Helping your Child Learn to be Independent

The transfer of responsibility from parent to child should be done gradually, based on the child’s age and abilities.

Diabetic children learn independence by accepting their diabetes and the way their parents treat it, and through their parents’ confidence in their own and their child’s capabilities.

It is essential that parents, their diabetic child and their child’s friends know all about diabetes and its treatment, and that they all communicate and work together.

Transferring responsibility: a gradual process

Getting a child involved in his diabetes care helps him live more harmoniously with his illness. It is important to gradually involve the child in his treatment, even at a young age.

For example, let him choose which finger to prick or which room in the house to do it, or let him read the results on the glucose monitor.

The transfer of responsibility from parent to child should be done gradually, based on the child’s age and abilities.

Family teamwork

Developing a support and mutual help network requires educating the extended family (spouse, siblings, grandparents, uncles, aunts, etc.). This limits the stress of the unknown and promotes effective teamwork.

Family members who are uninformed about diabetes and its treatment often fear that they will not know what to do or will make a mistake in an emergency situation, like hypoglycemia.

It is important to train other family members in giving injections and measuring blood glucose (sugar) levels, in case they have to do these things in your absence.

Tips to involve the child and help the grownups

A chart and a checklist for special situations (excursions, parties) and specific events (illness, hypoglycemic attack) can make learning how to care for a diabetic child much simpler.

This chart provides the child with adult oversight to avoid omissions or errors in treatment. The person looking after the child checks off each activity as the day progresses to be sure nothing is missed.

Collaboration of friends, school and child-care services

A diabetic child is afraid of not being accepted. His friends probably know nothing about diabetes or its treatment and may have irrational fears (that the disease is contagious, etc.), making your child’s successful integration into the group difficult.

There is only one solution: educate your child’s friends to demystify the disease and its treatment. This also applies to teachers, monitors and organizers involved with your child’s school or extracurricular activities.

For example, you could invite a few of your child’s friends to your home. In front of them, you could read your child’s blood glucose (sugar) levels from a monitor, administer an injection before a meal, and then simply answer their questions as they arise – an easy way to reduce their anxiety and fear of the unknown.

Medical teamwork

In pre-adolescence and adolescence, the medical team can help get certain messages across to your child. Whether you like it or not, in this period of life, young people often prefer to listen to someone outside the family circle.

The medical team can help a young diabetic learn how to live safely (dating, alcohol, contraception, etc.). Why not encourage your child to have a frank discussion with each member of his care team? This can help you transfer the responsibility for managing his diabetes through the mediation of the medical team.

Motivation and reward

Motivation encourages the personal involvement of the child in his own diabetes treatment. Motivation is directly associated with beliefs, emotional acceptance of the diabetes, social support and the ability to adapt to the lifestyle. How well you motivate your child is undoubtedly affected by your own motivation, by the attention you give your child, and by how well you help your child overcome the challenges and pain associated with the treatment.

When they first get diabetes, many children believe they have done something wrong to merit such punishment. It is important to reassure your child that this is not the case.

Adding rewards to the care of your diabetic child can have a positive effect. The goal is not to promise the child something if he has been good, but to reward or encourage him for being brave.

One way to encourage your child is by using a motivation table, which combines the two great concepts of motivation and positive reinforcement.

At the end of the week, the child receives a reward based on the final point tally. There are four types of rewards:

  • objects (toys, clothes, etc.)
  • activities (special outings, etc.)
  • tokens or bonus points
  • social reinforcement (hugs, smiles, etc.)

To be effective, positive reinforcement must satisfy certain criteria:

  • the reward must be something that the child desires or finds satisfying
  • it must be offered to the child as a reward for a desired behavior
  • the reward should be something reasonable

By encouraging the child to behave appropriately toward his diabetes, you can significantly decrease conflict and the episodes where the child becomes manipulative. Over time, the child will behave properly without any need for reinforcement.

 

Research and adaptation: Diabetes Québec Team of Health Care Professionals

Scientific review: Caroline Boucher, Clinical Nurse, Diabetes Clinic, CHU Sainte-Justine

June 2014

Adapted from:

Roy, Johanne, Nurse. (Winter 1995). “Comment aider votre enfant diabétique à faire face à la douleur,” Plein Soleil, Diabetes Québec, pp .20-22.

Gagnon-Le Borgne, Danielle, Nurse. (Spring 1994). “Apprentissage de l’autonomie chez l’enfant diabétique,” Plein Soleil, Diabetes Québec, pp. 21-22.

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