Impact of chronic illness

D. stage Developmental tasks Effects of chronic illness

Infant Develop trust Multiple care givers and frequent

attach to parents separations.
learn through sensory Deprived of consistent nurturing
motor experiences Milestones delayed because of
begin to develop a separation, parental grief or
sense of separateness
from parents Increased exposure to painful
experiences over pleasurable
ones.
Limited contact with environment
from restricted movement or
confinement.
Increased dependency on parent
for care.
Parental over involvement in care.
 Supportive interventions
Encourage consistent care givers and care by parents in
hospital or other care settings.
Encourage parents to visit frequently (rooming in)
Emphasize healthy, perfect qualities of the infant.
Help parents learn special care needs of the infant.
Expose infant through pleasurable experiences through all
senses (touch, hearing, sight, taste and movement)
Encourage age appropriate developmental skills holding
bottle.
Encourage all family members to participate in care.
Encourage periodic respite from caring.
 Impact of chronic illness
D. stage Developmental tasks
Toddler Develop autonomy
Master locomotor and language
skills
learn through sensory motor
experiences, beginning
preoperational thought
Preschool Develop initiative and purpose,
Master self care skills
Begin to develop peer
relationship
Develop sense of body image
and sexual identification
Learn through preoperational
thought
Effects of chronic illness
Increased dependency on parent
Limited opportunity to test own abilities
and limits.
Increased exposure to painful
experiences
Limited opportunity for success in
accomplishing simple tasks or mastering
self care skills.
Limited opportunities for socialization
with peers.
Protection within family may cause child
to fear criticism & withdraw.
Awareness of body may center on pain,
anxiety and failure.
Sex role identification focused primarily
on mothering skills.
Guilt feelings. Thinks he or she caused
the illness.
 Supportive interventions
Toddler
Encourage independence in feeding, toileting and dressing.
Allow simple choices.
Provide toys that facilitate gross motor skills.
Institute age appropriate discipline and limit setting.
Recognize negative and ritualistic behaviors are normal.
Provide sensory experiences.
Preschool
Encourage mastery of self-help skills.
Encourage socialization such as inviting friends to play, day care
experience or trip to park.
Provide age appropriate play (associative play).
Help child deal with criticism.
Encourage interaction with same sex and opposite sex peers and adults.
Reassure that illness is not a punishment for his or her mistakes.
 Impact of chronic illness
D. stage Developmental tasks Effects of chronic illness

School child Develop a sense of Limited opportunities to achieve and compete

accomplishment. (many school absences and inability to
Form peer participate in sports).
relationships Limited opportunities for socialization.
Learn through Incomplete understanding of the imposed
concrete operations physical limitations and treatment
Adolescent Develop personal Increased sense of feeling different from peers
and sexual identity. and less able to compete with peers in
Achieve appearance, abilities and special skills.
independence from Increased dependency on family.
family Limited job / career opportunities.
Form personal Limited opportunity for heterosexual friendships.
relationships Less chance to discuss sexual concerns with
Learn through peers.
abstract thinking Increased concerns such as why did he / she get
the disease? Or Can he / she marry? Decreased
opportunity for earlier stages of cognition may
impede achieving level of abstract thinking.
 Supportive interventions
School Child
Encourage school attendance, Schedule medical visits at times other than school,
Encourage to make up missed work.

Encourage socialization.
Provide child with information about his / her condition.
Encourage creative activities.
Adolescent
Accept the difficulties experienced with adolescent as part of normal development
(rebelliousness, risk taking, lack of cooperation, hostility to authority). Provide
instruction on interpersonal and coping skills.
Encourage socialization with peers both with and without special needs.
Encourage increased responsibility to care for self or management of disease.
Encourage activities appropriate for age (attending parties, sports).
Be alert to cues that signal readiness for information on sexuality.
Emphasize good appearance.
Discuss planning for future and how condition can affect choices.