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University of Southern California Dissertations and Theses
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Maternal Child-Rearing Attitudes And Developmental Growth Of Rubella Deaf-Blind Children
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Maternal Child-Rearing Attitudes And Developmental Growth Of Rubella Deaf-Blind Children
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MATERNAL CHILDREARING ATTITUDES AND DEVELOPMENTAL GROWTH OF RUBELLA DEAF-BLIND CHILDREN by Kenneth Kurt Ortiz A Dissertation Presented to the FACULTY OF THE GRADUATE SCHOOL UNIVERSITY OF SOUTHERN CALIFORNIA In Partial Fulfillment of the Requirements for the Degree DOCTOR OF PHILOSOPHY (Educational Psychology) June 1973 INFORMATION TO USERS This material was produced from a microfilm copy of the original document. While the most advanced technological means to photograph and reproduce this document have been used, the quality is heavily dependent upon the quality of the original submitted. The following explanation of techniques is provided to help you understand markings or patterns which may appear on this reproduction. 1. The sign or "target" for pages apparently lacking from the document photographed is "Missing Page(s)". If it was possible to obtain the missing page(s) or section, they are spliced into the film along with adjacent pages. This may have necessitated cutting thru an image and duplicating adjacent pages to insure you complete continuity. 2. When an image on the film is obliterated with a large round black mark, it is an indication that the photographer suspected that the copy may have moved during exposure and thus cause a blurred image. You will find a good image of the page in the adjacent frame. 3. When a map, drawing or chart, etc., was part of the material being photographed the photographer followed a definite method in "sectioning" the material. It is customary to begin photoing at the upper left hand corner of a large sheet and to continue photoing from left to right in equal sections with a small overlap. If necessary, sectioning is continued again — beginning below the first row and continuing on until complete. 4. The majority of users indicate that the textual content is of greatest value, however, a somewhat higher quality reproduction could be made from "photographs" if essential to the understanding of the dissertation. Silver prints of "photographs" may be ordered at additional charge by writing the Order Department, giving the catalog number, title, author and specific pages you wish reproduced. 5. PLEASE NOTE: Some pages may have indistinct print. Filmed as received. Xerox University Microfilms 300 North Zeeb Road Ann Arbor, Michigan 48106 I 74—936 ORTIZ, Kenneth Kurt, 1943- MATERNAL CHILDREARING ATTITUDES AND DEVELOPMENTAL GROWTH OF RUBELLA DEAF-BLIND CHILDREN. University of Southern California, Ph.D., 1973 Education, psychology ; University Microfilms, A XEROX Company, Ann Arbor, Michigan THIS DISSERTATION HAS BEEN MICROFILMED EXACTLY AS RECEIVED. UNIVERSITY O F SO U TH E R N CA LIFO R NIA TH E G RADUATE SCHO OL U N IV E R S IT Y PARK LOS A NG ELES. C A L IF O R N IA 9 0 0 0 7 This dissertation, written by ....^EMEm.j^URX..0RTI2L.... under the direction of h..i s . . . Dissertation Com mittee, and approved by a ll its members, has been presented to and accepted by The Graduate School, in partial fulfillm ent of requirements of the degree of D O C T O R O F P H IL O S O P H Y I f f . 'Tn^o 2 Dean Date. m 3 DISSERTATION COMMITTEE Chairman DEDICATION No words can begin to describe how much I owe my | wife, Dottie. Her warm support, encouragement and love | were enduring forces throughout my graduate studies. In ; my heart I will never forget the enumerable sacrifices ; she made for me. i I I ii ACKNOWLEDGMENTS i This study, by necessity, required the assistance j of several persons. This writer wishes to express his j i sincere appreciation to those who contributed to the j i actual research investigation and/or the preparation of i this dissertation. These individuals include: C. Edward Meyers, Ph.D., who served as the Chairman i of the Doctoral Committee. His counsel during the ; initial design as well as his constructive criticism of ! the preliminary drafts of this dissertation were of I i invaluable assistance. This writer's regard for Professor Meyers, both as an instructor and advisor, is of the highest level. I Robert B. McIntyre, Ph.D., and H. Edward Ransford, | i Ph.D., who were the other members of the Doctoral ! Committee. Their suggestions were particularly useful with respect to the statistical analyses employed in the study and the technical editing of the manuscript. j Dorothy M. Ortiz, A.B., the writer's wife, spent j countless hours tabulating data and typing the many drafts j and revisions of the dissertation. She was also instru- ! mental in the actual field research as she conducted most I i ! of the parent interviews. j Malcolm L. Williamson, Ph.D., who assisted the writer in developing the research design and in the computer programming and analysis of the data. Donald I. Ashurst, Ph.D., the superintendent of the California State Diagnostic School for Neurologically i ; Handicapped Children, made records available so that ; pretest data could be gathered and provided the means by | which subjects could be located. I i iv TABLE OF CONTENTS Chapter Page I. THE PROBLEM AND ITS SIGNIFICANCE........... 1 Introduction Purpose of the Study Significance of the Study Questions to be Answered Statement of Hypotheses Outline of Procedure Assumptions Definition of Terms Scope of the Study Arrangement of the Chapters II. REVIEW OF THE LITERATURE................... 21 Maternal Rubella The Deaf-Blind Child The Deaf-Blind Rubella Child The Mother-Rubella Child Relationship Influence of Maternal Attitudes and Behavior on the Development of Non-Handicapped Children Maternal Attitudes and Their Effects on Severely Handicapped Children Summary and Conclusions III. RESEARCH METHODOLOGY ....................... 53 Research Design Methods of Analysis The Sample Procedure Data Gathering Instruments IV. RESULTS.................................... 88 Childrearing Attitudes of Rubella Mothers Developmental Growth in Deaf-Blind Rubella Children v Chapter Page Maternal Childrearing Attitudes and Developmental Growth in Deaf-Blind Rubella Children Evaluation of the Hypothesis Discussion of the Hypotheses V. SUMMARY, CONCLUSIONS AND RECOMMENDATIONS . . 147 t I | Summary ! Conclusions | Recommendations ! BIBLIOGRAPHY ....................................... 158 ! ; APPENDICES......................................... 172 ' A. Letter to Rubella Mothers i j B. A Modified Form of the Parental Attitude Research Instrument vi LIST OF TABLES ! Table 1. A Summary of the Construct Similarity Between Schaefer's Maternal Dimensions and Those Found by Other Researchers ........... 2. Selected Scales and Factors of the Modified PARI ............................. 3. Areas and Subtests of the PAR ............... 4. Interactions in the Consequence of Warmth vs Hostility and Restrictiveness vs Permissiveness .............................. 5. Multiple Correlations of PARI Scales Against IQ and SQ .................................. 6. Selected Scales and Factors of the Modified PARI .............................. 7. Repeat Reliabilities of Nonreversed and Reversed PARI Scales and the Correlations Between Them ................................ 8. Internal Consistency of the Preschool Attainment Record ......................... 9. Intercorrelation Matrix of the Eight Subtests of the Preschool Attainment Record ...................................... 10. Factor Structure of the Preschool Attainment Record ......................... 11. Means, Standard Deviations, Possible Ranges of the Scales, Subfactors and Factors of the PARI for 50 Mothers of Rubella Children . . 12. Means, Standard Deviations and Time Lapse Between Testing for the Physical Area Subtests on the Pre and Posttests of the PAR for 50 Rubella Children ............... Vll Page 7 10 11 41 48 78 80 85 86 87 90 96 Table 13. Means, Standard Deviations and Time Lapse Between Testing for the Social Area Subtests on the Pre and Posttests of the PAR for 50 Rubella Children ............ 14. Means, Standard Deviations and Time Lapse Between Testing for the Intellectual Area Subtests on the Pre and Posttests of the PAR for 50 Rubella Children ............. 15. Means, Standard Deviations and Time Lapse Between Testing for the Total Attainment Age on the Pre and Posttests of the PAR for 50 Rubella Children . . ............ 16. Linear Correlations Between Competing Variables and the Sets of Independent Variables (PARI) and the Dependent Variables (Posttest PAR) .......... 17. Linear and Stepwise Correlation Analysis Between the Posttest Ambulation Subtest of the PAR and the Scales, Subfactors and Factors of the PARI ............... 18. Linear and Stepwise Correlation Analysis Between the Posttest Manipulation Subtest of the PAR and the Scales, Subfactors and Factors of the PARI ..................... 19. Linear and Stepwise Correlation Analysis Between the Posttest Physical Area of the PAR and the Scales, Subfactors and Factors of the PARI.............................. 20. Linear and Stepwise Correlation Analysis Between the Posttest Rapport Subtest of the PAR and the Scales, Subfactors and Factors of the PARI ................... 21. Linear and Stepwise Correlation Analysis Between the Posttest Communication Subtest of the PAR and the Scales, Subfactors and Factors of the PARI . , 22. Linear and Stepwise Correlation Analysis Between the Posttest Responsibility Subtest of the PAR and the Scales, Subfactors and Factors of the PARI ..................... v m Page 101 107 113 117 119 120 121 122 123 124 Table Page 23. Linear and Stepwise Correlation Analysis Between the Posttest Social Area of the PAR and the Scales, Subfactors and Factors of the PARI......................... 125 24. Linear and Stepwise Correlation Analysis Between the Posttest Information Subtest of the PAR and the Scales, Subfactors and j Factors of the PARI.............................126 ; 25. Linear and Stepwise Correlation Analysis ! Between the Posttest Ideation Subtest of the PAR and the Scales, Subfactors and Factors of the PARI .......................... 127 26. Linear and Stepwise Correlation Analysis Between the Posttest Creativity Subtest of ! the PAR and the Scales, Subfactors and I Factors of the PARI.............................128 27. Linear and Stepwise Correlation Analysis | Between the Posttest Intellectual Area of the PAR and the Scales, Subfactors and I Factors of the PARI............................ 129 28. Linear and Stepwise Correlation Analysis ; Between the Posttest Attainment Age of the PAR and the Scales, Subfactors and Factors of the PARI.................................... 130 i 29. Multiple Regression Correlation Coefficients ; Between the Posttest Ambulation Subtest of the PAR and the Multiple Scale | Predictors of the P A R I ........................ 132 | 30. Multiple Regression Correlation Coefficients i Between the Posttest Manipulation Subtest | of the PAR and the Multiple Scale Predictors of the P A R I ....................... 132 i 31. Multiple Regression Correlation Coefficients Between the Posttest Physical Area of the PAR and the Multiple Scale Predictors“ of the PARI.................................... 133 ! 32. Multiple Regression Correlation Coefficients j Between the Posttest Rapport Subtest of the I PAR and the Multiple Scale Predictors of the PARI.................................... 133 Table 33. i i i i 34. 35. I 36. ! 37. | 38. ; 39. i I | i ; 4 ° - Multiple Regression Correlation Coefficients Between the Posttest Communication Subtest of the PAR and the Multiple Scale Predictors of the PARI ................................ Multiple Regression Correlation Coefficients Between the Posttest Responsibility Subtest of the PAR and the Multiple Scale Predictors of the PARI ................................ Multiple Regression Correlation Coefficients Between the Posttest Social Area of the PAR and the Multiple Scale Predictors of the PARI .................................. Multiple Regression Correlation Coefficients Between the Posttest Information Subtest of the PAR and the Multiple Scale Predictors of the PARI ................... Multiple Regression Correlation Coefficients Between the Posttest Ideation Subtest of the PAR and the Multiple Scale Predictors of the PARI ............................. Multiple Regression Correlation Coefficients Between the Posttest Creativity Subtest of the PAR and the Multiple Scale Predictors of the PARI ................................ Multiple Regression Correlation Coefficients Between the Posttest Intellectual Area of the PAR and the Multiple Scale Predictors of the PARI................................. Multiple Regression Correlation Coefficients Between the Posttest Total Attainment Age of the PAR and the Multiple Scale Predictors of the P A R I .................... Page | 134 | t 134 135 i 135 I 137 136 1 137 | i I 137 i X LIST OF FIGURES I i Figure Page 1. Hypothetical Circumplex Model for Maternal Behavior ............................ 8 2. Standard Scores for Each of the PARI Scales for 50 Mothers of Rubella Children.................................... 91 3. Standard Scores for Each of the PARI ; Subfactors for 50 Mothers of Rubella Children.................................... 93 4. Childrearing Attitudes of 50 Mothers of I Rubella Children ............................ 94 5. Mean Developmental Growth Gains Compared to Chronological Age and Time Lapse Between Pre and Posttesting on the Ambulation Subtest of the P A R ......................... 97 6. Mean Developmental Growth Gains Compared to Chronological Age and Time Lapse Between Pre and Posttesting on the Manipulation Subtest of the P A R .......................... 98 7. Mean Developmental Growth Gains Compared to Chronological Age and Time Lapse Between Pre and Posttesting on the Rapport Subtest of the P A R .................................... 102 8. Mean Developmental Growth Gains Compared to Chronological Age and Time Lapse Between Pre and Posttesting on the Communication Subtest of the P A R ............................ 103 9. Mean Developmental Growth Gains Compared to Chronological Age and Time Lapse Between Pre and Posttesting on the Responsibility Subtest of the P A R ............................ 104 xi Figure Page 10. Mean Developmental Growth Gains Compared to Chronological Age and Time Lapse Between Pre and Posttesting on the Information Subtest of the PAR......................... 108 11. Mean Developmental Growth Gains Compared to Chronological Age and Time Lapse Between Pre and Posttesting on the Ideation Subtest of the PAR......................... 109 12. Mean Developmental Growth Gains Compared to Chronological Age and Time Lapse Between Pre and Posttesting on the Creativity Subtest of the P AR ......................... 110 13. Mean Developmental Growth Gains Compared to Chronological Age and Time Lapse Between Pre and Posttesting on the Total Attainment Age of the P A R ................ 114 xii CHAPTER I THE PROBLEM AND ITS SIGNIFICANCE Introduction Rubella (German measles) has been recognized as a clinical entity for at least two centuries (Wesselhoeft, 1947). After more than a hundred years of relative obscurity among the common communicable diseases of childhood, this disease achieved a new prominence early in World War II through the far reaching observations of Dr. Norman McAlister Gregg (1941). From the systematic observations of 78 infants of mothers who had contracted rubella during the first trimester of pregnancy, Gregg found a connection between maternal rubella and congenital cataract in infants. Today it is known that maternal rubella may lead to a number of childhood handicaps in addition to congenital cataract. Bell (1959) in his work with "rubella children" pooled several statistical studies and reported the relative incidence of handicaps among 712 cases of maternal rubella. Of the 712 cases, 378 of the offspring showed one or more physical defects: 1 2 Condition Total Number Cataract Cataract and heart defect Cataract and deafness Cataract, heart, and deafness Deafness only Deafness and heart Heart only 27 78 10 30 151 46 36 Total 378 Bell cited 40 cases of combined visual and auditory disorders out of the 712 cases of maternal rubella. Additional similar statistics may be found in Rubella Synposium (1965) and Sheriden (1964) . The deaf-blind child is not the stereotype of Helen Keller drawn by many people based upon literature and the drama The Miracle Worker. Neither are deaf-blind children generally found to be totally "deaf" or totally "blind.” These children usually have some residual hearing and/or residual sight. Furthermore, combinations of visual and auditory impairment may vary substantially from one child to another. In winter, 1963, a severe epidemic of rubella occurred in the eastern portion of the United States and was evidenced on the West Coast in 1964-1965. Although statistical reports vary, it is estimated that there were approximately 1,800,000 cases of rubella and that 10,000 to 20,000 infants were born with congenital defects characteristic of the rubella syndrome (Wagner, 1967). These children have now reached school age, which presents certain special problems for those who must treat, care for and educate them. Because of the relative rarity of rubella deaf blindness and the methodological difficulties encountered in doing research with deaf-blind children, little is known of either the growth patterns of these children or those environmental influences that impede or facilitate growth. There can be little doubt as to the influence of environmental variables on the growth and development of children. One of the most significant environmental in fluences on a child is, of course, the mother. In many instances she is the primary source of stimulation. Because of the deaf-blind child's limitations in receiving stimuli, directed efforts in stimulating the child become crucial. Again the mother may become the central focus in directing such efforts. Virtually no empirical research, however, has been published in the United States regarding the influence of maternal childrearing attitudes and/or behavior on the developmental growth of deaf-blind children. There appears to be evidence that maternal child- rearing attitudes may influence the cognitive and social development of children. Research done on normal children has been conflicting, however, in terms of what specific types of childrearing attitudes and behaviors facilitate or impede cognitive development. Some investigators (Baldwin, Kalhorn, and Bresse, 1945; Watson, 1957) have advocated permissive, democratic attitudes; whereas other researchers (Drews and Teahan, 1957; Kent and Davis, 1957) have purportedly found that demanding, autocratic mothers tend to enhance the cognitive growth of their children. Most research relative to social development points to the fact that the warm, accepting, permissive parent has the greatest chance of producing a socially outgoing, well adjusted child (Becker, 1964). Regarding parental atti tudes and physical development, little research, if any, has been done in this area. Some authors (Breckenridge and Vincent, 1960) are of the opinion that the emotional reactions of parents can impede motor development, but empirical research to support this notion is relatively non-existent. Since no research is available regarding the maternal attitudes of rubella mothers, one might expect to obtain some insights into this area by surveying research on the attitudes of mothers with other severely handicapped children. Investigations in this area indicate that mothers of handicapped children often have negative, rejecting attitudes and these attitudes, in turn, apparent ly have adverse effects on the development of their handicapped children (McCarthy, 1954; Self, 1970). However, it should be kept in mind that one may be on tenuous ground in making inferences from studies on mothers 5 of severely retarded children, for example, to mothers of rubella children. Logically deducing from the evidence available, this researcher pursued the following line of thinking. There does appear to be some relationship between the childrearing attitudes of mothers and the cognitive and social development of normal children; however, the most advantageous type of childrearing attitude may still be in question. It is also known that different types of maternal attitudes can have harmful effects on certain types of handicapped children. It seemed that this certainly may be the case with the deaf-blind child. Furthermore, since the mother is such a significant environmental influence on the deaf-blind child, it appeared reasonable to suggest that there would be a significant relationship between maternal attitudes and developmental growth of rubella children. More specifi cally, the question became one of what types of child- rearing attitudes would be most beneficial for the development of their children. To demonstrate a relationship between maternal childrearing attitudes and developmental growth, it was necessary first to have a theoretical framework from which maternal childrearing attitudes could be identified and measured. After exploring several models, Schaefer's (1959) circumplex model for maternal behavior appeared most appropriate since it seemed to be closely aligned with the theoretical structure of the instrument used in this study to measure maternal attitudes. Schaefer's model was derived from organizing several empirical studies of maternal behavior and then applying Guttman's (1954) "circumplex model for analysis of the interrelationships of a set of concepts" to these data. Schaefer's major con tribution was that he was able to isolate or identify two major orthogonal dimensions of maternal behavior in the studies he factor analyzed. These dimensions were labeled Love vs Hostility and Autonomy vs Control. Schaefer and Bell (1958) as well as Zuckerman et al (1958) , identified a third dimension which was termed "democratic attitudes." This third factor was not included in the present study for several reasons. A detailed rationale for its exclu sion is put forth in Chapter III in the section describing the data gathering instruments. Other researchers have also identified dimensions similar to the two major ones found by Schaefer. A systematic summary of the construct similarity between Schaefer's dimensions and those of other investigators appears in Table 1. Schaefer's actual hypothetical circumplex of maternal behavior appears in Figure 1. The instrument previously alluded to, which measures maternal attitude and is closely aligned with Schaefer's model, is the Parental Attitude Research Instrument (PARI) TABLE 1.— A summary of the construct similarity between Schaefer's maternal dimensions and those found by other researchers I II Schaefer (1959) Autonomy control factor Hostility love factor Zuckerman, et al. (1958) Authoritarian control factor Parental warmth factor Oppenheim (1963) Autonomy factor Acceptance factor Sears (1967) Object oriented techniques Love oriented techniques LOVE f Accepting Over Indulgent * Cooperative Protective Indulgent* * Democratic Over Protective + Possessive CONTROL * Freedom * AUTONOMY * Detached Authoritarian Dictatorial * Indifferent Demanding Antagonistic+ ^Neglecting Rejecting HOSTILITY Fig. 1.— Hypothetical circumplex model for maternal behavior. constructed by Schaefer and Bell (1958). The actual instrument used in the present study was a modified form of the PARI, which appeared to be a reliable and valid device for assessing the childrearing attitudes of mothers. The main factors, subfactors, and individual scales of the modified PARI (hereafter simply referred to as PARI) are presented in Table 2. The primary application of this instrument was its use as a measure of the authoritarian, possessive, rejecting, et cetera, attitudes of mothers toward their children. An assessment device to measure developmental growth in rubella children was also needed. Because its design is based on developmental levels and because of its scoring advantages, the Preschool Attainment Record (PAR) devised by Edgar Doll (1966b), seemed to be appropriate for the measurement of development in rubella deaf-blind children. The various areas and subtests of the PAR are given in Table 3. It appeared plausible, then, that by administering the PARI to rubella mothers and obtaining estimates of developmental growth for their deaf-blind children on the PAR, correlational data could be ascertained to determine the extent of the relationship between childrearing attitudes of mothers and the development of rubella deaf- blind children. TABLE 2.— Selected scales and factors of the modified PARI Factors Subfactors Scales Factor A. Authoritarian-control 1. Harsh punitive-control a. Breaking the will b. Excluding outside influences c. Deification 2. Suppression and interpersonal distance d. Avoidance of communication e. Suppression of sex 3. Over-possessiveness f. Fostering dependency g. Martyrdom h. Intrusiveness 4. Excessive demand for striving i. Strictness j. Acceleration of development Factor B. Hostility-rejection k. Marital conflict 1. Irritability m. Rejection of the homemaking role 11 I TABLE 3.