Challenges Faced by Malaysian Parents in Caregiving of a Child with Disabilities

Abstract

Objective - Caregiving of a child with special needs can increase the cost of raising the child and parent’s stress. These two issues are commonly experienced by a parent who care for their special needs child themselves and the thought of challenges are different based on the disability of the child. Methodology/Technique – The challenges of raising a child with disability make it necessary for parents to work harder to to meet the cost of treatment. Meanwhile, levels of stress among those parents are understandably increased. Finding – Parents caring for a child with disability need to place greater emphasis on achieving a balance between their work, caring for their child and stress. Further, this paper includes a discussion on the cost of raising a disabled child and the increased levels of stress experienced by these parents. Novelty - The findings of this paper contribute to conceptual model on the challenges faced by Malaysian parents in caregiving for a child with special needs. Type of Paper: Review

Full text

ISSN 2180-0421, e-ISSN 2289-8506 © 2019 Global Academy of Training & Research (GATR) Enterprise. All rights reserved.
Global Journal of Business and Social Science Review
Journal homepage: www.gatrenterprise.com/GATRJournals/index.html
Global J. Bus. Soc. Sci. Review 7 (2) 118 – 124 (2019)
Challenges Faced by Malaysian Parents in Caregiving of a Child with
Disabilities
Norliza Saiful Bahry,1* Azmi Mat,2 Nur Liana Kori,3 Ainunnazlee Mohd Ali,4 Zarina Abdul
Munir,5 Mohammad Zaim Mohd Salleh6
Faculty Business and Management, Universiti Teknologi MARA, 42300 Puncak Alam, Selangor, Malaysia.
ABSTRACT
Objective - Caregiving of a child with special needs can increase the cost of raising the child and parent’s stress. These
two issues are commonly experienced by a parent who care for their special needs child themselves and the thought of
challenges are different based on the disability of the child.
Methodology/Technique – The challenges of raising a child with disability make it necessary for parents to work
harder to to meet the cost of treatment. Meanwhile, levels of stress among those parents are understandably increased.
Finding – Parents caring for a child with disability need to place greater emphasis on achieving a balance between their
work, caring for their child and stress. Further, this paper includes a discussion on the cost of raising a disabled child
and the increased levels of stress experienced by these parents.
Novelty - The findings of this paper contribute to conceptual model on the challenges faced by Malaysian parents in
caregiving for a child with special needs.
Type of Paper: Review
Keywords: Caregiving Child; Disabilities Child; Parents Stress; Cost of Raising.
Reference to this paper should be made as follows: Bahry, N.S.; Mat, A.; Kori, N. L.; Ali, A. M.; Munir, Z. A.; Salleh,
M. Z. M. 2019. Challenges Faced by Malaysian Parents in Caregiving of a Child with Disabilities, Global J. Bus. Soc.
Sci. Review 7 (2): 118 – 124 https://doi.org/10.35609/gjbssr.2019.7.2(2)
JEL Classification: I10, I14, I19.
__________________________________________________________________________________________
1. Introduction
Children with special needs are defined by the Salamanca Statement in 1994 as “children or youth whose
needs arise from disabilities or learning difficulties”. According to the Law of Malaysia (2008), children with
disabilities, commonly known as anak kurang upaya (OKU) or anak istimewa in a Malaysian context, refers
to any child (under the age of 18) with long-term physical, mental, intellectual and (or) sensory impairment
that, upon interaction with various barriers, can prevent them from participating fully and effectively in
society (Siti Nor Ismalina et. al. 2016).
_____________________________
* Paper Info: Revised: March 9, 2019
Accepted: June 22, 2019
* Corresponding author: Norliza Saiful Bahry
E-mail: norliza_sb@yahoo.com
Affiliation: Faculty Business and Management, Universiti Teknologi MARA (UiTM), Malaysia.

