Parent Couples’ Coping Resources and Involvement in their Children’s Intervention Program

Parent Couples’ Coping Resources and Involvement in their Children’s Intervention Program Abstract Parental involvement is vital to the implementation of intervention programs for deaf and hard-of-hearing (DHH) children. The current study examined the dyadic relationships between mothers’ and fathers’ coping resources and their involvement in their child’s intervention program. In addition, the moderating roles of parent’s gender and family religiosity on the associations between coping resources and involvement were examined. Seventy Jewish couples of parents of DHH children, representing various levels of religiosity, completed questionnaires regarding involvement in their child’s intervention program, child acceptance, parental self-efficacy, and perceived social support. Multilevel modeling analyses were used to test actor–partner interdependence. The findings indicated significant actor effects for child acceptance, parental self-efficacy, and social support. All were positively associated with parental involvement. Gender was found to moderate the actor effect of child acceptance. Partner effects were found only for mothers, for child acceptance, and social support. Fathers’ child acceptance and social support were negatively associated with mothers’ involvement. Religiosity did not moderate neither actor nor partner effects. These results have important implications for planning intervention programs that are sensitive to each of the parent’s needs. Parental involvement is a multidimensional construct defined as the family’s active participation in an intervention program of their child, the quality of the interactions and relationships they establish with the program professionals, and the way the family feels about the services they receive (Korfmacher et al., 2008). Similarly, parental involvement of children who are deaf or hard-of-hearing (DHH) is described by the parents as their active participation and interest in their child’s intervention, their engagement in on-going communication and interactions with professionals, their active initiation and taking responsibilities regarding their child’s therapeutic process, and their establishment of social relationships with other families (Ingber, 2004). Parental involvement in early intervention programs for children who are DHH has been acknowledged as a vital component in the program implementation (Yoshinago-Itano, 2014). Parental involvement in DHH children’s intervention promotes children’s emotional, social, academic, and language development (Calderon, 2000; DesJardin & Eisenberg, 2007; Harvey & Kentish, 2010; Hintermair, 2006; Kurtzer-White & Luterman, 2003; Sarant, Holt, Dowell, Rickards, & Blamey, 2009). In addition, parental involvement enhances professionals’ understanding of the child and the family’s needs, improves parent-professional communication, and increases the generalization of child skills across the intervention program and home (Dunlap, Newton, Fox, Benito, & Vaughn, 2001; Kaiser & Hancock, 2003). Although parental involvement in children’s early intervention programs is highly important, there is scant research on parental involvement in parents of DHH children. Despite reports of increasing father involvement in their children’s care (Bouchard, Lee, Asgary, & Pelletier, 2007; McBride, Dyer, Liu, Brown, & Hong, 2009; Pleck & Masciadrelli, 2004), and the unique positive contribution to intervention outcomes of fathers’ involvement with children with disabilities (MacDonald, Hastings, & Fitzsimons, 2010; McBride et al., 2009) most research has focused solely on maternal involvement (DesJardin & Eisenberg, 2007). Among parents of DHH children, mothers reported higher levels of involvement than fathers (Zaidman-Zait, Most, Tarrasch, & Haddad, 2017). Nevertheless, no differences were found in father’s involvement between fathers of typical hearing children and fathers of DHH children. Overall, all fathers reported being highly involved with their children (Ingber & Most, 2012). Interest in the contribution of both fathers and mothers stems from family system theory which views families as social systems (Parke & Buriel, 1998) where each individual or subsystem in the family is influenced by the others (Steinglass, 1987). However, studies that have examined both mothers and fathers considered them as a single parental unit and have ignored the interdependence of data and the interpersonal influences inherent within the family system. It is recommended that data from married couples be treated as non-independent observations since the emotions and experiences of one spouse often affect the emotions and experiences of the other spouse (Kelley et al., 2003). Belsky’s model of the determinants of parenting behavior is a theoretical framework for guiding research into the broader personal and socio-ecological factors associated with parenting (Belsky, 1984). According to this model, parenting is influenced by three domains: personal factors related to the parents (e.g., parents’ perceptions and beliefs), the broader social contextual influences in which parents are embedded (e.g., social support, cultural norms) and the child’s characteristics (e.g., having a hearing loss). Given that parental involvement is a specific component of parenting behaviors, it is reasonable to assume that these determinants of parenting have a comparable influence on parental involvement. Thus, informed by Belsky’s model it is possible that parental traits such as their cognitions and beliefs and social context should be salient factors in explaining levels of parental involvement in DHH children’s early intervention programs. It is important to note that approximately 90−95% of DHH individuals are born to hearing parents, who have little or no prior knowledge about hearing loss (Mitchell & Karchmer, 2004). Accordingly, for the most part, studies that have examined the impact of parents’ personal characteristics reflect the perspectives of hearing parents who have DHH children. Similarly, the present study itself focuses on this population and therefore does not represent all perspectives on families with deaf children. Parents’ personal characteristics associated with involvement Acceptance of a DHH child Child acceptance reflects the parents’ positive appraisals that serve as an internal personal resource (Zaidman-Zait et al., 2017). Acceptance is reflected by the ability to face with what is being offered by an event or situation without trying to avoid experiences. In other words, abandon dysfunctional agendas, taking stock of the situation including the challenges, constraints, and resources, and focusing on making the best of the options while adopting an active process of coping effectively (Blackledge & Hayes, 2001; Walsh, 2003). It has been suggested that acceptance of the child and his/her disability is a positive “stage” in family adjustment and enables parents to meet their child’s needs (MacDonald et al., 2010). Parents who experience difficulties in accepting their child can end up denying their child’s special needs (Lloyd & Hastings, 2008). Muñoz, Blaiser and Barwick (2013) showed that one of the reasons for the delay between identification of hearing loss and fitting hearing aids was parental denial that their child needed a hearing aid. Parents may benefit from reaching a state where they can accept their child along with the associated difficulties of having a child who is DHH, such as dealing with communication needs of their child, obtaining appropriate intervention programs and services, learning about technological supports, and advocate for themselves and for their child (Zaidman-Zait, 2007). Among mothers and fathers of DHH children, higher levels of child acceptance were associated with lower levels of parenting stress (Zaidman-Zait, Most, Haddad, Tarash, & Brand, 2016). Similarly, parents of children diagnosed with autism experienced lower levels of parenting stress when they reported higher levels of child acceptance (Jones, Hastings, Totsika, Keane, & Rhule, 2014). It should be mentioned that findings of studies examined the contribution of coping resources among parents of children diagnosed with autism spectrum disorders (ASD) were brought considering the scarce research examining DHH children mothers’ and fathers’ of coping resources. These examples do not intend to compare DHH children to children diagnosed with ASD. Parental self-efficacy An additional theoretical construct that is important in considering influences on parent involvement is parental self-efficacy. Parental self-efficacy refers to how parents perceive their competence as successfully fulfilling their parenting role and their ability to function competently while raising their children (Jones & Prinz, 2005). Parental self-efficacy is a crucial coping resource in dealing with children’s rehabilitation demands and promoting parental involvement (Punch & Hyde, 2010). Parents with an increased sense of self-efficacy tend to learn more about parenting, participate in parenting education programs, and be responsive to their child’s needs (Coleman & Karraker, 2003). Low parental self-efficacy, on the other hand, has been associated with negative parenting such as withdrawal of love (Hill & Bush, 2001) and a tendency to give up easily when faced with parenting challenges (Ardelt & Eccles, 2001). Parental self-efficacy has also been associated with increased involvement in home learning activities such as reading, playing, and everyday household activities (Giallo, Treyvaud, Cooklin, & Wade, 2013). A few studies have examined the relationship between parenting self-efficacy and involvement in parents of DHH children. Mothers’ self-efficacy was positively associated with their involvement in therapy activities with their child (DesJardin & Eisenberg, 2007), whereas fathers’ self-efficacy was positively associated with their involvement in daily activities (Ingber & Most, 2012). In another study, fathers’ but not mothers’ self-efficacy was also related to increased involvement in their child’s intervention program (Zaidman-Zait et al., 2017). Parenting self-efficacy has been posited to improve children’s language competence and social behavioral skills (Stika et al., 2015) as a result of increased parents’ involvement in their children’s intervention program and therapy activities. Parents’ social and contextual characteristics associated with involvement Social Support A social contextual coping resource that also found to impact parental involvement is the support parents receive from others. Parents’ social support can include both formal and informal sources of support including the spouse, in-laws, family members, close friends, friends, neighbors, community, professionals, and work colleagues (Rodrigo, Martín, Máiquez, & Rodríguez, 2007). Studies have indicated that social support makes an important contribution to the adjustment of parents of DHH children (Åsberg, Vogel, & Bowers, 2008; Henderson, Johnson, & Moodie, 2014; Zaidman-Zait, 2007), including a decrease in parenting stress (Åsberg et al., 2008; Lederberg & Golbach, 2002), and improved parent–child interactions (Hintermair, 2006). Several studies have examined the beneficial effects of social support on parental involvement among parents of DHH children (Ingber, Al-Yagon, & Dromi, 2010; Zaidman-Zait et al., 2017). The findings indicated that parents with higher perceived social support were more involved in their children’s intervention programs (Ingber et al., 2010; Zaidman-Zait et al., 2017). In describing their coping experience, the parents indicated that receiving support and guidance from professionals increased their motivation to become more involved in their children’s intervention (Zaidman-Zait, 2007). Similarly, among mothers of children with ASD, higher levels of perceived social support predicted higher levels of parental school-based involvement (Benson, Karlof, & Siperstein, 2008). This small body of research thus suggests that social support promotes parental involvement by providing parents with the psychosocial and instrumental resources to be actively involved in their children’s intervention, and allows parents to better manage the countervailing stressors and demands placed upon them. Religiosity The contribution of religiosity to individuals’ resilience, physical health, and psychological wellbeing has been consistently acknowledged (Caldwell & Senter, 