— Areas and subtests of the PAR i . Major Area Subtest Physical Ambulation Manipulation Social Rapport Communication Responsibility Intellectual Information Ideation Creativity 12 Purpose of the Study The primary purpose of this investigation was to determine what relationship exists between maternal child- rearing attitudes and the amount of developmental growth rubella children make in the physical, social and intel lectual areas. More specifically, it was the objective of this study to obtain correlational data on the afore mentioned variables of attitude and development by correlating the factors, subfactors, scales and combination of scales of the PARI with the posttest PAR subtests, major areas and total attainment age. The secondary purposes of the study were to ascertain some idea of the types of maternal childrearing attitudes that are typical of rubella mothers and to learn more about the developmental growth patterns characteristic of rubella children. Significance of the Study It has been estimated by certain investigators (Ingalls et al., 1960), that rubella epidemics run six to seven year cycles. Although a rubella vaccine is now available, it is unlikely that the disease will be completely eliminated, and rubella infants will continue to be born with congenital defects. Stein and Green (1972) have indicated that fewer deaf-blind children are now being placed in residential schools, more attending day schools 13 and living at home with their parents. Thus, there seems to be a greater need to examine those influences in the home that might hinder or facilitate development in rubella children. If it could be demonstrated that a significant relationship exists between maternal childrearing attitudes and the amount of measured developmental growth in deaf- blind children, then a base might be laid for a concerted effort in the area of parental counseling. Dinsmore (1967) has stated that perhaps the most serious unmet need of deaf-blind children is in the area of parental counseling. This counseling, emphasizing attitude formation, would hopefully become an integral part of any educational or developmental program for rubella deaf-blind children. Currently most persons involved in the education of deaf- blind children agree that parental counseling is important, but few describe the techniques or approaches that might be most appropriately employed. Furthermore, this study will make available for one of the first times, empirical data on the developmental rates of rubella children. It is hoped that these data will stimulate and/or assist future research in this area. Questions to be Answered The questions the study attempted to answer in the achievement of its objectives were as follows: 14 1. What childrearing attitudes are characteristic of mothers who have rubella deaf-blind children? 2. How much developmental growth do rubella deaf- blind children make in the physical, social and intellec tual areas? 3. Is there a significant relationship between the childrearing attitudes of rubella mothers and the develop mental growth of their deaf-blind children? Statement of Hypotheses In the process of answering the questions proposed in this study, the following hypotheses were tested: 1. There is a significant relationship between the individual scale scores of the PARI and the amount of developmental growth shown on the posttest PAR subtests and major areas. 2. There is a significant relationship between combinations of scale scores on the PARI and the posttest PAR subtests and major areas. 3. There is a significant relationship between the subfactors of the PARI and the amount of developmental growth shown on the posttest PAR subtests and major areas. 4. There is a significant relationship between the individual scale scores, combination of scale scores, sub factors and factors of the PARI and the total posttest PAR developmental attainment age. I 15 5. There is a significant relationship between either of the two major factors of the PARI (Authoritarian- control and Hostility-rejection) and the amount of develop mental growth shown on the posttest PAR subtests and major areas. Outline of Procedure The research sample for this study was obtained from the records of the California State Diagnostic School for Neurologically Handicapped Children (DSNHC). From 1968 to 1971 the DSNHC evaluated 96 deaf-blind rubella children. Of this number, 50 rubella children and mothers were selected as subjects. Pretest data of an ex post facto nature were gathered from the DSNHC records relative to the severity of the rubella children's handicaps and their levels of development in the physical, social and intellectual areas. The developmental levels were represented by the PAR scores which had been obtained during the initial evaluation at the DSNHC. During the summer, 1972, interviews were held with mothers of the 5& rubella children. During these inter views the PAR and the PARI were administered. (PAR scores may be obtained by interviewing someone close to the child, such as his mother.) The posttest PAR was identified as the dependent variable and the PARI the independent 16 variable. The pretest PAR acted as a base which enabled the investigator to ascertain what type of developmental growth rubella children make over specific lengths of time. However, the amount of developmental growth made between pre and posttesting was not, as such, considered a dependent variable. The main purpose of the study— to discover what relationship exists between maternal childrearing attitudes and development of rubella children in the physical, social and intellectual areas— was expressed as the correlation between the scales, subfactors and factors of the PARI and the subtests, major areas and total attainment score of the PAR. Previous research had identified four possible competing variables which correlated with both the dependent and independent variables. The competing variables were the child's intellectual estimate, his hearing loss, his visual deficit and his mother's educational level. Through a stepwise correlation analysis, each of the competing variables was partialed out as the independent and dependent variables were being correlated. The results were multiple partial correlations representing the relations- ships between maternal childrearing attitudes and develop mental growth in rubella children. 17 Assumptions Because of the numerous methdological difficulties one faces in doing research involving attitudes and the deaf-blind child, it was necessary to make certain assumptions. 1. It was assumed that there is an integral and significant relationship between maternal childrearing attitudes and maternal behavior. Studies by Schaefer and Bailey (1960) as well as Zunich (1961) have lent support to this assumption. 2. It was assumed that the PARI and the PAR are valid and reliable instruments for assessing maternal childrearing attitudes and development in deaf-blind children. 3. It was assumed that the pretest data gathered from the DSNHC were reliable and valid. Definition of Terms The deaf-blind child.— The National Study Committee on the Education of Deaf-Blind Children provides the following definition which has certain educational implications: A deaf-blind chid is one whose combination of handicaps (disability) prevents him from profiting satisfactorily from educational programs provided for the blind child or the deaf child. (1954, p. 30) It is important to note that nowhere in this definition is it indicated that the child must be legally 18 deaf and/or legally blind. A child may have residual hearing and/or sight and still be considered deaf-blind according to the National Study Committee definition. This definition was the one utilized in the present study. Rubella child.— As used in this study the "rubella child" is an abbreviated way of referring to a child with the congenital rubella syndrome and who satisfies the definition of deaf-blindness stated above. Scope of the Study Delimitations The present investigation was delimited to the relationship between mothers' childrearing attitudes and development. It was not assumed, however, that fathers play an unimportant role in the rearing of rubella child ren. But because of the practical consideration of availability for interviewing, only mothers were studied. It was decided that the mother is more crucial in the early rearing of the child since she generally assumes the major responsibility for his care. The study was also delimited to rubella deaf-blind children presently living in Southern California at home with their mothers on a full-time basis. Children were selected only if adequate pretest data were avilable on them and they were locatable during the follow-up phase of the investigation. 19 Limitations A portion of the present study was ex post facto in nature. That is, the actual gathering of pretest informa tion relating to the rubella children's developmental levels and the severity of their disabilities occurred prior to the design of the study. Causality Issue This investigation was conducted as a correlational study. This approach seemed justified because of the exploratory nature of the dissertation. Nevertheless, as is the case with most correlational studies, one must exercise caution in implying causation between two correlated variables. In this study, however, a special effort was made to control for possible competing variables so that possible inferences could be made between maternal attitudes and developmental growth. Arrangement of the Chapters Chapter II presents a review of the literature on the rubella child, the nature of the mother-child relationship, maternal and parental influences on cognitive, social and physical growth, research relative to attitudes characteristic of parents of severely handicapped children, and the feasibility of parental counseling as an avenue to possible attitude change. Chapter III puts forth the research design of the study, the competing variables to be controlled, the basic procedures used, the methods of analysis, and descriptions of the data gathering instruments and techniques. Chapter IV presents the research findings on the childrearing attitudes of rubella mothers, the develop mental growth patterns of rubella children, and the relationship between maternal attitudes and development in rubella deaf-blind children. Chapter V summarizes the study, enumerates the major findings and conclusions, and puts forth recommenda tions for future practice and research with rubella mothers and children. CHAPTER II REVIEW OF THE LITERATURE In reviewing the literature on the deaf-blind rubella child, one is initially impressed by the paucity of research that has been conducted in this area. In a survey of over ninety articles dealing with deaf-blind children, this writer found only a handful that could be considered empirical reports. The overwhelming majority of material written in this area has been based primarily on opinion or "observational" data. To provide the proper background and support for the present study, it was necessary to cover five general areas. The first two sections on maternal rubella and the deaf-blind rubella child were designed primarily to acquaint the reader with the rubella syndrome, the characteristics of the rubella child, and certain develop mental attributes found with this type of child. The third section, which deals with the relationship between the mother and the rubella child, was included in order to indicate the nature and importance of this relationship in the development of the rubella child. The last two sections, which relate to the influence of mothers' attitudes and behaviors on handicapped and nonhandicapped 21 22 children's development, were presented because of the virtual nonexistence of research available on the rela tionship between maternal attitudes and the development of rubella children. That is, an attempt was made to apply the research findings in these related areas to rubella children and their mothers. Maternal Rubella Much has been written in medical journals on the effects of rubella during the first trimester of pregnancy. Following Gregg's (1941) historic finding of the associa tion of maternal rubella and infant cataract, other researchers (Swan and Tostevin, 1946) drew attention to the relation of maternal rubella to congenital heart disease and to congenital deafness. As a virus, the agent involved in causing rubella has most of the characteristics commonly found in other viruses. Like most viruses, it obtains its nourishment from body cells. As many as 100 or more new virus parti cles often appear inside a cell originally infected with one particle only. These newly produced viruses then spread in the tissues of the body to infect more cells (Hillenbrand, 1956). Thus, within the infected pregnant mother there takes place a process of viral multiplication. This process often has serious consequences, since the virus may spread inside the infected person by circulating in the blood. If a viral infection occurs during early pregnancy, the virus may enter the blood, cross the placenta and settle in the tissues of the fetus (Alford, et al., 1964). The fetus may be so badly affected by this invasion of virus that it dies and an abortion takes place. On the other hand, the virus may fail to kill the fetus but may localize in certain specializing cells in the eye, ear, heart or brain. When this occurs there may be extensive tissue damage, thus producing birth defects of the eye, ear, heart or brain (Roy and Deutsh, 1966). The precise nature of the birth defects depends to some extent on the stage in pregnancy at which rubella occurs. Thus, if rubella occurs in about the sixth week, cataracts may develop in the unborn child's eyes (Swan, et al., 1943); or if in approximately the ninth week of pregnancy, deafness may develop (Manson, et al., 1969; Myklebust, 1960), Heart defects and dental deformations may result from rubella between the fifth and the ninth weeks (Rhodes, 1963) . It is in these critical weeks that the tissues destined to form the lens of the eye, the organs of the inner ear, the teeth and walls of the heart begin to develop. Mill and his associates (Stevens and Heber, 1964) have indicated that fetal defects occur in 50 percent of the cases where the mother contracted the disease in the 24 first month of pregnancy, 25 percent when the disease was contracted in the second month, 17 percent in the third month and none in the fourth month. Dr. Bradford Hill of London University has obtained similar percentages (Rhodes, 1963). Gesell and Amatruda (1962) have suggested that not only the timing of the infection, but also the severity of the infection appears to be of importance in determining the nature and severity of consequent anomalies. Since the present study was concerned mainly with rubella deaf-blind children, the most important aspects of eye and hearing defects will be described briefly. Eye defects.— The most common defect in the eye is a cataract or opacity of the lens, which causes complete or partial blindness. The opacities tend to be more often present in both eyes than in only one, and they are present at birth. Less common defects include squints and glaucoma (increased tension of the eyeball) (Weiss, et al., 1966). Also, since one eye may develop embryologically more slowly than the other, there will not necessarily be the same type or degree of damage to both eyes (Wagner, 1967). Deafness.— This defect is attributed to the effect of the rubella virus on the structure of the inner ear known as the organ of Corti (Gray, 1959). In about two of 25 every three rubella deaf children both ears are involved, but the hearing loss is often greater in one than the other. Fortunately deafness is seldom complete (Rhodes, 1963). Another interesting aspect of the rubella syndrome is the fact that the rubella virus has been found to survive in the defective offspring of the mother who initially contracted rubella. Menser, et al. (1967), have reported that they have isolated the rubella virus in cataractous material removed from the eye of a two year, eleven month old boy. Monif and Sever (1966) have reported that there seems to be chronic CNS infection, as evidenced by the presence of the rubella virus in the spinal fluid and brain tissues of children with the congenital rubella syndrome. The implication here is that although some defects may not be noticed at birth, damage may continue to occur from the virus. Virginia Guldager (1970) has stated that these factors may complicate estimates about the numbers of young children who are handicapped as a result of the rubella epidemic of 1963-1965 and smaller epidemics which occurred before and since that time. For many years it was felt that the only solution to the rubella problem was in the development of a safe and effective vaccine. Initial trials with live virus vaccines were unsuccessful because of the spread of the virus from 26 vaccinated subjects to susceptible contacts (Karelitz, et al., 1967; Plotkin, Cornfield and Ingalls, 1965). Early in 1965, however, Drs. Harry M. Meyer and Paul D. Parkman at the National Institutes of Health found a strain of rubella virus that protected monkeys without spreading to other animals. In October of 1965, human tests of the Meyer-Parkman vaccine were begun and eventually shown to be effective. By mid-1969, the federal government approved the placement of this rubella vaccine on the market (Edelson, 1970). Unfortunately, this vaccine has come too late to help the thousands of rubella victims of the 1963-1965 epidemic. Also, it will probably be several years before an effective immunization program is initiated. In this interim period, other deaf-blind children will no doubt be born as a result of maternal rubella. The Deaf-Blind Child Many attempts have been made to describe the effects of deaf-blindness on the child. These have ranged from unrealistic descriptions of the minimum effects on certain outstanding deaf-blind persons to the more pessimistic appraisals which stress the devastation of the deaf-blind disability. Helen Keller (1959) once described deaf- blindness as "a comparatively few people surrounded by a multitude of cruel problems" (p. 152). 27 Waterhouse (1957) pointed out there can be few complications more baffling than the combination of deaf ness and blindness. The deaf child who can see finds that he can substitute sight for hearing. The blind child who pays effective attention to sounds can acquire a "facial vision." But when both senses are so impaired as to preclude such substitutions, then problems associated with communication and mobility become intensely profound. As mentioned previously, not all deaf-blind children are totally deaf or totally blind. Dinsmore (1953) esti mated that only one-fourth to one-third of all deaf-blind children fall into this category. Others (Robbins and Stenquist, 1967? Waterhouse, 1969) have reported even a smaller proportion. It is currently impossible to state the total number of deaf-blind children in the United States. Lowenfeld (1968) was able to account for 240 deaf-blind children in his California survey. Over one-half of these children were of a preschool age at that time. The tiologies of deaf-blindness are various. In addition to maternal rubella which causes congenital defects, deaf-blindness has also found its origin in scarlet fever and meningitis. Another frequently reported etiology is retinitis pigmentosa, a disease which may occur later in the life of a child who has congenital deafness (Myklebust, 1966). Those children who are born with these 28 dual handicaps (via maternal rubella) have a much more difficult period of rehabilitation and education than those who were stricken later in infancy or childhood with a disease such as meningitis. The Deaf-Blind Rubella Child In addition to the aforementioned vision, hearing and heart defects characteristic of rubella children, other disabilities have been indicated. In their study of 271 abnormal rubella infants, Cooper and Frugman (1967) found that 109 of them exhibited psychomotor retardation. In the severe cases spastic quadriparesis and mental retardation were evident. Lowenfeld's survey showed that of 240 deaf- blind children, most of whom were postrubella, 68.8 percent were shown to be mentally retarded. Other writers (Plotkin, et al., 1967; Wagner, 1967; Waterhouse, 1967) have also indicated mental retardation to be characteristic of rubella children. Sheridan (1964), however, in investigating 227 rubella children between eight and eleven years of age, found a normal distribution curve on intelligence tests. She found no evidence for mental retardation as a common sequel of early maternal rubella. This disagreement may be due, in part, to the enormous medical and psychometric difficulties encountered by diagnosticians who must evaluate the mental capacities of these multi-handicapped children. Burns and Stenquist 29 (1960) have stated that it takes a skilled diagnostic team to differentiate mental defect from normal ability blunted by lack of experience. One of the most detailed investigations of the characteristics of rubella children was done by Robbins and Stenquist (1967). They studied 28 rubella children at the Perkins School for the Blind. Some of the character istics of these children were as follows: thinness, a bumpy nose with a deviated septum, delicate hands and feet, an almost fanatical obsession with light, a delay in physical progress, unusual pleasure in rocking, little interest in food, and difficulties with toilet training. Medical-physiological manifestations of the rubella syndrome include low birth weight, microcephaly, retino pathy, thrombocytopenic purpura, hepatomegaly, splenome galy, bone lesions, large anterior fontanelle, jaundice, cloudy cornea, general adenopathy, hemolytic anemia, cerebrospinal fluid pleocytosis, retarded growth, prematurity and abnormal EEG tracings (Cooper and Krugman, 1966; Giles, et al., 1965; Keir, 1965; Laguaite and Maurice, 1965; Manson, et al., 1960; Pitt and Keir, 1965a; Pitt and Keir, 1965b; Plotkin, et al., 1967; Rudolph et al., 1965). One of the few researchers that has described the behavioral characteristics of rubella children has been Guldager (1970). She indicated that the preschool children 30 in her study exhibited many bizarre types of behavior. As infants they often pulled away and screamed when held. As young children they banged their heads, pulled their hair and gazed at lights. It was Guldager's opinion that much of this behavior was done for the sensual pleasure that it gave. These children appeared to make a world of their own body and provided pleasure for themselves by stimulating their intact and residual senses. The rubella children's stereotyped movements and their inability to relate to people led Guldager to describe them as autistic. Development in Rubella Children Very little is known of, or at least has been written about, the development of the rubella child. To this writer's knowledge, there has been only one attempt made to survey his development (Robbins and Stenquist, 1967). In their study of 28 rubella children they obtained the following data on motor development: mean time lapsed before sitting up was 14.2 months, for standing was 22.1 months and for walking alone was 28.4 months.- Shirley (1933) has reported on the same motor behaviors for normal children and obtained for sitting, standing and walking alone, 7, 14 and 15 months respectively. In addition to the obvious delays in gross motor development, Robbins and Stenquist also concluded that delays in social and mental growth were characteristic. 31 They reported that of 26 children tested, the preponderance of IQ's on various intelligence measures were below 50. Waterhouse (1967) has stated that at the chronolo gical age of five, most rubella children have the social age of an infant. Mesheheriakov (1962) , who has laid down some basic concepts for teaching deaf-blind children, indicated that even with great potential the deaf-blind child will attain only the lowest levels of mental develop ment without specialized assistance. It should be noted that Waterhouse's and Mesheheriakov's statements appear to have been based on their clinical experience with deaf- blind children rather than quantitative research. When one begins to explore the reasons for the rubella child's limited growth, the most obvious explana tion appears to reside in the fact that his sensory handicaps are so great that he cannot receive the environ mental stimulation needed to develop properly. Piaget's theory of intellectual development seems to give credence to this idea. According to Piaget, intellectual growth occurs as an outgrowth of the interplay between the child's mental structures and the environment. Therefore, if the child is unable to assimilate his environment, he then in turn cannot make the proper accomodation and progress through the developmental scheme. Such seems to be the case with rubella deaf-blind children. They simply do not receive enough environmental stimulation for them to adapt 32 and grow cognitively in a normal way. Other supporting evidence for this hypothesis can be found in Vernon's (1966) work with perception and cognition, in which she emphasized how vital immediate sensory data is to cognitive growth. Miller (1969) in his study of visually impaired children concluded that on the basis of performance on conservation tasks, visually impaired subjects demonstrated a reasoning deficit of several years. Although it can only be speculatory at this time, it appears feasible that the rubella child's retarded cognitive and motor development may be due to two factors: (1) his lack of distal sensory stimulation, which in turn affects his ability to adapt, and (2) the possibility of congenital neurological damage which may lead to mental retardation. In the social-emotional area, the rubella child's bizarre, withdrawn and sometimes "autistic like" behavior may be due, again, to distal sensory deprivation and therefore the social isolation he suffer.". It also may be due to his inability to perceive social models and to learn social modes of behavior. No direct research, however, has been conducted in the social-emotional, cognitive or physical areas that would either confirm or refute these hypotheses. 