developmental transitions jill weissberg-benchell, ph.d., cde
TRANSCRIPT
DEVELOPMENTALDEVELOPMENTALTRANSITIONSTRANSITIONS
Jill Weissberg-Benchell, Ph.D., CDEJill Weissberg-Benchell, Ph.D., CDE
DEVELOPMENTAL ISSUES FOR DEVELOPMENTAL ISSUES FOR PRESCHOOLERSPRESCHOOLERS
Learning and DiscoveringLearning and Discovering Magical Thinking and CreativityMagical Thinking and Creativity Want to have Control over their Want to have Control over their
worldworld ““NO’S”NO’S”
EMOTIONAL ISSUES THAT MAY EMOTIONAL ISSUES THAT MAY ARISE FOR PRESCHOOLERSARISE FOR PRESCHOOLERS
Emotions are not well-regulatedEmotions are not well-regulated Communication skills are still Communication skills are still
developing.developing. May develop fears around blood May develop fears around blood
sugar checks, insulin injections site sugar checks, insulin injections site changes.changes.
PARENTS AND PARENTS AND PRESCHOOLERSPRESCHOOLERS
Not allowing diabetes-specific tasks to Not allowing diabetes-specific tasks to become the primary source of attentionbecome the primary source of attention
Balancing Normative Experiences and Balancing Normative Experiences and SafetySafety
Unique challenges of finding Unique challenges of finding babysitting, specialized services and babysitting, specialized services and supportssupports
DEVELOPMENTAL ISSUES FOR DEVELOPMENTAL ISSUES FOR SCHOOL-AGE CHILDRENSCHOOL-AGE CHILDREN
Time Away From Parent Time Away From Parent SupervisionSupervision
Expanding “Known World”Expanding “Known World” Recognizing Differences Among Recognizing Differences Among
PeersPeers Issues of FairnessIssues of Fairness
EMOTIONAL ISSUES FOR EMOTIONAL ISSUES FOR SCHOOL AGE CHILDRENSCHOOL AGE CHILDREN
Roots of Self-Esteem Begin to GrowRoots of Self-Esteem Begin to Grow Pitfalls of Blame and ShamePitfalls of Blame and Shame Miscarried Helping May BeginMiscarried Helping May Begin Peer teasing may beginPeer teasing may begin
PARENTS AND PARENTS AND SCHOOL AGE CHILDRENSCHOOL AGE CHILDREN
Separating Normative Independence Goals Separating Normative Independence Goals From The Non-Normative Task of Managing From The Non-Normative Task of Managing DiabetesDiabetes
Promoting family discussions and family Promoting family discussions and family problem-solvingproblem-solving
Clarifying who is responsible for:Clarifying who is responsible for:• Monitoring suppliesMonitoring supplies• Watching the clockWatching the clock• Checking blood sugarsChecking blood sugars• Carbohydrate countingCarbohydrate counting• Taking insulinTaking insulin
DEVELOPMENTAL ISSUES FOR DEVELOPMENTAL ISSUES FOR ADOLESCENTSADOLESCENTS
Wanting to be the same as peersWanting to be the same as peers Increased problem-solving and abstract Increased problem-solving and abstract
thinking skillsthinking skills Ability to understand goals of treatment Ability to understand goals of treatment
regimenregimen Frustration that adherence doesn’t always Frustration that adherence doesn’t always
lead to improved outcomes, and poor lead to improved outcomes, and poor adherence doesn’t always lead to worse adherence doesn’t always lead to worse outcomes.outcomes.
Desire for increased independence and Desire for increased independence and responsibilityresponsibility
DEVELOPMENTAL ISSUES FOR DEVELOPMENTAL ISSUES FOR ADOLESCENTSADOLESCENTS
Increasing independence often results in Increasing independence often results in decreasing supervision.decreasing supervision.
Schedules are more erratic than younger Schedules are more erratic than younger peers.peers.
Puberty may play a role in diabetes Puberty may play a role in diabetes outcomes.outcomes.
Experimenting in Sex, Drugs, Alcohol.Experimenting in Sex, Drugs, Alcohol. Sense of invulnerability in this age group.Sense of invulnerability in this age group.
DEVELOPMENTAL ISSUES FOR DEVELOPMENTAL ISSUES FOR ADOLESCENTSADOLESCENTS
Understand Sarcasm.Understand Sarcasm. Understand – keenly aware of – Understand – keenly aware of –
HypocrisyHypocrisy Sometimes will not pay attention to the Sometimes will not pay attention to the
risks or consequences of what they dorisks or consequences of what they do
Time-Lapse Imaging Tracks Brain Maturation from ages 5 to 20
•10-year NIH fMRI study•4-21 y.o. participants•Brain continues to Change until mid 20s
EMOTIONAL ISSUES FOR EMOTIONAL ISSUES FOR TEENAGERSTEENAGERS
Pubertal changes Pubertal changes Managing moodsManaging moods Miscarried helping may lead to Miscarried helping may lead to
increased conflictincreased conflict
PARENTS AND TEENAGERSPARENTS AND TEENAGERS
Diabetes is a family diseaseDiabetes is a family disease Avoiding a blame/shame cycleAvoiding a blame/shame cycle Balancing nagging with monitoringBalancing nagging with monitoring Promoting family discussions and Promoting family discussions and
family problem-solvingfamily problem-solving
PARENTS AND TEENAGERSPARENTS AND TEENAGERS Separating normal responsibilities from Separating normal responsibilities from
diabetes-specific responsibilitiesdiabetes-specific responsibilities Encouraging success in normal tasksEncouraging success in normal tasks As with younger children, clarifying who is As with younger children, clarifying who is
responsible for:responsible for:• Monitoring suppliesMonitoring supplies• Watching the clockWatching the clock• Carbohydrate countingCarbohydrate counting• Insulin administrationInsulin administration• Blood sugar checkingBlood sugar checking
Interdependence is KeyInterdependence is Key
No one is truly independent.No one is truly independent. The hallmark of being an adult is The hallmark of being an adult is
knowing when you need help, and knowing when you need help, and asking for it.asking for it.
Normalize feelings of “burn-out” and Normalize feelings of “burn-out” and plan for them. This is not a failure.plan for them. This is not a failure.• Schedule times when responsibility is Schedule times when responsibility is
turned back to parents and then back to turned back to parents and then back to teen.teen.
SURVIVAL ADVICESURVIVAL ADVICE
Self- Care is NOT EASYSelf- Care is NOT EASY Lapses are NOT a sign of failureLapses are NOT a sign of failure
• Life can get in the wayLife can get in the way• Lapses Lapses ≠ going on strike ≠ there’s no point to ≠ going on strike ≠ there’s no point to
trying.trying.• Don’t skip appointmentsDon’t skip appointments
Set goals that are achievable.Set goals that are achievable. Everyone works/learns at a different pace.Everyone works/learns at a different pace.
SURVIVAL ADVICESURVIVAL ADVICE
Sharing ResponsibilitySharing Responsibility• Avoid Excessive Self-Care Avoid Excessive Self-Care
AutonomyAutonomy• Facilitate InterdependenceFacilitate Interdependence• Separate Knowledge from Judgment Separate Knowledge from Judgment
and Maturityand Maturity• Avoid Vicious Cycle of Miscarried Avoid Vicious Cycle of Miscarried
HelpingHelping