ORIGINAL ARTICLE
FAMILY COHESION AND FLEXIBILITY WHEN THE CHILD HAS CENTRAL AUDITORY PROCESSING DISORDER: MOTHERS’ PERCEPTIONS
 
 
 
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Experimental Audiology Department, World Hearing Center, Institute of Physiology and Pathology of Hearing, Warsaw/Kajetany, Poland
 
 
A - Research concept and design; B - Collection and/or assembly of data; C - Data analysis and interpretation; D - Writing the article; E - Critical revision of the article; F - Final approval of article;
 
 
Submission date: 2025-09-30
 
 
Final revision date: 2025-11-11
 
 
Acceptance date: 2025-12-11
 
 
Online publication date: 2026-02-02
 
 
Publication date: 2026-02-02
 
 
Corresponding author
Joanna Kobosko   

Experimental Audiology Department, World Hearing Center, Institute of Physiology and Pathology of Hearing, Mochnackiego 10, 02-042 Warsaw, Poland
 
 
J Hear Sci 2025;15(4):46-57
 
KEYWORDS
TOPICS
ABSTRACT
Introduction:
Families with children with auditory processing disorder (APD) can experience stress when their child encounters difficulties in communication, speech and language development, and learning. Coping with these conditions depends, among other things, on the family’s cohesion and flexibility, and so it is important to understand these factors in order to provide effective psychological support. Currently, no research has explored how families with an APD child function. This study investigated family dynamics in cases where the child had APD. Based on Olson’s Circumplex Model, we studied how mothers perceived the situation and examined the relationships between family cohesion and flexibility, maternal trait anxiety, and a number of socio-demographic factors.

Material and methods:
There were 106 mothers of children with APD (child’s average age 10 years) who participated in the study. Three groups of families were distinguished: those where the child only had APD (APD1); those with APD and speech, language, and/or articulation disorders (APD2); and those with APD accompanied by other severe health conditions (APD3). Mothers completed the Flexibility and Cohesion Evaluation Scales (FACES-IV) in its Polish adaptation (SOR) and a State–Trait Anxiety Inventory (STAI X-2).

Results:
The three groups of families differed significantly in terms of the ‘unbalanced’ dimensions of ‘disengaged’ and ‘rigid’. APD2 and APD3 families had higher disengaged and rigid scores compared to APD1; these scores were also higher than in the general Polish population. The mothers who had a lower education level expressed a lower level of family cohesion and had higher levels of the enmeshed and chaotic dimensions. The anxiety traits of the mothers correlated significantly with all dimensions of cohesion and flexibility, except for rigidity.

Conclusions:
Families which have children with APD, especially when accompanied by difficulties in speech and language development and/or articulation or other serious health problems, may experience changes in family cohesion due to increased level of disengagement between family members. Such families, including mothers with lower levels of education and/or higher trait anxiety, would benefit from various forms of psychoeducation and psychological intervention to improve family functioning.
ACKNOWLEDGEMENTS
The author thanks Prof. Andrew Bell for his valuable comments on the early version of the manuscript.
FUNDING
This research and article did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.
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