2013; Yoon & Lee, 2006). Religious beliefs can be considered as both a personal and a social coping resource. Religious beliefs can inform ways of coping and give meaning to life events that in turn promotes adjustment (Johnstone, Glass, & Oliver, 2007). In addition, being religious may entail belongingness to a community that can provide social support which can enhance the parents’ wellbeing (Poston & Turnbull, 2004). Hence, religious beliefs can affect a family’s outlook on disability (Tarakeshwar & Pargament, 2001) and ways of coping with the demands involved in parenting a child with disabilities (Kamei, 2014). Poston and Turnbull (2004) reported that spirituality and religion can play important roles in the life of families of children with disabilities. Previous studies have indicated that religious beliefs and practices support parents of DHH children through the coping process and acceptance of their child (Ahlert & Greeff, 2012; White, 2009). Overall, religious belief may thus provide strength and resources that enable families to withstand daily challenges. Religiosity can be assumed to play an important role in the lives of parents raising a child who is DHH and may contribute to their parenting behaviors and practices. Among Israel’s Jewish population, religiosity is a clear factor in social group definition. Individuals tend to characterize themselves according to their level of observance, which ranges from secular (i.e., non-orthodox), traditional (denoting those who are partially observant), orthodox/religious, and ultraorthodox. In general, secular Jews have values similar to Western society and do not adhere to religious commandments. Traditional Jews may follow some traditional commandments for ethnic and/or social reasons (Lazar, Kravetz, & Frederich–Kedem, 2002). Within the Jewish adult population 8% define themselves as ultraorthodox, 12% modern orthodox, 38% traditional, and 42% secular (Arian & Keissar-Sugarmen, 2012). A recent study examined the contribution of support resources to family quality of life among Israeli Jewish families of children with developmental disabilities who differed in their level of religiosity. The findings indicated small but significant differences in families’ satisfaction with family quality of life based on their religiosity. Religious families reported a higher quality of life. However, there were no differences between religious and secular families in terms of familial, social, or service support (Taub & Werner, 2016). However, parents of children with disabilities reported experiencing stress regarding the acceptance of their child by members of their religious community (Herman, 2006; Kamei, 2014; Leyser & Dekel, 1991; O’Hanlon, 2013). The current study Parents of DHH children face a variety of unique demands and long-term challenges in raising their children. These multiple demands prompt parents to examine and reframe their beliefs and coping strategies, and may imply that couples share their care giving experience including their cognitions, emotions and coping resources with each other. Consequently, when examining factors associated with parents’ involvement from a system perspective, both mothers and fathers should be examined in tandem with factors relating to the other caregiver. The goal of the present study was to shift the focus from intra-individual models to systemic ones that include both fathers and mothers and place special emphasis on examining self and partner coping resources in relation to parental involvement in their DHH child’s intervention. In the current study, we examined the relationship between fathers’ and mothers’ coping resources, including child acceptance, self-efficacy, and social support and their parental involvement. In addition, we examined whether parental gender and family religiosity moderated the associations between mothers’ and fathers’ coping resources and their involvement. As the child’s degree of hearing loss might affect child’s functioning and in turn impact parental adjustment (Pipp-Siegel, Sedey, & Yoshinaga-Itano, 2002; Yoshinaga-Itano, 2003), the children’s degree of hearing loss was included in the analytic models. To summarize, the current study had three main purposes: (a) To examine the relations between parents individual coping resources and their involvement. Specifically, to examine whether mothers and fathers self-reported coping resources will be positively associated with their report on involvement (i.e., actor effects); (b) To examine the relations between mothers coping resources and fathers’ involvement and the relations between fathers coping resources and mothers’ involvement (i.e., partner effects); and (c) To examine whether parental gender and family level of religiosity will moderate these actor- partner effects. Method Participants The sample was composed of 70 Jewish married couples (father–mother pairs) of children with mild to profound hearing loss, whose mean age was 5.25 years (SD = 1.6). The mean age of hearing loss identification was 13.9 months (SD = 12.8). All parents were hearing and communicated in spoken language at home with their children. Mothers mean age was 34.5 years (SD = 5.1) and fathers mean age was 36.6 years (SD = 6.2). The families were recruited from early intervention centers that provide specialized services to DHH children and their families. The parents and their children’s characteristics are listed in Table 1. Table 1 Parents’ and Children’s Demographics Parents’ characteristics Mothers Fathers Frequencies N (%) Frequencies N (%) Level of education  Elementary school education — 1 (2)  High school education 17 (24) 13 (18)  Vocational education 7 (10) 2 (3)  Religious Education — 20 (28)  College education 10 (15) 4 (5)  University degree 36 (52) 30 (44) Employment status  Employed 63 (90) 67 (95) Religiosity levels  1 26 (37)  2 7 (10)  3 15 (21)  4 22 (31) Additional D/HH children in family 13% Parents’ characteristics Mothers Fathers Frequencies N (%) Frequencies N (%) Level of education  Elementary school education — 1 (2)  High school education 17 (24) 13 (18)  Vocational education 7 (10) 2 (3)  Religious Education — 20 (28)  College education 10 (15) 4 (5)  University degree 36 (52) 30 (44) Employment status  Employed 63 (90) 67 (95) Religiosity levels  1 26 (37)  2 7 (10)  3 15 (21)  4 22 (31) Additional D/HH children in family 13% Child’s characteristics Frequencies N (%) Gender  Female 37 (54)  Male 32 (46) Degree of hearing loss  Mild to severe 16 (24)  Severe to profound 51 (76) Amplification  Hearing aids 18 (26)  Cochlear implant 51 (74) Communication  Spoken 58 (84)  Spoken & signs 11 (16) Child’s characteristics Frequencies N (%) Gender  Female 37 (54)  Male 32 (46) Degree of hearing loss  Mild to severe 16 (24)  Severe to profound 51 (76) Amplification  Hearing aids 18 (26)  Cochlear implant 51 (74) Communication  Spoken 58 (84)  Spoken & signs 11 (16) Table 1 Parents’ and Children’s Demographics Parents’ characteristics Mothers Fathers Frequencies N (%) Frequencies N (%) Level of education  Elementary school education — 1 (2)  High school education 17 (24) 13 (18)  Vocational education 7 (10) 2 (3)  Religious Education — 20 (28)  College education 10 (15) 4 (5)  University degree 36 (52) 30 (44) Employment status  Employed 63 (90) 67 (95) Religiosity levels  1 26 (37)  2 7 (10)  3 15 (21)  4 22 (31) Additional D/HH children in family 13% Parents’ characteristics Mothers Fathers Frequencies N (%) Frequencies N (%) Level of education  Elementary school education — 1 (2)  High school education 17 (24) 13 (18)  Vocational education 7 (10) 2 (3)  Religious Education — 20 (28)  College education 10 (15) 4 (5)  University degree 36 (52) 30 (44) Employment status  Employed 63 (90) 67 (95) Religiosity levels  1 26 (37)  2 7 (10)  3 15 (21)  4 22 (31) Additional D/HH children in family 13% Child’s characteristics Frequencies N (%) Gender  Female 37 (54)  Male 32 (46) Degree of hearing loss  Mild to severe 16 (24)  Severe to profound 51 (76) Amplification  Hearing aids 18 (26)  Cochlear implant 51 (74) Communication  Spoken 58 (84)  Spoken & signs 11 (16) Child’s characteristics Frequencies N (%) Gender  Female 37 (54)  Male 32 (46) Degree of hearing loss  Mild to severe 16 (24)  Severe to profound 51 (76) Amplification  Hearing aids 18 (26)  Cochlear implant 51 (74) Communication  Spoken 58 (84)  Spoken & signs 11 (16) Procedure Ethical approval was obtained from the University and the research ethics committees of the clinical institutions involved. Parents were recruited through intervention centers that serve DHH children. The questionnaires were distributed to the parents by the professionals working with them. Each of the parents completed four self-report questionnaires. Measures Parental involvement To assess parental involvement in the intervention program of their DHH child, the Parental Involvement Questionnaire (Ingber, 2004) was used. This questionnaire was designed to identify parental behaviors that typify family involvement in early intervention programs for children with hearing loss. It consists of 23 items describing parental involvement behaviors related to parents’ interest and attendance during the child’s interventions, communication between parents and professionals, parental activities reflecting their initiation and responsibility for their child’s therapy, and parental participation in activities with other families (e.g., “I am in constant contact with my child’s therapist”; “I examine the professionals’ recommendations”; “I participate in the evaluation and diagnosis process of my child”). Parents rated each item on a 5-point Likert scale ranging from Never (1) to Always (5). The questionnaire was found to be reliable, with supporting evidence for its construct validity (Ingber et al., 2010). The current internal reliabilities (α) were .87 for mothers, and .89 for fathers. Child acceptance This questionnaire assesses parents’ feelings of acceptance or rejection of their child (e.g., “Parents think that it’s not necessary to tell relatives what is wrong with their child”). The questionnaire was developed in Israel for parents of children with disabilities (Weisbol, 1973). This questionnaire was previously used in a study on Israeli parents of DHH children (Zaidman-Zait et al., 2016). Parents rated each of the 30 items on a 5-point Likert scale ranging from strongly agree (1) to strongly disagree (5). Higher scores reflect higher degree of acceptance of the child. The current internal reliabilities for the present study were α = .89 for mothers and α = .86 for fathers. Parental self-efficacy The Early Intervention Parental Self Efficacy Scale (EIPSES; Guimond, Wilcox, & Lamorey, 2008) was employed. EIPSES is designed to measure whether parents feel competent and confident in their skills, knowledge, and the ability to make a difference in the lives of their children, especially when their children have a disability or developmental delay within the context of early intervention. It consists of 16 items (e.g., “If my child encounters difficulties, I can think of a number of ways to help him/her”). Parents rated each item on a 7-point Likert scale ranging from strongly disagree (1) to strongly agree (7). The internal reliability for the current sample was α = .78 for mothers and α = .77 for fathers. Social Support To assess parental perception of social support, the Support System Questionnaire was used (Dunst, Jenkins, & Trivette, 1984). This instrument consists of 23 items that measure the degree to which different sources of support, including formal (e.g., “What is the degree of support you receive/d from the preschool teacher?”) and informal (e.g., “What is the degree of support you receive from your spouse?”) have been helpful to families in rearing young children with disabilities. It has been used with parents of children who are DHH (Pipp-Siegel et al., 2002; Zaidman-Zait et al., 2016). Parents rated each item on a 6-point Likert-type scale ranging from “Does not exist” (0) to “Helps a lot” (5). The current internal consistency reliabilities were, α = .84 for mothers and α = .83 for fathers. Religiosity scale Each couple was asked to define the family’s religiosity level on a four level scale of religiosity based on accepted definitions of Jewish religious practices and group membership including secular (nonobservant), traditional, orthodox, and ultraorthodox. Self-definition of religiosity has been used successfully in studies in Israel (e.g., Mansbach & Greenbaum, 