The death of a child with diabetes from neglect. A case study.
This case report of a child with insulin-dependent diabetes mellitus (IDDM) describes a naturally occurring ABABCA design. The A condition represents poor diabetes management provided in the home setting, and the B and C conditions represent improved diabetes management in residential treatment (condition B) or foster care (condition C). The A condition was consistently associated with episodes of diabetic ketoacidosis, high glycosylated hemoglobin percentage, and school failure. In contrast, the B/C conditions were consistently associated with improved health status and school performance. On two occasions, the child was returned to condition A by the state's protective service agency (HRS) in direct conflict with the recommendations of the child's psychological and medical treatment staff. During her last condition A placement, the youngster died. Chronically ill children who are neglected may not receive the protection they need because of lack of awareness about the psychosomatic aspects of their problem.
Geffken
G
G
Department of Psychiatry, University of Florida, Gainesville 32610-0234.
Johnson
S B
SB
Silverstein
J
J
Rosenbloom
A
A
D002648:Child; D002649:Child Abuse / Q000523:psychology; D002651:Child Advocacy / Q000592:standards; D002652:Child Behavior; D002655:Child Custody; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000523:psychology* / Q000628:therapy; D016883:Diabetic Ketoacidosis / Q000523:psychology; D005260:Female; D005581:Foster Home Care; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D012114:Residential Treatment
D006442:Glycated Hemoglobin