33 The Mother—Rubella Child Relationship Almost all writers in the area of child growth and development acknowledge that there is a certain relation ship between maternal behaviors and developmental outcomes in children. In the same manner, those persons who have worked with deaf-blind children also seem to agree that parental behaviors in general and maternal behaviors in particular are crucial in the development of these youngsters. Salmon and Rusalem (1966) have stated that, "the literature stresses the vital role of the mother in the development of the deaf-blind child" (p. 44). The Royal National Institute (1961) recommended that only the mother should initially handle the deaf-blind child. The rationale behind this recommendation was that if only one person handled the child, the chances for a good relation ship and a consistent approach would be greatly increased. Giving birth to a deaf-blind child generally results in an enormous shock for the typical mother. It is, according to Robbins (1960), a traumatic experience for which parents are, most likely, neither emotionally nor intellectually prepared. Like parents of other severely handicapped children, parents of the deaf-blind child may have feelings of anger, guilt or frustration because of having produced a defective child. Guldager (1970) suggested that the mother may consciously or unconsciously 34 reject the deaf-blind child and thus offer a minimum amount of care. Luszki (1964) in his work with the retarded deaf child has pointed out that it is exceedingly important for the young deaf child to have contact with his mother for healthy ego and superego development. He has further stated, however, that the nature of deafness is such that it is likely to interfere with normal mother-child relationships. The child fails to respond in the expected fashion to the mother and the mother, through rejection or ignorance, reacts by failing to respond to the child in conventional ways. This type of situation may be true to an even greater degree with visually and auditorily handicapped infants. Influence of Maternal Attitudes and Behavior on the Development of Non-Handicapped Children As mentioned previously, because of the dearth of research available on the maternal childrearing attitudes of rubella mothers, one is forced to explore the same relationship between mothers and non-handicapped children to obtain information on this variation. More specifically, the review conducted in this section was considered worth while since it tended to lend more support to the importance of the mother-child relationship in the child's cognitive and social development. This survey also pointed 35 to the specific types of childrearing attitudes that have been found to stifle or facilitate developmental growth in children. In the past two decades the literature dealing with the consequences of maternal attitudes and behaviors on child development has concentrated on two major areas: the child's cognitive development and his social-emotional development. The present investigation also involves a third aspect, physical development. The literature pertaining to these three areas will be explored sequen tially. Cognitive Development Regardless of the specific type of childrearing practice employed, one fact does appear clear: if the child is to develop cognitively he will require at least a minimum amount of sensory stimulation. Studies previously reviewed as well as summaries by Casler (1961) and Yarrow (1961) emphasize this point. Childrearing practices become a critical variable when one begins to examine the quantity and quality of this stimulation. The now famous studies by Rheingold (1956), Skeels and Dye (1939) and Skeels (1966) on "maternal enrichment" as well as recent animal studies (Davenport and Rogers, 1968; Davenport, Rogers and Menzel, 1969; Menzel, Davenport and Rogers, 1970; and Rogers and Davenport, 1971) also give 36 support to this idea. Although there is now agreement on the child's need for stimulation, unfortunately there is less agreement on what childrearing attitudes and practice have the most beneficial influence on cognitive growth. An early article by Baldwin, Kalhorn, and Breese (1945) indicated that children reared in families characterized as "Acceptant-Democratic-Indulgent" showed higher IQ's and more favorable changes in IQ over several years than children from authoritarian and rejecting homes. Watson (1957) presented data that tended to favor the "permissive" home as one that stimulated intellectual activity of a better quality. In the same manner, Caldwell and Richmond (1967) have shown that mothers demonstrating "affiliative" (emotionally supportive) maternal behavior produced children with higher measured IQ's than mothers exhibiting less supportive behavior. Using black and white lower- class mothers as subjects, Radin (1971) found that maternal behaviors reflective of warmth correlated significantly and positively with the child's IQ. Drews and Teahan (1957) sparked a controversy when they found that high achievers tended to have been reared in families where adult standards were not questioned and where mothers were more "authoritarian and restrictive." In attempting to serve as mediator, Hurley (1959) re evaluated the Drews and Teahan data and pointed out that 37 although mothers of high academic achievers tended to be more dominant and ignoring toward their children, mothers of "gifted" (high Stanford-Binet IQ) children tended to be less so. In a study of 118 eight year old English children, Kent and Davis (1957) reported that children from "uncon cerned" homes had significantly lower IQ's than children from normal homes. The eight year olds in the Kent-Davis study who obtained the highest IQ's were from "demanding" homes. Freeberg and Payne (1967), in a review of the literature in this area, concluded: "Children of superior intellectual ability come from homes where parental inter est in their intellectual development is evidenced by pressures to succeed and assistance in doing so, particu larly in the child's verbal skills" (p. 71). Several studies have attempted to determine the effect of various childrearing practices on the development of differential cognitive abilities. Previous research has indicated that "democratic homes" (Baldwin, Kalhorn, and Breese, 1945) as well as "warm, positive family atmosphere" (Milner, 1951) have had a positive influence on the rate of growth of children's verbal ability. On the other hand, there has been some suggestive evidence that while such family conditions favor the development of verbal ability, they also may impede the development of non-verbal skills, such as numerical and spatial ability. Studies by Witkin 38 (1959) and Levy (1943) have purportedly demonstrated that such- childrearing practices as parental overlimitation, excessive control, and maternal overprotection favor verbal development but have a relatively less stimulating effect on non-verbal abilities. Most of these studies, however, have been correlational in nature and have not satisfac torily addressed themselves to the causality issue. It should be clear to the reader at this point that consistency and agreement are certainly not the earmarks of the research done on the influence of maternal and parental attitudes on children's cognitive growth. On the one hand some researchers have advocated democratic-permissive attitudes as being most beneficial to such development whereas others have purportedly shown that cognitive devel opment is enhanced more by demanding, autocratic attitudes and practices. It is this writer's opinion that the controversy remains unresolved and as such one can only speculate on the application of these research findings to the deaf-blind rubella child. Social-Emotional Development For several years it has been a fairly well accepted point of view that parental behaviors have a pervasive influence on the social-emotional growth of the child. Various theoretical frameworks have emerged in order to explain this relationship. Probably the one model of 39 parental behaviors that has most frequently appeared in the literature is the "loving, warm, affectionate" versus the "rejecting, cold, and neglecting" dimension of child- rearing (Becker, 1964; Roe and Siegelman, 1963; Roff, 1949; Schaefer, 1961; Sears, Maccoby, and Levin, 1957) . Relative to loving versus rejecting parental behaviors, researchers have found that the child who experiences the psychological pain of parental rejection tends to manifest signs of maladjustment (Medinnus, 1965), such as delinquency (McCord, McCord, and Howard, 1963), excessive anxiety (Siegelman, 1965), aggressive behavior (Kagan and Moss, 1962), inadequate self-concept (Medinnus, 1965) , and autism (Eisenberg and Kanner, 1958). In addition to the hostility-rejection dimension (also known as love-rejection or acceptance-rejection), another childrearing dimension has also gained attention— that of authoritarian-control (also referred to as control- autonomy, restrictiveness-permissiveness or dominance- submissiveness). Symonds (1939), in an early review of studies related to the dominance-submissiveness and acceptance-rejection model, concluded that children who were "accepted" appeared to show generally desirable personality characteristics whereas rejected children were reported to be more neurotic, rebellious and delinquent. For the best perspective of childrearing practices, one should view these two orthogonal dimensions as they 40 interact together. Schaefer's (1959) hypothetical cir- cumplex model for maternal behavior, discussed in Chapter I, reflects this interaction. Becker (1964), however, has probably produced the most comprehensive hypothetical model for parental behavior (Figure 1 in Chapter I). He arrived at this model through a series of factor analyses of studies on parental behavior. Using this theoretical model, Becker has skillfully summarized some of the salient research on the outcomes of parental behaviors when viewed from the two dimensions of warmth versus hostility and restrictiveness versus permissiveness. This summary appears in Table 4. Taken as a whole it would seem reasonable to assume that most childrearing specialists and researchers would probably agree that the parent with warm-permissive attitudes has the greatest chance of producing the socially outgoing, well adjusted child. In the same light, most investigators have been critical of the authoritarian parent. Read (1945), using an attitude questionnaire designed by Stogdill (1933), found that it was the children whose parents were more libertarian who were the better emotionally adjusted. Other workers (Baldwin, 1948; Gough, et al., 1950; Radke, 1946; Rosenthal, et al., 1959) also have obtained results which implied that children of authoritarian parents compared unfavorably with those whose parents were more permissive and democratic. |TABLE 4.— Interactions in the consequence of warmth vs hostility and restrictiveness vs I permissiveness Restrictiveness Permissiveness Submissive, dependent, polite, neat, Active, socially outgoing, success- obedient (Levy, 1943)_______ fully aggressive (Baldwin, 1949) Warmth Minimal aggression (Sears, 1961) Maximum rule enforcement, boys (Maccoby, 1961) Dependent, not friendly, not creative (Watson, 1957) Maximal compliance (Meyers, 1944) Minimal rule enforcement, boys (Maccoby, 1961) Facilitates adult role taking (Levin, 1958) Minimal self-aggression, boys (Sears, 1961) Independent, friendly, creative, low protective hostility (Watson, 1957) ^Neurotic" problems (clinical studies) Delinquency (Gluecks, 1950; Bandura and Walters, 1959) More quarrelling and shyness with peers (Watson, 1957 Noncompliance (Meyers, 1944) Hostility Socially withdrawn (Baldwin, 1949) Maximal aggression (Sears, 1961) Low in adult role taking (Levin, 1958) Maximal self-aggression, boys (Sears, 1961) i Reproduced from Becker in Hoffman and Hoffman (1964, p. 198) i 42 A primary question that was raised in the present study was what type of maternal childrearing practice would be most beneficial for the social growth of the rubella deaf-blind child. If one proceeded from data obtained on non-handicapped children, it would appear obvious that the deaf-blind child should be reared in an accepting (warm), submissive (permissive), non-authoritarian atmosphere. Yet it has been established that the deaf-blind child has a need for stimulation, control and guidance. This apparent conflict and its implications were matters which were considered in the present study. Physical Development In contrast to the two preceding sections on cognitive and social growth, there has been very little empirical research reported concerning the influence of specific maternal and/or parental attitudes on physical development. Breckenridge and Vincent (1960) have written that the emotional reactions of parents can impede motor development. For instance, they indicated that too great anxiety or overenthusiasm on the part of parents may make the child overly anxious regarding certain physical activities. This, in turn, may restrict the child's ability to actively explore his environment and thus impede his motor development. On the other hand, the authors 43 caution that some children may prove slow to develop motor skills because they have no need to get about, since everything is brought within their reach and they receive more reinforcement from the coddling than in the adventure involved in finding things for themselves. Gardner (1972), in a rather comprehensive article, describes the phenomenon of "deprivation dwarfism." Using a myriad of illustrations, he points out that when children are raised in emotionally deprived environments they may become physically stunted. In general it would appear that with the obvious exception of extreme cases of rejection, deprivation or overprotection, the issue of specific parental attitudes and physical development seems to be an open one. Maternal Attitudes and Their Effects on Severely Handicapped Children It was assumed that by surveying the available research on the influence of childrearing attitudes of mothers of severely handicapped children, some possible insights might be arrived at regarding the relationship between rubella mothers and the development of their children. The basic assumption being made here was that rubella mothers and mothers of other severely handicapped children (i.e., severely retarded children) may have similar reactions, influences and feelings toward their children. In this section an attempt was made to answer 44 two basic questions: (1) What reactions and attitudes do mothers of the severely handicapped have toward their children? and (2) What effect do these attitudes have on severely handicapped children? Maternal Attitudes Toward the Severely Handicapped Child In a study by Cook (1963), 178 mothers of blind, deaf, mongoloid, cerebral palsied and organically impaired children were administered the Parental Attitude Research Instrument. According to Cook the most authoritarian attitudes were shown by mothers of blind children, followed by mongoloid, cerebral palsied, deaf and organically impaired. He suggested that the extent of the perceived inadequacy of a child may well be a determinant of strong attitudes of authoritarian control on the part of the mother. The present study was interested in finding whether rubella mothers tend to exhibit extremes of authoritarianism. Other evidence has been produced that has also indicated that mothers of handicapped children have attitudes that differ significantly according to the type of disability in question. Ricci (1970), in a well controlled study, used the PARI to determine the child- rearing attitudes of mothers of retarded, emotionally disturbed, and normal children. Very significant results were found between the three groups on not only the 45 authoritarian-control dimension but also on the hostility- rejection dimension. Mothers of mentally retarded children tended to have punitive attitudes, while mothers of emotionally disturbed children had rejecting attitudes. Mothers of normals were found to be somewhat overprotec- tive. Boles (1959) performed an often quoted study on the personality characteristics of mothers of cerebral palsied chidren. He found that mothers of cerebral palsied children were significantly more overprotective and experienced more marital conflict than mothers of non handicapped children. No significant differences were found with respect to anxiety, guilt or rejection. Levy (1943) has found the condition of maternal overprotection to be rather typical of the relationship of mothers with deformed or defective children. In the same manner, Imamura (1965) has found that the one outstanding charac teristic in the mother-blind child relationship is succorance, and the fostering of succorance by the mother. Parental and Maternal Attitudes and Their Effect on the Handicapped Child Hurley (1967) has stated that "it seems widely accepted that rejecting or hostile parental behaviors adversely influence children's adjustment. . ." (p. 199). In light of Hurley's statement it is interesting to examine 46 what research findings have indicated relative to the acceptance-rejection dimension of childrearing as it pertains to handicapped children and their parents. Farber and his associates in their classic studies of the 1960's (Farber, 1968; Farber and Jenne, 1963; and Farber and Ryckman, 1965) strongly acknowledged the "crisis" which occurs in the family having a retarded child and the resulting adverse effects on the family members, as well as their attempts to deal with the "crisis." Badt (1957) Kvaraceus (1956), and Peck and Stephens (1960) have suggested that mentally retarded children are less favorably rated and frequently rejected by their parents. Grebler (1952) has demonstrated that the more difficulties parents have in accepting their mentally retarded child, the harder it will be for the youngster to accept himself and make proper social adjustments. Worchel and Worchel (1961) found that parents rated retarded children significantly less favorably on a set of personality traits than normal children. These authors stated that the implications of parental rejection of retarded children were clear and the adjustment of the retarded child would be facilitated if parents could accept this type of child more positively. In support of Worchel and Worchel's point of view was Self (1970), who found a low but significant correlation between parental acceptance and the adjustment of mentally retarded children. Weslund and Palumbo (1956) have studied parental attitudes in parents of crippled children. They noted an increase in parental rejection of the child as the severity or chronicity of the debility increased. This study would seem to have serious implications for the deaf-blind child who represents one of the extremes of all possible disabilities. Almost all studies done on the influence of parental and maternal attitudes on the handicapped child have been done on the hostility-rejection dimension. These studies almost universally show that when the handicapped child is rejected, his development tends to be impaired. Unfor tunately, research dealing with the authoritarian-control dimension has been sparse. Although certain studies have been done that indicate mothers of handicapped children differ on the authoritarian-control dimension when: compared to mothers of normal children, little has been done to demonstrate what the influence of such childrearing attitudes is on the development of the child. Probably the only study to date that has dealt with this problem in any way has been Jordan's (1961). Using the PARI, Jordan correlated the attitudes of mothers with the IQ's (WISC) and SQ's (Vineland Social Maturity Scale) of their retarded children. His results clearly indicated the difficulty one encounters in attempting to relate single dimensions of 48 maternal behavior to such complex variables as intellectual or social growth of a retarded child. However, when Jordan combined groups of dimensions, more significant results were obtained. The correlations between groups of dimensions and the IQ's and SQ's appear in Table 5. TABLE 5.— Multiple correlations of PARI scales against IQ and SQ PARI Scales IQ SQ Scales 14, 17, 5, 20, 15 .5529 - Scales 21, 17, 9, 5, 7 - .6570 Scales 4, 5, 8, 10, 11, 15, 22 (Excessive Demand for Striving) - .3929 Scales 5, 12, 2, 20, 18 (Over-Possessiveness) — .5619 Taken from Jordan (1961). The significance of Jordan's study was that it demonstrated that maternal childrearing attitudes were associated to some extent with the mental and social growth of handicapped children. His study was also a possible demonstration of the relevance of the PARI for research on child growth. The drawbacks in his investigation were that (1) he did not combine all of the scales on the two major factors or dimensions (authoritarian-control and hostility-rejection); and (2) he did not control for 49 possible confounding variables such as mother's education that may have been correlated with both maternal attitudes and the child's IQ and/or SQ, and he did not control for possible response sets of the mothers who were administered the PARI. In the present study an effort was made to control for possible confounding variables through a step wise correlation analysis in which these variables were partialed out; also an attempt was made to control for the acquiescence response set on the part of the mothers. Counseling Parents of Handicapped Children Ramsey <1967), in a review of group methods with parents of mentally retarded children, reported that through group processes improvement was made in such areas as attitudes toward the child, childrearing practices, and ability to handle the child. In a study to determine the effectiveness of a series of parent discussion groups with regard to the attitudes toward mentally retarded children, Bitter (1963) concluded that group sessions were a successful means of changing parental attitudes toward mentally retarded children. Appell et al. (1964), found that parental group counseling resulted in a better understanding and acceptance of the retarded child's condition and a general elevation in the parents' level of optimism. After reviewing pertinent research related to the counseling of parents of retarded children, Cummings 50 and Stock (1962) concluded that the need for group therapy was substantial and was likely to increase. Summary and Conclusions Empirical research on deaf-blind rubella children has been, heretofore, extremely sparse. The rubella child is frequently born with a multitude of handicaps such as cataracts, deafness, heart defects and possible mental retardation. Although little is known about his develop ment, observation of the rubella child has pointed to his excruciatingly slow growth in the physical, social and intellectual areas. In addition to retarded development, some writers have noted his sometimes bizarre and autistic like behavior. Most authorities agree that the child's need for stimulation is one of the most critical variables in his cognitive and social development. Because of the rubella child's handicaps, his need for stimulation may be greater than for any other type of child. Some writers have indicated that the mother appears to be the key factor here, since she must assume the major responsibility for his care. However, the birth of a deaf-blind infant is usually a traumatic experience for the mother and may give rise to feelings of guilt and hostility on her part. The rubella child's handicaps prevent him from relating properly to his mother. These difficulties in the mother- 51 rubella child relationship may influence the mother's childrearing attitudes and approaches. Studies on childrearing attitudes have identified two basic orthogonal dimensions: (1) hostility-rejection, and (b) authoritarian-control. These dimensions are reflected in the design of the PARI. Research on the mothers of non-handicapped children give few clues as to which childrearing attitudes would be most beneficial for the development of the rubella child. Studies in this area seem to indicate that maternal attitudes do influence the cognitive and social growth of the child. These studies do not agree, however, on which specific childrearing attitudes have the most positive effect on cognitive development. Relative to social development, democratic-permissive attitudes appear to have the most salutary influence. Research on the interaction of physical development and specific childrearing atti tudes is virtually non-existent. A significant characteristic of the literature on the relationship between childrearing and development is that* most of it has been of a correlational nature. As such, one must be somewhat suspicious of the causality implied between the two variables. Although the present study was also correlational, it differed from previous investigations in that a special effort was made to control competing variables so that possible inferences could be made. Research in the area of the severely handicapped child indicates