1999; Olshtain-Mann & Auslander, 2008). Demographic background Information was collected on each parent (e.g., age, gender, education), and the child with HL (e.g., degree of loss, onset of HL, use of sensory aids, main communication mode). Analytic Plan Preliminary descriptive statistics and correlations were computed for all variables using the Statistical Package for the Social Sciences v.24.0 (SPSS Inc., Chicago, IL, USA). To examine whether parental gender and family religiosity moderated the associations between mothers’ and fathers’ coping resources and their involvement the Dyadic Actor Partner Interdependence Model (APIM) was applied to analyze the data (Kashy & Kenny, 2000). The APIM accounts for non-independence between mothers’ and fathers’ scores within each couple. As shown in Figure 1, two types of effects can be calculated within this approach; namely, actor and partner effects. Actor effects estimate the extent to which a predictor variable of one parent influences his/her own outcome. For example, a mother’s level of acceptance affects her own involvement. Conversely, a partner effect refers to the extent to which a predictor variable of one parent influences his/her partner’s outcome. For example, a mother’s level of acceptance can affect her spouse’s (father) involvement. Figure 1 View largeDownload slide Relationships between coping resources and parent involvement using AMIM. Figure 1 View largeDownload slide Relationships between coping resources and parent involvement using AMIM. To examine our APIM, we used the Multiple Level Modeling approach (Raudenbush & Bryk, 2002) with HLM 6.0 software (HLM; Raudenbush, Bryk, Cheong, & Congdon, 2004). HLM accounts for the non-independence of the data and multiple sources of variance, including both the between- and within-couple variance using multiple levels (Raudenbush & Bryk, 2002). In the current study, individuals (Level 1) were nested within a family (level 2). Three separate models were tested with acceptance, self-efficacy, and social support predicting involvement. Parents’ gender was included in Level 1 (fathers = −1, mothers = 1). The Level 2 (couple-level) variables included the couples’ average age, religiosity level, and child’s degree of hearing loss. Since we wanted to examine whether the relationships between coping resources and involvement would be moderated by parent’s gender (level 1) and family religiosity (level 2), interaction effects were included in the models. HLM 6.0 software was used to run the APIM models (Raudenbush et al., 2004). Missing data Prior to this analysis missing values were imputed based on the missing completely at random (MCAR) testing assumption (Enders, 2010). Missing data were found with no set patterns; hence, they were considered as missing completely at random MCAR: Little’s test for MCAR, Chi-square = 149.81, p = .31, df = 146; (Little, 1988). In this case, the data were completed once using a stochastic regression model (Enders, 2010; Little, 2013) since the missing data did not exceed 5%. Results Descriptive statistics Table 2 presents the means, standard deviations, and inter-spouse correlations for mother and father ratings of child acceptance, parental self-efficacy, social support, and involvement in early intervention. First, inter-spouse correlations were conducted to examine the degree of correspondence between mothers’ and fathers’ ratings of child acceptance, parental self-efficacy, social support, and involvement. The inter-spouse correlations for all the independent variables (coping resources) were significant. These significant correlations obtained between fathers and mothers indicate similarities and patterns of relationships within couples and, thus, the appropriateness of the APIM. Table 2 Means, standard deviations, and Pearson correlations among the variables 1 2 3 4 5 6 7 8 M (SD) 1 Mothers—acceptance — .66*** .27* .21 .37** .32** .21 −0.11 4.39 (.52) 2 Fathers—acceptance — .09 .17 .43*** .59*** .13 .25* 4.38 (.41) 3 Mothers—social support — .53*** .45*** .17 .37** .28* 3.08 (.94) 4 Fathers—social support — .17 .18 .28* .21 3.08 (.86) 5 Mothers—self-efficacy — .49*** .48*** .14 5.56 (.69) 6 Fathers—self-efficacy — .32** .29* 5.31 (.67) 7 Mothers—involvement — .14 3.72 (.49) 8 Fathers—involvement — 3.25 (.62) 1 2 3 4 5 6 7 8 M (SD) 1 Mothers—acceptance — .66*** .27* .21 .37** .32** .21 −0.11 4.39 (.52) 2 Fathers—acceptance — .09 .17 .43*** .59*** .13 .25* 4.38 (.41) 3 Mothers—social support — .53*** .45*** .17 .37** .28* 3.08 (.94) 4 Fathers—social support — .17 .18 .28* .21 3.08 (.86) 5 Mothers—self-efficacy — .49*** .48*** .14 5.56 (.69) 6 Fathers—self-efficacy — .32** .29* 5.31 (.67) 7 Mothers—involvement — .14 3.72 (.49) 8 Fathers—involvement — 3.25 (.62) *p < .05, **p < .01, ***p < .001. Table 2 Means, standard deviations, and Pearson correlations among the variables 1 2 3 4 5 6 7 8 M (SD) 1 Mothers—acceptance — .66*** .27* .21 .37** .32** .21 −0.11 4.39 (.52) 2 Fathers—acceptance — .09 .17 .43*** .59*** .13 .25* 4.38 (.41) 3 Mothers—social support — .53*** .45*** .17 .37** .28* 3.08 (.94) 4 Fathers—social support — .17 .18 .28* .21 3.08 (.86) 5 Mothers—self-efficacy — .49*** .48*** .14 5.56 (.69) 6 Fathers—self-efficacy — .32** .29* 5.31 (.67) 7 Mothers—involvement — .14 3.72 (.49) 8 Fathers—involvement — 3.25 (.62) 1 2 3 4 5 6 7 8 M (SD) 1 Mothers—acceptance — .66*** .27* .21 .37** .32** .21 −0.11 4.39 (.52) 2 Fathers—acceptance — .09 .17 .43*** .59*** .13 .25* 4.38 (.41) 3 Mothers—social support — .53*** .45*** .17 .37** .28* 3.08 (.94) 4 Fathers—social support — .17 .18 .28* .21 3.08 (.86) 5 Mothers—self-efficacy — .49*** .48*** .14 5.56 (.69) 6 Fathers—self-efficacy — .32** .29* 5.31 (.67) 7 Mothers—involvement — .14 3.72 (.49) 8 Fathers—involvement — 3.25 (.62) *p < .05, **p < .01, ***p < .001. Multilevel Modeling: APIM Model 1 Prior to examine the main research purposes, we examined in Model 1, the effects of dyadic level variables, including child’s degree of HL, parents’ age, family religiosity, and parent gender on parental involvement. As reported in Table 3, family religiosity had a significant main effect, where parents with a higher level of religiosity tended to be less involved in their child’s early intervention (b = −.10, p < .05). In addition, as expected, parental gender had a significant main effect, indicating that mothers tended to be more involved than fathers in their child’s intervention program (b = .24, p < .001). Table 3 Multilevel Model Coefficients, Effects of Religiosity, Coping Resources, and their Interactions on Parents’ Involvement Parental involvement models Model 1 Model 2 Model 3 Child acceptance Self-efficacy Social support Fixed effects  Intercept 3.49***(.05) 3.49*** (.05) 3.49*** (.05) 3.49*** (.05)  Parent (father= −1, mother= 1) .24*** (.04) .23*** (.04) .21*** (.04) .24*** (.04)  Parents’ age −.01(.01) −.01 (.01) −.01 (.01) −.01 (.01)  Religiosity −.10* (.05) −.10* (.05) −.05 (.04) −.10* (.04)  Degree of HL .01 (.02) .02 (.02) −.01 (.02) −.01 (.03)  Actor coping resource .49*** (.13) .27*** (.05) .20*** (.04)  Partner coping resource −.35** (.13) −.03 (.07) −.06** (.05) Two way interaction  Parent × religiosity .01 (.03) .01 (.04) .01 (.03)  Parent × actor resource −.30** (.13) −.01 (.07) −.05 (.06)  Parent × partner resource .26* (.11) .05 (.08) .13* (.06)  Actor resource × religiosity −.05 (.08) .03 (.04) .01 (.03)  Partner resource × religiosity −.09 (.08) −.01 (.05) −.04 (.03) Variance  Level 1 .26 (.51) .21 (.46) .25 (.50) .22 (.47)  Level 2 .03 (.16) .04* (.19) .01 (.10) .03* (.17)  Deviance 222.63 198.94 205.83 204.39 Total pseudo R2 .20 .32 .29 .29 Parental involvement models Model 1 Model 2 Model 3 Child acceptance Self-efficacy Social support Fixed effects  Intercept 3.49***(.05) 3.49*** (.05) 3.49*** (.05) 3.49*** (.05)  Parent (father= −1, mother= 1) .24*** (.04) .23*** (.04) .21*** (.04) .24*** (.04)  Parents’ age −.01(.01) −.01 (.01) −.01 (.01) −.01 (.01)  Religiosity −.10* (.05) −.10* (.05) −.05 (.04) −.10* (.04)  Degree of HL .01 (.02) .02 (.02) −.01 (.02) −.01 (.03)  Actor coping resource .49*** (.13) .27*** (.05) .20*** (.04)  Partner coping resource −.35** (.13) −.03 (.07) −.06** (.05) Two way interaction  Parent × religiosity .01 (.03) .01 (.04) .01 (.03)  Parent × actor resource −.30** (.13) −.01 (.07) −.05 (.06)  Parent × partner resource .26* (.11) .05 (.08) .13* (.06)  Actor resource × religiosity −.05 (.08) .03 (.04) .01 (.03)  Partner resource × religiosity −.09 (.08) −.01 (.05) −.04 (.03) Variance  Level 1 .26 (.51) .21 (.46) .25 (.50) .22 (.47)  Level 2 .03 (.16) .04* (.19) .01 (.10) .03* (.17)  Deviance 222.63 198.94 205.83 204.39 Total pseudo R2 .20 .32 .29 .29 Note: For the fixed effects, the standard error is in parentheses. For the variance components, the standard deviation is in parentheses. *p < .05, **p < .01, ***p < .001. Table 3 Multilevel Model Coefficients, Effects of Religiosity, Coping Resources, and their Interactions on Parents’ Involvement Parental involvement models Model 1 Model 2 Model 3 Child acceptance Self-efficacy Social support Fixed effects  Intercept 3.49***(.05) 3.49*** (.05) 3.49*** (.05) 3.49*** (.05)  Parent (father= −1, mother= 1) .24*** (.04) .23*** (.04) .21*** (.04) .24*** (.04)  Parents’ age −.01(.01) −.01 (.01) −.01 (.01) −.01 (.01)  Religiosity −.10* (.05) −.10* (.05) −.05 (.04) −.10* (.04)  Degree of HL .01 (.02) .02 (.02) −.01 (.02) −.01 (.03)  Actor coping resource .49*** (.13) .27*** (.05) .20*** (.04)  Partner coping resource −.35** (.13) −.03 (.07) −.06** (.05) Two way interaction  Parent × religiosity .01 (.03) .01 (.04) .01 (.03)  Parent × actor resource −.30** (.13) −.01 (.07) −.05 (.06)  Parent × partner resource .26* (.11) .05 (.08) .13* (.06)  Actor resource × religiosity −.05 (.08) .03 (.04) .01 (.03)  Partner resource × religiosity −.09 (.08) −.01 (.05) −.04 (.03) Variance  Level 1 .26 (.51) .21 (.46) .25 (.50) .22 (.47)  Level 2 .03 (.16) .04* (.19) .01 (.10) .03* (.17)  Deviance 222.63 198.94 205.83 204.39 Total pseudo R2 .20 .32 .29 .29 Parental involvement models Model 1 Model 2 Model 3 Child acceptance Self-efficacy Social support Fixed effects  Intercept 3.49***(.05) 3.49*** (.05) 3.49*** (.05) 3.49*** (.05)  Parent (father= −1, mother= 1) .24*** (.04) .23*** (.04) .21*** (.04) .24*** (.04)  Parents’ age −.01(.01) −.01 (.01) −.01 (.01) −.01 (.01)  Religiosity −.10* (.05) −.10* (.05) −.05 (.04) −.10* (.04)  Degree of HL .01 (.02) .02 (.02) −.01 (.02) −.01 (.03)  Actor coping resource .49*** (.13) .27*** (.05) .20*** (.04)  Partner coping resource −.35** (.13) −.03 (.07) −.06** (.05) Two way interaction  Parent × religiosity .01 (.03) .01 (.04) .01 (.03)  Parent × actor resource −.30** (.13) −.01 (.07) −.05 (.06)  Parent × partner resource .26* (.11) .05 (.08) .13* (.06)  Actor resource × religiosity −.05 (.08) .03 (.04) .01 (.03)  Partner resource × religiosity −.09 (.08) −.01 (.05) −.04 (.03) Variance  Level 1 .26 (.51) .21 (.46) .25 (.50) .22 (.47)  Level 2 .03 (.16) .04* (.19) .01 (.10) .03* (.17)  Deviance 222.63 198.94 205.83 204.39 Total pseudo R2 .20 .32 .29 .29 Note: For the fixed effects, the standard error is in parentheses. For the variance components, the standard deviation is in parentheses. *p < .05, **p < .01, ***p < .001. Next, following our research purposes, three models at Level 2 were examined. Each model included one of the parent’s coping resources (i.e., acceptance, self-efficacy, social support) and examined its actor effect, partner effect, and the interaction effects (i.e., with religiosity and parent gender) on parental involvement. Model 2: Acceptance In Model 2, the actor and partner effects of child acceptance on parental involvement were examined. The findings indicated actor effects, where the parents’ child acceptance had a positive effect on their involvement (b = .47, p < .001). In addition, child acceptance exerted significant partner effects on involvement (b = −.34, p < .01), such that partners’ child acceptance was negatively related to their spouses’ involvement. However, parent’s gender moderated both actor and partner effects on involvement (b = −.30, p < .01; b = .26, p < .05, respectively). Analysis of the gender-actor interaction indicated that the positive actor association between child acceptance and involvement was only found among fathers (b = .79, t = 3.77, p < .001) and not among mothers (b = .18, t = 1.23, p =.22; see Figure 2a). Analysis of the partner-gender interaction indicated that the partner effect was found only for mothers. In other words, fathers’ child