Chronic illness and disability in Adolescents

Chronic illness and disability in Adolescents

·        Between 1- 20 % of young people have a chronic or disabling condition

·        US prevalence:

o  Asthma: 50/1,000

o  Mental retardation: 25/1,000

o  Epilepsy: 4.1/1,000

o  Diabetes mellitus: 4.1/1,000

o  Down syndrome: 1.1/1,000

o  Cystic fibrosis: 0.2/1,000

·        Survival rates are improving

·        Developmental impacts:

o  Primary: effects of the disease

o  Secondary: effects of delayed development

o  Tertiary: effects of treatment

·        Similar risk taking behaviours to healthy adolescents

·        Impacts on development:

o  Most don‟t have major problems, and consider their illness less severe than doctors do 

o  Process of separation from parents may be slowed if dependent on parents for care or limited opportunities to socialise with peers 

o  Learning disorders ® embarrassment, failure, frustration, ¯self worth, performance anxiety, learned helplessness 

o  Slowed sexual development or physical deformity ® problems with sexual identity 

o  Normal developmental issues such as struggle for independence, concrete thinking, narcissism (what feels good is right) and sense of omnipotence (future is a long way off) ® non-compliance with treatment

·        Mental health in those with chronic illness:

o  Highly variable

o  Vulnerable periods: early years, transitions, severe illness 

o  Important variables: onset, disruption to early attachments, premorbid function, family stress, mental health of parents, experience of failure or victimisation, repeat hospitalisation, life expectancy

·        Resilience:

o  Focus on the young person not just the disability/illness

o  Focus on building strengths, achieving successes

o  Competence in self-care/management of illness/disability

o  Access to age appropriate coping strategies

o  Opportunities for responsibility/required helpfulness

o  Family relationships

o  Peer relationships

o  School attendance