Norliza Saiful Bahry, Azmi Mat, Nur Liana Kori, Ainunnazlee Mohd Ali, Zarina Abdul Munir, Mohammad Zaim Mohd Salleh
119
Global J. Bus. Soc. Sci. Review 7 (2) 118 –124 (2019)
More specifically, the types of disabilities are divided into seven categories, including: hearing, visual,
physical, learning, mental, speech and multiple disabilities, as extracted from UNICEF Malaysia (2014) and
depicted in Table 1.
Table 1: Categories of Disabilities
No.
Category
Explanation
1.
Hearing
Unable to hear clearly in both ears without the use of a hearing aid or unable to
hear at all even with the use of a hearing aid.
2.
Vision
Blind in both eyes or blind in one eye or limited vision in both eyes or any
other permanent visual impairment.
3.
Speech
An inability to speak that impairs proper communication and cannot be
understood by those interact with the person.
4.
Physical
Permanent inability of parts of the body whether caused by loss or absence or
the inability of any part of the body that can affect their functions in fully
carrying out basic activities. (Example: Limb defects, spinal cord injury, stroke,
traumatic brain injury, Dwarfism, Cerebral Palsy)
5.
Learning Difficulties
Intellectual capabilities that do not conform with biological age. (Example:
Late Global Development, Down Syndrome and Intellectual Disabilities)
This category also includes conditions that affect the learning ability of an
individual such as Autism, Attention Deficit Hyperactivity Disorder (ADHD)
and specific learning difficulties such as Dyslexia, Dyscalculia and Dysgraphia.
6.
Mental
Severe mental illness that causes an inability to function in person whether
partly or fully in matters related to him/herself or his/her relationship within the
community.
Among the types of mental illness are serious and chronic Organic Mental
Disorder, Schizophrenia, Paranoia, Mood Disorder (depression, bipolar) and
other Psychotic Disorders (Schizoaffective Disorder and Persistent Delusional
Disorder)
7.
Various (Multiple
Disabilities)
Having more than one type of disability and in general is not appropriate to be
classified in category I to VI.
(Sources: https://www.unicef.org/malaysia/UNICEF-Children_with_Disability_in_Malaysia_2014_lowres.pdf)
According to the Department of Social Welfare (2015), the number of children with disability in Malaysia
between the ages of 0 and 18 years old is 105,174. However, in 2016, there was an 8.5 percent increase in the
number of disabled children in Malaysia and the statistics show that children with disabilities account for 28
percent of the disabled population in Malaysia (Department of Social Welfare, 2016). Furthermore,
approximately 10 – 16 percent of all children have disabilities; these figures vary according to the data
source, definition used, and community surveyed (Ammar, 2008). Statistics from 2016 produced by the
Department of Social Welfare Malaysia reported the highest registered category of disability as learning
disability with the lowest being mental disability (Department of Social Welfare, 2016). Based on research
by Tan and Yadav (2008), delayed speech is the most common disability among the entire age group while
cerebral palsy is the lease common. In addition, according to Amar (2008), 10 to 16 percent of pre-school
children aged between 5 to 6 years old have an intellectual disability, Attention Deficit Hyperactivity
Disorder, Pervasive Developmental Disorders (Autism, ASD, Asperger), Learning Disability (e.g. Dyslexia,
Cerebral Palsy, hearing impairment, visual impairment) and/or visual disorders (squint, amblyopia, refractive
error). Furthermore, in a recent study by Kamaralzaman, Toran, Mohamed and Abdulla (2018), it was

Norliza Saiful Bahry, Azmi Mat, Nur Liana Kori, Ainunnazlee Mohd Ali, Zarina Abdul Munir, Mohammad Zaim Mohd Salleh
120
Global J. Bus. Soc. Sci. Review 7 (2) 118 –124 (2019)
reported that approximately 47,000 people in Malaysia are autistic and it is estimated that one out of every
600 children is born with autism. However, the actual data is still being gathered to determine the total
number of the children with disability in Malaysia (UNICEF, 2017).