acceptance was negatively associated with mothers’ involvement (b = −.61, t = −4.21, p < .001) but there was no association between mothers’ child acceptance and fathers’ involvement (b = −.09, t = −.47, p = .64; see Figure 2b). Figure 2 View largeDownload slide Simple slope analyses of significant interactions. (a) The association between parental gender and parent–child’s acceptance on parental involvement (actor effect); (b) the association between parental gender and parent–child’s acceptance on the spouse’s parental involvement (partner effect). Figure 2 View largeDownload slide Simple slope analyses of significant interactions. (a) The association between parental gender and parent–child’s acceptance on parental involvement (actor effect); (b) the association between parental gender and parent–child’s acceptance on the spouse’s parental involvement (partner effect). Model 2: Self-efficacy The dyadic analysis indicated an actor effect for parenting self-efficacy on involvement (b = .27, p < .001). Mothers’ and fathers’ self-efficacy were positively associated with their own involvement. No significant partner effect was found for parental self-efficacy on involvement. In addition, no interaction effects were found between self-efficacy and parental gender nor between self-efficacy and family religiosity (Figure 3). Model 3: Social support The results of model 3 indicated a significant positive actor effect of social support on involvement (b = .20, p < .001). Mothers’ and fathers’ perceived social support were positively associated with their own involvement. A significant interaction effect for partner effect with gender was found (b = .13, p < .05). Analysis of the interaction revealed a partner effect only among mothers (see Figure 2). In other words, fathers’ social support was negatively associated with mothers’ involvement (b = −.19, t = −2.50, p = .02). Religiosity did not moderate either the partner or actor effect (Figure 3). Discussion The present study examined the interdependent relationships between fathers’ and mothers’ coping resources including child acceptance, self-efficacy, and social support, and their association with parents’ involvement in the intervention program of their DHH child. In addition, it examined whether parental gender and family Jewish religiosity moderated the associations between mothers’ and fathers’ coping resources and their involvement. Figure 3 View largeDownload slide Simple slope analysis of significant interaction. The association between parental gender and parental social support on the spouse’s parental involvement (partner effect). Figure 3 View largeDownload slide Simple slope analysis of significant interaction. The association between parental gender and parental social support on the spouse’s parental involvement (partner effect). Consistent with the previous studies, the findings indicated that mothers reported higher involvement in their children’s intervention program than fathers (Bristol, Gallagher, & Schopler, 1988; Zaidman-Zait et al., 2016). Higher maternal involvement may indicate that the majority of the households are organized in a “manager-helper” dynamic where mothers largely orchestrate family life and fathers provide assistance through task completion (Daly, 2002). It is possible that mothers take on the main responsibilities with care giving and supporting the child with a disability (Brett, 2002; Tehee, Honan, & Hevey, 2009), whereas fathers take on other roles in order to allow mothers’ availability to be involved in their child’s intervention (Erbasi, Scarinci, Hickson, & Ching, 2016). Hence, the nature of the involvement of each parent is different (McNeil & Chabassol, 1984). In addition, in a previous qualitative study, fathers of children with different disabilities indicated that they feel left out by the educational team at the child’s intervention center, who are mostly females and who tend to regard the mother as the primary caretaker (Mueller & Buckley, 2014). In turn, fathers’ experiences at their children intervention center might also impact their involvement. With respect to family religiosity, it was evident that more religiously observant families were less involved in their child’s intervention. This finding contrasts with the previous studies, which have indicated that religious beliefs and practices among families of typically developing children increase parental involvement (Clydesdale, 1997; Wilcox, 2002). However, in these studies, parental involvement focused mainly on involvement with the child at home or during after-school activities and not within the educational system. Religious parents may feel that at the intervention center, they should respect the authority of professionals and that it is not their place to actively intervene (Yaffa, 2009). It is also possible that religious beliefs and practices lead to different involvements among parents of DHH children than parents of children with typical development. Religious parents might be hesitant to attend the intervention center from fear of stigma in their community, which, in turn, influence their social status (Coleman-Brueckheimer & Dein, 2011). The results revealed different patterns of significant associations between coping resources and mothers’ and fathers’ involvement in each of the actor–partner independent models examined. The actor–partner independent models analysis indicated a main actor effect in all models, suggesting that parents’ coping resources were associated with parental involvement. With regard to parental self-efficacy, mothers and fathers with a higher sense of parental self-efficacy tended to be more involved in their child’s intervention program. However, since this study was cross-sectional, causality could not be inferred. Thus, it is also possible that increased involvement leads to a greater sense of parental self-efficacy. This finding is in line with the previous studies among parents of children without a hearing loss (Giallo et al., 2013; Ingber & Most, 2012) and among mothers of DHH children (DesJardin & Eisenberg, 2007; DesJardin, 2005). An actor effect was also found for social support. Similar to previous studies, parents with higher levels of perceived social support reported higher parental involvement in their child’s intervention (Ingber et al., 2010; Zaidman-Zait et al., 2017). Parents reported that receiving support and guidance from professionals increased their motivation to be more involved in their children’s intervention (Zaidman-Zait, 2007). Similarly, among mothers of children with autism, higher levels of perceived social support predicted higher rates of parental involvement (Benson et al., 2008). It is possible that social support, which is known to contribute to parents’ wellbeing (White & Hastings, 2004) may provide an emotional resource to promote parental involvement. Thus, social support should be considered as a crucial component in early intervention programs (Moeller, Carr, Seaver, Stredler-Brown, & Holzinger, 2013). The finding that the level of child acceptance of fathers but not that of mothers was associated with their involvement (i.e., actor and parent gender interaction) might be explained by differences in perceptions of their parenting responsibilities. Fathers’ child acceptance might motivate their involvement, whereas mothers’ involvement might be motivated by their perceived role of responsibility as the primary caregiver, regardless of their child’s acceptance. Parents’ motivation and perceived responsibilities should thus be explored further in future research. Significant partner effects were also found for child acceptance and social support. However, these main partner effects were moderated by parental gender. Specifically, fathers’ child acceptance and perceived social support not only increased their own involvement, but also decreased their spouse’s involvement. Thus the increased fathers’ child acceptance and perceived social support may have promoted their involvement, which, in turn, allowed mothers to share their responsibility of caring for the child and decrease their own involvement. Overall, this may allow for more flexibility and mutuality in parenting roles and is an example of the crossover and compensatory effects that have been hypothesized in family systems theory, where one parent’s experience affects not only his or her behavior but that of the spouse (Nelson, O’Brien, Blankson, Calkins, & Keane, 2009). This finding lends weight to viewing the family as an organized system that consists of various subsystems and relationships, where each individual or subsystem relationship is influenced by the other. More research is needed to understand the dyadic relations within the family system as expressed among families of children who are DHH. Professionals who work with DHH children and their families should be aware of the differences and dyadic relationships that exist between mothers’ and fathers’ involvement in children’s intervention programs. Intervention programs should address parents’ cognitions regarding their child and their parenting of DHH children. One way that may facilitate parents’ self-efficacy is participation in parent support groups where they can derive encouragement from other parents dealing with similar issues (Leahy-Warren, McCarthy, & Corcoran, 2012). In addition, providing guidance and encouraging parents “agency regarding their role in their child’s development, and adopting effective strategies while interacting with their child might also facilitate parents” self-efficacy (Kuhn & Carter, 2006). Since both mothers’ and fathers’ involvement has been found to be beneficial to children’s developmental and educational outcomes (Calderon, 2000; Harvey & Kentish, 2010; Sarant et al., 2009), professionals should encourage fathers’ involvement while maintaining their sensitivity to families’ needs and preferences. In addition, it may be helpful to understand the reasons preventing religious parents from becoming involved in their DHH child’s intervention program. For example, in Jewish culture, male professionals might be more effective in communication with fathers, and home visits may help parents avoid being seen at the intervention center. Home visits and therapy times convenient to both fathers and mothers may help both fathers and mothers regardless of their religious beliefs to be more involved. In order to encourage the involvement of religious families in their child’s intervention program, it may be helpful to promote their sense of belonging by introducing them to other parents as well as professionals from the same religious group. In addition, it might be helpful to engage leaders or other religious officials in educating their communities about hearing loss and exposing them to leaders from the Deaf community which in turn might reduce stigma among their communities. Qualitative research would be helpful in addressing the effects of religious practices and beliefs regarding parental involvement in their DHH child’s intervention program. In addition, it is important to consider additional children’s characteristics such as communication skills and behavioral-social adjustment that might also impact parents coping resources and involvement in accordance to Belsky’s model. Future studies are needed to understand parents’ involvement in intervention programs for their DHH children, while taking into account processes within the family system and difference between families. It is important to note that the sample herebiased was composed of volunteers made up of parents who were enrolled in intervention centers, so the data may be biased since only more involved parents agreed to participate. Thus caution should be exercised when attempting to generalize to other parents. Conflict of interest No conflicts of interest were reported. 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This article is published and distributed under the terms of the Oxford University Press, Standard Journals Publication Model (https://academic.oup.com/journals/pages/about_us/legal/notices) http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png The Journal of Deaf Studies and Deaf Education Oxford University Press

Parent Couples’ Coping Resources and Involvement in their Children’s Intervention Program

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Oxford University Press
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© The Author(s) 2018. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.
