1. Child Psychopathology
Chronic Childhood Illness
Diabetes, Childhood cancer
Reading: Chapter 12

2. What chronic illnesses in childhood are you aware of?

3. Psychology’s role in a Children’s Hospital
Trauma of child and family
Adjustment/ coping with chronic illness, medical regimens, transplants, surgery
Assessment in conjunction with medical diagnosis
Management of problem behaviors such as poor eating, noncompliance
Bereavement counselling: For death, as well as loss of “healthy self”, or “ideal child”
Family stressors associated with child illness

4. Normal variation in children’s expression of health concerns
Did you ever use your health to try to avoid goinbg to school? What happened?
Children experience pain in the same way as adults
Children often express fears, worries, anxiety by somatic complaints (“I have a sore tummy”)
Children commonly use pain for secondary gain (e.g., increased parental attention)
Girls report more symptoms of pain than boys, although differences likely stem from social expectations and not physiological differences
Family influences and social learning impact pain expression

5. Chronic illnesses in children
Affect 10 to 20% of population, 1/3 of these are severe
Asthma is the most common chronic illness in childhood
Social class and ethnicity not factors, with the exception of racially-linked disorders
Sickle-cell anemia
Tay Sachs
Low SES may affect survival/outcome rate

6. Symptoms Of Childhood Diabetes
Insulin-dependent (onset is usually sudden):
frequent urination
excessive thirst
excessive irritability
extreme hunger accompanied by loss of weight
nausea and vomiting
weakness and fatigue
Non-insulin-dependent (may develop slowly):
any of the above insulin-dependent symptoms, though not
necessarily weight loss and/or tingling or numbness in hands or feet
recurring or hard-to-heal skin, gum, or bladder infections
fatigue
blurred vision
itching

7. Diabetes Can Cause:
Retinopathy: Nearly 39,000 Americans lose their sight to diabetes each year.
Nephropathy: 1 out of 3 people with insulin-dependent diabetes develops kidney failure and need kidney transplants.
Arteriosclerosis: Diabetes can cause arteriosclerosis which leads to heart disease, gangrene and loss of extremities.
People with diabetes are 2-4 times more likely to have heart disease than the general population.
Neuropathy: Diabetic neuropathy leads to severe pain and loss of sensation in extremities. Intestinal problems may
also occur. Over 54,000 lower extremity amputations are performed each year on people with diabetes.
Therefore metabolic control and treatment adherence is a key

8. Childhood cancer
In comparison to adults, onset is more sudden and disease at advanced state when detected
Most common is acute lymphoblastic leukemia
White Blood cells reproduce uncontrollably, attack red blood cells and other organs
Survival used to be low, now 2/3’s children survive to adulthood
Treatment: chemotherapy, blood marrow transplants, reduced psychosocial stress

9. Do power lines cause leukemia?
Electromagnetic Fields (EMF) measured in the current and former homes and schools of 638 children with leukemia and 620 children without leukemia living in nine different state.
The study included homes where their mothers lived during pregnancy. The New England Journal of Medicine recently published the results of the study
Conclusion: Risk of acute lymphoblastic leukemia is not correlated with exposure to electromagnetic field levels.

10. Imagery in children http://coninfo. nursing. uiowa
Terrill Tyrannosaurus the Tyrant
Captain Chemo - One of our heroes!!
What happens to Terrill after Captain Chemo Works!!

11. Brenda Bone makes blood: Ben Blood (red cells) and
Monte, Lenny, Benny, Neut & Bob (white cells).
Zapman, Captain Chemo and Surgery may all work together to help you get well or may work alone. It all depends on where Terrill the Terrible is attacking you.

12. Who has has their tonsils out?
What most frightening about the surgery?
What was most helpful?

13. Pain management in children
Analgesics: Acetaminophin, Codeine
Behavioral techniques
Breathing excercises
Muscle relaxation
Distraction, information/ control
Chronic procedures
LP Punctures for CSF
Blood samples
Chemotherapy, surgery recovery

14. Psychosocial impact of childhood illness
At risk for emotional problems
anxiety and depression may be high, self esteem may be low
Family risk: PTSD Symptoms
How was the illness dx? Accident or trauma? Marital stress? Sibling impact?
Severe disruptive illnesses have greatest impact on children
Academic problems due to disruption in schooling or neurological involvement

15. Time permitting, we will see a videotape on obesity.