Chronic Illness May Affect a Child's Social Development
June 22, 2000 (Atlanta) -- Chronically ill children tend to be more
submissive and less socially outgoing than healthy children, a new study shows.
Further, kids who live with pain and physical restrictions may be more likely
to have problems relating to their peers.
Study author Susan Meijer, DrS, a behavioral researcher at Utrecht
University Medical Center in the Netherlands, and colleagues explored the
effect of disease on social development in children 8 to 12 years of age. More
than 100 chronically ill children and their parents participated in the study,
which was published in the Journal of Child Psychology and
The children's diagnoses included cystic fibrosis (a hereditary disease
characterized by lung disease and problems with the pancreas), diabetes,
arthritis, the skin inflammation eczema, and asthma. The children and their
parents were asked about the children's social activity, behavior, self-esteem,
physical restrictions, and pain.
Compared with healthy Dutch children, the participants had fewer positive
peer interactions and exhibited less aggressive behavior. Compared with other
chronically ill participants, children with cystic fibrosis and eczema had more
social anxiety. And kids with physical restrictions and pain had significantly
less social involvement than others.
Researchers say the reasons for these findings are not yet clear. "Sick
kids may unconsciously avoid aggressive exchanges that they're unable to deal
with," Meijer says. "It's also possible that sick kids don't learn some
social skills because they receive less feedback about inappropriate behavior
than healthy kids."
Meijer tells WebMD that intervention programs can boost social development
in chronically ill children. Child psychiatrists say school involvement and
parental strategies may be even more effective.
"When kids are out of school for long periods, they miss both cognitive
and social learning," says Nina Bass, MD, a behavioral medicine specialist
and assistant clinical professor of psychiatry at Emory University School of
Medicine in Atlanta. "And no matter how hard they try, parents can't give
kids the same social experience they get at school."
Bass tells WebMD that chronically ill children need both individual and
group social activities. "An example of an individual activity is
corresponding with a pen pal; an example of a group activity is participating
in a book club," Bass says. "And if the child can't keep pace, parents
should identify some better alternatives."
Chronically ill children also are at increased risk for depression.
"Kids with chronic illnesses are 30% more likely to become depressed,"
she says. "And even if it's just a side effect of medication, parents can
help with symptom management." But an awareness of factors that may lead to
depression helps tremendously, she says.
In fact, parents' intuition may be more useful than record keeping.
"Diaries are helpful, but they can turn a child into a guinea pig,"
Bass says. "It's often more helpful just to compare adverse symptoms to the
child's normal rhythms and routines."
Bass says questions remain about the study's findings, and the researchers
"Because parents of the participants were highly educated, the results
could be biased," Meijer says. "So in the future, longer studies with
more participants may provide more insight."
- Chronic illness can affect a child's social development; children who have
physical restrictions and pain are particularly vulnerable.
- Psychiatrists recommend both individual and group social activities for
chronically ill children.
- Children with chronic illnesses are 30% more likely to develop depression,
but parents can help manage symptoms by being aware of a child's depression and
of the factors that may lead to it.