5EMOTIONAL ISSUES THAT MAY ARISE FOR PRESCHOOLERS Emotions are not well-regulatedCommunication skills are still developing.May develop fears around blood sugar checks, insulin injections site changes.
6PARENTS AND PRESCHOOLERS Not allowing diabetes-specific tasks to become the primary source of attentionBalancing Normative Experiences and SafetyUnique challenges of finding babysitting, specialized services and supports
7DEVELOPMENTAL ISSUES FOR SCHOOL-AGE CHILDREN Time Away From Parent SupervisionExpanding “Known World”Recognizing Differences Among PeersIssues of Fairness
8EMOTIONAL ISSUES FOR SCHOOL AGE CHILDREN Roots of Self-Esteem Begin to GrowPitfalls of Blame and ShameMiscarried Helping May BeginPeer teasing may begin
9PARENTS AND SCHOOL AGE CHILDREN Separating Normative Independence Goals From The Non-Normative Task of Managing DiabetesPromoting family discussions and family problem-solvingClarifying who is responsible for:Monitoring suppliesWatching the clockChecking blood sugarsCarbohydrate countingTaking insulin
10DEVELOPMENTAL ISSUES FOR ADOLESCENTS Wanting to be the same as peersIncreased problem-solving and abstract thinking skillsAbility to understand goals of treatment regimenFrustration that adherence doesn’t always lead to improved outcomes, and poor adherence doesn’t always lead to worse outcomes.Desire for increased independence and responsibility
11DEVELOPMENTAL ISSUES FOR ADOLESCENTS Increasing independence often results in decreasing supervision.Schedules are more erratic than younger peers.Puberty may play a role in diabetes outcomes.Experimenting in Sex, Drugs, Alcohol.Sense of invulnerability in this age group.
12DEVELOPMENTAL ISSUES FOR ADOLESCENTS Understand Sarcasm.Understand – keenly aware of – HypocrisySometimes will not pay attention to the risks or consequences of what they do
13Time-Lapse ImagingTracks Brain Maturationfrom ages 5 to 2010-year NIH fMRI study4-21 y.o. participantsBrain continues toChange until mid 20s
14EMOTIONAL ISSUES FOR TEENAGERS Pubertal changesManaging moodsMiscarried helping may lead to increased conflict
15PARENTS AND TEENAGERS Diabetes is a family disease Avoiding a blame/shame cycleBalancing nagging with monitoringPromoting family discussions and family problem-solving
16PARENTS AND TEENAGERSSeparating normal responsibilities from diabetes-specific responsibilitiesEncouraging success in normal tasksAs with younger children, clarifying who is responsible for:Monitoring suppliesWatching the clockCarbohydrate countingInsulin administrationBlood sugar checking
19Interdependence is Key No one is truly independent.The hallmark of being an adult is knowing when you need help, and asking for it.Normalize feelings of “burn-out” and plan for them. This is not a failure.Schedule times when responsibility is turned back to parents and then back to teen.
20SURVIVAL ADVICE Self- Care is NOT EASY Lapses are NOT a sign of failureLife can get in the wayLapses ≠ going on strike ≠ there’s no point to trying.Don’t skip appointmentsSet goals that are achievable.Everyone works/learns at a different pace.
21Sharing Responsibility SURVIVAL ADVICESharing ResponsibilityAvoid Excessive Self-Care AutonomyFacilitate InterdependenceSeparate Knowledge from Judgment and MaturityAvoid Vicious Cycle of Miscarried Helping