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1081-4159
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1465-7325
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Abstract

Abstract Parental involvement is vital to the implementation of intervention programs for deaf and hard-of-hearing (DHH) children. The current study examined the dyadic relationships between mothers’ and fathers’ coping resources and their involvement in their child’s intervention program. In addition, the moderating roles of parent’s gender and family religiosity on the associations between coping resources and involvement were examined. Seventy Jewish couples of parents of DHH children, representing various levels of religiosity, completed questionnaires regarding involvement in their child’s intervention program, child acceptance, parental self-efficacy, and perceived social support. Multilevel modeling analyses were used to test actor–partner interdependence. The findings indicated significant actor effects for child acceptance, parental self-efficacy, and social support. All were positively associated with parental involvement. Gender was found to moderate the actor effect of child acceptance. Partner effects were found only for mothers, for child acceptance, and social support. Fathers’ child acceptance and social support were negatively associated with mothers’ involvement. Religiosity did not moderate neither actor nor partner effects. These results have important implications for planning intervention programs that are sensitive to each of the parent’s needs. Parental involvement is a multidimensional construct defined as the family’s active participation in an intervention program of their child, the quality of the interactions and relationships they establish with the program professionals, and the way the family feels about the services they receive (Korfmacher et al., 2008). Similarly, parental involvement of children who are deaf or hard-of-hearing (DHH) is described by the parents as their active participation and interest in their child’s intervention, their engagement in on-going communication and interactions with professionals, their active initiation and taking responsibilities regarding their child’s therapeutic process, and their establishment of social relationships with other families (Ingber, 2004). Parental involvement in early intervention programs for children who are DHH has been acknowledged as a vital component in the program implementation (Yoshinago-Itano, 2014). Parental involvement in DHH children’s intervention promotes children’s emotional, social, academic, and language development (Calderon, 2000; DesJardin & Eisenberg, 2007; Harvey & Kentish, 2010; Hintermair, 2006; Kurtzer-White & Luterman, 2003; Sarant, Holt, Dowell, Rickards, & Blamey, 2009). In addition, parental involvement enhances professionals’ understanding of the child and the family’s needs, improves parent-professional communication, and increases the generalization of child skills across the intervention program and home (Dunlap, Newton, Fox, Benito, & Vaughn, 2001; Kaiser & Hancock, 2003). Although parental involvement in children’s early intervention programs is highly important, there is scant research on parental involvement in parents of DHH children. Despite reports of increasing father involvement in their children’s care (Bouchard, Lee, Asgary, & Pelletier, 2007; McBride, Dyer, Liu, Brown, & Hong, 2009; Pleck & Masciadrelli, 2004), and the unique positive contribution to intervention outcomes of fathers’ involvement with children with disabilities (MacDonald, Hastings, & Fitzsimons, 2010; McBride et al., 2009) most research has focused solely on maternal involvement (DesJardin & Eisenberg, 2007). Among parents of DHH children, mothers reported higher levels of involvement than fathers (Zaidman-Zait, Most, Tarrasch, & Haddad, 2017). Nevertheless, no differences were found in father’s involvement between fathers of typical hearing children and fathers of DHH children. Overall, all fathers reported being highly involved with their children (Ingber & Most, 2012). Interest in the contribution of both fathers and mothers stems from family system theory which views families as social systems (Parke & Buriel, 1998) where each individual or subsystem in the family is influenced by the others (Steinglass, 1987). However, studies that have examined both mothers and fathers considered them as a single parental unit and have ignored the interdependence of data and the interpersonal influences inherent within the family system. It is recommended that data from married couples be treated as non-independent observations since the emotions and experiences of one spouse often affect the emotions and experiences of the other spouse (Kelley et al., 2003). Belsky’s model of the determinants of parenting behavior is a theoretical framework for guiding research into the broader personal and socio-ecological factors associated with parenting (Belsky, 1984). According to this model, parenting is influenced by three domains: personal factors related to the parents (e.g., parents’ perceptions and beliefs), the broader social contextual influences in which parents are embedded (e.g., social support, cultural norms) and the child’s characteristics (e.g., having a hearing loss). Given that parental involvement is a specific component of parenting behaviors, it is reasonable to assume that these determinants of parenting have a comparable influence on parental involvement. Thus, informed by Belsky’s model it is possible that parental traits such as their cognitions and beliefs and social context should be salient factors in explaining levels of parental involvement in DHH children’s early intervention programs. It is important to note that approximately 90−95% of DHH individuals are born to hearing parents, who have little or no prior knowledge about hearing loss (Mitchell & Karchmer, 2004). Accordingly, for the most part, studies that have examined the impact of parents’ personal characteristics reflect the perspectives of hearing parents who have DHH children. Similarly, the present study itself focuses on this population and therefore does not represent all perspectives on families with deaf children. Parents’ personal characteristics associated with involvement Acceptance of a DHH child Child acceptance reflects the parents’ positive appraisals that serve as an internal personal resource (Zaidman-Zait et al., 2017). Acceptance is reflected by the ability to face with what is being offered by an event or situation without trying to avoid experiences. In other words, abandon dysfunctional agendas, taking stock of the situation including the challenges, constraints, and resources, and focusing on making the best of the options while adopting an active process of coping effectively (Blackledge & Hayes, 2001; Walsh, 2003). It has been suggested that acceptance of the child and his/her disability is a positive “stage” in family adjustment and enables parents to meet their child’s needs (MacDonald et al., 2010). Parents who experience difficulties in accepting their child can end up denying their child’s special needs (Lloyd & Hastings, 2008). Muñoz, Blaiser and Barwick (2013) showed that one of the reasons for the delay between identification of hearing loss and fitting hearing aids was parental denial that their child needed a hearing aid. Parents may benefit from reaching a state where they can accept their child along with the associated difficulties of having a child who is DHH, such as dealing with communication needs of their child, obtaining appropriate intervention programs and services, learning about technological supports, and advocate for themselves and for their child (Zaidman-Zait, 2007). Among mothers and fathers of DHH children, higher levels of child acceptance were associated with lower levels of parenting stress (Zaidman-Zait, Most, Haddad, Tarash, & Brand, 2016). Similarly, parents of children diagnosed with autism experienced lower levels of parenting stress when they reported higher levels of child acceptance (Jones, Hastings, Totsika, Keane, & Rhule, 2014). It should be mentioned that findings of studies examined the contribution of coping resources among parents of children diagnosed with autism spectrum disorders (ASD) were brought considering the scarce research examining DHH children mothers’ and fathers’ of coping resources. These examples do not intend to compare DHH children to children diagnosed with ASD. Parental self-efficacy An additional theoretical construct that is important in considering influences on parent involvement is parental self-efficacy. Parental self-efficacy refers to how parents perceive their competence as successfully fulfilling their parenting role and their ability to function competently while raising their children (Jones & Prinz, 2005). Parental self-efficacy is a crucial coping resource in dealing with children’s rehabilitation demands and promoting parental involvement (Punch & Hyde, 2010). Parents with an increased sense of self-efficacy tend to learn more about parenting, participate in parenting education programs, and be responsive to their child’s needs (Coleman & Karraker, 2003). Low parental self-efficacy, on the other hand, has been associated with negative parenting such as withdrawal of love (Hill & Bush, 2001) and a tendency to give up easily when faced with parenting challenges (Ardelt & Eccles, 2001). Parental self-efficacy has also been associated with increased involvement in home learning activities such as reading, playing, and everyday household activities (Giallo, Treyvaud, Cooklin, & Wade, 2013). A few studies have examined the relationship between parenting self-efficacy and involvement in parents of DHH children. Mothers’ self-efficacy was positively associated with their involvement in therapy activities with their child (DesJardin & Eisenberg, 2007), whereas fathers’ self-efficacy was positively associated with their involvement in daily activities (Ingber & Most, 2012). In another study, fathers’ but not mothers’ self-efficacy was also related to increased involvement in their child’s intervention program (Zaidman-Zait et al., 2017). Parenting self-efficacy has been posited to improve children’s language competence and social behavioral skills (Stika et al., 2015) as a result of increased parents’ involvement in their children’s intervention program and therapy activities. Parents’ social and contextual characteristics associated with involvement Social Support A social contextual coping resource that also found to impact parental involvement is the support parents receive from others. Parents’ social support can include both formal and informal sources of support including the spouse, in-laws, family members, close friends, friends, neighbors, community, professionals, and work colleagues (Rodrigo, Martín, Máiquez, & Rodríguez, 2007). Studies have indicated that social support makes an important contribution to the adjustment of parents of DHH children (Åsberg, Vogel, & Bowers, 2008; Henderson, Johnson, & Moodie, 2014; Zaidman-Zait, 2007), including a decrease in parenting stress (Åsberg et al., 2008; Lederberg & Golbach, 2002), and improved parent–child interactions (Hintermair, 2006). Several studies have examined the beneficial effects of social support on parental involvement among parents of DHH children (Ingber, Al-Yagon, & Dromi, 2010; Zaidman-Zait et al., 2017). The findings indicated that parents with higher perceived social support were more involved in their children’s intervention programs (Ingber et al., 2010; Zaidman-Zait et al., 2017). In describing their coping experience, the parents indicated that receiving support and guidance from professionals increased their motivation to become more involved in their children’s intervention (Zaidman-Zait, 2007). Similarly, among mothers of children with ASD, higher levels of perceived social support predicted higher levels of parental school-based involvement (Benson, Karlof, & Siperstein, 2008). This small body of research thus suggests that social support promotes parental involvement by providing parents with the psychosocial and instrumental resources to be actively involved in their children’s intervention, and allows parents to better manage the countervailing stressors and demands placed upon them. Religiosity The contribution of religiosity to