Tuesday, February 28, 2012

Successful Transitions: Start Early, Little by Little

Transition should be a step-by-step process starting as early as possible; preferably when our children are toddlers. You've all seen the milestone charts we get from our pediatricians at well-baby visits, right? Children reach milestones in how they play, learn, speak, behave, and move.

For children who have special medical needs, there are also milestones for their illness including the self-care skills they should be doing independently. Many illnesses have transition plans which provide a step-by-step plan for keeping a child moving forward in areas they should be growing and taking responsibility.

One of the most common patterns of transition mismanagement is that of a parent who does it all even past early childhood. Then, the kid becomes a teenager and parents suddenly want the child to do more and take more responsibility.  Of course the teen resists getting dumped on and everyone is set up failure. 

So instead of falling into this pattern, wise parents lovingly lay the responsibility for medical adherence on their child in small, age- appropriate increments as early as possible. When we use choices and questions and allow our children to make their own decisions early on, they will grow in responsibility naturally. Lisa shares an experience:

At about age six, my son surprised me by putting on his vest (a mechanical chest physical therapy device) and loading up his nebulizer with medication right out of the blue because he “wanted to get it done before his friend came over so that they could play longer.” At the time, I didn’t realize he was ready and capable of starting up his own treatments. Since the toddler years, we have given Jacob many choices around when, where and how he does his treatments. Notice we don't give him the choice IF he does his medical treatments. We set firm limits around treatments being completed within a certain time frame.  

When we teach our children early on and empower them to make choices, they might surprise us with what they can really do! When we become a watchful manager, rather than doing everything for our kids, it makes our lives easier, too.

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.  

© Copyright by Foster Cline, MD and Lisa Greene. All rights reserved.  


  1. Amen! I agree 100%. Rachel has been given some "responsiblity" for her healthcare since about 4. I started with her clinic appointments; having her talk to the doctor about her throat swabs. I also have her tell me how many enzymes she needs. I set up chest therapy and she puts on her vest, hooks up the hoses, and starts the machine. I was floored one day when she asked me if she could do chest therapy. I think more responsibilty is a good way of giving her more "control" in her life.

    1. Thanks for sharing your comments. Wow- that is great that your daughter is already taking so much responsibility at 4. I LOVE that!! I am going to share your comments in my classes. People are often surprised at how young we can gently start our kids on the road to independence.

  2. Isn't it amazing? I am constantly surprised by how mature my little one is - but that's just kids. They really embrace their conditions. For my son, it's eczema, food allergies, and asthma. I can't believe how calm he is at kid's birthday parties where he can't eat ANY of the food and must stick to what I bring from home. I'd throw a fit, why doesn't he.

    Kids are awesome.



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