Disability and the transition to adulthood: issues for the disabled child, the family, and the pediatrician.
The pediatrician treating a child with a disability must focus not only on the physical needs of the child but also on the emotional and social issues associated with being disabled in our society. This dual focus becomes increasingly important as the child matures through adolescence and transitions into adulthood. In addition, the pediatrician must understand the complex interrelationships between the family and their maturing, disabled child during the vital process of separation from the family. This transition is particularly difficult for an adolescent who is dependent on others for physical care and other independent living skills. Many of the transitional problems faced by disabled adolescents and their parents have roots in early childhood. With an awareness of the specific stressors on the parent caregivers and an understanding of the influence of disability on the developmental processes, the pediatrician can play a major role in easing the transition of a disabled adolescent into adulthood. By guiding the parents of a young child through the important tasks of childhood and adolescence, the pediatrician can set the stage for both the parents and their disabled child to have independent, yet supportive lives--lives that are focused not on the disability but on mutual respect and life satisfaction. It is recommended that disabled teens and young adults be given more help in independence skills, personal counseling services should be made available, and physicians should give teens age-appropriate information about disabilities. There are needs for sex education, preparation for parenthood, and genetic counseling. Other issues that should be addressed are early vocational awareness, alternatives to work, and leisure time use. Just because an adolescent is disabled, we cannot assume that he or she will have self-esteem and self-concept difficulties. To adjust to being devalued by society, the disabled person must challenge societal beliefs that strength, independence, and appearance are the essential aspects of a quality life. The importance of being kind, intelligent, and productive to one's capacity must become more important. (See Table 3 for additional resource information.)
Hallum
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University of California/San Francisco State University Graduate Program in Physical Therapy, USA.
D000203:Activities of Daily Living; D000223:Adaptation, Psychological; D000293:Adolescent; D000328:Adult; D000367:Age Factors; D017028:Caregivers; D002648:Child; D003153:Community Health Services; D006233:Persons with Disabilities / Q000331:legislation & jurisprudence / Q000523:psychology / Q000534:rehabilitation; D004651:Employment; D005260:Female; D006801:Humans; D008297:Male; D010819:Physician's Role; D012725:Sexual Behavior; D012917:Social Adjustment; D012946:Social Welfare