that the mother may have attitudes which are quite different from those found in mothers with normal children. Their attitudes tend to be more authoritarian than those of mothers with non-handicapped children. In light of the deaf-blind child's need: for control and guidance, it appeared conceivable that authori tarian attitudes may be the most beneficial in facilitating his development. Studies on the severely handicapped child have also pointed to the adverse effects of rejecting attitudes. Finally, research on the use of parental counseling with parents of handicapped children has indicated the efficacy of this approach in dealing with problems of attitudes and rearing practices. The use of parental counseling with mothers or rubella children as an avenue for attitude formation and/or change appeared plausible. CHAPTER III RESEARCH METHODOLOGY Research Design The basic purpose of this study was to determine what relationship exists between the maternal childrearing attitudes of rubella mothers and the amount of develop mental growth made by their deaf-blind children. It was also the purpose of this investigation to ascertain what attitudes were typical of the mothers and what develop mental growth patterns were characteristic of their rubella children. To obtain characteristic developmental growth patterns of the rubella sample, it was necessary to gather pretest data on their PAR performances (July, 1969 to December, 1971) in an ex post facto manner from the records at the DSNHC. During the posttest phase (July, 1972 to October, 1972) PAR measures were derived from individual interviews with the rubella mothers. The PAR is designed in such a way that it may be scored from information obtained from someone close to the child, such as the mother. Thus, the purpose of the pretest PAR was simply to establish a base to determine the amount of growth rubella children make over a specified length of 53 - ■ ■ 54 time in the physical, social and intellectual areas. Also during the posttest phase, in addition to being administered the PAR, each mother was individually given the PARI as a means of obtaining some idea of her child- rearing attitudes. The relationship between the mother's attitude and the developmental growth of her child, then, was derived from correlating her PARI scores (Independent Variables) with the posttest PAR scores (Dependent Variables). More specifically, this relationship involved the correlation of the 13 scales, four subfactors and two factors of the PARI with the posttest PAR eight subtests, three major areas and the total attainment age. Thus, there were a total of 19 independent variables and 12 dependent variables. Furthermore, the best combination of four predictors or PARI scales were obtained for each dependent variable. That is, the data were allowed to "float" in the computer so that for each dependent variable the best combination of four predicting PARI scales were obtained. This combination, taken as a whole, was then correlated with that particular dependent variable. For example, for the dependent variable "Ambulation," the best combination of scales might be "Fostering Dependency," "Strictness," "Breaking the Will" and "Intrusiveness." This combination, then, would be correlated with "Ambulation" to obtain a 55 multiple regression coefficient. Possible Competing Variables When one attempts a correlational study, he almost always runs the risk of having his research interpretations confounded by competing variables. That is, when the independent variable (maternal childrearing attitudes) is correlated with the dependent variable (developmental growth in deaf-blind children), there is the possibility of one or more variables being correlated with both the independent and dependent variables. If such a situation arises, interpretation of the relationship between the independent and dependent variables is made most difficult. There is a statistical technique, however, for overcoming this difficulty. Through the use of a stepwise correlation analysis (Afifi and Azin, 1972) competing variables may be partialed out or their influence removed as the independent and dependent variables are correlated. In this study there appeared to be four possible competing variables: 1. Intelligence level of deaf-blind children. Because of the possible relationship between the deaf-blind child's intellectual level and the intellectual subtests of the PAR (Information, Ideation, and Creativity) and because certain investigators (Kenny, 1967) have indicated a relationship between maternal attitudes and the IQ level of 56 the child, intelligence level appeared to qualify as a possible competing variable. Each child's intellectual level was estimated from the psychologist1s evaluation at the Diagnostic School for Neurologically Handicapped Children (DSNHC). The following classification scheme, adopted from Wechsler (1949), was used: Estimated IQ Classification (6) 120 and above Superior (5) 110-119 Bright Normal (4) 90-109 Average (3) 80-89 Dull Normal (2) 70-79 Borderline (1) 69 and below Mental Defective 2. Severity of the deaf-blind child's handicap. Obviously, the more severe the child's degree of deafness and blindness, the smaller the expected gain will be in developmental growth. Westlund and Palumbo (1956) have noted in their studies of the handicapped child that parental rejection appears to increase as the severity and chronicity of the disability increases. The severity of the child's auditory and visual deficits appeared to be a plausible competing variable. 2(a). Hearing loss. Information on the degree of hearing loss was obtained from the audiologist's evaluation done at the DSNHC. The following classification scheme, developed by Streng, et al. (1958), was employed: Classification of Hearing Loss_____ Behavioral Description 57 (5) Mild (20-30 db) (4) Marginal (30-50 db) May have difficulty in hearing faint speech at a distance. Can understand average con versational speech at a distance of 3 feet. (3) Moderate (40-60 db) Can understand loud conver sation at about 3 feet. (2) Severe (60-75 db) May be able to hear moderate voice at several inches from ear. (1) Profound (75 db +) May hear loud shout one inch from ear to no response at all. 2 (b). Visual loss. The degree of visual deficit was acquired through a review of the pediatrician's or opthalmologist's report made at the DSNHC. For purposes of classification, an adaptation of the California State Department of Education (1970, 1971) scheme was used: Classification of Visual Loss______ (3) Mild (2) Moderate (1) Severe Behavioral Description Central visual acuity of better than 20/70 in the better eye with correcting glasses. Central visual acuity between 20/70 and 20/200 in the better eye with correcting glasses. Central visual acuity of 20/ 200 or less in the better eye with correcting glasses. 58 3. Mother's level of education. Schaefer and Bell (1958) have found low negative correlations between PARI scales and educational level of mothers. There also seems to be evidence of a low correlation between cognitive as well as personality development in children and the educational levels of their parents. It was possible to use a classification scheme with each of the four variables in such a way that each subject could be categorized and assigned an ordinal ranking or number on each variable. For instance, each rubella child would receive a score of one to six on the intelligence variable, one to five on the hearing loss variable and one to three on the visual loss variable. These quantitative values were then correlated with the independent and dependent variables and partialed out. This made possible the obtaining of multiple partial correlations between the independent and dependent variables. Methods of Analysis To ascertain what developmental growth patterns were characteristic of deaf-blind rubella children, means and standard deviations for the differences between the pre and posttest PAR'S were obtained. That is, growth gains in the physical, social and intellectual areas are demonstrated through the use of simple descriptive statistics. 59 Childrearing attitudes typical of rubella mothers were also exhibited through the use of descriptive statistics. Means and standard deviations for the scales, subfactors and major factors of the PARI were presented in both tabular and graphic form (Chapter IV). To determine whether there were significant rela tionships between the factors, subfactors, scales and combination of scales of the PARI and the categories of the PAR, it was necessary to utilize a stepwise correlation analysis so that the four competing variables could be partialed out. More specifically, through this procedure, each dependent variable was correlated with a set of independent variables. Intelligence was partialed out in step one, in step two visual loss was partialed out, in step three hearing loss was partialed out, and in step four mother's education was partialed out. It was at this point that multiple partial correlations, along with their corresponding F ratios, were made available for purposes of interpretation. Relative to correlation of the combination of scales of the PARI and the various areas of the PAR, multiple regression coefficients and F ratios were obtained. Because of the somewhat exploratory nature of this study, the level of significance for the multiple partial correlations was set at .10. It was felt that having an alpha level as high as .10 was justified since the "power" 60 of the statistical test would be increased and the Type II error rate decreased. In an exploratory investigation the emphasis most often is focused on the prevention of a Type II error. The data were keypunched on IBM cards and analyzed through the use of an IBM 370, Model 155 computer at the University of Southern California Computer Facility. The Sample The Rubella Children The research sample for this study was obtained from the Diagnostic School for Neurologically Handicapped Children (DSNHC). Since 1969 there have been 125 deaf- blind children diagnostically evaluated. Of these, 96 were identified as being rubella children. Lowenfeld (1968), in what was purported to be a comprehensive statistical survey conducted for the California State Department of Education, could identify only 92 preschool deaf-blind rubella children in the entire state. Since the number of children evaluated at the DSNHC was greater than this total, it would appear that these 96 children were not only a representative sample of rubella children in Southern California, but probably approached the population of such handicapped children in this area. The research design required that four criteria be 61 met in order for any particular subject to qualify as a legitimate member of the research sample. The four criteria were as follows: 1. The rubella child must have been administered a PAR during the pretest phase of the study. 2. The subject must have lived at home with his mother on a full-time basis. This would exclude those rubella children who received residential care either on a part-time or full-time basis. The rationale for this criterion is that the thrust of this study was aimed at making inferences about the influences and interactions between rubella children and mothers who must care for and deal with their children on a daily basis. 3. The mother of the rubella child must have been capable (i.e., mentally and/or linguistically) of giving valid responses during the posttest interview phase of the study. 4. The subject must have been locatable in order that posttest data could be obtained. Thus, of the initial subject pool of 96, a final research sample of 50 subjects were obtained by the following elimination process: 96 - Initial subject pool -19 - Rubella children who did not have pretest PAR'S “ 77 62 - 9 - Rubella children receiving residential care ZS - 1 - Rubella child who lived with the mother only part Z T of the week and not during the summers - 1 - Rubella mother who spoke only Spanish; the data gathering instruments could not validly be 66 transplanted -16 - Rubella children who were unlocatable for post- 5TF test interview purposes The possibility of some sample bias resulting from the elimination process should be noted. It is within the realm of possibility that a biased research sample could have resulted due to the fact that 46 children not included in the sample could have represented a somewhat different group. However, a survey of the intellectual estimates, and the visual and hearing handicaps of the 46 children not in the study revealed that they closely resembled the research sample. Age. Virtually all of the 50 children in the study were handicapped due to the 1965 rubella epidemic and accordingly were approximately the same age. At pretest ing the mean age for the sample was 53.42 months, with a standard deviation of 13.75 months. At posttesting the mean age was 71.54 with a standard deviation of 13.69. In other words, the subjects were relatively homogeneous in terms of age. Sex. The sex distribution was almost equal. There were 24 boys and 26 girls. 63 Description of handicap. Three major areas of handicaps were surveyed at the time of pretesting. These involved the intellectual area, the extent of the visual deficit and the extent of the hearing loss. The methods of classification used for the three areas were identical to those described on pages 55-58. 1. Intellectual.— From a review of the psychometric devices administered at the DSNHC and the psychologist's written observations of the child, each child was sub jectively placed by this writer in one of the six categories described on page 57 and assigned an appropriate numerical score of one through six. The actual data on the rubella children were gathered by highly skilled psycholo gists with several years of experience evaluating multiply handicapped children. Their reports were in a rather standardized form which allowed this writer to reliably classify the subjects into the various categories. The mean categorical score for the sample was 1.86, with a standard deviation of 1.33. More specifically, 68 percent of the rubella children were in the "mentally defective" range, 4 percent in the "borderline," 2 percent in the "dull normal," 26 percent in the "average," and none were in the "bright normal" or "superior" ranges. Taken at face value, the majority of rubella children were functioning intellectually in the defective range. However, it is important to understand in assessing these percentages 64 that even though conventional psychometric instruments were used to obtain these estimates, conventional interpreta tions are more or less invalid for this population. Also, these categories are indicative of only the present functioning level of the child in comparison with the "normal" population. Therefore, one should not misconstrue from these data that rubella children are characteris tically defective in intelligence. Certainly a more appropriate and profitable manner to assess their capabilities would be to evaluate them in terms of developmental status, which was done in this study and reported in detail in Chapter IV. However, because of the statistical necessity to partial out the influence of intelligence on the correlational data, it was required that some ordinal scheme be used to classify the subjects in a general way. 2. Visual deficit.— The three point ordinal scheme referred to on page 57 was used to classify each of the rubella children. A numerical score ranging from one to three was assigned to each subject, depending on the degree of visual loss. The mean score for the sample was 1.56, with a standard deviation of .81. The relatively high standard deviation indicated a great deal of variability among the rubella sample relative to this variable. The actual breakdown of scores was as follows: 64 percent had a "severe" loss, 16 percent had a "moderate" loss and 20 65 percent had a "mild" loss. Only one had vision that approached complete normality. In general, the majority of subjects were considered to be legally blind at the time of pretesting. 3. Hearing loss.— The classification scheme described on page 57 was utilized to categorize each of the subjects in terms of hearing deficit. As was done with the two preceding variables, an ordinal value was assigned to each subject depending on the extent of his hearing loss. With a possible range of one to five, the mean sample score was 2.38 and the standard deviation was 1.31. Once again the variability among the rubella children with regard to this disability was great. Taking the 50 sub jects as a whole, 26 percent had a "profound" loss, 42 percent had a "severe" loss, 14 percent a "moderate" loss, 4 percent a "marginal" loss and 14 percent had a "mild" loss. Only two of the subjects had hearing that approached complete normality. In a general sense, most of the rubella children in the sample had severe hearing losses. Education— training. At the time of the initial diagnostic evaluation at the DSNHC, 86 percent of the rubella sample were already in some type of special educational or training program; 14 percent were in no special program. In the period between pre and posttesting, 60 percent of the sample made no shift in their education 66 program (school), 32 percent made one shift, and 8 percent made two shifts to other programs. The mean period ! i ! between pre and posttesting was 21 months. At the time of |the posttesting 100 percent of the rubella sample were in j isome type of special education program. Most of the sample ! were in programs specifically designed for the deaf-blind. j I Others were in multihandicapped classes, classes for the deaf and hard of hearing, classes for the blind, and a few j miscellaneous special education categories such as cerebral j palsy. It is interesting to note that the 50 rubella children in the sample attended 29 different educational | : 1 ^facilities. The East San Gabriel Valley School for ; i Multihandicapped Children had the greatest number with : . I nine. i : t Summary. To summarize, most of the rubella child- j | fen, taken as a unit, were functioning intellectually at a j ' i ■"defective" level (relative to conventional norms) . Also, the majority were considered legally blind, had severe j hearing losses, and were in special education programs for j handicapped children. Variability among the rubella sample ; I j with respect to the specific handicaps was also a \ characteristic of this group. This is one reason why it may be erroneous to speak of the "typical" rubella child. i i i 67 The Rubella Mothers | The 50 rubella mothers in the sample were, of |course, derived from the corresponding sample of 50 rubella |children. Of the 50 in the group, 86 percent were natural ; ; mothers, 8 percent were foster mothers and 6 percent were ! grandmothers. In terms of the years spent with the rubellaj ! i ;children and the closeness of the relationships involved, j I there was little doubt that the foster mothers and grand- j pothers could be considered the effective mothers for each j of the seven children in these categories. ! j Age, The mean age for the mothers at posttesting j i was thirty-six years, six months, with a noticeable | j i standard deviation of eight years, eight months. The j i I particular age group clusterings were as follows: i Age in Years Percentage ! 20-29 28 30-39 36 40-49 26 50-59 8 60-69 2 i | Socioeconomic status. Relative to socioeconomic ! {status, an attempt was made to classify each mother in very! j i ; i igeneral terms, based on the parents' educational and | ! i 'occupational backgrounds and on the location and apparent i jvalue of their home. A six category classification scheme, jsomewhat patterned after Warner's (1949) was employed. The specific socioeconomic breakdown of the sample was as 68 follows: Social Class Status Percentage Lower-lower class Upper-lower class Lower-middle class Upper-middle class Lower-upper class Upper-upper class 2 25 42 24 2 0 Ethnically speaking, 76 percent were considered of European descent, 16 percent of Mexican descent, 6 percent black and 2 percent Polynesian. occupation and education the 50 mothers comprised a fairly homogeneous group. The following occupational analysis indicates that almost all of the sample were housewives at the time of pretesting: Clerk 1 Part-time clerk 1 Grocery checker 1 Child attendant 1 School bus driver 1 Vocational nurse 1 Registered nurse 1 College student 1 The mean number of years completed in school was 12.02, with a rather small standard deviation of 1.73 grades. Of the total group 22 percent had less than high school educations, 52 percent were high school graduates, 22 percent had some college education, and 4 percent were college graduates. Educational and occupational status. In terms of Occupational Group Housewife Frequency 42 69 Mother's opinion of child's educational program. As part of the interview survey, each mother was asked to give her opinion of her child's current educational-training program. Although this information was not related to any of the study's hypotheses, it was believed that it might be helpful to those professionals engaged in training programs for rubella children. Each mother's opinion was classified into three general categories. If her state ments were positive, her response was rated "favorable"; if her response had both positive and negative elements, it was rated "mixed"; and if her statements were negative, her response was rated "unfavorable." The following breakdown depicts the mothers' overall feeling of satisfaction with their children's educational programs: Opinion Percentage "favorable" 82 "mixed" 12 "unfavorable" 6 Summary. Briefly recapitulating, the overwhelming majority of mothers in the sample were natural mothers, housewives, high school graduates, representing a diversity of social stratification, and holding favorable attitudes toward their rubella children's educational programs. Procedure It is the current practice of most parents of rubella deaf-blind children to commute to a central location for diagnostic evaluations of their children. Many such parents living in Southern California (San Luis Obispo to San Diego) have taken their children to the Diagnostic School for Neurologically Handicapped Children (DSNHC), located in Los Angeles. At the diagnostic school, deaf-blind children are given complete evaluations by a pediatrician, audiologist, psychologist, and special education teacher. The assessment of any particular child takes approximately one full week. At the end of the assessment period the diagnostic team meets to discuss their findings. Thereafter a conference is held with the parents and recommendations are made regarding further treatment and educational placement. The pretest PAR data, as well as information regarding the severity of handicap and other demographic data related to the rubella children and their mothers, were obtained from the case records of the DSNHC. All pretest PAR's, except for three, were administered by two credentialed school psychologists with several years of experience in dealing with exceptional children. The data on the specific handicaps were initially gathered by highly experienced pediatricians, opthalmologists and audiologists. Of the initial subject pool of 96, 76 subjects (mother-child sets) appeared to be viable for the purposes set forth in this study. 