School children with neuropsychological handicap: coping strategies and parents' impact.

One hundred forty six boys (mean age 9 years 1 months, SD = two years, nine months) and forty one girls (mean age 8 years 6 months, SD = three years, three months) received medical, developmental, psychoeducational, and psychiatric evaluations in a multidisciplinary developmental pediatric clinic. Two hundred fifty variables were analyzed by developing ten scales to quantitatively evaluate neuropsychological risk factors, family and parent functioning, and outcome measures of academic achievement, social adjustment and coping or psychiatric symptom pattern. Higher academic achievement, and lower behavioral symptomatology were associated with high IQ scores but not with higher scores on neurobehavioral risk factors. Chief complaints reported by parents did not correlate with their children's final psychiatric diagnoses and also were found to be independent of children's coping styles observed in the office. Problem parenting, as observed in the pediatrician's office, was associated with behavioral problems, and also with decreased competence on language measures and lower academic achievement in relation to IQ. In this sample, assessing parenting yielded a stronger prediction of the child's school and behavioral functioning than did taking a detailed history of neuropsychological risk factors.