Family caregivers play an important role in the wellbeing of disabled children. A care giver is defined as
“the parent (either mother or father) or other family members (grandmother or grandfather, siblings, aunt or
uncle and adoptive parent) of the disabled child who are responsible for parenting or caring for the disabled
child” (Siti Nor Ismalina, et. al, 2016). According to Juhásová (2015), a child with disabilities represents a
heavy psychological, physical, social and economic burden for a family. Parenting a child with disabilities
goes beyond ‘ordinary’ parenting, and the parents must cope with many changing demands related to their
child's specific needs (Siti Nor Ismalina, et. al, 2016). When caring for a disabled child, it becomes
increasingly difficult to balance their working life and their attention to their child. A healthy family
development will affect the development of a child with disabilities (Juhásová, 2015). The most important
part of caring for child with disabilities is undertaken by the family and their local community. Hence, this
study focuses on the issues and challenges in caring for a child with disabilities. In addition, this study
identifies strategies to minimize issues and maximize the facilities for caring for a disabled child. Moreover,
the aim of this research is to compare the quality of life between families with disabled children and families
without disabled children in Malaysia.
2. Challenges of Caregiving for a Disabled Child
Most of the literature relating to caring for a child with special needs highlight several ways to reduce the
caregiving burden and increase the caregiver’s quality of life. Three major issues of caregiving disabled
children are highlighted in this study, including: the cost of raising disabled children, parenting stress and
additional time allocation. Understanding the issues and challenges these parents face can be understood
through conversation of resources theory. According to Hobfoll et. al. (2011), The Conservation of Resource
Theory is a reliable basis for understanding the process involved with experiencing, coping with, and
overcoming chronic and traumatic stress. According to that theory, a certain level of stress is incurred when
an individual’s resources are threatened, depleted, or when investment(s) in new resources do not adequately
increase (Joyner & Leake, 2018; Hobfoll et. al., 2011). Resources are defined as anything that the person
values, specifically objects (e.g., house, car, telephone), states (e.g., optimism, hope, knowledge), and
conditions (e.g., stable employment, good financial, good health, work-life balance). Through the lense of the
Conversation of Resource Theory, raising a child with challenging disorders is likely to strain one’s cognitive
and physical resources which may lead to different levels of stress (Hobfoll, 1989). In addition, Boundary
Theory provides a good understanding for managing one’s work and family roles. Boundary Theory
examines the mechanisms people enact to create, maintain, and change boundaries in order to classify and
simplify their world (Ashforth, Kreiner & Fugate, 2000). When caring for a child with disabilities, it is likely
that the caregiver will require a high level of integration between their work and family roles in order to meet
their child’s needs.
3. Cost of Raising Disable Child
In a recent UNICEF (2016) report, it was stated that financial barriers are one of the major burdens in
caregiving for a child with disabilities (UNICEF, 2016). Those barriers include transport to services, medical
bills, nutritional supplements, diapers, and assistive devices. In addition, they received limited disability
allowances, which increases the financial strain. Nowadays, the cost of raising disabled children is very
expensive and burdensome for parents. Items such as food, special equipment or devices uses for the child
have increased in cost over time. A survey conducted in Kelantan by Surianti, Raishan, Azizah and Mohd
(2017) reports that living with disabilities generates extra costs and a majority of the mothers surveyed were
not able to afford the resources they believe are essential for their disabled children. According to Suriati,

Norliza Saiful Bahry, Azmi Mat, Nur Liana Kori, Ainunnazlee Mohd Ali, Zarina Abdul Munir, Mohammad Zaim Mohd Salleh
121
Global J. Bus. Soc. Sci. Review 7 (2) 118 –124 (2019)
Zainiyah, Lye, and Norlijah (2011), two-thirds of caregivers earn less than RM2000 which may further
compound the need for financial support. The findings of that study show that most parents do not have
financial stability and need to earn more money to meet the costs involved with caregiving for disabled
children. This is also the case in other countries; Newacheck and McManus (1998) have found that a parent
spends almost twice as much when caring for a disabled child, including costs of medical expenses.
