Background
Like many chronic disorders, the psychological and social impact of multiple sclerosis (MS) extends beyond the people living with the disease to encompass their families. For young children, a parent’s chronic disorder can be a source of stress and anxiety and, in some instances, can affect the child’s psychosocial behaviour. There is, however, very little research detailing the effects of parental MS on early childhood development.
To this end, MS Society of Canada-funded PhD student Neda Razaz, along with epidemiologists Dr. Helen Tremlett, Dr. Ruth Ann Marrie and colleagues, carried out a retrospective analysis to examine the possible relationship between parental MS and childhood development. Their work was published in the journal Multiple Sclerosis.
The Study
The study was conducted in Manitoba, and information was pooled and collated from linked health care repositories, including databases on drug programs, physician claims, hospital discharge records, and health insurance registries in order to identify parents living with MS. Early Development Instrument (EDI) data was used to assess childhood development.
The EDI is a checklist completed by the child’s teacher during kindergarten (around 5 years of age) and is meant to gauge the child’s readiness for school. The checklist measures five core areas of early childhood development: physical health and well being, social competence, emotional maturity, language and cognitive development, as well as communication skills and general knowledge. As noted by the authors, the EDI is a well-established and validated tool for predicting a child’s success and psychological health later in life.
EDI data was available for 153 children where one parent had MS (if both parents had MS, the child was excluded from the study), and, for comparison, 876 children whose parents did not have MS.
In addition to examining EDI data, the authors analyzed a number of additional variables, including common parental comorbidities (other accompanying diseases) such as mental health disorders and chronic lung disease.
Results
The authors did not observe a difference on any EDI measure when comparing children whose parent had MS and those children whose parents did not have MS, suggesting that having a parent with MS does not significantly affect a child’s vulnerability on any developmental outcome.
The data did demonstrate, however, that if a parent – regardless of whether they had MS or not – was diagnosed with a mental health disorder (such as anxiety and/or depression), the child was more likely to have lower EDI scores across multiple developmental areas. This was an important finding because the study found that parents with MS were more likely to have a mental health comorbidity compared to non-MS parents (49.5% versus 35.5% in each group). When looking within the MS parent group on its own, a child whose parent had a mental health disorder was more likely to have lower EDI scores in social competence and emotional maturity.
Comment
The authors found that parental MS overall is not associated with adverse early childhood development. Instead, the parent’s mental health status was the most important determinant of a child’s developmental outcomes. Since a person with MS is more likely to have a mental health comorbidity (a finding supported by this study and others), and parental mental health is linked to early childhood development, it is important that appropriate support be made available to the child, the family, and the person living with MS to manage the risk of negatively affecting childhood development.
On the other hand, the authors do note that their results are not entirely consistent with previous research – other groups having shown an association between parental MS and the psychological and social behaviour of older children and adolescents (reviewed here by the same authors of this study). The authors acknowledge that it is possible for children to have normal development early on (the focus of this study) while being vulnerable to parental MS later in childhood. To fully address the question, much larger and longer studies that span the entire period of childhood and adolescence will be required.
Source
Razaz N et al. (2015). Impact of parental multiple sclerosis on early childhood development: A retrospective cohort study. Multiple Sclerosis. 21(9): 1172-83.