By Dr. Charles Sophy
All children will likely have many different health problems during infancy and childhood: the flu, chicken pox, broken bones, stitches, ear infections, to name a few. For most children, these problems are mild – they come and go without incident and with little disruption in a child’s daily life or routine. A chronic long-term medical problem is different and often doesn’t come alone, as children with serious medical illnesses are at risk of developing associated emotional problems. Learning to live with a chronic medical condition can be very challenging for a child, for parents, and for siblings and friends, and can lead to feelings of anger, fear and depression.
The way children react to diagnosis with a chronic illness depends on several factors, including the child’s personality, the specific illness, family emotional dynamic, and the child’s age and emotional maturity.
A smaller child may react aggressively as they begin to cope with changes in schedule due to hospital visits and all the new found pampering, and special attention. In usual development, young children are beginning to assert their sense of independence. Dealing with their illness may challenge their developing self-image and cause the child to feel out of control of their world. They counter lack of control over their world by challenging limits set by parents. A young child can also sense the difference in the attention now being lavished on him / her. This special attention may feel much different to the child and may cause them to react negatively in an attempt to stop the pampering.
The adolescent, in the midst of healthy adolescent behavior, may react to a diagnosis much as they would any other factor which inhibits their control – by challenging authority and rebelling against family and friends. It is common for a teenager to choose to discontinue all medical treatments and medications. It is important to help your teenager gain a sense of control of their disease management and respect their decisions, while guiding them to safer decisions.
Let’s take a look at Laura:
Laura is 9 yrs old. She had always been an energetic child who had maintained a healthy weight since pre-school. Over the past few months, Laura has lost weight, has become lethargic and frequently complained she was hungry and thirsty. Laura’s doctor diagnosed her with insulin-dependent, or Type I, diabetes.
Laura is frightened. Her only knowledge of this disease is watching grandpa give himself his insulin shot. She would often run from the room due to her fear of needles.
Laura’s initial treatments must be managed in a clinical environment until her glucose is better managed. While in the hospital she refuses to eat and eventually refuses all visitors. The emotional stress that she experiences only adds to the inability to control her diabetes.
Concerned that her emotional state is indicative of depression, Laura’s medical team decides to have her evaluated by the mental health team. Laura cooperates for the visit and recommendations were provided to her doctor.
Laura is asked to attend group sessions for children with diabetes and begins to see children in similar situations. Through her sessions, she is encouraged to communicate her fears and concerns to her family, which are received openly and with love and support. While in the hospital, Laura’s grandmother taught her to knit which had a tremendous impact upon her ability to move forward. Her knitting was a new found strength.
Here are some ways to assist your child when faced with chronic illness:
• Communicate: Children need age-appropriate honesty about their illness and treatment
• Self-evaluate: Keep yourself in check; your child understands verbal and non-verbal messages regarding the illness
• Support: Build upon your child’s strengths.
• Consult: Rely upon your child’s medical team for expertise
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