Moreover, Loprest and Davidoff (2004) examine the impact of having a child with special health care needs
(CSHCN) on low-income parents’ employment and reveal that parents spends a significant amount on
medical and treatment costs that are, for the most part, unaffordable. Those parents have additional expenses,
which require them to work harder to increase their financial support. In another study, 45 percent of families
reported incurring extra expenses for these children (Meyers, Brady, Seto, 2006). The need for increased
incomes would tend to increase the likelihood of work.
One study related to the economic burden of families with Autism Spectrum Disorders (ASD) children,
comprehensively discussed the costs incurred and burden of raising those children children in Malaysia. As
shown in Table 2, the costs can be classified into direct and development costs. Direct costs refers to medical
direct costs and non-medical direct costs. Direct medical costs refers to the purchase of medical, diagnostic
test, surgery ward, entrance fees, treatment, medical and therapy fees. Non-medical direct costs, however,
includes transportation and accommodation costs related to the use of medical services. Amar (2018) also
further states that the cost of raising disabled children includes pediatric treatment, physiotherapy and
occupational therapists, speech or language therapists and child psychology. All of these treatments are
important to ensure the positive improvement of their child. Meanwhile, development costs refer to domestic
helpers, nurseries, special education, special diets, daily necessities and insurance. These cost fall in the range
of RM 25,763 to RM 37,905.
In Malaysia, the learning options for students with special needs fall within three broad categories of
special needs: visual impairment, hearing impairments and learning disabilities in special schools and
integration programs in mainstream schools (Norshidah & Manisah, 2010). Despite the positive
developments in providing education for children with disabilities, Muhamad and Alfa (2016) report that
there remain an abundance of challenges that need to be addressed and resolved by different stakeholders,
namely, the Ministry of Education, teachers and school management. The authors also explain that in
Malaysia, there remain issues in unsupervised and unstructured early intervention programs, poor
infrastructure, and technological accessibility, financial constraints, low level of readiness among special and
general educators and individual self-conflict. Due to the issues in public special needs school, some parents
choose to send their children to private special education where the fees can range from RM1000 to RM4500
per month. Although those costs are a burden on those families, they struggle to fulfil the needs in order to
ensure that their children maintain healthy, active and continuous development (Kamaralzaman, Toran,
Mohamed & Abdulla, 2018). Due to rising costs, most families require both the husband and wife to work in
order to earn extra financial support.
4. Parenting Stress
Caregiving of disabled children is challenging for the parents. Olsson and Hwang (2001) report that
parents of children with disabilities are likely to experience a higher burden compared to parents of children
that do not have disabilities. Some of the challenging aspects of caring for these children include excessive
caring burden, less quality time with family members, handling sibling problems, education and future
concerns, as well as financial difficulties (Shirley, Amily, Zulhabari & Norashikin, 2017). Furthermore, they
need to spend extra time to assist in feeding, dressing and walking children with physical disabilities, whilst
some children with learning disabilities may have difficulties in understanding and following instructions
(Suriati et. al., 2011).
The physical and mental stress associated with raising children with disabilities could be multifold
(Ganjiwale, Ganjiwale, Sharma & Mishra, 2016). Studies have shown that parental stress is related to the

Norliza Saiful Bahry, Azmi Mat, Nur Liana Kori, Ainunnazlee Mohd Ali, Zarina Abdul Munir, Mohammad Zaim Mohd Salleh
122
Global J. Bus. Soc. Sci. Review 7 (2) 118 –124 (2019)
psychological well-being and QoL of caregivers (Siti Nor Ismalina, et. al., 2016; Cramm & Nieboer, 2011).
Parents with disabled children experience more stress as they must assist the child to do things such as eating,
moving, clothing, and personal hygiene. Coping with all of these stresses is one of the challenges for these
parent. According to Allik, Larson and Smedje (2006), many parents have experienced intense feelings of
anger, guilt, depression or anxiety most of the time.
Immediate attention needs to be given to these parents to avoid burnout and other mental health issues
(Pushpalatha & Shivakumara, 2016). A recent study found that more than half of the respondents with
autistic children experienced a moderate burden and nearly half of them had mild to moderate stress
(Nagaraju & Wilson, 2013). Visilopoulou and Nisbet (2016) also state that parents of children with ASD
have higher rates of stress, depression, and anxiety as compared to parents of typically developing children
and children with other developmental disabilities. It can be concluded that, in addition to the financial stress
and physical stress of caregiving for disabled children, the prevalence of caregiver stress is also caused by the
difficulties of adapting to the several roles parents are required to fulfil.