individuals’ resilience, physical health, and psychological wellbeing has been consistently acknowledged (Caldwell & Senter, 2013; Yoon & Lee, 2006). Religious beliefs can be considered as both a personal and a social coping resource. Religious beliefs can inform ways of coping and give meaning to life events that in turn promotes adjustment (Johnstone, Glass, & Oliver, 2007). In addition, being religious may entail belongingness to a community that can provide social support which can enhance the parents’ wellbeing (Poston & Turnbull, 2004). Hence, religious beliefs can affect a family’s outlook on disability (Tarakeshwar & Pargament, 2001) and ways of coping with the demands involved in parenting a child with disabilities (Kamei, 2014). Poston and Turnbull (2004) reported that spirituality and religion can play important roles in the life of families of children with disabilities. Previous studies have indicated that religious beliefs and practices support parents of DHH children through the coping process and acceptance of their child (Ahlert & Greeff, 2012; White, 2009). Overall, religious belief may thus provide strength and resources that enable families to withstand daily challenges. Religiosity can be assumed to play an important role in the lives of parents raising a child who is DHH and may contribute to their parenting behaviors and practices. Among Israel’s Jewish population, religiosity is a clear factor in social group definition. Individuals tend to characterize themselves according to their level of observance, which ranges from secular (i.e., non-orthodox), traditional (denoting those who are partially observant), orthodox/religious, and ultraorthodox. In general, secular Jews have values similar to Western society and do not adhere to religious commandments. Traditional Jews may follow some traditional commandments for ethnic and/or social reasons (Lazar, Kravetz, & Frederich–Kedem, 2002). Within the Jewish adult population 8% define themselves as ultraorthodox, 12% modern orthodox, 38% traditional, and 42% secular (Arian & Keissar-Sugarmen, 2012). A recent study examined the contribution of support resources to family quality of life among Israeli Jewish families of children with developmental disabilities who differed in their level of religiosity. The findings indicated small but significant differences in families’ satisfaction with family quality of life based on their religiosity. Religious families reported a higher quality of life. However, there were no differences between religious and secular families in terms of familial, social, or service support (Taub & Werner, 2016). However, parents of children with disabilities reported experiencing stress regarding the acceptance of their child by members of their religious community (Herman, 2006; Kamei, 2014; Leyser & Dekel, 1991; O’Hanlon, 2013). The current study Parents of DHH children face a variety of unique demands and long-term challenges in raising their children. These multiple demands prompt parents to examine and reframe their beliefs and coping strategies, and may imply that couples share their care giving experience including their cognitions, emotions and coping resources with each other. Consequently, when examining factors associated with parents’ involvement from a system perspective, both mothers and fathers should be examined in tandem with factors relating to the other caregiver. The goal of the present study was to shift the focus from intra-individual models to systemic ones that include both fathers and mothers and place special emphasis on examining self and partner coping resources in relation to parental involvement in their DHH child’s intervention. In the current study, we examined the relationship between fathers’ and mothers’ coping resources, including child acceptance, self-efficacy, and social support and their parental involvement. In addition, we examined whether parental gender and family religiosity moderated the associations between mothers’ and fathers’ coping resources and their involvement. As the child’s degree of hearing loss might affect child’s functioning and in turn impact parental adjustment (Pipp-Siegel, Sedey, & Yoshinaga-Itano, 2002; Yoshinaga-Itano, 2003), the children’s degree of hearing loss was included in the analytic models. To summarize, the current study had three main purposes: (a) To examine the relations between parents individual coping resources and their involvement. Specifically, to examine whether mothers and fathers self-reported coping resources will be positively associated with their report on involvement (i.e., actor effects); (b) To examine the relations between mothers coping resources and fathers’ involvement and the relations between fathers coping resources and mothers’ involvement (i.e., partner effects); and (c) To examine whether parental gender and family level of religiosity will moderate these actor- partner effects. Method Participants The sample was composed of 70 Jewish married couples (father–mother pairs) of children with mild to profound hearing loss, whose mean age was 5.25 years (SD = 1.6). The mean age of hearing loss identification was 13.9 months (SD = 12.8). All parents were hearing and communicated in spoken language at home with their children. Mothers mean age was 34.5 years (SD = 5.1) and fathers mean age was 36.6 years (SD = 6.2). The families were recruited from early intervention centers that provide specialized services to DHH children and their families. The parents and their children’s characteristics are listed in Table 1. Table 1 Parents’ and Children’s Demographics Parents’ characteristics Mothers Fathers Frequencies N (%) Frequencies N (%) Level of education  Elementary school education — 1 (2)  High school education 17 (24) 13 (18)  Vocational education 7 (10) 2 (3)  Religious Education — 20 (28)  College education 10 (15) 4 (5)  University degree 36 (52) 30 (44) Employment status  Employed 63 (90) 67 (95) Religiosity levels  1 26 (37)  2 7 (10)  3 15 (21)  4 22 (31) Additional D/HH children in family 13% Parents’ characteristics Mothers Fathers Frequencies N (%) Frequencies N (%) Level of education  Elementary school education — 1 (2)  High school education 17 (24) 13 (18)  Vocational education 7 (10) 2 (3)  Religious Education — 20 (28)  College education 10 (15) 4 (5)  University degree 36 (52) 30 (44) Employment status  Employed 63 (90) 67 (95) Religiosity levels  1 26 (37)  2 7 (10)  3 15 (21)  4 22 (31) Additional D/HH children in family 13% Child’s characteristics Frequencies N (%) Gender  Female 37 (54)  Male 32 (46) Degree of hearing loss  Mild to severe 16 (24)  Severe to profound 51 (76) Amplification  Hearing aids 18 (26)  Cochlear implant 51 (74) Communication  Spoken 58 (84)  Spoken & signs 11 (16) Child’s characteristics Frequencies N (%) Gender  Female 37 (54)  Male 32 (46) Degree of hearing loss  Mild to severe 16 (24)  Severe to profound 51 (76) Amplification  Hearing aids 18 (26)  Cochlear implant 51 (74) Communication  Spoken 58 (84)  Spoken & signs 11 (16) Table 1 Parents’ and Children’s Demographics Parents’ characteristics Mothers Fathers Frequencies N (%) Frequencies N (%) Level of education  Elementary school education — 1 (2)  High school education 17 (24) 13 (18)  Vocational education 7 (10) 2 (3)  Religious Education — 20 (28)  College education 10 (15) 4 (5)  University degree 36 (52) 30 (44) Employment status  Employed 63 (90) 67 (95) Religiosity levels  1 26 (37)  2 7 (10)  3 15 (21)  4 22 (31) Additional D/HH children in family 13% Parents’ characteristics Mothers Fathers Frequencies N (%) Frequencies N (%) Level of education  Elementary school education — 1 (2)  High school education 17 (24) 13 (18)  Vocational education 7 (10) 2 (3)  Religious Education — 20 (28)  College education 10 (15) 4 (5)  University degree 36 (52) 30 (44) Employment status  Employed 63 (90) 67 (95) Religiosity levels  1 26 (37)  2 7 (10)  3 15 (21)  4 22 (31) Additional D/HH children in family 13% Child’s characteristics Frequencies N (%) Gender  Female 37 (54)  Male 32 (46) Degree of hearing loss  Mild to severe 16 (24)  Severe to profound 51 (76) Amplification  Hearing aids 18 (26)  Cochlear implant 51 (74) Communication  Spoken 58 (84)  Spoken & signs 11 (16) Child’s characteristics Frequencies N (%) Gender  Female 37 (54)  Male 32 (46) Degree of hearing loss  Mild to severe 16 (24)  Severe to profound 51 (76) Amplification  Hearing aids 18 (26)  Cochlear implant 51 (74) Communication  Spoken 58 (84)  Spoken & signs 11 (16) Procedure Ethical approval was obtained from the University and the research ethics committees of the clinical institutions involved. Parents were recruited through intervention centers that serve DHH children. The questionnaires were distributed to the parents by the professionals working with them. Each of the parents completed four self-report questionnaires. Measures Parental involvement To assess parental involvement in the intervention program of their DHH child, the Parental Involvement Questionnaire (Ingber, 2004) was used. This questionnaire was designed to identify parental behaviors that typify family involvement in early intervention programs for children with hearing loss. It consists of 23 items describing parental involvement behaviors related to parents’ interest and attendance during the child’s interventions, communication between parents and professionals, parental activities reflecting their initiation and responsibility for their child’s therapy, and parental participation in activities with other families (e.g., “I am in constant contact with my child’s therapist”; “I examine the professionals’ recommendations”; “I participate in the evaluation and diagnosis process of my child”). Parents rated each item on a 5-point Likert scale ranging from Never (1) to Always (5). The questionnaire was found to be reliable, with supporting evidence for its construct validity (Ingber et al., 2010). The current internal reliabilities (α) were .87 for mothers, and .89 for fathers. Child acceptance This questionnaire assesses parents’ feelings of acceptance or rejection of their child (e.g., “Parents think that it’s not necessary to tell relatives what is wrong with their child”). The questionnaire was developed in Israel for parents of children with disabilities (Weisbol, 1973). This questionnaire was previously used in a study on Israeli parents of DHH children (Zaidman-Zait et al., 2016). Parents rated each of the 30 items on a 5-point Likert scale ranging from strongly agree (1) to strongly disagree (5). Higher scores reflect higher degree of acceptance of the child. The current internal reliabilities for the present study were α = .89 for mothers and α = .86 for fathers. Parental self-efficacy The Early Intervention Parental Self Efficacy Scale (EIPSES; Guimond, Wilcox, & Lamorey, 2008) was employed. EIPSES is designed to measure whether parents feel competent and confident in their skills, knowledge, and the ability to make a difference in the lives of their children, especially when their children have a disability or developmental delay within the context of early intervention. It consists of 16 items (e.g., “If my child encounters difficulties, I can think of a number of ways to help him/her”). Parents rated each item on a 7-point Likert scale ranging from strongly disagree (1) to strongly agree (7). The internal reliability for the current sample was α = .78 for mothers and α = .77 for fathers. Social Support To assess parental perception of social support, the Support System Questionnaire was used (Dunst, Jenkins, & Trivette, 1984). This instrument consists of 23 items that measure the degree to which different sources of support, including formal (e.g., “What is the degree of support you receive/d from the preschool teacher?”) and informal (e.g., “What is the degree of support you receive from your spouse?”) have been helpful to families in rearing young children with disabilities. It has been used with parents of children who are DHH (Pipp-Siegel et al., 2002; Zaidman-Zait et al., 2016). Parents rated each item on a 6-point Likert-type scale ranging from “Does not exist” (0) to “Helps a lot” (5). The current internal consistency reliabilities were, α = .84 for mothers and α = .83 for fathers. Religiosity scale Each couple was asked to define the family’s religiosity level on a four level scale of religiosity based on accepted definitions of