengthening supportive relationships within the family. Information on
sources of support within the family, in the health care system, and in the
community facilitate family strengths and hardiness. These conclusions
can only be validated by further research and actual clinical practice.

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Susanne Frost Olsen, Ph.D. (University of Georgia), is an associate professor in the

School of Family Life at Brigham Young University. She does research on adaptation in
families with children with disabilities and parenting across the life span. Recent
publications include (with E. S. Marshall, S. Chipman, J. Bingham, M. Buchanan, & B.
L. Mandleco) “Daily Stressors and Coping Responses of Siblings of Children With

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 Olsen et al. / Families With Children With Disabilities 291

Disabilities” (in C. Shehan, Ed., Children’s Lived Experiences, Sage, in press)

and (with P. Martin & C. F. Halverson) “Personality, Marital Relationships, and
Par-enting in Two Generations of Mothers” (International Journal of Behavioral
Development, in press).

Elaine Sorensen Marshall, R.N., Ph.D. (University of Utah), is the associate dean of
research and scholarship at the College of Nursing at Brigham Young University. She
has done research on children’s stress and coping as well as on family adaptation to a
child with disabilities. Recent publications include (with C. O. Conger) “Recreating
Life: Toward a Theory for Relationships in Acute Home Care” (Qualitative Health
Research, 1998) and “Daily Stressors and Coping Responses: A Comparison Between
Rural and Suburban Children” (Public Health Nursing, 1994).

Barbara L. Mandleco, R.N., Ph.D. (Brigham Young University), is an associate pro-

fessor in the College of Nursing at Brigham Young University. Her research interests
include adaptation of siblings of children with disabilities; and resiliency, coping, and
social competence in children. Her recent publications include (with J. C. Peery) “An
Organizational Framework for Resilience” (Journal of Child and Adolescent Psy-
chiatric Nursing, in press) and (with S. F. Olsen, C. C. Robinson, E. S. Marshall, & M.
K. McNeilly-Choque) “Social Development and Peer Relationships of Children With
Disabilities: Family Linkages” (in P. T. Slee & K. Rigby, Eds., Children’s Peer
Relations: Current Issues and Future Directions, Routledge, 1998).

Keith W. Allred, Ph.D. (Vanderbilt University), is an early childhood special

educa-tion consultant for the Nevada State Department of Education. His research
is in the area of interventions and parent education for children with disabilities.
Publications include (with S. Hendrickson & J. H. Baldwin) “Factors Perceived
by Mothers as Preventing Families From Obtaining Early Intervention Services
for Their Children With Special Needs” (Children’s Health Care, in press) and
(with G. S. Gibb, J. R. Young, T. T. Dyches, M. W. Egan, & C. F. Ingram) “A
Team-Based Junior High Inclusion Program: Parent Perceptions and Feedback”
(Remedial and Special Education, 1997).

Tina Taylor Dyches, Ed.D. (Illinois State University), is an assistant professor in the
Department of Counseling Psychology and Special Education at Brigham Young
University. She is involved in research on the education and treatment of individuals
with severe disabilities and autism. Publications include “Effects of Switch Training on
the Communication of Children With Autism and Severe Disabilities” (Focus on
Autism and Other Developmental Disabilities, 1998) and (with G. S. Gibb, C. F.
Ingram, K. W. Allred, M. W. Egan, & J. R. Young) “Developing and Evaluating an
Inclusion Program for Junior High Students With Disabilities: A Collaborative Team
Approach” (B.C. Journal of Special Education, 1998).

Nancy Sansom, M.S. (San Francisco State University), is a doctoral candidate in the
School of Family Life at Brigham Young University and an occupational therapist.

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