5. Time Allocation
Maintaining a full-time job and caring for a child with special needs is undoubtedly difficult (Shirley et.
al., 2017). Those parents must find balance between their work and the care of their children. Time
requirements may be regular or highly unpredictable (Loprest & Davidoff, 2004). Due to the many
conflicting requirements of both full-time work and caregiving for their child, those parents often find it
difficult to balance their schedule and/or take leave from their paid employment (Shirley, et. al., 2017).
Therapy and hospital appointments for their children usually take a long time and require a parent to spend a
lot of time away from their job. In Malaysia, not all of the local or even private hospitals provide sufficient
specialized services for disabled children. This is due to the limited supply of assistive devices and limited
expertise of therapists, psychiatrists, doctors and medical officers. Shirley et. al., (2017) states that the
inability to allocate adequate time to either of their roles may be another source of stress for those parents.
6. Proposed Research Methodology
The aim of this research is to compare the quality of life between families with disabled children and
families without disabled children in Malaysia. The quality of life is compared from the point of view of
parents based on the physical, psychological, social and environmental aspects. The first group of
respondents consists of parents who care for a disabled child under the age of 18. The second group,
consisting of a family without a disabled child, will be used as the control to compare the quality of life
between the two types of families. This study is conducted using convenient sampling techniques and
quantitative studies.
A self-administered questionnaire will be given to the parents with disabled children and parents without a
disabled child. In the first section of the questionnaire, the caregiver and child’s socio-demographic
characteristics will be examined to determine if there are any subgroup differences. The second section of the
questionnaire will be adapted from a standardized questionnaire of the World Health Organization for the
assessment of quality of life WHOQOL-BREF which was originally created in 1995 and has been validated
by several studies in specific subgroups of the population (Kruithof, et. al., 2018).
7. Conclusions
In conclusion, the challenges of caregiving differ depending upon the type of disability of the child and
the socio-demographic background of the family. In general, however, most of the parenting burden stems
from difficulties with time allocation, treatment and equipment costs as well as the balance between paid
employment and caring responsibilities. The implication of this study is to identify recommendations for the

Norliza Saiful Bahry, Azmi Mat, Nur Liana Kori, Ainunnazlee Mohd Ali, Zarina Abdul Munir, Mohammad Zaim Mohd Salleh
123
Global J. Bus. Soc. Sci. Review 7 (2) 118 –124 (2019)
government to develop better policies and facilities that may reduce the burden of those family with disabled
children. In addition, it is recommended that parents focus on controlling their emotional and physical stress
in order to cope with the requirements of caring for a disabled child. There is no doubt that the parent will
experiences stress, limited financial support, lack of time and emotional and physical exhaustion.
As a parent, they should be more knowledgeable, informative and willing to learn in managing disabled
children. It is also recommended that parents engage in positive thinking so that they able to manage these
constraints. The limitation of this study is that it does not examine any specific disability in a child, as
different disabilities presents a unique set of challenges. In addition, the lack of quality data on the total
number of children with disabilities will hinder the ability to generalize the results. Future research should
aim to investigate strategies to assist parents in managing the challenges they face effectively and practicably.
It is also important to note that issues and challenges of caring for children with disabilities do not equally
affect the QoL of all caregivers (Ganjiwale et. al., 2016). There would be a number of factors affecting the
QoL of caregivers, and it is recommended that future research be undertaken to investigate the differences of
QoL between families with disabled children and families without disabled children in Malaysia.
Acknowledgements
This research was made possible by a LESTARI grant from Universiti Teknologi MARA (Grant no: 600-
IRMI/DANAKCM5/3/LESTARI (200/2017).