71 Each of the 76 rubella mothers was sent a letter (see Appendix) from the DSNHC explaining the purpose of the study. Of this number, 50 rubella child-mother sets meeting the sample criteria were finally located. Each was contacted by telephone and asked permission for approximately a two hour interview concerning their child's developmental progress since leaving the DSNHC and what some of their views were regarding the rearing of their child. None of the mothers refused to be interviewed and all were most cooperative in giving their time. All interviews were conducted in the mother's home and by one of two interviewers. One interviewer, the present writer, was a school psychologist with five years experience in working with exceptional children and their parents. The other interviewer, his wife, was a social worker for six years with experience in the area of child welfare. Each interviewer was thoroughly familiar with the instruments and procedures involved so that the inter viewing process was as standardized as possible. During the months of July, August, September, and October, 1972, the 50 interviews were held. Geographi cally, the subjects were located throughout the Southern California area: in Los Angeles, Orange, Riverside, San Bernardino, Ventura and San Diego counties. Each mother was initially administered the posttest PAR to determine her child's current developmental status. Thereafter she 72 was administered the PARI which was tape-recorded to insure standardization. Her responses were made on an IBM answer sheet. Finally, each mother was asked about her child's educational experiences, what programs he had attended since being evaluated at the DSNHC, and her opinion of the relative effectiveness of her child's current program. All mothers were told that their individual responses would be held confidential and that the overall results of the study would be made available to them upon the completion of the investigation. The data were then tabulated and programmed for computer analysis. Data Gathering Instruments Parental Attitude Research Instrument The original PARI is a Liker-type instrument that evaluates the attitudes of parents toward childrearing. The PARI was developed by Schaefer and Bell (1958) and follows the format of prior scales by Mark (1953) and Shoben (1949). It uses rather generalized third-person statements about childrearing such as "Children who are troublemakers have most likely been spanked too much." Through conceptual analyses and traditional item selection procedures, Schaefer and Bell obtained twenty-three homogeneous scales, each measured by five items, so that the total number of items is 115. The twenty-three scales 73 are entitled: encouraging verbalization fostering dependency seclusion of the mother breaking the will martyrdom fear of harming the baby marital conflict strictness irritability excluding outside influences deification suppression of aggression rejection of homemaking role equalitarianism approval of activity avoidance of ommunication inconsiderateness of husband suppression of sex ascendence of the mother intrusiveness comradeship and sharing acceleration of development dependency of the mother Each item is answered in one of four ways: strongly agree, mildly agree, mildly disagree, or strongly disagree. Factor analysis of the PARI. Factor analyses by Zuckerman, et al (1958), and Schaefer (1961) have indicated the presence of two major factors. The two factors have been labeled by Schaefer and Bell as "approval of maternal control of the child" and "approval of maternal expression of hostility." Zuckerman, et al., named the first factor "authoritarian-control" and the second factor "hostility-rejection." A third dimension termed "democratic attitude" was also found by Schaefer and Bell (1958) and Zuckerman, et al. Reliability, In order to establish the reliability | of the PARI, the authors applied Kuder-Richardson formula ;20's to each of the 23 scales. The K-R20 coefficients j :ranged from .40 to .77, with a median coefficient of .68. j I It must be noted, however, that it is confusing to this !writer how Schaefer and Bell derived K-R20 coefficients : since the PARI is a Likert-type scale? and one of the basicj i i assumptions of a Likert-type scale is that the items be | scored one or zero— this would appear impossible because ;each item on the PARI is generally scored 1, 2, 3 or 4. j I ;This criticism of Schaefer is not necessarily crucial, ; j : however, since others (Zuckerman, 1959) have established I 1 the reliability of this instrument through more appropriate! : i I procedures. Zuckerman's approach will be dealt with in j : | ;more detail when the modified form of the PARI is j :discussed. j ; ! I j Validity. The most extensive studies on the PARI ! i ihave been done by Zuckerman and his associates. Zuckerman i | | ! and Oltean (1959) examined the validity of the PARI by j j j I correlating it with the Edwards Personal Preference i Schedule (EPPS), and the F scale. Three samples were usedsj ia group of 60 female acute psychiatric patients (most of | i I | them mothers), 24 mothers of college students, and 88 j ! ! unmarried student nurses. The F scale was found to | correlate .51 with the PARI authoritarian-control factor j 75 in the patient group and .61 in the student nurse group. Zuckerman, Norton and Sprague (1958) have indicated, however, that the correlation of .61 was reduced to .44 when one partialed out the effects of the "acquiescence- response set" (to be discussed in the following section). When the PARI and the EPPS were compared, it was found that a number of EPPS variables showed significant relations to the hostility-rejection factor of the PARI for the mothers of students but not for the student nurses. For the mothers' group, those having highly rejective attitudes on the PARI tended to score high on achievement and aggression, and low on nurturance and affiliation. In the patient population, the authoritarian-control factor was found to be related to the MMPI Masculinity-Feminity Scale (r = .56). Patients with authoritarian childrearing attitudes tended to score higher on the masculinity side. The hostility-rejection factor was found to be related to pathological tendencies on the MMPI. For instance, relationships to variables on the psychotic triad (Pa, Pt, Sc) were particularly high. While these results generally give support to the construct validity of the PARI, in the sense of its correlation with other measures of similar meaning, Becker and Krug (1965) have pointed out that what was being related were self-reports from one instrument to self-reports from another instrument. They have cautioned that with self-report measures, possible response sets of 76 the subjects could be a contaminating influence, such as was demonstrated by the Zuckerman, Norton and Sprague study mentioned above. Nevertheless, it should not be over looked that the previously presented factor analysis studies all demonstrated various factor loadings on the various dimensions. These cluster analyses of the PARI undoubtedly insure at least some degree of construct validity for the attitudes which are measured. Criticism of the original PARI. One of the major criticisms of the PARI made by Becker and Krug was that the PARI seemed to be sensitive to educational influences and readily reflected differences in educational levels. Studies by Schaefer and Bell (1958), Kitane (1961) and Zuckerman, Barrett and Bragiel (1960) have supported this criticism. However, since mothers' educational level was identified as a competing variable and partialed out in the present study, this criticism of the PARI would not apply. Another criticism of the PARI was that it did not control for the "acquiescence response set" (Becker and Krug, 1965; Zuckerman and Norton, 1961; Zuckerman, Norton and Sprague, 1958). The acquiescence response set is the tendency for the respondent to agree with positively stated items. For example, with an acquiescence response set a respondent would have a tendency to agree with the fol lowing statement because of its positive nature: "A good 77 mother should shelter her child from life's little difficulties." In all fairness to the designers of the PARI, they conceived of their scale as a preliminary, broad-banded research instrument and not a finished product. Schaefer and Bell acknowledged that in its original form the PARI was influenced by an acquiescence response set. A Modified Form of the PARI Zuckerman (1959) developed a modified form of the PARI designed to control for the acquiescence response set. Zuckerman's approach was to take the original items on the PARI and reverse them. For instance, the reverse of the above item concerning a good mother sheltering her child was "A good mother lets her child learn the hard way about life." By administering both items the examiner is able to obtain a more accurate measure of the content of an item rather than having the item influenced by an acquiescence response set. Of the 23 original scales, the 13 scales recommended by Zuckerman were used in this investigation. One of the basic reasons for the selection of these scales was their high loadings on the two major factors. Based on factor analytic studies by Zuckerman, et al. (1958), and Schaefer and Bell (1957), the various factor loadings are presented in Table 6. It should be noted that the 78 TABLE 6.— Selected scales and factors of the modified PARI Factors Subfactors Scales Factor A. Authoritarian-control (Zuckerman, et al., 1958) 1. Harsh punitive-control (Schaefer & Bell, 1957) a. Breaking the will b. Excluding outside influences c. Deification 2. Suppression and interpersonal distance (Schaefer & Bell, 1957) d. Avoidance of communication e. Suppression of sex 3. Over-possessiveness (Schaefer & Bell, 1957) f. Fostering dependency g. Martyrdom h. Intrusiveness 4. Excessive demand for striving (Schaefer & Bell, 1957) i. Strictness j. Acceleration of development Factor B. Hostility-rejection (Zuckerman, et al., 1958; Schaefer & Bell, 1957) k. Marital conflict 1. Irritability m. Rejection of the homemaking role 79 dimension of democratic attitudes is not represented by the 13 scales or subfactors. Its deletion was made primarily on the grounds of practicality. Since each scale has ten items in it (five nonreversed and five reversed items), there was a total of 130 items. This number seemed to be about the upper limit when one considered such variables as subject fatique and boredom. Reliability of the modified PARI. According to Zuckerman, high negative correlations between the original items and the reversed items would be an indication of the adequacy of the reversed items. Table 7 presents the correlations (corrected for attenuation) between the non reversed and reversed items for the scales used in this study. Zuckerman also did a reliability study on the non reversed and reversed items of the PARI. The test-retest reliabilities obtained from 88 unmarried student nurses are given in Table 7. For the nonreversed scales the coefficient ranged from .52 to .80, with a median of .67. For the reversed items the coefficients ranged from .50 to .72, with a median of .66. On first inspection, it might appear that these reliability coefficients are low considering that they are test-retest reliability coefficients. However, each scale is a Likert-type and has five items in it. This means that the slightest difference TABLE 7.— Repeat reliabilities of nonreversed and reversed PARI scales and the correlations between them Test-Retest Reliability Correlation Between Tests NonreversedReversec Scale Scale Scale (Corrected for Attenuation) Postering dependency .70 .66 -.63 Breaking the will .80 .68 -.38 Martyrdom .64 .50 -.81 Marital conflict .71 .61 -.70 Strictness .80 .71 -.62 Irritability .65 .64 -.82 Excluding outside influences .70 .72 -.42 Deification .63 .69 -.52 Rejection of homemaking role .73 .55 -.44 Avoidance of communication .62 .61 -.80 Suppression of sex .67 .71 -.65 Intrusiveness .52 .64 -1.02 Acceleration of development .60 .65 -.58 Adapted from Zuckerman (1959) 81 in response from one administration to the next would result in a sizeable decrease in the coefficient. Taking this into account, one might consider the reliability coefficients reported to be remarkable. Thus, it appeared that both the reversed and nonreversed scales were reliable measures for the purposes set forth in this study. Validity of the modified PARI. The validity of the modified PARI is based primarily on the validity studies (Zuckerman and Oltean, 1959) done on the original PARI, which were discussed previously. Furthermore, the factor analysis studies by Zuckerman, et al. (1958), and Schaefer and Bell (1958), which were presented in Table 6, give ample indication of the construct validity of this instrument. Preschool Attainment Record (Research Edition) The psychometric appraisal of deaf-blind children is often, if not always, vitiated by difficulties of reception and expression. Basically, the psycho-social evaluation of these children is made uncertain because one cannot be sure the child understands what is wanted or is able to do what his intelligence dictates. With these types of diffi culties in mind, Edgar Doll (1966a) began developing indirect appraisal techniques. The best known of these is the Vineland Social Maturity Scale. 82 The PAR is somewhat of an extension of the Vineland Scale to lower age levels with a broader set of performance items and smaller age units. The PAR is an instrument that is used in the assessment of developmental levels of children. As implied above, it was designed primarily for handicapped children who cannot be evaluated by convention al devices. Its purpose is to provide baselines for achievement in three categories of behavior: physical, social and intellectual. These categories are further divided into eight subtests: ambulation, manipulation, rapport, communication, responsibility, information, ideation, and creativity. Each of the subtests has one item for each age level from birth to 84 months, by six month intervals. The administration of this scale is comparable to that of the Vineland Scale, after which it is patterned. Rather than "test" the subject, an interview is obtained from an informant who knows the child well in respect to the performances considered. Thus a standardized technique of interviewing is employed with an informant who knows the subject well and whose reliability can be determined by the interview technique itself. Inconsistencies in information can be clarified by further questioning and especially by asking when the performance began, how consistently it is maintained, how much help is given, and what variables affect it. Therefore, many of the obstacles 83 normally encountered in evaluating deaf-blind children can be overcome by using the PAR with mothers and teachers. Reliability and validity of the PAR. To this date there has been only one reliability and validity study done on the PAR. Using a sample of 100 retarded children, Owens and Bowling (1970) obtained estimates of the internal consistency and factor structure of the PAR. The internal consistency of the PAR was obtained through a procedure involving a generalization of Cronbach's alpha (Rajaratnam, Cronbach and Gleser, 1965). The estimates of internal consistency as well as the intercorrelations among the subtests appear in Tables 8 and 9 respectively. Owens and Bowling employed the same data used for their reliability study to verify the factor structure of the PAR. Employing Kaiser's (1965) criteria, two factors were indicated. Table 10 shows the resulting orthogonal solution, as well as an oblique solution (Harmon, 1967). Owens and Bowling concluded that "... the internal consistency of the PAR with retarded children appears satisfactorily high. With such children the test appears to measure two factors, a physical-developmental factor and a social-intellectual factor. The results suggested that the PAR is an adequate test for measuring development in retarded children." (p. 171). Considering the many developmental parallels between rubella and retarded children, the PAR appeared to be a reliable and valid instrument for the research sample. 85 TABLE 8.— Internal consistency of the preschool attainment record Subtest Cronbach's alpha Ambulation .843 Manipulation .799 Rapport .797 Communication .803 Responsibility .770 Information .759 Ideation .516 Creativity .658 Combined subtests .955 Taken from Owens and Bowling (1970) 86 j TABLE 9.— Intercorrelation matrix of the eight subtests of I the preschool attainment record Subtest 2 3 4 5 6 7 8 1. Ambulation .676 .318 .244 .496 .389 .404 .411 2. Manipulation .665 .430 .660 .628 .716 .702 3. Rapport .514 .734 .662 .712 .704 4. Communication .497 .730 .587 .497 5. Responsibility .672 .651 .617 6. Information .767 .610 7. Ideation .702 8. Creativity Taken from Owens and Bowling (1970) 87 TABLE 10.— Factor structure* of the preschool attainment record Subtest Orthogonal Solution Oblique Solution I II I II Ambulation .719 .154 .560 .136 Manipulation .771 .470 .456 .136 Rapport .408 .719 .018 .506 Communication .128 .728 .233 .622 Responsibility .522 .614 .169 .365 Information .309 .821 .118 .638 Ideation .430 .745 .025 .521 Creativity .495 .621 .141 .382 *Factor I was a physical-developmental factor; | Factor II, a social-intellectual factor. j Taken from Owens and Bowling (1970) CHAPTER IV RESULTS The results of the study are presented and inter preted in this chapter. To examine the relationship between maternal attitudes and development, it was necessary to answer three basic questions: 1. What childrearing attitudes are characteristic of mothers who have rubella deaf-blind children? 2. How much developmental growth do rubella deaf- blind children make in the physical, social and intellectual areas? 3. Is there a significant relationship between the childrearing attitudes of rubella mothers and the developmental growth of their deaf-blind children? The third question was, of course, the most critical one. The first two questions were put forth primarily for the purpose of setting the proper base for examining the relationship between maternal attitudes and developmental growth. It was from the third and last question that the actual hypotheses of the study emanated. 88 89 Childrearing Attitudes of Rubella Mothers To obtain an estimate of the childrearing attitudes characteristic of mothers of rubella children, it was necessary to individually administer the PARI to each of the 50 mothers in the sample. The means and standard deviations, as well as the possible raw score ranges of the scales, subfactors and major factors of the PARI for the total sample, are given in Table 11. Due to the fact that normative data is available only for the nonreversed PARI scales, the reversed scales were not used to obtain the profile of maternal child- rearing attitudes. To adjust the sample's raw scores to a more meaningful form, it was necessary to convert the raw scores on the nonreversed scales to standard scores using Zuckerman, et al. (1958), normative data. Zuckerman, et al. (1958) normative sample was composed of 222 mothers of normal children, including mothers of nursery school child ren, mothers of young adults attending a night extension college and mothers contacted at meetings of church and social groups. A survey of Figure 2 appears to indicate that mothers in the rubella sample professed attitudes that were extremely similar to mothers of normal children. Mothers of rubella children apparently differed from mothers of normals only on the fostering dependency scale. TABLE 11.— Means, standard deviations, possible ranges of the scales, subfactors and factors of the PARI for 50 mothers of rubella children Factors Subfactors Scales Mean Raw Score Standard Deviations Possible Range of Raw Scores Factor A. Authoritarian-control 209.14 33.20 100.00-400.00 1. Harsh punitive control 64.54 12.96 30.00-120.00 a. Breaking the will 20.18 4.43 10.00-40.00 b. Excluding outside influences 20.86 4.85 10.00-40.00 c. Deification 23.50 6.17 10.00-40.00 2. Suppression and interpersonal distance 34.04 8.82 20.00-80.00 d. Avoidance of communication 16.82 4.26 10.00-40.00 e. Suppression of sex 17.22 5.32 10.00-40.00 3. Over-possessiveness 58.98 11.72 30.00-120.00 f. Fostering dependency 19.80 4.43 10.00-40.00 g. Martyrdom 18.64 4.36 10.00-40.00 h. Intrusiveness 27.98 4.86 10.00-40.00 4. Excessive demand for striving 51.58 6.93 20.00-80.00 i. Strictness 29.66 5.54 10.00-40.00 j. Acceleration of development 21.92 4.59 10.00-40.00 Factor B. Hostility-rejection 78.10 12.41 30.00-120.00 k. Marital conflict 28.76 4.41 10.00-40.00 1. Irritability 27.98 4.86 10.00-40.00 m. Rejection of homemaking role 22.36 5.39 10.00-40.00 1 VO o Standard Scores PARI Scales -1.00 -.75 -.50 -.25 0 .25 .50 .75 ________________________________i ______i ______■ ______ i ______ i _____ i — Breaking the will (-.060) Excluding outside influences (.096) Deification (-.097) Avoidance of communication (-.228) Suppression of sex (-.212) Fostering dependency (-.428) Martyrdom (-.084) Intrusiveness (-.028 Strictness (.214) Acceleration of development (-.137) Marital conflict (.018) Irritability (.106) Rejection of homemaking role (.086) __ 1.00 Fig. 2.— Standard scores for each of the PARI scales for 50 mothers of rubella children. The standard scores were derived from normative data collected by Zuckerman, et al. (1958). 92 The negative standard score on the fostering dependency scale points out that rubella mothers believed that their handicapped children should function independently from others. This is an interesting finding when one considers the enormous amount of attention and guidance young deaf- blind children require from their mothers. This attitude is also noteworthy from the standpoint that avoiding dependency and encouraging independency in disabled children is generally an established objective of most rehabilitation centers. When surveying childrearing attitudes of rubella mothers, as expressed in the subfactors of the PARI and shown in Figure 3, it becomes apparent that the subfactors basically reflect what was exhibited by the individual scales. In general, there was little, if any, difference found between the research sample and mothers of normal children. In order to plot the sample1s relative position on the authoritarian-control and hostility-rejection dimen sions, it was again necessary to convert the mean raw scores of the sample to standard scores for each ortho gonal dimension. A review of Figure 4 may be somewhat deceptive. In examining the two orthogonal dimensions, one initially observes that as a whole the rubella mothers were located in the "rejecting" quadrant. However, a more discerning review reveals that the sample's relative PARI Subfactors -1.00 -.75 -.50 -.25 0 .25 .50 .75 1.00 Harsh-punitive control (-.020) Suppression and interpersonal distance (-.220) Excessive demand for striving (-.039) Over-possessiveness (-.180) Fig. 3.— Standard scores for each of the PARI subfactors for 50 mothers of rubella children. The standard scores were derived from normative data collected by Zuckerman, et al. (1958). vo CJ Warmth (Love) 94 Authoritarian Control Overprotective Punitive 1.00 ■ 75 50 25 .25 1.00 - 1.00 50 -.25 Rubella Mothers -.75 . -1.00 . Rejecting Overindulgent Autonomy Fig. 4.— Childrearing attitudes of 50 mothers of rubella children. The standard scores were derived from normative data collected by Zuckerman, et al. (1958). Hostility (Rejection) 95 position is well within what one might consider "neutral territory." That is, in relation to these two dimensions rubella mothers do not differ from mothers of normal children. This finding is contrary to previous research (Boles, 1959; Imamura, 1965; Levy, 1943; Ricci, 1970) showing mothers of severely handicapped children to be authoritarian, rejecting, punitive and overprotective. Developmental Growth in Deaf-Blind Rubella Children As indicated in Chapter III, developmental growth in rubella children was measured through pre and postmeasures of the PAR. The PAR measures three major areas: physical, social and intellectual. Developmental-Physical Growth in Rubella Children The means and standard deviations of the ambulation and manipulation subtests for the pre and posttesting, as well as the amount of developmental gain, are presented in Table 12 and graphically shown in Figures 5 and 6. At the time of pretesting the mean age for the sample was four years, four months. In general, the rubella sample represented a rather homogeneous group in terms of chronological age, as indicated by the relatively small standard deviation. It is apparent from the data on the rubella children's physical development that they were functioning TABLE 12.— Means, standard deviations and time lapse between testing for the physical area subtests on the pre and posttests of the PAR for 50 rubella children Physical Subtests Mean Chronological Age of Rubella Sample at Pretest in Months Mean Pretest Developmental Age in Months Mean Chronological Age of Rubella Sample at Posttest in Months Mean Posttest Developmental Age in Months Mean Time Lapse Between Pre & Post testing in Months Mean Develop mental Gain in Months Ambulation X = 53.42 X = 34.86 X = 71.54 X = 55.56 X = 21.76 X = 20.76 S.D. = 13.75 S.D. = 20.28 S.D. = 13.69 S.D. = 19.58 S.D. = 7.50 S.D. = 10.84 Manipulation X = 53.42 X = 31.81 X = 71.54 X = 50.28 X = 21.76 X = 18.42 S.D. = 13.75 S.D. = 20.05 S.D. = 13.69 S.D. = 21.78 S.D. = 7.50 S.D. = 11.59 vo cn U1 in Age at Pretest Pretest Score Age at Posttest Posttest Score Time Lapse Between Testing Developmental Growth Gain Developmental Status in Months t o t o i o c j t C t ^ i n u i g ^ o t O i n O i n o i n < ~ > i n i - > t n -O- in 00 _Q 10 -J 3 G. § ff H- O *a 3 3 o M l —1 p o ^ ft iQ H' H- H* vQ O O 3 P cn & to P. p i & > £ > i rt © 3 © © W P P ft g 3 Oi o hi ft r o rt S* ro 3* © M © ,o t-* >g T3 p 3 > »d © JO W 3 • ® O' H> © 13 „ H vQ © P H- p 3 3 01 Pi O *2 § C O 13 SR © © c o P i rt H - & O 3 3" © rt O Developmental Status in Months U1 ui to o to in 10 o 10 in ib O in in O ui in 01 O G\ in O < 1 in CD O Age at Pretest Pretest Score Age at Posttest Posttest Score Time Lapse Between Testing Developmental Growth Gain ID co 99 at a rather rudimentary level at the time of pretesting. On the ambulation subtest, which is actually a scale of large motor ability, the "mean" rubella child could, for instance, perform such activities as running, balancing and climbing; but he could not hop nor join in games which required group ambulation. On the manipulation subtest, which reflects a child's fine motor functioning, the "mean" youngster in the sample could scribble with a pencil and take simple objects apart; but he was unable to put simple parts together or purposefully throw objects in a definite direction. Figures 5 and 6 reveal that the sample, as a whole, made notable developmental gains in the physical areas between pre and posttestings. At posttesting the mean chronological age was approximately six years. In terms of physical development the rubella group was about a year and a half behind their chronological ages, but had made virtually one month of developmental gain for each month between pre and posttesting. At posttesting most of the rubella children could join in games, skip on alternate feet, catch hurled objects and reproduce a geometric square design. Developmental-Social Growth in Rubella Children The means and standard deviations for the rapport, communication and responsibility subtests of the PAR on the 100 pre and posttesting as well as the amount of developmental gain made in these social areas, are given in Table 13 and graphically presented in Figures 7, 8 and 9. Data on the social development of the rubella children at the time of pretesting showed them to be functioning at a very low level. On the rapport subtest, which measures the youngster's ability to relate to other people and things, the sample as a whole was able to show evidence of likes, dislikes and preferences, but was unable to play with sustained interest alongside or among other children or with adults. The communication subtest, which is of paramount importance and is a gauge of the child's verbal abilities, demonstrated that the "mean" rubella child was at a sensorimotor stage at pretesting. That is, he was only capable of echo sounds and possibly a few simple words but could not utilize simple speech equivalents (i.e., words) to obtain his wants. In the area of personal responsibility, most of the rubella children at pretesting were able to be careful of things and avoid hazardous places such as stairs and streets. They were not, however, capable of helping themselves in simple ways as filling a glass from a tap or bottle. They were also unable to fasten or remove most of their garments. As was the case in the physical area, the rubella TABLE 13.