Developmental Level

How your child responds to a chronic illness and the role he/she plays in managing it are related to his/her developmental level.

The manner in which illness impacts children varies with their cognitive development:

• Infants and toddlers are unable to understand why they have difficulty breathing, don't feel well or itch all over. They depend on their parents for physical comfort, and they take their emotional cues from their parents' emotional reactions.

• Preschoolers are especially vulnerable emotionally because their cognitive development allows some understanding of their body and its functioning, but their characteristic magical thinking leads to misconceptions and fears.

• School-age children have a greater capacity to understand their illness, although at a concrete level. This understanding has the potential of providing them tools for actively coping with both the day-to-day demands and the emotional demands of their illness. For school-age children, distress about illness often is manifested through problems with peers.

• Adolescents, with their remarkable development of abstract reasoning, have the potential for even greater self-management skills. However, with their advanced cognitive abilities comes the capacity to project into the future and imagine what life is likely to hold, including the restrictions they may encounter in adulthood. Furthermore, adolescents are notorious for not following their doctor's recommendations and instead testing out their own ideas of illness management.