References
Allik H, Larson J and Hans Smedje. (2006) Health-Related Quality of Life in Parents of School-Age Children with
Asperger Syndrome or High Functioning Autism. Health and Quality of Life Outcomes, 4:1 doi: 10.1186/1477-7525-4-
1
Amar H. S. (2008). Meeting the Needs of Children with Disability in Malaysia. Medical Journal of Malaysia; 63(1): 1-3
https://www.ncbi.nlm.nih.gov/pubmed/18935722
Ashforth, B., Kreiner, G. and Fugate, M. (2000). All in a Day’s Work: Boundaries and Micro Role Transitions.
Academy of Management Review, 25(3), 472–491. Retrieved from http://amr.aom.org/content/25/3/472.short DOI:
10.2307/259305
Brehaut, J. C., Kohen, D. E., Garner, R. E., Miller, A. R., Lach, L. M., & Klassen, A. F. (2009). Health among
Caregivers of Children with Health Problems: Findings from a Canadian Population-Based Study. American Journal of
Public Health. 99(7), 1254-1262 DOI: 10.2105/AJPH.2007.129817
Button, S., Pianta, R. C., & Marvin, R. S. (2001). Partner support and maternal stress in families raising young children
with cerebral palsy. Journal of Developmental and physical disabilities, 13(1), 61-81
https://link.springer.com/article/10.1023/A:1026509400487
Cramm, J. M., & Nieboer, A. P. (2011). Psychological well-being of caregivers of children with intellectual disabilities:
Using parental stress as a mediating factor. Journal of Intellectual Disabilities, 15(2), 101-113
https://doi.org/10.1177/1744629511410922
Department of Social Welfare (2015) Statistics of Social Welfare Department. Available at: www.jkm.gov.my
Hobfoll, S. E. (1989). Conservation of resources: A new attempt at conceptualizing stress. American psychologist,
44(3), 513 http://dx.doi.org/10.1177/1744629511410922
Hobfoll, S. E. (1991). Traumatic stress: A theory based on rapid loss of resources. Anxiety Research, 4(3), 187-197
https://doi.org/10.1080/08917779108248773
Hobfoll, S. E. (2011). Conservation of resources theory: Its implication for stress, health, and resilience. The Oxford
handbook of stress, health, and coping, 127-147 https://psycnet.apa.org/record/2010-25086-007
Ganjiwale, D., Ganjiwale, J., Sharma, B., & Mishra, B. (2016). Quality of life and coping strategies of caregivers of
children with physical and mental disabilities. Journal of family medicine and primary care, 5(2), 343 DOI:
10.4103/2249-4863.192360
Law of Malaysia (2008). Act 685. Persons with Disabilities Act. Percetakan Nasional Malaysia Bhd., Kuala Lumpur

Norliza Saiful Bahry, Azmi Mat, Nur Liana Kori, Ainunnazlee Mohd Ali, Zarina Abdul Munir, Mohammad Zaim Mohd Salleh
124
Global J. Bus. Soc. Sci. Review 7 (2) 118 –124 (2019)
Juhásová, A. (2015). Comparison of quality of life of families with children with disability and families with children
without disability. Procedia Social and Behavioral Sciences, 174, 3378-3384
https://doi.org/10.1016/j.sbspro.2015.01.1007
Joyner, J., & Valerie Leake (2018, January 24). A Brief Review of the Conservation of Resources Theory as it Applies
to Military Trauma. Retrieved from http://traumapsychnews.com/2018/01/a-brief-review-of-the-conservation-of-
resources-theory-as-it-applies-to-military-trauma/
Kamaralzaman, S., Ying, T. C., Mohamed, S., Toran, H., Satari, N., & Abdullah, N. (2018). The economic burden of
families of children with cerebral palsy in Malaysia. Malaysian Journal of Public Health Medicine,
2018(Specialissue1), 156-165.
