Do the Parent–Child Relationship and Parenting Behaviors Differ Between Families With a Child With and Without Chronic Illness? A Meta-Analysis

Objective The present meta-analysis compared the quality of the parent–child relationship as well as parenting behaviors and styles of families with a child with chronic physical illness with families of healthy children or test norms. Methods Empirical studies were identified with the help of electronic databases and cross-referencing. Based on 325 included studies, random-effects meta-analysis was performed. Results Although most effect sizes were small or very small, the parent–child relationship tended to be less positive if a child had a chronic physical illness (g = −.16 standard deviation units). In addition, lower levels of parental responsiveness (emotional warmth; g = −.22) as well as higher levels of demandingness (control, monitoring; g = .18) and overprotection (g = .39) were observed in these families. However, effect sizes were heterogeneous and only significant for a limited number of diseases. There was also some evidence for higher levels of authoritarian (g = .24) and neglectful parenting (g = .51) as well as lower levels of authoritative parenting compared with families with healthy children (g = −.13). Effect sizes varied, in part, by length of illness, child age, rater, assessment method, and target of comparison. Conclusions We conclude that most families with a child with chronic physical illness adapt well with regard to the parent–child relationship and parenting behaviors/styles. Nonetheless, some families of children with specific diseases—such as epilepsy, hearing impairment, and asthma—may have difficulties finding appropriate levels of protective behaviors, control, and parental warmth and building positive mutual relationships between parents and children.