— Means, standard deviations and time lapse between testing for the social area subtests on the pre and posttests of the PAR for 50 rubella children Social Subtests Mean Chronological Age of Rubella Sample at Pretest in Months Mean Pretest Developmental Age in Months Mean Chronological Age of Rubella Sample at Posttest in Months Mean Posttest Developmental Age in Months Mean Time Lapse Between Pre & Post testing in Months Mean Develop mental Gain in Months Rapport X = 53.42 S.D. = 13.75 X = 28.38 S.D. = 20.13 X = 71.54 S.D. = 13.69 X = 51.36 S.D. = 16.20 X = 21.76 S.D. = 7.50 X = 22.98 S.D. = 11.13 Communication X = 53.42 S.D. = 13.75 X = 14.04 S.D. = 12.20 X = 71.54 S.D. = 13.69 X = 28.92 S.D. = 18.34 X = 21.76 S.D. = 7.50 X = 14.88 S.D. = 11.48 Responsibility X = 53.42 S.D. = 13.75 "x = 29.64 S.D. = 22.90 X = 71.54 S.D. = 13.69 X = 49.92 S.D. = 21.44 X = 21.76 S.D. = 7.50 X = 20.52 S.D. = 13.19 TOT m p « I S *o o m r t o 3 " M O 3 O H* O CO iQ C V r t I D to r t * 1 H - < n H - o P i M ~ J p i i Q O ( D Ml p i g . o . r t r o U ' i S ) ® H • o I - 1 I Q P J 3 •O C D tn 3 c o r t tr h a t r t iQ « 3 r o O ( D £ *J M iQ ( 0 P I P I g . »0 o 0 1 10 rt r t m m rt H* 3 <0 O 3 3 M ( D Q> r t O Developmental Status in Months Age at Pretest Pretest Score Age at Posttest Posttest Score Time Lapse Between Testing Developmental Growth Gain to o to on u> _£2_ co on _ Q _ i t * Ja i n -C l in m 0 1 in -O O -o in o o o 102 Fig. 8.— Mean developmental growth gains compared to chronological age and time lapse between pre and posttesting o n the communication subtest of the PAR. Developmental Status in Months Age at Pretest in in ro o to in u O C O cn _£2_ ( J l cn _£2_ cn JUL. a\ _ Q _ cn cn _Q_ - J JU1_ GO -Q _ Pretest Score Age at Posttest Posttest Score Time Lapse Between Testing Developmental Growth Gain 103 n I D 01 H J 0 3 to H - O ' H - H H - $ 0 ) & ( D 0 1 r t O M l f t cr (D o 3 o H* O *! iQ H- H- U J 0 • S O H I D B ) * 1 ■ s i ID o > so 3 3 Oj & ( 1 - ( O < „ (D (D H O i-* *3 so 3 ►a r o 0 1 3 r o S’ tr h- (D r t i Q 5 t J •a M V Q ( ! ) S O H- S O 3 Q j •a o 01 »u r t s o r t M (D ( D 0 ) Q i r t H- £ o 3 5 ( 0 Developmental Status in Months U l t o o t o U l u o c j ( J l O U l U l o U l U l 01 o 0 1 U l ' J o U l 00 o Age at Pretest Pretest Score Age at Posttest Posttest Score Time Lapse Between Testing Developmental Growth Gain 104 105 sample made significant developmental gains in the social area between pre and posttesting. Figures 7 and 9 demon strate that on the rapport and responsibility subtests the group made approximately one month of developmental gain for each passing chronological month. Although continuing to be lagging developmentally, at posttesting they were able to play cooperatively with others and to follow simple game rules. In addition, they were able to dress them selves and care for their ordinary toilet needs without undue assistance. It was evident that the sample had made significant growth in the area frequently referred to as "activities for daily living." Of all the aspects of development that were studied, the rubella child1s growth was poorest in verbal communi cation. Figure 11 portrays the fact that in the 21 months between pre and posttesting, the mean sample gain was only 14 months. At about six years of age, most of the rubella children had a noun-verb vocabulary of from 10 to 20 familiar words, but few had speaking (or sign language) and listening vocabularies of 50 words or more. The rela tively slow development in communication is not particu larly surprising considering the nature of the rubella child's disabilities. Deaf children can learn communica tion skills through the visual modality, and blind children have few problems in conversing since they have intact hearing. But when a child is deprived of some degree of 106 both modalities, the difficulties associated with communi cation become compounded in geometric rather than additive proportions. Developmental-Intellectual Growth in Rubella Children The means and standard deviations for the informa tion, ideation and creativity subtests on the pre and posttesting, as well as the amount of developmental gain, are given in Table 14 and presented graphically in Figures 10, 11 and 12. A survey of the pretest performance of the rubella subjects on the three subtests in the intellectual area indicates that the sample was, as a whole, functioning at the sensorimotor level, in Piaget's terms. None of the mean subtest scores was above the lower limit of what Piaget refers to as the "preconceptual phase" (two to four years of age). That is, the "mean" rubella child had not reached the most incipient stages in the development of mental imagery, language or preconceptual thought. More specifically, the information subtest revealed that at a chronological age of four years, four months, the average rubella child was able to show some sense of ownership regarding his parents, toys, et cetera, but was unable to express any real regard or affection toward them or his possessions. According to the ideation subtest, most rubella children at pretesting were capable of making TABLE 14.— Means, standard deviations and time lapse between testing for the intellectual area subtests on the pre and posttests of the PAR for 50 rubella children Intellectual Subtest- - Mean Chronological Age of Rubella Sample at Pretest in Months Mean Pretest Developmental Age in Months Mean Chronological Age of Rubella Sample at Posttest in Months Mean Posttest Developmental Age in Months Mean Time Lapse Between Pre & Post testing in Months Mean Develop mental Gain in Months Information X = 53.42 S.D. = 13.75 X = 2-.10 S.D. = 17.22 X = 71.54 S.D. = 13.69 X = 37.98 S.D. = 19.05 X = 21.76 S.D. = 7.50 X = 17.76 S.D. = 9.38 Ideation X = 53.42 S.D. = 13.75 X = 19.44 S.D. = 18.45 X = 71.54 S.D. = 13.69 X = 40.80 S.D. = 23.17 X = 21.76 S.D. = 7.50 X = 22.08 S.D. = 15.40 Creativity X = 53.42 S.D. = 13.75 X = 22.52 S.D. = 19.61 X = 71.54 S.D. = 13.69 X = 42.24 S.D. = 18.93 X = 21.76 S.D. = 7.50 X = 19.80 S.D. = 10.29 107 Fig. 10.— Mean developmental growth gains compared to chronological age and time lapse between pre and posttesting on the information subtest of the PAR. Developmental Status in Months O U l O U i O t n O U l O l n O U l O U l O Age at Pretest Pretest Score Age at Posttest Posttest Score Time Lapse Between Testing Developmental Growth Gain 'J 03 Ul o 108 Fig. 11.— Mean developmental growth gains compared to chronological age and time lapse between pre and posttesting o n the ideation subtest of the PAR. Developmental Status in Months M H t O t O W W i C » , c . u i t n C T > ( j * ^ j ^ j 00 o cn oi no tn oi no tn ou io ui o Age at Pretest Pretest Score Age at Posttest Posttest Score Time Lapse Between Testing Developmental Growth Gain 109 Fig. 12.— Mean developmental growth gains compared to chronological age and time lapse between pre and posttesting on creativity subtest of the PAR. Developmental Status in Months to o to Ul w o u> Ul o i t * Ul Ul o Ul Ul < x > o o> Ul ■ v l Ul 00 o Age at Pretest Pretest Score Age at Posttest Posttest Score ( D Time Lapse Between Testing Developmental Growth Gain 110 Ill certain physical gestures and could successfully compare familiar objects as to color and simple form, but could not indicate an awareness of the concept of "one more." Relative to the creativity subtest the mean sample performance showed that the rubella children were able to investigate their surroundings but were unable to "unbuild" or break down materials as a purposeful way of learning or experiencing. As was found in the physical and social areas, the rubella sample made creditable developmental gains in the intellectual area between pre and posttestings. The post testing demonstrated that at about a chronological age of six years, most of the rubella children in the sample could identify themselves by name and associate their name with some self-identity. They were also capable of manipulating number concepts meaningfully to more than two. The majority of the sample could show imagination in using simple building blocks and construction toys. In general, they developed intellectually at approximately the same rate as the chronological time lapse between pre and post testing. Overall Developmental Growth in Rubella Children As a gauge of overall development, the eight sub tests of the PAR as a conglomerate can be converted to a total attainment age. 112 The mean and standard deviation for the total attainment age on the pre and posttesting, as well as the amount of overall developmental gain are given in Table 15 and graphically presented in Figure 13. When the pretest PAR's were administered, the mean developmental attainment age for the rubella sample was over two years behind their mean chronological age. Upon posttesting the same discrepancy was evident, but the rubella children had not "lost ground" developmentally. Even though the absolute developmental lag had not decreased the amount of relative lag had diminished. That is, at pretesting the mean developmental level for the sample was only 47 percent of the children's mean chronological age. On the posttesting, however, the developmental level of the sample was 62 percent of the group's mean chronological age. It should be acknowledged at this point that since different examiners were used for the pretesting and the posttesting that there is the possibility of some biases in one direction or the other. All examiners, however, made every effort to follow the standardized procedures put forth in the examiner's manual. Variability Among Rubella Children A review of the standard deviations accompanying the mean scores clearly points to the tremendous amount of I TABLE 15.— Means, standard deviations and time lapse between testing for the total attainment age on the pre and posttests of the PAR for 50 rubella children Total Attainment Age Mean Chronological Age of Rubella Sample at Pretest in Months Mean Pretest Developmental Age in Months Mean Chronological Age of Rubella Sample at Posttest in Months Mean Posttest Developmental Age in Months Mean Time Lapse Between Pre & Post testing in Months Mean Develop mental Gain in Months Total Attainment (Developmental) Age X = 53.42 S.D. = 13.75 X - 71.54 S.D. = 17.95 X = 71.54 S.D. = 13.69 X = 44.43 S.D. = 18.05 X = 21.76 S.D. = 7.50 X = 19.46 S.D. - 7.89 113 Fig. 13.— Mean developmental growth gains compared to chronological age and time lapse between pre and posttesting on total attainment age of the PAR. Developmental Status in Months o c n o u i o c n o u i o i n o c n o i n o i n o Age at Pretest Pretest Score Age at Posttest Posttest Score Time Lapse Between Testing Developmental Growth Gain t b 114 115 variability among the rubella subjects. This is not a surprising phenomenon considering the variability one finds in the extent of disability and intellectual potential from one deaf-blind rubella child to another. For example, it is not uncommon to find one rubella child with normal intelligence and a mild visual and hearing loss, while another may have defective intellectual capacity as well as being severely deaf and blind. The large amount of variability deserves special attention as it has obvious implications for educational programs designed to assist rubella children. From these findings it would appear that there are no "typical" rubella children, only deaf- blind handicapped children with varying degrees of disability, potential, et cetera. Maternal Childrearing Attitudes and Developmental Growth in Deaf-Blind Rubella Children In its simplist form the relationship between maternal childrearing attitudes (independent variable) and development in rubella children (dependent variable) consists of correlating the scales, subfactors, and factors of the PARI (independent variables) with the subtests, major areas and total attainment age of the posttest PAR (dependent variables). However, due to the tremendous variability among subjects, it was required that certain competing variables be partialed out. The competing variables, as identified in Chapter III, were intellectual 116 level, degree of hearing and visual loss, and mother's level of education. The actual correlations between the four competing variables and the sets of independent and dependent variables appear in Table 16, which reveals the following noteworthy points of interest: 1. There appeared to be a low, but significant, relationship between the mother's childrearing attitude and her educational level. 2. There were high positive correlations between the rubella child's intelligence level and his performance in all areas of developmental growth. 3. The extent of visual loss seemed to be a much more reliable predictor of the amount of the rubella child's developmental growth than the extent of hearing loss. 4. Taking all the correlations in Table 16 as whole, the efficacy of partialling out the competing variables appears to have been supported. Tables 17 through 28 individually show the rela tionship between each of the PAR posttest dependent variables and the scales, subfactors and factors of the PARI. In addition to the presentation of linear correla tions, multiple partial correlations are given from the stepwise correlation analysis of the data. As indicated in Chapter III, each dependent variable of the PAR was correlated with some combination of TABLE 16.— Linear correlations between competing variables and the sets of independent variables (PARI) and the dependent variables (posttest PAR) j ________________Competing Variables________________ I Hearing Visual Mother's Intelligence Loss Loss Education | INDEPENDENT VARIABLES (PARI) | Scales Fostering dependency .03 -.24 -.17 -.35 Breaking the will .17 .08 -.16 -.36 Martyrdom -.06 -.01 -.07 -.05 Marital conflict -.15 .17 .11 .20 Strictness -.01 .24 .08 -.23 Irritability -.16 .15 .13 .16 Excluding outside influences .22 .05 -.11 -.42 Deification .13 .07 -.08 -.34 Rejection of homemaking role -.15 .05 .16 .13 Avoidance of communication .03 .06 -.15 -.26 Suppression of sex .21 -.04 .13 -.46 Intrusiveness -.06 .05 -.17 -.39 Acceleration of development .04 -.01 -.28 -.38 Subfactors Harsh punitive control .20 .08 -.13 -.43 Suppression and interpersonal distance .14 .00 -.15 -.41 Excessive demand for striving .02 .18 -.12 -.44 Over-possessiveness -.04 -.06 -.18 -.35 Factors Hostility-rejection -.20 .05 .22 .20 Authoritarian- control .11 .05 -.18 -.49 117 TABLE 16.— Continued Competing Variables Hearing Visual Mother's Intelligence Loss Loss Education DEPENDENT VARIABLE (POSTTEST PAR) |Subtests Ambulation .60 -.05 .29 .10 i Manipulation .72 -.12 .40 .06 Rapport .65 -.13 .39 .07 1 Communication .64 .14 .37 .03 i Responsibility .53 -.09 .31 .13 Information .73 -.03 .47 .07 Ideation .64 .09 .35 -.01 Creativity .70 -.18 .41 .05 1 Major Areas Physical .69 -.09 .37 .08 Social .67 -.01 .39 .10 Intellectual .72 -.01 .43 .04 !Total i Attainment age .71 -.04 .39 .07 118 119 TABLE 17.— Linear and Stepwise correlation analysis between the posttest ambulation subtest of the PAR and the scales, subfactors and factors of the PARI Posttest ........... . . . PAR Ambulation Subtest Partial r after IQ, handicap and mother's PARI Scales, Subfactors education were F ratio and Factors Linear r partialed out (Partial r) Scales Fostering dependency - .23 - .26 3.31* Breaking the will - .09 - .21 2.22 Martyrdom - .31 - .34 5.97** Marital conflict - .09 - .01 0.00 Strictness — .08 - .12 0.65 Irritability - .19 - .19 1.65 Excluding outside influences .05 - .05 0.13 Deification .03 - .02 0.01 Rejection of homemaking role - .12 - .08 0.30 Avoidance of communica tion - .06 - .07 0.20 Suppression of sex - .00 - .10 0.48 Intrusiveness _ .28 - .28 3.84* j Acceleration of development - .00 .04 0.08 i Subfactors Harsh punitive control - .00 - .11 0.51 Suppression and inter personal distance - .03 - .09 0.39 Excessive demand for j striving - .06 - .07 0.25 ! | Overpossessiveness — .35 - .38 7.52***| i Factors | Hostility-rej ection - .16 - .11 0.55 j Authoritarian control .14 - .23 2.50 *.05 < p < .10 **.01 < p < .05 ***p < .01 120 TABLE 18.— Linear and stepwise correlation analysis between the posttest manipulation subtest of the PAR and the scales, subfactors and factors of the PARI PARI Scales, Subfactors and Factors Posttest PAR Manipulation Subtest Linear r Partial r after IQ, handicap and mother education were partialed out ' s F ratio (Partial r, Scales Fostering dependency - .12 - .17 1.30 Breaking the will .09 .00 0.00 Martyrdom - .14 - .13 0.79 Marital conflict .05 .19 1.60 Strictness — .07 _ .13 0.74 Irritability - .16 - .14 0.85 Excluding outside influences .13 .01 0.01 Deification .06 - .01 0.00 Rejection of homemaking role - .16 - .14 0.92 Avoidance of communica tion - .01 .00 0.00 Suppression of sex .09 - .02 0.02 Intrusiveness — .11 - .05 0.11 Acceleration of development .06 .14 0.83 Subfactors Harsh punitive control .11 .00 0.00 Suppression and inter personal distance .05 - .01 0.00 Excessive demand for striving - .02 .02 0.02 Overpossessiveness — .15 — .14 0.87 Factors Hostility-rej ection - .11 - .02 0.02 Authoritarian control .00 «■» .06 0.16 121 TABLE 19.— Linear and stepwise correlation analysis between the posttest physical area of the PAR and the scales, subfactors and factors of the PARI PARI Scales, Subfactors and Factors Posttest PAR Physical Area Linear r Partial r after IQ, handicap and mother education were partialed out s F ratio (Partial r) Scales Fostering dependency - .18 - .23 2.56 Breaking the will .00 - .12 0.64 Martyrdom - .24 - .26 3.19* Marital conflict .00 .09 0.39 Strictness _ .08 _ .13 0.81 Irritability - .19 - .18 1.42 Excluding outside influences .10 - .02 0.02 Deification .05 - .01 0.01 Rejection of homemaking role - .15 - .12 0.65 Avoidance of communica tion - .03 - .04 0.06 Suppression of sex .05 - .07 0.20 Intrusiveness — .20 - .18 1.51 Acceleration of development .30 .10 0.40 Subfactors Harsh punitive control .06 - .06 0.15 Suppression and inter personal distance .01 - .06 0.14 Excessive demand for striving - .05 - .05 0.12 Overpossessiveness — .26 — .28 3.85* Factors Hostility-rejection - .14 - .07 0.23 Authoritarian control mm .07 ” .16 1.14 *.05 < p < .10 122 TABLE 20.— Linear and stepwise correlation analysis between the posttest rapport subtest of the PAR and the scales, subfactors and factors of the PARI PARI Scales, Subfactors and Factors Posttest PAR Rapport Subtest Linear Partial r after IQ, handicap and mother's education were r partialed out F ratio (Partial r) Scales Fostering dependency - .14 - .18 1.42 Breaking the will - .06 - .18 1.46 Martyrdom - .20 - .20 1.91 Marital conflict .06 .17 1.37 Strictness _ .09 — .14 0.91 Irritability - .08 - .03 0.07 Excluding outside influences - .02 - .12 0.61 Deification - .08 - .19 1.57 Rejection of homemaking role - .14 - .12 0.66 Avoidance of communica tion - .07 - .08 0.29 Suppression of sex .05 — .05 0.11 Intru s ivenes s — .16 _ .12 0.63 Acceleration of development .01 .07 0.23 Subfactors Harsh punitive control - .05 - .20 1.91 Suppression and inter personal distance - .00 - .07 0.22 Excessive demand for striving - .07 - .07 0.25 Overpossessiveness — .21 “ .21 2.04 Factors Hostility-rejection - .06 .02 0.02 Authoritarian control .11 .20 1.81 123 TABLE 21.— Linear and Stepwise correlation analysis between the posttest communication subtest of the PAR and the scales, subfactors and factors of the PARI PARI Scales, Subfactors and Factors Posttest PAR Communication Subtest Linear r Partial r after IQ, handicap and mother' education were partialed out s F ratio (Partial r) Scales Fostering dependency - .15 - .09 0.39 Breaking the will .07 - .03 0.05 Martyrdom - .09 - .05 0.12 Marital conflict .04 .09 0.35 Strictness .15 .13 0.76 Irritability - .04 - .01 0.01 Excluding outside influences .23 .18 1.51 Deification .16 .14 0.87 Rejection of homemaking role - .17 - .17 1.32 Avoidance of communica tion - .15 - .22 2.23 Suppression of sex .01 - .12 0.61 Intrusiveness _ .04 in o • 0.10 Acceleration of development - .07 - .06 0.15 Subfactors Harsh punitive control .19 .13 0.74 Suppression and inter personal distance - .07 - .18 1.50 Excessive demand for striving .08 .07 0.23 Overpossessiveness — .11 - .03 0.04 Factors Ho s tility-re j ec tion - .06 .02 0.02 Authoritarian control .03 .01 0.00 L . 124 TABLE 22.— Linear and stepwise correlation analysis between the posttest responsibility subtest of the PAR and the scales, subfactors and factors of the PARI Posttest PAR Responsibility Subtest PARI Scales, Subfactors and Factors Linear r Partial r after IQ, handicap and mother's education were partialed out F ratio | (Partial r)! I Scales iFostering dependency jBreaking the will i Martyrdom :Marital conflict .17 .03 .13 .07 - .17 - .01 - .10 .13 1.32 0.007 0.42 0.78 Strictness I Irritability ;Excluding outside influences jDeification Rejection of homemaking role ;Avoidance of communica- i tion |Suppression of Sex iIntrusiveness Acceleration of development Subfactors Harsh punitive control | Suppression and inter- | personal distance j Excessive demand for I striving I Overpossessiveness i i i Factors. Hostility-rej ection Authoritarian control .18 .07 .05 .00 - .03 - .04 - .01 - .15 - .06 .02 - .02 - .19 - .19 .03 .10 - .22 - .05 - .01 - .04 .01 - .01 - .06 - .07 - .06 - .03 - .04 - .20 - .14 .03 - .12 2.33 0.09 0.01 0.06 0.00 0.01 0.17 0.25 0.01 0.04 0.07 1.84 0.87 0.05 0.65 125 TABLE 23.— Linear and stepwise correlation analysis between the posttest social area of the PAR and the scales, subfactors and factors of the PARI |PARI Scales, Subfactors I and Factors Posttest PAR Social Area Linear r Partial r after IQ, handicap and mother's education were partialed out F ratio ! (Partial r) | I Scales |Fostering dependency jBreaking the will |Martyrdom Marital conflict .15 .07 .09 .09 .11 .01 .05 .19 0.56 0.00 0.11 1.57 Strictness !Irritability |Excluding outside influences ;Deification j Rejection of homemaking role i Avoidance of communica tion ;Suppression of sex ;Intrusiveness J Acceleration of i development i ;Subfactors |Harsh punitive control 'Suppression and inter- 1 personal distance i Excessive demand for ] striving j Overpossessiveness ! I Factors |Hostility-rejection iAuthoritarian control .01 .03 .10 .07 - .09 - .06 .04 .09 .03 .09 - .01 - .03 - .13 .01 .02 .06 .01 .02 .03 - .06 - .06 - .03 .01 .04 .02 - .05 - .03 - .05 .08 .03 0.18 0.00 0.01 0.03 0.14 0.16 0.05 0.01 0.08 0.03 0.12 0.03 0.13 0.27 0.05 126 TABLE 24.— Linear and stepwise correlation analysis between the posttest information subtest of the PAR and the scales, subfactors and factors of the PARI i Posttest PAR Information Subtest Partial r after IQ, ! handicap and mother's I PARI Scales, Subfactors education were F ratio and Factors Linear r partialed out (Partial r) Scales Fostering dependency - .13 - .08 0.31 Breaking the will .08 .02 0.04 Martyrdom - .12 - .10 0.42 Marital conflict .16 .25 3.04* Strictness — .01 - .08 0.27 Irritability .02 .10 0.47 Excluding outside influences .12 .03 0.03 Deification .07 .03 0.04 Rejection of homemaking role - .01 - .05 0.12 Avoidance of communica tion .07 - .07 0.25 Suppression of sex .07 - .09 0.36 Intrusiveness .15 - .08 0.31 Acceleration of development .01 .09 0.37 Subfactors Harsh punitive control .11 .04 0.06 Suppression and inter personal distance .02 - .09 0.36 Excessive demand for striving - .01 - .01 0.00 Overpossessiveness .17 - .11 0.58 iFactors Hostility-rejection .04 .17 1.36 Authoritarian control 1 ! .02 - .06 0.14 I i *.05 < p < .10 127 TABLE 25.— Linear and stepwise correlation analysis between the posttest ideation subtest of the PAR and the scales, subfactors and factors of the PARI i Posttest PAR Ideation Subtest i 1 j ;PARI Scales, Subfactors and Factors Linear Partial r after IQ, handicap and mother education were r partialed out 1 s F ratio (Partial r) Scales Fostering dependency - .13 - .10 0.46 Breaking the will .13 .04 0.09 Martyrdom - .17 - .17 1.29 Marital conflict .14 .26 3.15* iStrictness .06 - .00 0.00 Irritability Excluding outside - .07 - .04 0.08 influences .17 .05 0.12 Deification j .09 .01 0.00 1 Rejection of homemaking role Avoidance of communica - .13 - .10 0.49 tion .00 - .01 0.00 Suppression of sex .09 - .01 0.00 Intrusiveness Acceleration of develop - .07 - .02 0.03 ment .02 .06 0.18 Subfactors ;Harsh punitive control Suppression and inter .15 .04 0.06 personal distance Excessive demand for .06 - .01 0.00 | striving .06 .03 0.05 pverpossessiveness i - .15 - .11 0.57 Factors jHostility-rejection - .00 .11 0.59 Authoritarian control 1 1 .03 - .02 0.02 *.05 < p < .10 128 TABLE 26.