Although much is known about the risks to health and well-being that occur among family caregivers of children with disability, little is known about the unique group of caregivers of children with severe neurodisabilities who require varying degrees of respiratory care including ventilator support. This present study examined the psychological adjustment of caregivers in these situations, and tested the prediction that caregiver coping and problem-solving styles would be predictive of their physical and emotional health. Hierarchical regression analyses revealed that demographic characteristics and the severity of pulmonary condition were unrelated to caregiver adjustment. A coping style characterized by developing relationships, pursuing activities that promote self-worth and individuality, and a lower negative orientation toward solving problems were significantly predictive of caregiver distress. These data indicate that caregiver adjustment in these situations is influenced by cognitive-behavioral characteristics that could be addressed in educational and therapeutic programs provided in the clinic and in the community.