Jewish religious practices and group membership including secular (nonobservant), traditional, orthodox, and ultraorthodox. Self-definition of religiosity has been used successfully in studies in Israel (e.g., Mansbach & Greenbaum, 1999; Olshtain-Mann & Auslander, 2008). Demographic background Information was collected on each parent (e.g., age, gender, education), and the child with HL (e.g., degree of loss, onset of HL, use of sensory aids, main communication mode). Analytic Plan Preliminary descriptive statistics and correlations were computed for all variables using the Statistical Package for the Social Sciences v.24.0 (SPSS Inc., Chicago, IL, USA). To examine whether parental gender and family religiosity moderated the associations between mothers’ and fathers’ coping resources and their involvement the Dyadic Actor Partner Interdependence Model (APIM) was applied to analyze the data (Kashy & Kenny, 2000). The APIM accounts for non-independence between mothers’ and fathers’ scores within each couple. As shown in Figure 1, two types of effects can be calculated within this approach; namely, actor and partner effects. Actor effects estimate the extent to which a predictor variable of one parent influences his/her own outcome. For example, a mother’s level of acceptance affects her own involvement. Conversely, a partner effect refers to the extent to which a predictor variable of one parent influences his/her partner’s outcome. For example, a mother’s level of acceptance can affect her spouse’s (father) involvement. Figure 1 View largeDownload slide Relationships between coping resources and parent involvement using AMIM. Figure 1 View largeDownload slide Relationships between coping resources and parent involvement using AMIM. To examine our APIM, we used the Multiple Level Modeling approach (Raudenbush & Bryk, 2002) with HLM 6.0 software (HLM; Raudenbush, Bryk, Cheong, & Congdon, 2004). HLM accounts for the non-independence of the data and multiple sources of variance, including both the between- and within-couple variance using multiple levels (Raudenbush & Bryk, 2002). In the current study, individuals (Level 1) were nested within a family (level 2). Three separate models were tested with acceptance, self-efficacy, and social support predicting involvement. Parents’ gender was included in Level 1 (fathers = −1, mothers = 1). The Level 2 (couple-level) variables included the couples’ average age, religiosity level, and child’s degree of hearing loss. Since we wanted to examine whether the relationships between coping resources and involvement would be moderated by parent’s gender (level 1) and family religiosity (level 2), interaction effects were included in the models. HLM 6.0 software was used to run the APIM models (Raudenbush et al., 2004). Missing data Prior to this analysis missing values were imputed based on the missing completely at random (MCAR) testing assumption (Enders, 2010). Missing data were found with no set patterns; hence, they were considered as missing completely at random MCAR: Little’s test for MCAR, Chi-square = 149.81, p = .31, df = 146; (Little, 1988). In this case, the data were completed once using a stochastic regression model (Enders, 2010; Little, 2013) since the missing data did not exceed 5%. Results Descriptive statistics Table 2 presents the means, standard deviations, and inter-spouse correlations for mother and father ratings of child acceptance, parental self-efficacy, social support, and involvement in early intervention. First, inter-spouse correlations were conducted to examine the degree of correspondence between mothers’ and fathers’ ratings of child acceptance, parental self-efficacy, social support, and involvement. The inter-spouse correlations for all the independent variables (coping resources) were significant. These significant correlations obtained between fathers and mothers indicate similarities and patterns of relationships within couples and, thus, the appropriateness of the APIM. Table 2 Means, standard deviations, and Pearson correlations among the variables 1 2 3 4 5 6 7 8 M (SD) 1 Mothers—acceptance — .66*** .27* .21 .37** .32** .21 −0.11 4.39 (.52) 2 Fathers—acceptance — .09 .17 .43*** .59*** .13 .25* 4.38 (.41) 3 Mothers—social support — .53*** .45*** .17 .37** .28* 3.08 (.94) 4 Fathers—social support — .17 .18 .28* .21 3.08 (.86) 5 Mothers—self-efficacy — .49*** .48*** .14 5.56 (.69) 6 Fathers—self-efficacy — .32** .29* 5.31 (.67) 7 Mothers—involvement — .14 3.72 (.49) 8 Fathers—involvement — 3.25 (.62) 1 2 3 4 5 6 7 8 M (SD) 1 Mothers—acceptance — .66*** .27* .21 .37** .32** .21 −0.11 4.39 (.52) 2 Fathers—acceptance — .09 .17 .43*** .59*** .13 .25* 4.38 (.41) 3 Mothers—social support — .53*** .45*** .17 .37** .28* 3.08 (.94) 4 Fathers—social support — .17 .18 .28* .21 3.08 (.86) 5 Mothers—self-efficacy — .49*** .48*** .14 5.56 (.69) 6 Fathers—self-efficacy — .32** .29* 5.31 (.67) 7 Mothers—involvement — .14 3.72 (.49) 8 Fathers—involvement — 3.25 (.62) *p < .05, **p < .01, ***p < .001. Table 2 Means, standard deviations, and Pearson correlations among the variables 1 2 3 4 5 6 7 8 M (SD) 1 Mothers—acceptance — .66*** .27* .21 .37** .32** .21 −0.11 4.39 (.52) 2 Fathers—acceptance — .09 .17 .43*** .59*** .13 .25* 4.38 (.41) 3 Mothers—social support — .53*** .45*** .17 .37** .28* 3.08 (.94) 4 Fathers—social support — .17 .18 .28* .21 3.08 (.86) 5 Mothers—self-efficacy — .49*** .48*** .14 5.56 (.69) 6 Fathers—self-efficacy — .32** .29* 5.31 (.67) 7 Mothers—involvement — .14 3.72 (.49) 8 Fathers—involvement — 3.25 (.62) 1 2 3 4 5 6 7 8 M (SD) 1 Mothers—acceptance — .66*** .27* .21 .37** .32** .21 −0.11 4.39 (.52) 2 Fathers—acceptance — .09 .17 .43*** .59*** .13 .25* 4.38 (.41) 3 Mothers—social support — .53*** .45*** .17 .37** .28* 3.08 (.94) 4 Fathers—social support — .17 .18 .28* .21 3.08 (.86) 5 Mothers—self-efficacy — .49*** .48*** .14 5.56 (.69) 6 Fathers—self-efficacy — .32** .29* 5.31 (.67) 7 Mothers—involvement — .14 3.72 (.49) 8 Fathers—involvement — 3.25 (.62) *p < .05, **p < .01, ***p < .001. Multilevel Modeling: APIM Model 1 Prior to examine the main research purposes, we examined in Model 1, the effects of dyadic level variables, including child’s degree of HL, parents’ age, family religiosity, and parent gender on parental involvement. As reported in Table 3, family religiosity had a significant main effect, where parents with a higher level of religiosity tended to be less involved in their child’s early intervention (b = −.10, p < .05). In addition, as expected, parental gender had a significant main effect, indicating that mothers tended to be more involved than fathers in their child’s intervention program (b = .24, p < .001). Table 3 Multilevel Model Coefficients, Effects of Religiosity, Coping Resources, and their Interactions on Parents’ Involvement Parental involvement models Model 1 Model 2 Model 3 Child acceptance Self-efficacy Social support Fixed effects  Intercept 3.49***(.05) 3.49*** (.05) 3.49*** (.05) 3.49*** (.05)  Parent (father= −1, mother= 1) .24*** (.04) .23*** (.04) .21*** (.04) .24*** (.04)  Parents’ age −.01(.01) −.01 (.01) −.01 (.01) −.01 (.01)  Religiosity −.10* (.05) −.10* (.05) −.05 (.04) −.10* (.04)  Degree of HL .01 (.02) .02 (.02) −.01 (.02) −.01 (.03)  Actor coping resource .49*** (.13) .27*** (.05) .20*** (.04)  Partner coping resource −.35** (.13) −.03 (.07) −.06** (.05) Two way interaction  Parent × religiosity .01 (.03) .01 (.04) .01 (.03)  Parent × actor resource −.30** (.13) −.01 (.07) −.05 (.06)  Parent × partner resource .26* (.11) .05 (.08) .13* (.06)  Actor resource × religiosity −.05 (.08) .03 (.04) .01 (.03)  Partner resource × religiosity −.09 (.08) −.01 (.05) −.04 (.03) Variance  Level 1 .26 (.51) .21 (.46) .25 (.50) .22 (.47)  Level 2 .03 (.16) .04* (.19) .01 (.10) .03* (.17)  Deviance 222.63 198.94 205.83 204.39 Total pseudo R2 .20 .32 .29 .29 Parental involvement models Model 1 Model 2 Model 3 Child acceptance Self-efficacy Social support Fixed effects  Intercept 3.49***(.05) 3.49*** (.05) 3.49*** (.05) 3.49*** (.05)  Parent (father= −1, mother= 1) .24*** (.04) .23*** (.04) .21*** (.04) .24*** (.04)  Parents’ age −.01(.01) −.01 (.01) −.01 (.01) −.01 (.01)  Religiosity −.10* (.05) −.10* (.05) −.05 (.04) −.10* (.04)  Degree of HL .01 (.02) .02 (.02) −.01 (.02) −.01 (.03)  Actor coping resource .49*** (.13) .27*** (.05) .20*** (.04)  Partner coping resource −.35** (.13) −.03 (.07) −.06** (.05) Two way interaction  Parent × religiosity .01 (.03) .01 (.04) .01 (.03)  Parent × actor resource −.30** (.13) −.01 (.07) −.05 (.06)  Parent × partner resource .26* (.11) .05 (.08) .13* (.06)  Actor resource × religiosity −.05 (.08) .03 (.04) .01 (.03)  Partner resource × religiosity −.09 (.08) −.01 (.05) −.04 (.03) Variance  Level 1 .26 (.51) .21 (.46) .25 (.50) .22 (.47)  Level 2 .03 (.16) .04* (.19) .01 (.10) .03* (.17)  Deviance 222.63 198.94 205.83 204.39 Total pseudo R2 .20 .32 .29 .29 Note: For the fixed effects, the standard error is in parentheses. For the variance components, the standard deviation is in parentheses. *p < .05, **p < .01, ***p < .001. Table 3 Multilevel Model Coefficients, Effects of Religiosity, Coping Resources, and their Interactions on Parents’ Involvement Parental involvement models Model 1 Model 2 Model 3 Child acceptance Self-efficacy Social support Fixed effects  Intercept 3.49***(.05) 3.49*** (.05) 3.49*** (.05) 3.49*** (.05)  Parent (father= −1, mother= 1) .24*** (.04) .23*** (.04) .21*** (.04) .24*** (.04)  Parents’ age −.01(.01) −.01 (.01) −.01 (.01) −.01 (.01)  Religiosity −.10* (.05) −.10* (.05) −.05 (.04) −.10* (.04)  Degree of HL .01 (.02) .02 (.02) −.01 (.02) −.01 (.03)  Actor coping resource .49*** (.13) .27*** (.05) .20*** (.04)  Partner coping resource −.35** (.13) −.03 (.07) −.06** (.05) Two way interaction  Parent × religiosity .01 (.03) .01 (.04) .01 (.03)  Parent × actor resource −.30** (.13) −.01 (.07) −.05 (.06)  Parent × partner resource .26* (.11) .05 (.08) .13* (.06)  Actor resource × religiosity −.05 (.08) .03 (.04) .01 (.03)  Partner resource × religiosity −.09 (.08) −.01 (.05) −.04 (.03) Variance  Level 1 .26 (.51) .21 (.46) .25 (.50) .22 (.47)  Level 2 .03 (.16) .04* (.19) .01 (.10) .03* (.17)  Deviance 222.63 198.94 205.83 204.39 Total pseudo R2 .20 .32 .29 .29 Parental involvement models Model 1 Model 2 Model 3 Child acceptance Self-efficacy Social support Fixed effects  Intercept 3.49***(.05) 3.49*** (.05) 3.49*** (.05) 3.49*** (.05)  Parent (father= −1, mother= 1) .24*** (.04) .23*** (.04) .21*** (.04) .24*** (.04)  Parents’ age −.01(.01) −.01 (.01) −.01 (.01) −.01 (.01)  Religiosity −.10* (.05) −.10* (.05) −.05 (.04) −.10* (.04)  Degree of HL .01 (.02) .02 (.02) −.01 (.02) −.01 (.03)  Actor coping resource .49*** (.13) .27*** (.05) .20*** (.04)  Partner coping resource −.35** (.13) −.03 (.07) −.06** (.05) Two way interaction  Parent × religiosity .01 (.03) .01 (.04) .01 (.03)  Parent × actor resource −.30** (.13) −.01 (.07) −.05 (.06)  Parent × partner resource .26* (.11) .05 (.08) .13* (.06)  Actor resource × religiosity −.05 (.08) .03 (.04) .01 (.03)  Partner resource × religiosity −.09 (.08) −.01 (.05) −.04 (.03) Variance  Level 1 .26 (.51) .21 (.46) .25 (.50) .22 (.47)  Level 2 .03 (.16) .04* (.19) .01 (.10) .03* (.17)  Deviance 222.63 198.94 205.83 204.39 Total pseudo R2 .20 .32 .29 .29 Note: For the fixed effects, the standard error is in parentheses. For the variance components, the standard deviation is in parentheses. *p < .05, **p < .01, ***p < .001. Next, following our research purposes, three models at Level 2 were examined. Each model included one of the parent’s coping resources (i.e., acceptance, self-efficacy, social support) and examined its actor effect, partner effect, and the interaction effects (i.e., with religiosity and parent gender) on parental involvement. Model 2: Acceptance In Model 2, the actor and partner effects of child acceptance on parental involvement were examined. The findings indicated actor effects, where the parents’ child acceptance had a positive effect on their involvement (b = .47, p < .001). In addition, child acceptance exerted significant partner effects on involvement (b = −.34, p < .01), such that partners’ child acceptance was negatively related to their spouses’ involvement. However, parent’s gender moderated both actor and partner effects on involvement (b = −.30, p < .01; b = .26, p < .05, respectively). Analysis of the gender-actor