— Linear and stepwise correlation analysis between the posttest creativity subtest of the PAR and the scales, subfactors and factors of the PARI | | Posttest PAR Creativity Subtest 1 Partial r after IQ, handicap and mother 's PARI Scales, Subfactors education were F ratio and Factors Linear r partialed out (Partial r) | Scales ' Fostering dependency - .11 - .15 1.03 Breaking the will .05 - .05 0.09 Martyrdom - .16 - .15 1.01 Marital conflict .02 .13 0.73 Strictness .04 .04 0.07 Irritability - .16 - .13 0.78 Excluding outside influences .14 .04 0.06 Deification .11 .06 0.18 Rejection of homemaking role - .11 - .07 0.22 Avoidance of communica tion - .02 - .02 0.02 Suppression of sex .10 - .01 0.01 Suppression of sex .10 - .01 0.01 Intrusiveness - .10 - .04 0.06 Acceleration of development - .01 .03 0.05 Subfactors Harsh punitive control .12 .03 0.04 Suppression and inter personal distance .05 - .02 0.01 Excessive demand for striving .03 .05 0.13 Overpossessiveness .19 - .13 0.78 Factors Hostility-rejection - .09 - .00 0.00 Authoritarian control .01 - .03 0.04 I 129 TABLE 27.— Linear and stepwise correlation analysis between the posttest intellectual area of the PAR and the scales, subfactors and factors of the PARI 1 Posttest PAR Intellectual Area i j iPARI Scales, Subfactors and Factors Linear Partial r after IQ, handicap and mother's education were r partialed out F ratio (Partial r) i 'Scales Fostering dependency - .13 - .12 0.73 {Breaking the will .10 .02 0.02 Martyrdom - .16 - .15 1.01 Marital conflict .10 .25 2.83* {Strictness .04 - .01 0.01 ilrritability lExcluding outside — .07 - .02 0.03 influences .15 .05 0.09 Deification .10 .04 0.07 Rejection of homemaking role Avoidance of communica " • .11 - .08 0.30 tion - .03 - .03 0.05 Suppression of sex .08 - .04 0.06 Tntrusiveness Acceleration of develop - .11 - .05 0.11 ment .00 .07 0.20 1 iSubfactors Harsh punitive control {Suppression and inter- .14 .05 0.09 1 personal distance Excessive demand for .03 - .04 0.07 striving .03 .03 0.04 joverpossessiveness .16 - .13 0.77 Factors Hostility-rej ection - .01 .11 0.56 Authoritarian control .01 - .04 0.06 *.05 < p < .10 TABLE 28.— Linear and stepwise correlation analysis between the posttest attainment age of the PAR and the scales, subfactors and factors of j the PARI I Posttest PAR Attainment Age ! PARI Scales, Subfactors 'and Factors Partial r after IQ, handicap and mother's education were Linear r partialed out (Partial r) Scales Fostering dependency - .16 Breaking the will .05 Martyrdom - .17 Marital conflict .06 Strictness - .03 ^Irritability - .11 Excluding outside influences .13 Deification .07 Rejection of homemaking role - .14 I Avoidance of communica- ! tion - .04 'Suppression of sex .06 Intrusiveness - .13 Acceleration of develop ment . 01 Subfactors Harsh punitive control .10 Suppression and inter- | personal distance .02 Excessive demand for I striving - .02 Qverpossessiveness - .19 Factors - .07 - .03 Hostility-rejection Authoritarian control .18 .05 .17 .17 .08 .07 .02 .01 .11 .04 .05 .08 .07 .00 .05 .03 .17 .03 .09 1.51 0.10 1.36 1.33 0.30 0.24 0.03 0.01 0.53 0.09 0.10 0.25 0.22 0.00 0.11 0.03 1.38 0.03 0.34 131 four scales of the PARI, which represented the best predictors of that particular dependent variable. The linear and multiple partial correlations showing the relationship between the combination of scales and the various dependent variables are given in Tables 29 through 40. Evaluation of the Hypotheses Hypothesis One Statement of the null hypothesis— There is no significant relationship between the individual attitude scale scores of the PARI and the amount of developmental growth shown on the posttest subtests and major areas of the PAR. There were a total of 143 possible relationships between the two sets of data in hypothesis one. An examination of Tables 17 through 28 points to one striking finding, the paucity of relationships between the attitude scales of the PARI and the areas of development on the PAR. Of the 143 possible relationships there were only seven statistically significant correlations (p < .10) . The seven relationships were as follows: Fostering dependency— ambulation (Table 17). There was a low, but significant negative correlation between the PARI scale of fostering dependency and the ambulation subtest of the PAR. That is, the less a mother felt she 132 TABLE 29.— Multiple regression correlation coefficients between the posttest ambulation subtest of the PAR and the multiple scale predictors of the PARI Posttest PAR Ambulation Subtest Multiple Scale ____________________________________ Predictors of the PARI Multiple r r squared F ratio Fostering dependency Suppression of sex .49 .24 3.50* Intrusiveness Acceleration of development *p < .05 TABLE 30.— Multiple regression correlation coefficients between the posttest manipulation subtest of the PAR and the multiple scale predictors of the PARI Multiple Scale Predictors of the PARI Posttest PAR Manipulation Subtest Multiple r r squared F ratio Fostering dependency Marital conflict Irritability Suppression of sex .34 .11 1.42 133 I TABLE 31.— Multiple regression correlation coefficients between the posttest physical area of the PAR and the multiple scale predictors of the PARI Multiple Scale Predictors of the PARI Posttest PAR Physical Area Multiple r r squared F ratio Postering dependency Martyrdom Suppression of sex Intrusiveness .42 .17 2.34* *.05 < p < .10 TABLE 32.— Multiple regression correlation coefficients between the posttest rapport subtest of the PAR and the multiple scale predictors of the PARI Multiple Scale Predictors of the PARI Posttest PAR Rapport Subtest Multiple r r squared F ratio Fostering dependency Martyrdom Suppression of sex Intrusiveness .35 .12 1.56 134 TABLE 33.— Multiple regression correlation coefficients between the posttest communication subtest of the PAR and the multiple scale predictors of the PARI .. i ^ i , Posttest PAR Communication Multiple Snale Subtest Predictors of the PARI Multiple r r squared F ratio Fostering dependency Breaking the will .43 .18 Excluding outside influences Avoidance of communication 2.50* *.05 < p < .10 TABLE 34.— Multiple regression correlation coefficients between the posttest responsibility subtest of the PAR and the multiple scale predictors of the PARI , . , Posttest PAR Responsibility Subtest Multiple Scale Predictors of tne pari Multiple r r squared F ratio Fostering dependency Breaking the will .39 .16 Martyrdom Strictness 2.07* *.05 < p < .10 135 TABLE 35.— Multiple regression correlation coefficients between the posttest social area of the PAR and the multiple scale predictors of the PARI Multiple Scale Predictors of the PARI Posttest PAR Social Area Multiple r r squared ;F ratio Fostering dependency Martyrdom Strictness Excluding outside influences .30 .09 1.10 TABLE 36.— Multiple regression correlation coefficients between the posttest information subtest of the PAR and the multiple scale predictors of the PARI Multiple Scale Predictors of the PARI Posttest PAR Information Subtest Multiple r r squared F ratio Fostering dependency Breaking the will Excluding outside influences Intrusiveness .33 .11 1.38 136 TABLE 37.— Multiple regression correlation coefficients between the posttest ideation subtest of the PAR and the multiple scale predictors of the PARI . S B a e = S ^ B B S 3 S E l ^ a K 3 B S S S a Q B a C S a K 3 ^ B K S a B B K S 5 S S C e B 2 S 3 a B S 3 B B e K 3 8 C C a S ^ M ^ B a S B a C S 2 3 £ S a 3 3 5 S S 3 e S S S B n a = S S a M B . „ . , , Posttest PAR Ideation Subtest Multiple Scale ____________________________________ Predictors of the PARI Multiple r r squared F ratio Martyrdom Marital conflict Excluding outside influences Suppression of sex .41 .17 2.25* * . 05<p <. 10 TABLE 38.— Multiple regression correlation coefficients between the posttest creativity subtest of the PAR and the multiple scale predictors of the PARI Posttest PAR Creativity Subtest Multiple Scale ____________________________________ Predictors of the PARI Multiple r r squared F ratio Fostering dependency Irritability .33 .11 1.41 Suppression of sex Intrusiveness 137 TABLE 39.— Multiple regression correlation coefficients between the posttest intellectual area of the PAR and the multiple scale predictors of the PARI Multiple Scale Posttest PAR Intellectual Area Predictors of the PARI Multiple r r squared F ratio Martyrdom Marital conflict .34 .12 1.51 Excluding outside influences Suppression of sex TABLE 40.— Multiple regression correlation coefficients between the posttest total attainment age of the PAR and the multiple scale predictors of the PARI Multiple Scale Posttest Total Attainment Age Predictors of the PARI Multiple r r squared F ratio Fostering dependency Martyrdom .36 .13 1.70 Excluding outside influences Suppression of Sex 138 should shelter her child and the more she encouraged him to do things on his own, the more development the rubella youngster made in the area of large motor coordination (i.e., being able to climb, jump, skip, et cetera). Martyrdom— ambulation (Table 17). There was a statistically significant negative relationship between the PARI scale of martyrdom and the PAR's ambulation subtest. The less a mother felt she should sacrifice her personal life for that of her child, the more development he made in the area of large motor coordination. Intrusiveness— ambulation (Table 17). There was a low but significant correlation between the PARI scale of intrusiveness and the ambulation subtest of the PAR. It can be inferred from this relationship that the less the mother pried or forced her way into her child's everyday life and thoughts, the more development he tended to make in activities involving large muscle coordination. Martyrdom— physical area (Table 19). There was a low but statistically significant negative relationship between the PARI martyrdom scale and the total physical area of the PAR. Marital conflict— information (Table 24). There was a low but significant positive correlation between the PARI scale of marital conflict and the information subtest of 139 the PAR. Mothers who reported that disagreements and arguments should be part of a marriage tended to have rubella children who were more aware of themselves and their environment. Marital conflict— ideation (Table 25). There was a low but significant positive relationship between the marital conflict scale of the PARI and the PAR ideation subtest. The more mothers believed that disagreements were an integral part of marital life, the more development their rubella children made in their ability to conceptual ize (i.e., count and match objects). Marital conflict— intellectual area (Table 27). As one might expect, there was a low significant positive correlation between the PARI marital conflict scale and the total intellectual area of the PAR. With the exception of the aforementioned seven significant correlations, the results lead one to accept the null hypothesis relative to 136 of the 143 possible relationships and reject the research hypothesis that a significant association exists between the individual maternal childrearing attitude scales of the PARI and developmental growth as expressed on the posttest PAR subtests and major areas. It should also be noted that, since the alpha level was set at .10, twelve correlations could have been "significant" as a consequence of chance. 140 Hypothesis Two Statement of the null hypothesis— There is no significant relationship between the combination of scale scores on the PARI and the posttest subtests and major areas of the PAR. The best combination of four predictors (PARI scales) were obtained for each dependent variable (PAR subtest and major area) through a computer procedure in which the data were allowed to "float" until each combina tion had been secured. The combinations and their corre lations with the various dependent variables appear in Tables 29 through 39. Of the 11 possible correlations, four were statis tically significant (p .10) and another was very significant (p < .05). The fact that almost half of the correlations were statistically significant points to the efficacy of analyzing combinations of childrearing attitudes rather than looking at them separately or in terms of their purported factorial loadings.* It is noteworthy that the PARI scale of fostering dependency appeared in four of the five significant combinations. Furthermore, in examining the relative jf For example, when fostering dependency and ambula tion were correlated only 7 percent of the variance was explained. However, when ambulation was correlated with fostering dependency, suppression of sex, intrusiveness and acceleration of development, 24 percent of the variance was explained. 141 amount of variance accounted for by each of the four scales in each of these four combinations, it was very apparent that fostering dependency was responsible for the major portion of variance in each combination. In collaborating the findings of the combination of scales that were found to be significant predictors with the negative or positive direction of the specific individual scales that were found to be significantly correlated (hypothesis one), it was quite evident that hypothesis two reaffirmed what was found in hypothesis one. That is, it appeared that mothers who expressed attitudes of fostering independence in their children and at the same time rejected both the idea of being a martyr and sup pressing the ideas of their children, had children who made the greatest developmental gains. In general, the results lead one to accept the null hypothesis in six of the 11 relationships and reject the research hypothesis that a significant relationship does exist between the combination of scale scores on the PARI and the subtests and major areas of the PAR. The research hypothesis was accepted, however, in five of the relation ships . Hypothesis Three Statement of the null hypothesis— There is no significant relationship between the subfactors of the PARI and the amount of developmental growth shown on the post test PAR subtests and major areas. A review of Tables 17 through 27 reveals that of the 44 possible correlations, there were only two statistically significant relationships (p -c .10) . These relationships were as follows: Over-possessiveness— ambulation (Table 17). There was a significant negative correlation between the PARI over-possessiveness subfactor and the ambulation subtest of the PAR. It can be interpreted from this relatively strong negative relationship that the more a mother indicated that she should encourage her child to be independent of her, the less she intruded into his affairs, and the more of a life she had independent of her rubella child, the more development in the area of large muscle coordination the child tended to make. Over-possessiveness— physical area (Table 19). There was a low but statistically significant negative relationship between the PARI over-possessiveness subfactor and the total physical area of the PAR. Besides the relationships between over-possessive ness and the dependent variables of ambulation and total physical area, the results indicate that the null hypo thesis should be accepted relative to the 42 remaining associations. One would thus reject the research hypothe 143 sis that s significant correlation exists between the attitude subfactors of the PARI and growth as demonstrated on the posttest PAR subtests and major areas. Again, the reader should note that because the alpha level was established at .10, the two correlations could have been "significant" as a result of chance factors. Hypothesis Four Statement of the null hypothesis— There is no significant relationship between the individual scale scores, combination of scale scores, subfactors and factors of the PARI and the total posttest PAR developmental attainment age. A review of Tables 28 and 40 shows that of the 20 possible relationships, none was statistically significant. Therefore, in all cases the null hypothesis was accepted and the research hypothesis that a significant relationship exists between the PARI and the posttest PAR total attainment age was rejected. Hypothesis Five Statement of the null hypothesis— There is no significant relationship between either of the two major factors of the PARI (authoritarian-control and hostility- rejection) and the amount of developmental growth shown on the posttest PAR subtests and major areas. Tables 17 through 27 indicate that no relationship 144 existed between the major orthogonal factors of the PARI and any of the dependent variables as expressed on the posttest PAR. One is forced to accept the null hypothesis relative to all 22 possible relationships. Discussion of the Hypotheses The acceptance of the overwhelming majority of null hypotheses indicated the relative lack of relationship between maternal childrearing attitudes and developmental growth of rubella children in the physical, social and intellectual areas. Combining the five hypotheses, there were 240 possible relationships; of these only 14 correlations were statistically significant. If one operates from the premise that maternal behavior is influential in determining the rate of developmental growth in children, then why were not more relationships dis covered? One explanation may be that there is a rather dubious association between the expressed attitudes of mothers and their actual childrearing behavior. Possibly the old proverb, "Do as I say, not as I do," may have application here. It may be that one of the basic assumptions of this study, that maternal attitudes and behavior are integrally linked, was unfounded. Or, possibly more tenable as an explanation is the fact that rubella deaf-blind children may be so severely handicapped that other variables, aside from maternal childrearing j !attitudes, become more prominent as influences on the j ! developmental growth of this population. What may be valid; |for "normal" or mildly handicapped populations may be j :totally erroneous for rubella children. That is, child- :rearing attitudes may have a pervasive effect on the | development of normal children, as indicated in the review j I of literature, but may rate very low on the hierarchy of j environmental variables determining development in rubella ' ichildren. It is interesting to note that the dependent ivariable that showed the most impressive relationship with j :maternal childrearing attitudes was the physical area. Relative to physical development a central theme did appearj J i to run through the statistically significant relationships.j That is: (1) the less mothers fostered dependency, (2) the; I less they felt they should force themselves upon their children, and (3) the more they believed they should have j ; I I a life of their own, apart from their child, the greater ! i ;development the rubella child made in the physical areas, j | such as large motor coordination. In addition, an analysis; 1 of the subfactors and combination of scales of the PARI j !revealed that the less possessive a mother was of her childj i I jand the less she felt she should "push" his development, | i ' l i I |the more physical development he tended to make. There can! ! ' i ibe little question that these maternal attitudes tend to be! 146 in concert with each other. Paradoxically as it may seem, perhaps those mothers who became quite involved in and "a part of" their rubella child and his handicaps, also may have been the least effective or the most inhibitory of his physical development. It seems plausible that when mothers were able to "free" themselves from their children, this may in turn have provided the rubella youngsters with the needed opportunity to physically experience and explore their environment. Another interesting and enigmatic correlation that evolved from this study was the relationship between marital conflict and intellectual development. One reasonable explanation of this association may be that the two sets of variables are possibly related to one or more other variables which may produce some cause and effect pheno menon. For example, most of the items on the marital conflict scale imply some aggressiveness on the part of the mother. It could be that maternal aggressiveness is the key factor in enhancing intellectual development in rubella children. At any rate, one can only be speculatory in dealing with such a curious relationship. CHAPTER V SUMMARY, CONCLUSIONS AND RECOMMENDATIONS Summary The Problem In 1941, Dr. Norman McAlister Gregg found a connection between mothers who had contracted rubella during the first trimester of pregnancy and congenital cataract in infants. Today it is known that maternal rubella may lead to a number of childhood handicaps including deafness, blindness and heart defects. It is from this maternal condition that the deaf-blind "rubella" child is derived. In winter, 1963, a severe epidemic of rubella occurred in the eastern part of the United States and affected the West Coast in 1964-65. It is estimated that possibly 20,000 infants were born with congenital defects characteristic of the rubella syndrome. These children are now school age and present special problems for those who are involved in their care and treatment. Unfortunately, because of the relative rarity of rubella deaf-blindness and the methodological problems encountered in doing research with this group, little is known of the environmental influences that may impede or facilitate 147 148 their development. Some writers report that there are fewer deaf-blind children being placed in residential schools and more attending day schools and living at home with their parents. Thus, there seems to be a need to examine those influences in the home that negatively or positively effect developmental growth in rubella children. Existing research on normal as well as handicapped children suggested that the type of childrearing attitudes expressed by mothers may be a significant variable in the developmental rates shown by their children. Purpose of the Study The primary purpose of this investigation was to determine what relationship exists between maternal child- rearing attitudes and the amount of developmental growth rubella children make in the physical, social and intel lectual areas. Secondary purposes of the study were to: (1) ascertain some idea of the types of maternal child- rearing attitudes typical of rubella mothers and (2) to learn more about the developmental growth patterns charac teristic of rubella children. If a significant relation ship could be shown between maternal attitudes and development, then a base might be laid for a concerted effort in the area of parental counseling. Also, this study will make available, for one of the first times, 149 empirical data on the developmental rates of rubella children. It is hoped that the data will stimulate and/or assist future research in this area. Sample, Research Design, and Procedures The sample for this study was obtained from the records of the California State Diagnostic School for Neurologically Handicapped Children (DSNHC). From 1968 to 1971 the DSNHC evaluated 96 deaf-blind rubella children. Of this number, 50 were finally selected as subjects on the basis of a systematic process of elimination. Although it is doubtful, this elimination process may have produced a somewhat biased sample. To measure maternal childrearing attitudes and development in rubella children, a modified form of the Parental Attitude Research Instrument (PARI) and the Preschool Attainment Record (PAR) were used. Pretest data of an ex post facto nature were gathered from the DSNHC records relative to the severity of the rubella children's handicaps as well as their developmental levels in the physical, social and intel lectual areas. Their developmental levels were represented by the PAR scores which had been obtained during the initial evaluation at the DSNHC. From July through October, 1972, interviews were held with the mothers of the 50 rubella children, during 150 which time the PARI and the PAR were administered. The posttest PAR was identified as the dependent variable and the PARI the independent variable. The pretest PAR served as a base to obtain longitudinal data on rubella children, but was not, as such, considered the dependent variable. In more specific terms, the main purpose of the study— to determine what relationship exists between maternal childrearing attitudes and development in rubella children— was expressed as the correlation between the scales, subfactors and factors of the PARI and the sub tests, major areas, and total attainment score of the PAR. Previous research had identified four competing variables which were correlated with both the independent and dependent variables: the child's intellectual estimate, his hearing loss, his visual deficit, and the mother's level of education. Through a stepwise correla tion analysis, each of the competing variables was partialed out as the independent and dependent variables were being correlated. The results were expressed as multiple partial correlations and multiple regression coefficients representing the relationship between maternal childrearing attitudes and development in rubella children. Major Findings To achieve the purposes of this investigation, it was necessary to answer three questions: i I 151 Question 1— What childrearing attitudes are characteristic of mothers who have rubella deaf-blind children? Taken as a whole, the sample of rubella mothers professed childrearing attitudes which were extremely similar to attitudes found for mothers of normal children. The only significantly different attitude was related to the