Cancer Center for Kids

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Understanding Developmental And Behavioral Issues

Special Developmental Concerns:

Infants and Toddlers:
Infants and toddlers are the most sensitive to separation from parents during medical treatment. While it is sometimes necessary that a patient must be away from a parent (during surgery, bone marrow transplant, overnight in an Intensive Care Unit, and during some procedures), every effort to minimize these periods is made. The psychosocial team helps support the parents’ ability to stay with the child during painful procedures and helps them identify people in their support network who can manage other family responsibilities. When it is not possible for parents to manage child care for siblings or maintain their income without leaving the child to hospital caretakers, interventions are developed which mitigate the effects of separation. Child Life personnel is particularly helpful in maximizing the child’s adjustment. Adherence to medical regimens can be a challenge to the parent of an infant or toddler. Creative ways to give medication, change catheters and dressings and encourage feeding are taught by all staff, especially nurses.

Pre-Schoolers:
Pre-schoolers are normally uneven in their moods and behavior. Tantrums, sleep difficulties, and refusal to cooperate with demands of treatment tax the strength of parents. Behavioral techniques and medical play help to give both parents and the sick pre-schooler some control over stressful situations. Written and video materials have been developed which provide a familiar way for pre-schoolers to master information. Coloring books, workbooks, and story books are available for children with cancer. The psychosocial team and child life specialists use these materials to help children of this age.

School-age Children:
Children in this age group are most sensitive to humiliation from their peers and are particularly concerned about the bodily changes caused by the disease and the treatment. As their educational and social development will suffer as a result of the frequent absences, every effort must be made to encourage peer interventions. School districts may be asked to work creatively with parents and hospital staff to allow a schedule that is flexible enough to all treatment and growth. The Center has an Educational Coordinator who can consult with families.

We are able to refer children to camp programs for children with cancer. There, patients meet one another and feel less isolated and different while experiencing normal camp activities.

Adolescence:
Cancer in the teenager threatens ability to develop autonomy and sexual identity and to plan for future life goals. While adolescent patients may understand all the implications of the disease and treatment, they may deny the seriousness of the diagnosis in order to justify poor compliance and risk-taking. The demands of treatment interfere with the normal activities of adolescence and depression and hopelessness may occur at various points.

Most adolescents will identify with one member of the team who should be able for discussion and support. Adolescent groups are usually more successful when they develop naturally in the hospital or clinic.



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