Coping mechanisms
Children with more positive and accepting attitudes about their chronic illness use a more adaptive coping style characterized by optimism, competence, and compliance.
Coping patterns used by children with special needs
Develops competence and optimism:
Accentuates the positive aspects of the situation and concentrates more on what he or she has or can do than on what is missing or on what he or she cannot do; is as independent as possible
Feels different and withdraws:
Sees self as being different from other children because of the chronic health condition; views being different as negative; sees self as less worthy than others; focuses on things he or she cannot do, and sometimes over-restricts activities needlessly
Is irritable, is moody, and acts out:
Uses proactive and self-initiated coping behaviors, although usually counterproductive in that the behaviors are not ego enhancing or socially responsible and do not result in desired outcomes; acts out irritability, which may or may not be associated with condition’s symptoms
Complies with treatment:
Takes necessary medications, treatments; adheres to activity restrictions; also uses behaviors that indicate developing independence (e.g., assumes responsibility for taking medication)
Seeks support:
Talks with adults, children, physicians, and nurses; develops plans to handle problems as they occur; uses downward comparison (i.e., realizes that others have it worse)
Hopefulness
Hopefulness is an internal quality that mobilizes humans into goal-directed action that may be satisfying and life sustaining.
Health education and self-care
Children need information about their condition, the therapeutic plan, and how the disease or the therapy might affect their situation.
Children nearing puberty also need to understand the maturation process and how their chronic illness may alter this event.
Responses to parental behavior
Parental behavior toward the child is one of the most important factors influencing the child’s adjustment.
Children’s perceptions of their mothers’ support and maternal perceptions of the psychosocial impact of the child’s chronic illness on the family were shown to be two of the greatest predictors of children’s psychologic adjustment
Type of illness or condition
The type of illness or condition also influences the child’s emotional response.
Interestingly, children with more severe disorders often cope better than those with milder conditions.
Children’s cognitive ability and the timing of onset of abstract thinking in adolescence, an obvious condition may be easier for them to accept because its limitations are concrete.
The onset of a disabling condition may generate a state of confusion for children, who may have trouble differentiating between actual bodily functions and their image of their bodies.
They may also experience problems in identifying themselves and those extensions of self (e.g., wheelchairs, braces, crutches, other mechanical or prosthetic devices) and may have difficulty in accepting functional aids.
