Parents of Children With PWS Feel More Stress in Their Interactions, Study Suggests

Parents of preschoolers with Prader-Willi Syndrome (PWS) tend to be relatively more stressed and overinvolved in interactions with their children, while the children themselves show less interest and social skill in these interactions, compared with their typically developing peers, according to a new study.

The study, titled “Preliminary Characterization of Parent-Child Interaction in Preschoolers With Prader-Willi Syndrome: The Relationship Between Engagement and Parental Stress,” was published in the American Journal on Intellectual and Developmental Disabilities.

Interactions between parents and children during the first years of development are critical for building social skills and can have long-lasting impacts.

Previous research has suggested that children with atypical social development (for instance, those with autism) show a reduced ability to attend to both play objects and their partner in a task. This is in line with prior observations of less eye contact and attention in such children, and poses challenges to day-to-day interaction with their parents.

“However, early parent-child interaction and how it relates to other factors such as parental stress has not been characterized in [the PWS] population,” according to the new study.

For the study, researchers at Case Western Reserve University recruited 17 parent-child pairs of children with PWS, as well as 20 pairs with typically developing children. Children in both groups were 3–5 years old (mean age of 4.5 years). One parent in each group was a biological father, and all others were biological mothers.

All parents completed the Parenting Stress Index (PSI), a questionnaire that measures parental stress. Parents of children with PWS reported higher scores in general, indicating more stress than those of typically developing children.

These parents also had significantly higher scores on the ‘”role restriction” domain of the PSI, which may reflect “a sense of limited freedom and constrained personal identity as a result of their parenting role,” the researchers said.

The parent-child pairs were recorded while playing with toys (blocks, small figurines, and cars) for five minutes. The researchers quantified these interactions by scoring parameters such as how often parents gave unsolicited help and how much children and parents seemed to enjoy each other.

Results showed that parents in the PWS group were overinvolved and more intrusive, including being more directly engaged with play and offering more unsolicited help.

In turn, children with PWS scored significantly lower in social interest and “social competence” than their peers (4.71 vs. 6.60). Mutual enjoyment of playtime was significantly lower among the PWS pairs (3.14 vs. 2.15, with higher scores indicating worse outcome).

Statistical analyses revealed that parents of children with lower scores in social skills tended to have higher depression scores and worse relationships with their spouse or partner. Also, parents who offered more unsolicited help during play rated their own feelings of parental competence lower.

“Results reported here suggest that early parent-child interactions are indeed disrupted in preschoolers with PWS and their primary caregiver,” the researchers wrote.

Notably, these alterations occur at an earlier age than the increased appetite typically seen in PWS, they said.

In contrast, the team found that scores of “response to child,” which assessed parental responses during play, did not differ between the two groups.

“[P]arents from both groups remained positive and encouraging during the interaction task,” the investigators wrote. “This finding is important and suggests that, even though PWS parent-child dyads may show difficulty in other areas while interacting, parents are able to remain supportive, which can provide a strong foundation to build other skills on during these periods of engagement.”