interaction indicated that the positive actor association between child acceptance and involvement was only found among fathers (b = .79, t = 3.77, p < .001) and not among mothers (b = .18, t = 1.23, p =.22; see Figure 2a). Analysis of the partner-gender interaction indicated that the partner effect was found only for mothers. In other words, fathers’ child acceptance was negatively associated with mothers’ involvement (b = −.61, t = −4.21, p < .001) but there was no association between mothers’ child acceptance and fathers’ involvement (b = −.09, t = −.47, p = .64; see Figure 2b). Figure 2 View largeDownload slide Simple slope analyses of significant interactions. (a) The association between parental gender and parent–child’s acceptance on parental involvement (actor effect); (b) the association between parental gender and parent–child’s acceptance on the spouse’s parental involvement (partner effect). Figure 2 View largeDownload slide Simple slope analyses of significant interactions. (a) The association between parental gender and parent–child’s acceptance on parental involvement (actor effect); (b) the association between parental gender and parent–child’s acceptance on the spouse’s parental involvement (partner effect). Model 2: Self-efficacy The dyadic analysis indicated an actor effect for parenting self-efficacy on involvement (b = .27, p < .001). Mothers’ and fathers’ self-efficacy were positively associated with their own involvement. No significant partner effect was found for parental self-efficacy on involvement. In addition, no interaction effects were found between self-efficacy and parental gender nor between self-efficacy and family religiosity (Figure 3). Model 3: Social support The results of model 3 indicated a significant positive actor effect of social support on involvement (b = .20, p < .001). Mothers’ and fathers’ perceived social support were positively associated with their own involvement. A significant interaction effect for partner effect with gender was found (b = .13, p < .05). Analysis of the interaction revealed a partner effect only among mothers (see Figure 2). In other words, fathers’ social support was negatively associated with mothers’ involvement (b = −.19, t = −2.50, p = .02). Religiosity did not moderate either the partner or actor effect (Figure 3). Discussion The present study examined the interdependent relationships between fathers’ and mothers’ coping resources including child acceptance, self-efficacy, and social support, and their association with parents’ involvement in the intervention program of their DHH child. In addition, it examined whether parental gender and family Jewish religiosity moderated the associations between mothers’ and fathers’ coping resources and their involvement. Figure 3 View largeDownload slide Simple slope analysis of significant interaction. The association between parental gender and parental social support on the spouse’s parental involvement (partner effect). Figure 3 View largeDownload slide Simple slope analysis of significant interaction. The association between parental gender and parental social support on the spouse’s parental involvement (partner effect). Consistent with the previous studies, the findings indicated that mothers reported higher involvement in their children’s intervention program than fathers (Bristol, Gallagher, & Schopler, 1988; Zaidman-Zait et al., 2016). Higher maternal involvement may indicate that the majority of the households are organized in a “manager-helper” dynamic where mothers largely orchestrate family life and fathers provide assistance through task completion (Daly, 2002). It is possible that mothers take on the main responsibilities with care giving and supporting the child with a disability (Brett, 2002; Tehee, Honan, & Hevey, 2009), whereas fathers take on other roles in order to allow mothers’ availability to be involved in their child’s intervention (Erbasi, Scarinci, Hickson, & Ching, 2016). Hence, the nature of the involvement of each parent is different (McNeil & Chabassol, 1984). In addition, in a previous qualitative study, fathers of children with different disabilities indicated that they feel left out by the educational team at the child’s intervention center, who are mostly females and who tend to regard the mother as the primary caretaker (Mueller & Buckley, 2014). In turn, fathers’ experiences at their children intervention center might also impact their involvement. With respect to family religiosity, it was evident that more religiously observant families were less involved in their child’s intervention. This finding contrasts with the previous studies, which have indicated that religious beliefs and practices among families of typically developing children increase parental involvement (Clydesdale, 1997; Wilcox, 2002). However, in these studies, parental involvement focused mainly on involvement with the child at home or during after-school activities and not within the educational system. Religious parents may feel that at the intervention center, they should respect the authority of professionals and that it is not their place to actively intervene (Yaffa, 2009). It is also possible that religious beliefs and practices lead to different involvements among parents of DHH children than parents of children with typical development. Religious parents might be hesitant to attend the intervention center from fear of stigma in their community, which, in turn, influence their social status (Coleman-Brueckheimer & Dein, 2011). The results revealed different patterns of significant associations between coping resources and mothers’ and fathers’ involvement in each of the actor–partner independent models examined. The actor–partner independent models analysis indicated a main actor effect in all models, suggesting that parents’ coping resources were associated with parental involvement. With regard to parental self-efficacy, mothers and fathers with a higher sense of parental self-efficacy tended to be more involved in their child’s intervention program. However, since this study was cross-sectional, causality could not be inferred. Thus, it is also possible that increased involvement leads to a greater sense of parental self-efficacy. This finding is in line with the previous studies among parents of children without a hearing loss (Giallo et al., 2013; Ingber & Most, 2012) and among mothers of DHH children (DesJardin & Eisenberg, 2007; DesJardin, 2005). An actor effect was also found for social support. Similar to previous studies, parents with higher levels of perceived social support reported higher parental involvement in their child’s intervention (Ingber et al., 2010; Zaidman-Zait et al., 2017). Parents reported that receiving support and guidance from professionals increased their motivation to be more involved in their children’s intervention (Zaidman-Zait, 2007). Similarly, among mothers of children with autism, higher levels of perceived social support predicted higher rates of parental involvement (Benson et al., 2008). It is possible that social support, which is known to contribute to parents’ wellbeing (White & Hastings, 2004) may provide an emotional resource to promote parental involvement. Thus, social support should be considered as a crucial component in early intervention programs (Moeller, Carr, Seaver, Stredler-Brown, & Holzinger, 2013). The finding that the level of child acceptance of fathers but not that of mothers was associated with their involvement (i.e., actor and parent gender interaction) might be explained by differences in perceptions of their parenting responsibilities. Fathers’ child acceptance might motivate their involvement, whereas mothers’ involvement might be motivated by their perceived role of responsibility as the primary caregiver, regardless of their child’s acceptance. Parents’ motivation and perceived responsibilities should thus be explored further in future research. Significant partner effects were also found for child acceptance and social support. However, these main partner effects were moderated by parental gender. Specifically, fathers’ child acceptance and perceived social support not only increased their own involvement, but also decreased their spouse’s involvement. Thus the increased fathers’ child acceptance and perceived social support may have promoted their involvement, which, in turn, allowed mothers to share their responsibility of caring for the child and decrease their own involvement. Overall, this may allow for more flexibility and mutuality in parenting roles and is an example of the crossover and compensatory effects that have been hypothesized in family systems theory, where one parent’s experience affects not only his or her behavior but that of the spouse (Nelson, O’Brien, Blankson, Calkins, & Keane, 2009). This finding lends weight to viewing the family as an organized system that consists of various subsystems and relationships, where each individual or subsystem relationship is influenced by the other. More research is needed to understand the dyadic relations within the family system as expressed among families of children who are DHH. Professionals who work with DHH children and their families should be aware of the differences and dyadic relationships that exist between mothers’ and fathers’ involvement in children’s intervention programs. Intervention programs should address parents’ cognitions regarding their child and their parenting of DHH children. One way that may facilitate parents’ self-efficacy is participation in parent support groups where they can derive encouragement from other parents dealing with similar issues (Leahy-Warren, McCarthy, & Corcoran, 2012). In addition, providing guidance and encouraging parents “agency regarding their role in their child’s development, and adopting effective strategies while interacting with their child might also facilitate parents” self-efficacy (Kuhn & Carter, 2006). Since both mothers’ and fathers’ involvement has been found to be beneficial to children’s developmental and educational outcomes (Calderon, 2000; Harvey & Kentish, 2010; Sarant et al., 2009), professionals should encourage fathers’ involvement while maintaining their sensitivity to families’ needs and preferences. In addition, it may be helpful to understand the reasons preventing religious parents from becoming involved in their DHH child’s intervention program. For example, in Jewish culture, male professionals might be more effective in communication with fathers, and home visits may help parents avoid being seen at the intervention center. Home visits and therapy times convenient to both fathers and mothers may help both fathers and mothers regardless of their religious beliefs to be more involved. In order to encourage the involvement of religious families in their child’s intervention program, it may be helpful to promote their sense of belonging by introducing them to other parents as well as professionals from the same religious group. In addition, it might be helpful to engage leaders or other religious officials in educating their communities about hearing loss and exposing them to leaders from the Deaf community which in turn might reduce stigma among their communities. Qualitative research would be helpful in addressing the effects of religious practices and beliefs regarding parental involvement in their DHH child’s intervention program. In addition, it is important to consider additional children’s characteristics such as communication skills and behavioral-social adjustment that might also impact parents coping resources and involvement in accordance to Belsky’s model. Future studies are needed to understand parents’ involvement in intervention programs for their DHH children, while taking into account processes within the family system and difference between families. It is important to note that the sample herebiased was composed of volunteers made up of parents who were enrolled in intervention centers, so the data may be biased since only more involved parents agreed to participate. Thus caution should be exercised when attempting to generalize to other parents. Conflict of interest No conflicts of interest were reported. 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The Journal of Deaf Studies and Deaf EducationOxford University Press

Published: Apr 17, 2018

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