Graduation Semester and Year
Spring 2026
Language
English
Document Type
Thesis
Degree Name
Master of Social Work
Department
Social Work
First Advisor
Weiwen Zeng
Second Advisor
Noelle L Fields
Third Advisor
Ling Xu
Abstract
Adolescence is a critical developmental period during which behavioral and physical health outcomes are shaped by social and family determinants of health; yet limited research has examined how these determinants operate among adolescents with intellectual and developmental disabilities (IDD) within a multilevel ecological framework. To address this gap, this thesis used data from Years 9 and 15 of the Future of Families and Child Wellbeing Study (FFCWS), with a final analytic sample of 3,176 adolescents at Year 15, including 150 with IDD. Descriptive analyses first examined the differences in demographic characteristics, behavioral outcomes (externalizing and internalizing behaviors), and physical outcomes (BMI percentiles) between adolescents with and without IDD. Hierarchical regression and interaction analyses then examined how socioeconomic status (SES), family, and other social factors were associated with the three outcomes, and whether these associations differed by IDD status. As hypothesized, adolescents with IDD exhibited significantly higher levels of internalizing and externalizing behaviors compared with peers without IDD. Although IDD status was not significantly associated with mean BMI percentiles, adolescents with IDD were more likely to be underweight or obese compared with peers without IDD. Material hardship was consistently associated with elevated externalizing behaviors, internalizing behaviors, and BMI percentiles, while receipt of welfare programs was positively associated with behavioral challenges. Stronger parent–child relationships were protective against behavioral challenges, whereas peer bullying emerged as a significant risk factor. Interaction analyses further indicated that the association between material hardship and internalizing behaviors was significantly stronger among adolescents with IDD. Unexpectedly, higher household income and homeownership were positively associated with internalizing behaviors. The findings from this study highlight the importance of comprehensively supporting adolescents with IDD and their families across research, social work practice, and policy contexts.
Keywords
intellectual and developmental disabilities, adolescents, externalizing behaviors, internalizing behaviors, BMI, material hardship, ecological systems theory, peer bullying, parent-child relationship
Disciplines
Social Work
License
This work is licensed under a Creative Commons Attribution 4.0 International License.
Recommended Citation
Li, Pingnan, "IMPACT OF FAMILY AND SOCIAL DETERMINANTS OF HEALTH ON BEHAVIORAL AND BMI OUTCOMES IN ADOLESCENTS WITH AND WITHOUT INTELLECTUAL AND DEVELOPMENTAL DISABILITIES: AN ECOLOGICAL SYSTEM PERSPECTIVE" (2026). Social Work Theses. 2.
https://mavmatrix.uta.edu/socialwork_theses2/2