Willems D L, de Vries J-N, Isarin J, Reinders J S
Department of General Practice, Academic Medical Centre/University of Amsterdam, Amsterdam, The Netherlands.
J Intellect Disabil Res. 2007 Jul;51(Pt 7):537-44. doi: 10.1111/j.1365-2788.2006.00924.x.
As a sequel to a report by the Health Council of the Netherlands on contraception in persons with intellectual disabilities (IDs), a fierce debate about parenthood by such persons occurred, in which a lack of knowledge about parenting competences became clear. Therefore, the Ministry of Health commissioned a study investigating examples of 'successful parenthood' by persons with IDs.
In conformity with the literature and with legal categories, we defined 'successful parenthood' as 'good enough parenthood', meaning no indications for child abuse and/or neglect, no dealings with child protection agencies and no legal custody. We combined a nationwide quantitative questionnaire study with a qualitative interview study. Questionnaires were sent to all institutions involved in caring for persons with ID, interviews were held with 'good enough' parents and their professional caregivers, selected on the basis of returned questionnaires.
Parenthood occurs in around 1.5% of persons with ID in the Netherlands and is mostly restricted to those with mild handicaps. In total, 51% of the cases were regarded, by caregivers, as not-good-enough parenthood, 33% were clearly good enough and 16% were doubtful. Predicting factors included the ability and the willingness to follow advice, the quality of the social network and the acceptance of parenting in the community. However, there is not one decisive predicting factor; particularly, the predictive value of the IQ alone is small.
A general policy of discouragement of parenthood, as advocated by the Dutch Ministry, is not supported by our results; moreover, it would probably be impossible and have negative effects on social acceptance of parents with ID. The overall conclusion from the study therefore is that some kind of balancing model, in which positive and negative factors are weighed, may be useful to predict success and need for support.
荷兰卫生委员会发布了一份关于智障人士避孕的报告，随后引发了一场关于此类人士为人父母的激烈辩论，辩论中凸显出对育儿能力的认识不足。因此，荷兰卫生部委托开展了一项研究，调查智障人士“成功育儿”的案例。
根据文献和法律类别，我们将“成功育儿”定义为“足够好的育儿”，即没有虐待和/或忽视儿童的迹象，没有与儿童保护机构打交道，也没有法律监护问题。我们将全国性的定量问卷调查与定性访谈研究相结合。问卷被发送给所有参与照顾智障人士的机构，访谈对象是根据回收问卷挑选出的“足够好”的父母及其专业护理人员。
在荷兰，约1.5%的智障人士为人父母，且大多限于轻度残疾者。护理人员认为，总体而言，51%的案例育儿情况不够好，33%明显足够好，16%存疑。预测因素包括听从建议的能力和意愿、社交网络的质量以及社区对育儿的接受度。然而，没有一个决定性的预测因素；特别是，仅智商的预测价值很小。
我们的研究结果不支持荷兰卫生部所倡导的普遍不鼓励生育的政策；此外，这可能也是不可能的，而且会对智障父母的社会接受度产生负面影响。因此，该研究的总体结论是，某种权衡正负因素的平衡模型可能有助于预测成功及支持需求。
