Date of Award


Document Type


Degree Name

Doctor of Philosophy (PhD)




A review of the literature on physical disability reveals competing viewpoints on the relationship between degree of severity of handicap and adjustment. Several studies report that severely disabled individuals exhibit more serious adjustment problems than the mildly handicapped, due to the social reactions to the visibility of deficits and to reductions in functioning and coping due to brain dysfunction. Other research efforts report the opposite relationship and hypothesize that the "marginal" position of mildly handicapped individuals leads to inconsistent and confusing expectations and resultant psychopathology. Sampling and assessment difficulties with these studies, especially in regard to the heterogeneity of experimental samples, necessitate cautious generalizations. In order to test this relationship for children with cerebral palsy, 60 children with cerebral palsy, aged 6-0 to 12-10, were rated on (a)degree of orthopedic handicap, (b)vision, (c)hearing, (d)speech, and (e)history of seizures. Ss were administered the Peabody Picture Vocabulary Test, Form A, and the Ss' mothers were administered the Children's Behavioral Classification Project (CBCP) questionnaire. An important consideration in choosing these instruments was that children in the widest range of severity of handicap could be assessed with minimal selection bias due to test taking ability. It was predicted that adjustment would be significantly related to degree of orthopedic handicap, history of seizures, and intellectual level. No significant findings were obtained in a stepwise regression analysis with a composite adjustment score from the CBCP as the criterion variable and the six handicap variables as predictors: overall F (2,57) = 1.28, p < 0.28. The hypothesis concerning intellectual level and adjustment was supported in a canonical correlation analysis relating nine CBCP factors with the six handicap variables: R(,c) = 0.78, Chi-square (54) = 96.92, p < .001. From this analysis, it was concluded that children exhibiting severe intellectual and speech deficits were rated as incontinent, less appreciative and socially oriented, and more dependent and apologetic. In contrast, the brighter, more fluent children were rated more likely to exhibit anti-social agressiveness. It was concluded that the differences in adjustment identified in the results were related to the limited behavioral repertoire of the severely mentally retarded children in the sample. The relationships between adjustment and degree of orthopedic handicap and seizure activity that appear in the literature were not replicated here. Although the null results with the orthopedic and seizure variables cannot be accepted definitively, the shortcomings in sampling techniques in previous studies must be considered. In particular, these studies have screened out those children with sub-normal intelligence, often because they could not take the psychological tests required. In contrast, the study reported here was based on a sample which was quite representative of children with cerebral palsy in terms of IQ, severity of handicap, and demographic variables. The results of this study call to question the generalizability for cerebral palsy of conclusions reached in previous studies based on mixed or unrepresentative samples. Especially doubtful is the utility of predictions about cerebral palsy and adjustment based on studies of children with normal intelligence. It is doubtful that cerebral palsied children with severe intellectual and communicative deficits are capable of the social comparisons and self-evaluations proposed in the interpretations of marginality and adjustment. Instead, what appears evident in the present study is the limited range of behaviors of mentally retarded children with cerebral palsy, almost certainly secondary to severe cerebral impairment.