The number of children suffering from chronic illnesses such as cancer, diabetes and asthma has more than doubled over the past two decades, affecting approximately 15 to 30 percent of those age 2 to 18 in the United States. Thanks to advances in medicine, however, they are living longer and living better.

But more children suffering from chronic diseases means greater psychological stress for both their patients and their families. A new book written by Temple University faculty members, “Chronic Illness in Children and Adolescents,” addresses the challenges for patients, families and mental health providers related to coping with chronic illness and enjoying a good quality of life.

In the book, written for healthcare and social services professionals, the authors concentrate on the most common chronic illnesses in children: asthma, sickle cell disease, diabetes, cystic fibrosis and cancer. Asthma is the leading cause of chronic illness in children, and cancer is the leading cause of death by disease for kids under age 15. Rates of chronic illness are higher among individuals of lower socioeconomic status.

According to author, Ronald Brown, Ph.D., professor and dean of the College of Health Professions at Temple University, such children understandably have high levels of stress, which puts them at risk for adjustment problems such as depression and anxiety. Additionally, frequent doctor and hospital visits keep them out of school, compounding the problems.

Jean Mackins and her daughter Michelle, a patient of Temple pediatrician Andrea McCoy, MD, understand the toll chronic illness can take. Michelle, a senior at Mast Community Charter School in Philadelphia, was diagnosed with asthma when she was 9 years old and with diabetes at 13.

That toll can take many forms. The illness might keep kids from routine activities or sports. They might miss school and usually need to take steps to manage their illness, like carrying an inhaler, which set them apart from their friends.

Parents might struggle with how much control to exert over their child’s condition. Younger children with diabetes, for example, will need help with testing blood sugar and eating healthy meals, while older children are capable of handling these tasks on their own. Experts suggest parents help their children transition to greater independence in taking care of themselves, but some children will have a harder time with this than others.

While Jean encourages Michelle to stick to her medicine routine and eat healthy foods, she also understands that Michelle is a mature teenager who needs to make her own decisions, especially next fall when she heads to college.

“Sometimes I have to surrender,” Jean said. “Michelle’s at the age where she knows what to do, and she is making better choices. Together, we made a New Year’s agreement to eat more fruits and vegetables.”

For Michelle, being in school and among friends present the biggest challenges.

“It’s hard to always pick the right foods when my friends are eating french fries. But I try to always eat fruit at school,” Michelle said.

Co-author Brian Daly, Ph.D., clinical assistant professor of public health at Temple, suggests that kids and teens get help in building effective coping skills to ward off emotional problems. Some helpful skills include:

• Relaxation exercises — important for pain management in children with sickle cell disease and cancer.

• Stress management — useful for children with diabetes who are at increased risk for depression, anxiety and eating disorders.

• Skills for stress, coping and problem solving — needed by children with asthma, as they may be at higher risk for behavior difficulties.

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Information for families from the American Academy of Pediatrics:

Chronic illness and siblings:
http://www.aap.org/publiced/BK5_ChronicIllness_Siblings.htm


Coping with a chronic illness:
http://www.aap.org/publiced/BK5_ChronicIllness_Cope.htm