21 Feb 2008 02:01:56 | 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
About Author :
: Dr. Charles Sophy serves as Medical Director
for the Los Angeles County Department of Children and Family
Services (DCFS), which is responsible for the health, safety and
welfare of nearly 40,000 foster children. He also has a private
psychiatry practice in Beverly Hills, California. Dr. Sophy has
lectured extensively and is an Associate Clinical Professor of
Psychiatry at the University of California Los Angeles
Neuro-Psychiatric Institute. His lectures and teachings are
consistently ranked as among the best by those in attendance.
