AMERICAN ACADEMY OF DEVELOPMENTAL MEDICINE & DENTISTRY

BY H. BARRY WALDMAN, DDS, MPH, PHD, JEFFREY SEIVER, DDS AND STEVEN P. PERLMAN, DDS, MSCD, DHL (HON)

"Every relationship is hard, and the challenges of co-parenting can increase the amount of stress on a marriage. When a child has special needs, like cerebral palsy, additional issues can arise out of whom primarily carries the burden and the different ways each parent handles the emotions involved. It is a sad truth that couples with children (who have) special needs face a much higher divorce rate than the rest of the married population… the exact rate still appears to be unclear..."1 (emphasis added)

"New studies debunk the frequently quoted statistic that 80 percent of parents with autistic children are divorced." 2

RESEARCHERS HAVE FOUND THAT:

• • Among couples with children without any disabilities, the risk of divorce was lowest for couples with one child and increased with each successive child.
• • The risk of divorce for parents of children with developmental disabilities remained unchanged with increasing family size…Other children in the family may be a vital support system for parents coping with the care of a child with a developmental disability.
• • Divorce rates were not elevated, on average, in families with a child with developmental disabilities. However, in small families, there was a significantly higher risk of divorce relative to a general population comparison group. 4-6 (Note: In the long-term study, population included primarily high school white graduates from Wisconsin.)
• • There is no consistent evidence of an association between a child having autism spectrum disorder (ASD) diagnosis and that child living in a nondivorce family. Once we control for cooccurring psychiatric disorders, our results show that a child with an ASD is slightly more likely than those without ASD to live in a nondivorce household. 7

The American Academy of Developmental Medicine and Dentistry (AADMD) was organized in 2002 to provide a forum for healthcare professionals who provide clinical care to people with neurodevelopmental disorders and intellectual disabilities (ND/ID). The mission of the organization is to improve the quality and assure the parity of healthcare for individuals with neurodevelopmental disorders and intellectual disabilities throughout the lifespan.

"While it is positive to hear that an oft-cited report that 80% of parents of a child with autism get divorced has been since debunked, (sic) there does exist a gap between marriage success of parents who do and do not face challenges with their child's development. On the issue of the autism spectrum disorder, the numbers were reexamined in a different study that found a 10% increase in the chance of parents getting divorced (sic) if their child was diagnosed. While this is not the 80% more likely, it's still a disappointment." 3

It just seemed reasonable to assume that since parenting a child with a developmental disability involves greater marital stress, there would likely be an increase in the divorce rates in these families. (Note: There has been a general undertone that, in the present time, divorces are easier and single person parenthood is more acceptable. The reality is the rates and number of divorces have decreased since 2000. 8)

• Number of divorces 
• 2016  827,261
• 2000  944,000 
• Rates per 1000 total population
• 2016 3.8 *
• 2000 4.0 **
• * 44 states + D.C. ** No report on number of states

PROTECT YOUR MARRIAGE – SUGGESTIONS

"All marriages have ups and downs. Tossing in kids can intensify whatever strengths or weaknesses are already there. Add a kid with a disability, and well, the stress is amplified. Even though they love their kid like crazy, the worrying and advocating and fighting with insurance companies or schools can wear parents down over time, and make them more snappish with one another. Sometimes, physical exhaustion from caring for a child who doesn't sleep well at night wears parents down. Sometimes, one parent puts so much energy into helping the child that they don't have much left at the end of the day for their spouse. Sometimes, couples feel a disconnect because they disagree about what is best for the child." 9