rubella mother's strong belief that she should foster independence in her handicapped child. Question 2— How much developmental growth do rubella deaf-blind children make in the physical, social and intellectual areas? Between pre and posttesting there was a mean chronological time lapse of approximately 21 months. Developmental growth was defined as the mean PAR gain scores made by the rubella group from pre to posttesting. Physical area. At pretesting, most rubella child ren were functioning at a very rudimentary level. However, during the 21 month period the rubella sample made approximately one month of developmental growth in the physical areas for each elapsed chronological month. Social area. At pretesting the mean performance of the sample indicated they were unable to relate to others, could not utilize simple speech equivalents, and were unable to help themselves in simple ways, such as filling ' 152 a glass from a tap. As was the case with the physical area, the sample made about one month's gain for each elapsed month on the rapport and responsibility subtests. However, on the communication subtest the group progressed 14 months, which may be viewed as a notable gain consi dering the extent and nature of the group's handicaps. Intellectual area. In Piagetian terms, the rubella sample was functioning at a sensorimotor level at the time of pretesting. By posttesting the group had made notable gains on the three intellectual subtests. In general, they made almost one month of progress for each elapsed chronological month on all three subtests. Probably as significant as the amount of growth made by the rubella children was the tremendous amount of variability found for each area of development. Except for the physical area, the individual standard deviations for all of the other subtests comprised over 50 percent of the actual mean developmental gains made. Question 3— Is there a significant relationship between the childrearing attitudes of rubella mothers and the developmental growth of their deaf-blind children? This question represented the main thrust of the study. It was from this question that the five basic hypotheses of this investigation were derived. Stated in the null, the following hypotheses were tested: (a) There is no significant relationship between the individual attitude scales of the PARI and the amount of developmental growth shown on the posttest PAR subtests and major areas. Of the 143 possible relationships, only seven were statistically significant (p < .10). There were negative correlations between fostering dependency and ambulation, martyrdom and ambulation, intrusiveness and ambulation, and martyrdom and the total physical area. There were positive correlations between marital conflict and information, mar tal conflict and ideation, and marital conflict and the total intellectual area. Thus, with the exception of these seven correlations, the results would lead one to accept the null hypothesis relative to the other 136 relationships. (b) There is no significant relationship between the combination of scale scores on the PARI and the posttest PAR subtests and major areas. Of the 11 possible correlations, five were found to be significant (p < .10). The significant correlations appeared to support what was found relative to hypothesis one. That is, rubella mothers who expressed childrearing attitudes of fostering independence in their children and rejected both the idea of martyrdom and suppression of their children's ideas, had children who showed the greatest 154 amount of developmental growth. In general, the results lead one to accept the null hypothesis relative to six of the correlations and reject it in five of the relation ships. (c) There is no significant relationship between the subfactors of the PARI and the amount of developmental growth shown on the posttest PAR subtests and major areas. Of the 44 possible relationships, only two correlations were statistically significant (p < .10): negative correlations between the independent variable of over-possessiveness and two dependent variables, ambulation and total physical area. These results were consistent with those found for the first hypothesis. Nevertheless, with the exception of these two relationships, the acceptance of the null hypothesis in the other 42 rela tionships was necessary. (d) There is no significant relationship between the individual scale scores, subfactors, and factors of the ( 7 # PARI and the total posttest PAR developmental attainment age. Relative to all 20 relationships the findings indicated that the null hypothesis should be accepted. (e) There is no significant relationship between either of the two major factors of the PARI (authoritarian- control and hostility-rejection) and the amount of developmental growth shown on the posttest PAR subtests 155 and major areas. In relation to the 22 possible relationships, the results indicated that the null hypothesis should be ac cepted. Conclusions This section contains answers to the three principle questions to which this study was directed. Mothers of Rubella Children Contrary to research showing mothers of handicapped children to be rejecting, authoritarian and self-suffering, the present study found that rubella mothers tend to be neither overly accepting nor rejecting, nor did it show them to be martyrs. Rubella mothers generally expressed childrearing attitudes characteristic of mothers having normal children. Developmental Growth in Deaf-Blind children Despite the rubella children's severe handicaps, they were capable of making notable developmental gains in the physical, social,, and intellectual areas. The fact that rubella deaf-blind children were capable of developing at a relatively satisfactory rate seems to support the idea that this group does have a noteworthy potential for development. Certainly this finding would lend support to those educational and training programs attempting to work 156 with and exploit this potential. As significant as the amount of development made by rubella children was the extraordinary amount of vari ability shown by them in the extent of their disabilities and their developmental rates. Thus, to stereotype rubella children for educational or other purposes would appear to be a mistake. Maternal Attitudes and Development in Rubella children The general lack of relationship between maternal childrearing attitudes and development in rubella children seems to lead one to make one of two possible conclusions: (1) there may be some question as to the validity of the relationship between expressed attitudes and actual be havior of mothers, or (2) the uniquely severe nature of the rubella child's handicaps may preclude a variable such as maternal childrearing attitudes from influencing his development. That is, there may be a hierarchy of vari ables that influence growth, and maternal childrearing attitudes may occupy a relatively low position on this hierarchy. Although not pervasive, there did appear to be some relationship between maternal attitudes and physical development. Those mothers who felt they should encourage independence and autonomy in their children, as well as have a life of their own separate from their handicapped 157 child, tended to have children who developed in the physical areas at a more rapid rate. Or, stated conversely, mothers who felt they should be over-possessive, foster dependency, and play the role of a martyr had children who made relatively poor development in the physical areas. Recommendations 1. Current programs and efforts to assist rubella children appear to be justified on the basis of the notable developmental progress shown and the potential implied by this group; these efforts should be continued. 2. Diagnostic and educational centers should avoid conceptualizing the rubella child as an entity in itself; there does not appear to be a "typical" rubella child. 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Medical Journal of Australia, I (1946), 645-659. ________ j • , Moore, B.; Mayo, H.; and Black, G. H. B. "Congenital Defects in Infants Following Infectious Diseases During Pregnancy." Medical Journal of Australia, II (1943), 201-210. Symonds, P. M. The Psychology of Parent-Child Relation ships . New York: Appleton-Century, 1939. Vernon, M. D. "Perception in Relation to Cognition," in A. H. Kidd and J. L. Rivoire (eds.), Perceptual Development in Children. New York: International Universities Press, l9(>6. Wagner, E. M. "Maternal Rubella: A General Orientation to the Disease." The New Outlook, LXI (1967), 105, 112. Warner, W. L.; Meeker, M.; and Eells, K. Social Class in America. Chicago: Science Research Associates, — 170 Waterhouse, E. J. "Helping the Deaf-Blind Face the Future." Journal of Rehabilitation, XXIII (1957), 15- 17. "Rubella: Implications for Education." The New Outlook, LXI (1967), 106-112. _____ . "Emphasis: The Deaf-Blind," in M. H. Goldberg (ed.), Blindness Research: The Expanding Frontiers. University Park, Penn.: The Pennsylvania State University Press, 1969. Watson, G. "Some Personality Differences in Children Related to Strict or Permissive Parental Discipline." Journal of Psychology, XLIV (1957), 227-249. Wechsler, D. Wechsler Intelligence Scale for Children. New York: The Psychological Corporation, 1949. Weiss, D. I.; Cooper, L. Z.; and Green, R. H. "Infantile Glaucoma: A Manifestation of Congenital Rubella." Journal of the American Medical Association, CLXV ( l W , '725-727.---------------------------- Wesselhoeft, C. "Medical Progress; Rubella "German Measles'." New England Journal of Medicine, CCXXXVI (1947), 943-55(5: Westlund, N., and Palumbo, A. "Parental Rejection of Cripple Children." American Journal of Ortho psychiatry, XVI (1956), 271-281. Witkin, H. A. "The Perception of the Upright." Scientific American, CC (1959), 50-56. Worchel, T. L., and Worchel, P. "The Parental Concept of the Mentally Retarded Child." American Journal of Mental Deficiency, LXV (1961), 782-788. Yarrow, L. J. "Maternal Deprivation: Toward An Empirical and Conceptual Re-Evaluation." Psychological Bulletin, LVIII (1961), 459-490.' Zuckerman, M. "Reversed Scales to Control Acqulescense Response Set in the Parental Attitude Research Instrument." Child Development, XXX (1959), 523-532. 171 Zuckerman, M.; Barrett, B. H.; and Bragiel, R. M. "The Parental Attitudes of Parents of Child Guidance Cases: 1. Comparisons with Normals, Investigations of Socioeconomic and Family Constellation Factors, and Relations to Parents Reactions to the Clinics." Child Development, XXXI (1960), 401-417. _____ , and Norton, J. "Response Set and Content Factors in the California F Scale and the PARI." Journal of Social Psychology, LIII (1961), 199-210. ________ , ________ , and Sprague, D. S. "Acquiescence and Extreme Sets and Their Role in Tests of Authoritar ianism and Parental Attitudes." Psychiatric Research Reports, X (1958), 28-45. ________ , and Oltean, M. "Some Relationships Between Maternal Attitude Factors and Authoritarianism, Personality Needs, Psychopathology, and Self- Acceptance." Child Development, XXX (1959), 27-36. i Ribback, B. M.; Monashkin, I.; and Norton, J. A. "Normative Data and Factory Analysis on the Parental Attitude Research Instrument." Journal of Consulting Psychology, XXII (1958), 165-171. Zunich, M. "A Study of Relationships Between Child Rearing Attitudes and Maternal Behavior." Journal of Experimental Education, XXX (1961), 231-241. APPENDICES 172 APPENDIX A LETTER TO RUBELLA MOTHERS 173 174 Dear From ______________________________ we evaluated your child, / in an attempt to diagnose his difficulties and to make various recommendations regarding his care and schooling. Currently we are conducting a research project to determine what types of environments are best for the development of children who have combined visual and hearing difficulties. The project is jointly sponsored by the University of Southern California and the California State Diagnostic School for Neurologically Handicapped Children, Southern California. During the summer we will call upon you to participate in this study. It will require little of your time. We will simply ask some questions about how your child is developing and what some of your ideas are on raising your youngster. The information in this study will remain strictly confidential. At no time will the child or his family be identifiable. The results of this study will be used in the design of new programs for children who have visual and hearing handi caps, as well as in the possible modification of current programs. More specifically, it will be aimed at estab lishing programs for assisting parents of these children. In the near future personnel from the University of Southern California will be contacting you to arrange a convenient time to come and talk with you. Any questions you may have regarding the research project will be gladly answered at that time. Sincerely yours, DONALD I. ASHURST, Ph.D. Super i ntend ent DIAsmv APPENDIX B A MODIFIED FORM OF THE PARENTAL ATTITUDE RESEARCH INSTRUMENT 175 A MODIFIED FORM OF THE PARENTAL ATTITUDE RESEARCH INSTRUMENT Each of the statements below were read and rated by the subjects as follows: They indicated their opinion by filling in the IBM score j sheet slot marked "A" if they strongly agreed, "a" if j they mildly agreed, "d” if they mildly disagreed, and "D" if they strongly disagreed. They were told that there were no right or wrong answers and to answer according to their own opinion. They were cautioned that many of the statements would seem alike but all were necessary to show slight differences in their i opinion. They were asked to think of only their rubella child when j answering these questions, even though they might have j other handicapped or non-handicapped children. To insure standardization, all subjects were administered the j instrument through the use of a tape recording of all 130 items. ! Scale (1): Fostering Dependency Non-reversed Items: I 1. A good mother should shelter her child from life's little difficulties. j 13. A mother should do her best to avoid any disappoint- j ment for her child. j 26. A child should be protected from jobs which might be j too tiring or hard for him. ; | 39. Parents should know better than to allow their j children to be exposed to difficult situations. j A strongly agree a mildly agree d mildly disagree D strongly disagree 52. Children should be kept away from all hard jobs which might be discouraging. Reversed Items: 65. A good mother lets her child learn the hard way about j life. I | 77. A child should learn that he has to be disappointed j sometimes. j ! | | 90. Children should be encouraged to undertake tough jobs ! | if they want to. j i : 103. Children have to face difficult situations on their own. I i Ill6. Children should be encouraged to undertake all kinds | of jobs no matter how hard. iScale (2) : Breaking the Will Non-reversed Items: j 2. Some children are just so bad they must be taught to fear adults for their own good. j I 14. It is frequently necessary to drive the mischief out | of a child before he will behave. j i 27. A wise parent will teach a child early just who is | j boss. | I 40. Children need some of the natural meanness taken out ! of them. | I 53. It is sometimes necessary for the parents to break j the child's will. i i I j jReversed Items: I 66. A child should never be taught to fear adults. ! I ! 78. You can't make a child behave by cracking down on. ihim.j | 91. There is no need for children to look on parents as j their bosses. jl04. If a child acts mean he needs understanding rather ! | than punishment. j ! I jll7. Children have a right to rebel and be stubborn some- j i times. i 178 Scale (3): Martyrdom INon-reversed Items: 3. Children should realize how much parents have to give | up for them. 15. A mother must expect to give up her own happiness for ! that of her child. ! ; ! 28. Pew women get the gratitude they deserve for all they j have done for their children. ! 41. Children should be more considerate of their mothers j since their mothers suffer so much for them. j ! I i 54. Mothers sacrifice almost all their own fun for their j children. j Reversed Items: j i 67. Parents shouldn't feel they have to sacrifice for j their children. | 79. There is no reason why a mother can't be happy and j make her child happy too. j ! i 92. Most children are grateful to their parents. i ; i 105. Children don't "owe" their mothers anything. i I 118. Having children doesn't mean you can't have as much j fun as you usually do. I Scale (4): Marital Conflict ; i ;Non-reversed Items: j People who think they can get along in marriage j without arguments just don't know the facts. j ! Sometimes it's necessary for a wife to tell off her j husband in order to get her rights. j No matter how well a married couple love one another, j there are always differences which cause irritation j and lead to arguments. There are some things which just can't be settled by a mild discussion. It's natural to have quarrels when two people who both have minds of their own get married. I ; 16. I ! 29. I j 42. ss. 1 1____ Reversed Items: 68. There is no reason for arguments in a happy marriage 80. A good wife never has to argue with her husband. 93. If a couple really loves each other there are very few arguments in their married life. 106. Almost any problem can be settled by quietly talking it over. 119. Husbands and wives who have different views can still get along without arguments. Scale (5): Strictness Non-reversed Items: 5. A child will be grateful later on for strict train ing. 17. Strict discipline develops a fine strong character. 30. Children who are held to firm rules grow up to be the best adults. 43. Most children should have more discipline than they get. 56. Children are actually happier under strict training. Reversed Items: 69. Strict training will make a child resent his parents later on. 81. Strict discipline makes children grow up to be mean or rebellious. 94. If children are given too many rules they will grow up to be unhappy adults. 107. Most children are disciplined too much 120. Strict training makes children unhappy. Scale (6): Irritability Non-reversed Items: 6. Children will get on any woman's nerves if she has to be with them all day. 18. Mothers very often feel that they can't stand their children a moment longer. 31. It's a rare mother who can be sweet and even tempered with her children all day. i 44. Raising children is a nerve-wracking job. j 57. It's natural for a mother to "blow her top" when j children are selfish and demanding. Reversed Items: 70. There is no reason why a day with the children should be upsetting. j 82. Most mothers never get to the point where they can't ; stand their children. 95. Most mothers can spend all day with the children and ' remain calm and even-tempered. i 108. Raising children is an easy job. ! ! 121. A mother should keep control of her temper even when children are demanding. j Scale (7): Excluding Outside Influences j I Non-reversed Items: 7. It's best for the child if he never gets started j wondering whether his mother's views are right. | I 19. A parent should never be made to look wrong in a child's eyes. 32. Children should never learn things outside the home j which make them doubt their parents' ideas. | I 45. The child should not question the thinking of his j parents. ! | 58. There is nothing worse than letting a child hear | criticisms of his mother. i Reversed Items: j 71. Children have every right to question their mothers1 i views. i ; i ; 83. If a parent is wrong he should admit it to his child.: i ; 96. A child should be encouraged to look for answers to j his questions from other people even if the answers contradict his parents. ! i i i 109. When a child thinks his parent is wrong he should j say so. : : i ; 122. A good mother can tolerate criticism of herself, j even when the children are around. j ! Scale (8): Deification ! Non-reversed Items: 20. The child should be taught to revere his parents above all other grown-ups. 33. A child soon learns that there is no greater wisdom j than that of his parents. j i I i I 46. Parents deserve the highest esteem and regard of their children. 59. Loyalty to parents comes before anything else. ! i ! ■ 129. More parents should teach their children to have ; i unquestioning loyalty to them. ! Reversed Items: I 84. A child should be taught that there are many other j | people he will love and respect as much or more than j his own parents. j 97. Most children soon learn that their parents were j j mistaken in many of their ideas. | 110. A parent should not expect to be more highly j esteemed than other worthy adults in their children's eyes. j 123. Loyalty to parents is an over-emphasized virtue. 130. Loyalty on the part of children to their parents is j something that the parents should earn. i 182 ! Scale (9): Rejection of Homemaking Role Non-reversed Items: 8. One of the worst things about taking care of a home | is a woman feels that she can't get out. 21. Having to be with the children all the time gives a woman the feeling her wings have been clipped. j 34. Mobt young mothers are bothered more by the feeling of being shut up in the home than by anything else. S 47. One of the bad things about raising children is that | you aren't free enough of the time to do just as ! you like. 60. A young mother feels "held down" because there are I lots of things she wants to do while she is young. i Reversed Items: ! 72. Taking care of a home doesn't have to coop a woman I up. j 85. Most mothers are content to be with children all the j time. | 98. Most young mothers don't mind spending most of their ; time at home. | I 111. If you run your home right, you have plenty of time to do the things you like to do. 124. Most young mothers are pretty content with home life. j | | Scale (10): Avoidance of Communication j ! Non-reversed Items: I ; 9. If you let children talk about their troubles they I end up complaining even more. ! j 22. Parents who start a child talking about his worried I don't realize that sometimes it's better to just ] leave well enough alone. I | 35. Children pester you with all their little upsets if | you aren't careful from the first. i 48. If a child has upset feelings it is best to leave him alone and not make it look serious. , 183 j 61. The trouble with giving attention to children's j problems is they usually just make up a lot of j stories to keep you interested. I Reversed Items: 73. Children should be encouraged to talk about their ; problems. i i 86. A child should always be encouraged to talk about his troubles. ■ 99. A mother should be concerned with any problem of a j child no matter how trivial. ° j 112. A mother should always be concerned about upset feelings in a child. ] 125. Anything a child wants to tell a parent is important enough to listen to. I i j Scale (11): Suppression of Sex j Non-reversed Items: I 10. A young child should be protected from hearing about ; sex. | 23. It is very important that young boys and girls not j be allowed to see each other completely undressed. 36. Children who take part in sex play become sex j criminals when they grow up. I 49. Sex is one of the greatest problems to be contended with in children. j 62. There is usually something wrong with a child who ! asks a lot of questions about sex. j Reversed Items: j 74. Children should be taught about sex as soon as possible. i 87. There is nothing wrong with bathing boys and girls j in the same bath tub. 100. Sex play is a normal thing in children. 113. Sex is no great problem for children if the parent doesn't make it one. 126. Children are normally curious about sex. Scale (12): Intrusiveness i Non-reversed Items: ! 11. A mother should make it her business to know ! everything her children are thinking. 24. A child should never keep a secret from his parents. i 37. An alert parent should try to learn all her child's j thoughts. i i 50. A mother has a right to know everything going on in j her child's life because her child is part of her. 63. It is a mother's duty to make sure she knows her child's innermost thoughts. i Reversed Items: 75. A child's thoughts and ideas are his own business. 88. Children are entitled to keep their own secrets. ; 101. A good parent doesn't try to pry into the child's | thoughts. I 114. Being a mother doesn't give women the right to know | everything in their childrens lives. | j 127. Every child should have an inner life which is only j his business. Scale (13): Acceleration of Development Non-reversed Items: 12. Most children are toilet trained by 15 months of age. 25. The sooner a child learns to walk the better he's trained. 38. The earlier a child is weaned from its emotional ties to its parents the better it will handle its own problems. 51. A mother should make an effort to get her child toilet trained at the earliest possible time. 185 64. A child should be weaned away from the bottle or breast as soon as possible. Reversed Items: 76. Very few children are toilet trained by 15 months of age. i | 89. A child should take all the time he wants to before he walks. 102. A child needs to be emotionally close to its parents | for a long time. i 115. Toilet training should be put off until the child ! indicates he is ready. j 128. The longer a child is bottle or breast fed the more I secure he will feel. I
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Ortiz, Kenneth Kurt
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Maternal Child-Rearing Attitudes And Developmental Growth Of Rubella Deaf-Blind Children
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