Kruithof, N., Haagsma J.A., Karabatzakis, M., Cnossen, M.C., de Munter, L, van de Ree, C.L.P., de Jongh, M.A.C. &
Polinder, S. (2018). Validation and reliability of the Abbreviated World Health Organization Quality of Life Instrument
(WHOQOL-BREF) in the hospitalized trauma population. International Journal of the Car of the Injured. 49(10), 1796-
1804 DOI: 10.1016/j.injury.2018.08.016
Loprest, P., & Davidoff, A. (2004). How children with special health care needs affect the employment decisions of
low-income parents. Maternal and Child Health Journal, 8(3), 171-182 DOI:10.1023/B:MACI.0000037650.83572.81
Muhamad N.A.N. & Alfa N.A.E.E. (2016) Special education for children with disabilities in Malaysia: Progress and
obstacles. Malaysian Journal of Society and Space. 12(10) 78 – 87.
Meyers, M. K., Brady, H. E., & Seto, E. Y. (2000). Expensive children in poor families: The intersection of childhood
disabilities and welfare. Public Policy Institute of Calif.
Nagaraju, K., & Wilson, J. (2013). Burden and stress perceived by mothers having autistic children. International
Journal of Multidisciplinary Research in Social & Management Sciences, 1(4), 53-57.
Newacheck P.W. & McManus M. (1998). Financing health care for disabled children. Paediatrics 1998; 81: 385–94.
Norshidah M.S. & Manisah M.A. (2010) Students with Visual Impairments and Additional Disabilities. Procedia Social
and Behavioral Sciences. 7(C) 714–719 DOI: http://dx.doi.org/10.17977/um005v1i12017p060
Olsson, M. B., & Hwang, C. P. (2001). Depression in mothers and fathers of children with intellectual disability.
Journal of intellectual disability research, 45(6), 535-543 https://doi.org/10.1046/j.1365-2788.2001.00372.x
Pushpalatha. R. & Shivakumara. K., (2016). Stress, Burden and Coping between Caregivers of Cerebral Palsy and
Autism Children. The International Journal of Indian Psychology. 4(1), 80.
Shirley A.S., Amily F., Zulhabri I., Norashikin H. (2017). Work-Family Conflict among Working Parents of Children
with Autism in Malaysia, Procedía Computer Science. 105 (2017) 345 – 352
https://doi.org/10.1016/j.procs.2017.01.232
Siti Nor Ismalina I.B , Ismarulyusda I., Azriani A.R., Nur Zakiah M.S., Normah C.D., Syarif H.L., Muhammad Faiz
M.I. (2016). Health and quality of life among the caregivers of children with disabilities: A review of literature. Asian
Journal of Psychiatry. 23 (2016) 71–77 https://doi.org/10.1016/j.ajp.2016.07.007
Sy, S. Z., & Ms, L. (2011). Assessing the unmet needs among caregivers of children with disabilities at the community-
based rehabilitation centres in Selangor. Malaysian Journal of Public Health Medicine, 11(2), 32-40
https://doi.org/10.1111/hsc.12325
Tan, K. L., & Yadav, H. (2008). Assessing the development of children with disability in Malaysia. The Medical
journal of Malaysia, 63(3), 199-202 https://www.ncbi.nlm.nih.gov/pubmed/19248689
UNICEF (2016). Childhood Disability in Malaysia: A study of Knowledge, Attitudes and Practices. Retrieved from
www.unicef.org/Malaysia.
UNICEF, (2017). Childhood Disability in Malaysia. A study of Knowledge, Attitudes and Practices. Retrieved from:
https://www.unicef.org/malaysia.
ll, S. E. (2011). Conservation of resources theory: Its implication for stress, health, and resilience. In S. Folkman (Ed.),
The Oxford handbook of stress, health, and coping (127–147) DOI: 10.1080/1047840X.2015.1002377
Hobfoll, S. E. (2011). Conservation of resources theory: Its implication for stress, health, and resilience. The Oxford
handbook of stress, health, and coping, 127-147. https://psycnet.apa.org/record/2010-25086-007
New York: Oxford University Press Vasilopoulou E., & Nisbet J. (2016). The quality of life of parents of children with
autism spectrum disorder: A systematic review. Research in Autism Spectrum Disorders 23, 36–49 DOI:
10.1016/j.rasd.2015.11.008