• • Do not just become "parent-partners." When parents' only connection to each other is through or about the child, it can cause problems… spend 20 to 30 minutes each day connecting to each other, with no talk of the children allowed. That helps you remember the person with whom you in fell in love.
• • Parents may have different ideas about what their expectations should be for their child, or the best course of treatment. One parent may grieve the child's diagnosis and the other may not. It's important to not just tolerate, but embrace your partner's point of view.
• • Whether it's asking your partner to pitch in more with the household chores, or putting him in charge of wrangling with your insurance company, ask for help sooner than later.
• • Get creative when it comes to romance. Look for imaginative ways to be romantic at home and make use of the time when the kids are in school for dates.
• • Parents may need to rethink their roles so that caring for the child is not exclusively one person's responsibility. Couples that are raising kids with disabilities often feel depleted, or put upon, she said, when one parent does all of the caregiving. Sharing the responsibilities and giving credit for effort can help make you feel more like a team. 9

Another approach: To solidify their marriage, parents of children with disabilities must dedicate time to each other. If the relationship deteriorates, they can take action to improve it. For instance: communicate the mutual concerns openly and find solutions together or go into a marriage counseling program.

MAKE UP OR BREAK UP: Divorce and children with disabilities is difficult. Parents can take action to avoid a divorce; children with disabilities cannot. Parents must dedicate time to each other to solidify their marriage - if the relationship deteriorates, they can take action to improve it.

Divorce and children with disabilities is difficult. Parents should avoid divorcing because of their children with disabilities. The children deserve better. Parents can take action to avoid a divorce. Children with disabilities cannot. 10

OK, YOU TRIED AND FAILED

So, what happens to the child with disabilities after the divorce? Divorce usually means children lose daily contact with one parent – most often fathers. Decreased contact affects the parent-child bond and researchers have found many children feel less close to their fathers after divorce. Divorce also affects a child's relationship with the custodial parent – most often mothers.

"… research has found that kids struggle the most during the first year or two after the divorce. Kids are likely to experience distress, anger, anxiety, and disbelief. But many kids seem to bounce back. They get used to changes in their daily routines and they grow comfortable with their living arrangements.

Others, however, never really seem to go back to "normal." This small percentage of children may experience ongoing—possibly even lifelong—problems after their parents' divorce." 12

"When there is a child with special needs involved in a divorce, issues of child custody, visitation, and support and property division are significantly more complex to negotiate. (emphasis added) As part of your divorce, make sure you consider globally what your child's special needs are and have your attorney walk you through a 'day in the life' of caring for your child." 13

• • Child support charts (for divorces) often do not address the extra expenses of a child with special needs.
• • Uncertainty about the nature and cost of future care makes it difficult to estimate disability-related expenses in a divorce agreement.
• • In the divorce agreement, care must be given to unique issues that arise in the child's transition into adulthood, such as guardianship, eligibility for quasi- government or private agency benefits, employment, recreation and social skills, independent living, or custodial care. • Typically with developing children, child support and custody end at age of majority or when they graduate from college. Divorcing parents of children with special needs who have severe impairments face the reality of life-long care-giving and, perhaps, co-parenting.
• • Alimony and child support payments need to consider the child's eligibility for public benefits as both a minor and adult.
• • It is essential that your family law attorney collaborates with a special needs attorney and an experienced financial adviser to eliminate risk of losing the child's entitlements. • Effectively channel support obligations and parenting plans in the divorce settlement to provide for more quality of life expenditures for the child. 13

And this is only a partial listing of the considerations when a divorce involves children with special needs! Now that you have a clearer picture of the whole story, must a child with a disability = a divorce? • 

ABOUT THE AUTHORS:

H. Barry Waldman, DDS, MPH, PhD is a SUNY Distinguished Teaching Professor, Department of General Dentistry, Stony Brook University, NY. E-mail: h.waldman@stonybrook.edu Jeffrey Seiver, DDS is a Clinical Assistant Professor, Department of General Dentistry, Stony Brook University, NY. Steven P. Perlman, DDS, MScD, DHL (Hon) is the Global Clinical Director and founder, Special Olympics, Special Smiles and Clinical Professor of Pediatric Dentistry, The Boston University Goldman School of Dental Medicine.

References

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