physical and psychological stress, guilt, and depression (Ireys & Silver 1996); deleterious effects on marital relationship (Pueschel 1986); stress related to life cycle transitions (Bristol & Schopler 1984); and socioeconomic hardships (Dunst & Trivette 1986, McCubbin 1989, Beckman 1991). Dunst and Trivette (1986) found that the severity of the illness or condition was predictive of the degree of stress in the family