Peer-reviewed article

Perceived Relational Harm Across Children's Disability Constellations in Parent-Professional Interactions.

Fuths S, Daubert R, Walter-Klose C · 1 Jul 2026

Abstract

Background Parents of children with disabilities frequently interact with professionals across healthcare, educational and social service systems and often describe these interactions as dismissive, blaming or controlling. Method This mixed-methods study examined the prevalence, accumulation, social patterning and qualitative manifestations of relational harm in these encounters using data from a nationwide survey of 645 parents in Germany. Quantitative analyses assessed four indicators of relational harm: not being taken seriously, ability negation of parental judgement, blame attribution and autonomy constraint through professional override. Results Relational harm was widespread (86.8% reported at least one form) and often cumulative. The most frequently reported experience was not being taken seriously (79.5%), followed by autonomy constraints (66.2%) and ability negation (59.4%), whereas blame attribution was reported by 44.3% of parents. Experiences of relational harm were also socially patterned. Parents of children with psychosocial disabilities reported substantially higher rates and combinations of harm experiences, with more than half reporting all four forms. Logistic regression analyses confirmed these patterns, showing elevated odds of relational harm for this group and for families with higher support intensity. Qualitative analyses identified three recurring domains of relational harm: epistemic marginalization of parental perspectives (41.8%), normative evaluation and attribution of responsibility to parents (29.8%) and autonomy-related constraints in interactions with professionals (28.4%). Across these domains, parents described experiences ranging from non-consideration of parental perspectives to discreditation of parents as knowers, from normative evaluation of parental behaviour to accusations of constructing the child's disability and from prescriptive guidance to coercive enforcement of professional decisions. Conclusion These findings highlight relational quality as a central component of professional practice in support systems serving families of children with disabilities, as experiences of relational harm may undermine trust in professionals, engagement with services and parental well-being, with potential consequences for children's support and well-being.