The aims of this project are: (a) determine if the birth of a child at-risk for a poor developmental outcome (retarded, handicapped, delayed, etc.) affects the social support network of the infant's family and (b) assess the extent to which a family's response and adaptation to the birth and rearing of a child at-risk for a poor developmental outcome is influenced by the nature of support available from the family's social support network. The manner in which the birth and rearing of an """"""""at-risk"""""""" child affects and is affected by a family's social support network will be examined in a prospective, longitudinal study of a short of 210 18- to 40- year- old women during the course of their pregnancies and following the birth of their child up to two years of age. The subjects will be families of children (1) at no risk for poor developmental outcomes, (2) at-risk due to low birth weight, (3) at-risk due to physical impairments (cerebral palsy, physical disabilities, spina bifida, etc.), (4) at-risk for retardation due to conditions known to lead to mental retardation (Down syndrome, microcephaly, hydrocephaly, etc.), (5) at-risk due to complications during pregnancy and delivery (prenatal infections, respiratory distress, etc.), and (6) at-risk due to other factors that increase the probability of poor developmental outcomes. (Approximately 500- 600 pregnant women will be studied up to 1 to 6 months following the child's birth until 30 subjects per group are identified.) The subjects will be seen during the second and third trimesters and at 1, 6, 12, 18, and 24 months postpartum. At each point, the subjects will be interviewed about their social networks, measures of coping and well-being administered, and data collected on parent, family, and child characteristics and functioning. The data will be analyzed using a mediational model that temporally orders parent, family, social support, and child variables in a manner that is predicted to influence a family's reactions to the birth and rearing of a child with a poor developmental outcome.
