This is Blog # 4 in our Transition series. The last three blogs discussed what transition is and why it matters. This week, we start looking at parenting strategies for raising children with special healthcare needs who are responsible, independent, confident and prepared for the transition/ transfer into the adult medical system.
Raising Responsible Children
All children must make a shift from parental to personal responsibility. All children must learn to make good choices which are independent of active adult involvement. And when a child has special healthcare needs, there is the additional process of shifting the medical tasks and responsibilities.
The challenge is, telling our children to simply “Be responsible!” doesn’t work. It is ineffective to demand, “Do your homework, take your medicine, and make good choices." Responsibility is something that has to come from inside the child- not from parents trying to force it from the outside. And taking responsibility starts early. In fact, learning about responsibility and making good choices starts when children are old enough to throw peas from the high chair!
This brings us to a critical subject: Parenting Skill Training. This includes how to talk and work with children: what to say and do when they are resistant, how to avoid power struggles in the first place, what responses work and don't work, and how to structure a home environment in such a way that best promotes responsibility, positive attitudes and a desire to make good choices. Research shows that parenting skills, responses, and disciplinary styles have a significant impact on all of this.
If a child won't get their shoes on without arguing, brush their teeth without nagging, and pick up their belongings when asked, how can they be expected to do their medical treatments? Or, from an article called Take as Directed: Improving Adherence in the Primary Care or Specialist Care Setting by Edward Christophersen Ph.D. and Susan Mortweet VanScoyoc Ph.D.:
"In the area of pediatrics, an often overlooked but important part of the medical adherence equation is that of the general behavioral compliance of the child. It is unrealistic to expect a child who will not follow the directions of her parents on anything else to follow the directions of her parents with respect to medical regimens. Often, failures with complicated regimens like Type 1 diabetes could have been predicted by the parent's prior lack of knowledge of strategies for addressing general compliance issues."
So the big question is: How do we raise kids with special healthcare needs who are respectful, responsible and prepared for the real world? Next week, we'll start to answer this question.
Foster W. Cline, MD is a child psychiatrist and co-founder of Love and Logic®. Lisa C. Greene is a parenting educator and mom of two children with cystic fibrosis. Together they have written the award-winning book “Parenting Children with Health issues." For free audio, articles and other resources, visit www.ParentingChildrenWithHealthIssues.com.