Growing Up with Diabetes
All Stages: A Developmental Perspective
The following section describes possible coping and parenting strategies for managing the challenges of T1D that are appropriate for parents to use with children/teens of any age.
This page is one branch on the tree “Growing Up with Diabetes: a Developmental Perspective”. If you haven’t already, you can read the introduction here.
Suggested Coping Strategies for All Age Groups:
- Communicate with your child. Talk to her about this diabetes thing. But don’t turn it into a big deal; make it casual and interesting.
- Be present, polite and patient. Listen to your child’s perspective – normalize and validate it. Allow that your child or teen’s journey of acceptance and effective self-management is a process, just as yours is.
- Michael Watts, Medical Social Worker at the Alberta Children’s Hospital, suggests that as parents we should avoid the MOANS (“Must”, “Ought”, “Always”, “Never”, “Should”), as in “You always forget to bring your monitor with you!”, or “You should take care of yourself.” When these words are being used by a parent, it probably means they’re talking at, not with, their child or teen – the response from kids is just to tune us out.
- Look beyond your child’s actual behaviour, to the forces and stresses and motivations that underlie that behavior. Ask: What is the real issue? This doesn’t mean that fear of injections means your child doesn’t have to have them. Nor does it mean that because another child was teasing her for wearing a pump, it’s okay to hit that other child. However, dealing with only the surface behaviour (running away when it’s needle time, hitting another child) will not resolve the underlying issue. Both need to be acknowledged and addressed.
- Give your child or teen space when she needs it. This doesn’t mean you avoid talking about issues or addressing misbehavior; it just means you are willing to allow for a better time, when she will be more receptive to hearing you. Rather than insisting on addressing it when she comes through the door after school, upset and frustrated, you may say that “We’ll sit down and discuss this after supper tonight”.
- Don’t push her to talk to you about how she feels; provide opportunities to talk to you or another adult she trusts, then leave it up to her to share, when and how she is willing.
- Be careful of creating negative self-perceptions. If you label your child or teen as irresponsible in her diabetes care, she will tend to accept that label and act irresponsibly. If you tell your child or teen that you believe she is responsible and you expect her to act that way, she will be more likely to rise to the expectation and act more responsibly.
Tips from the Trenches
“If you treat an individual as if he were what he…could be, he will become what he…could be.”
- We tend to focus on what’s wrong, but remember to let your child or teen know what she is doing well, what she does that makes you proud.
- Use explanations that are relevant to your child’s age-level. It is not very convincing (and is likely to increase resistance!) to talk to your child or teen about losing her eyesight when she is 50; she will be more motivated by the idea of being able to keep up on the soccer field, or have clear vision for reading a favourite book.
- Avoid threats motivated by love, as they are not effective ways to change behaviour. (For example, although you want desperately for your child to take care of herself so she does not experience future eye/nerve/kidney complications, using those possibilities as threat is not likely to motivate her to change.)
- Maintain boundaries. Decide who is responsible for what, and what is fair and reasonable to expect of your child. Once you’ve handed over a reasonable responsibility, support and assist, but don’t take it back.
- Try to control your own stresses, frustrations and anxieties surrounding diabetes. Work on your own “stuff” so that your issues don’t unduly impact your child/teen.
- Strive for an authoritative parenting style: nurturing, yet firm (not authoritarian/dictatorial, nor wishy-washy). See yourself as the confident and loving leader of the family.
- Consider 3 rules for interactions with your older child or teen, suggested by Joe Solowiejczyk, Diabetes Nurse Educator and Family Therapist:
- There is no negotiation: It’s pointless to ask her how many blood glucose checks she’d like to do – the answer will be “None”! Instead tell her: you need to check your blood glucose at least 4 times per day and write the number in your log book; and you have to bolus before you eat.
- You don’t have to like it, you just have to do it. Is it fair? No. Does it stink? Yes. Do you still have to do it? Yes.
- Discipline your child or teen for diabetes non-compliance as you would any other misbehaviour. For example, for every blood glucose check you miss, you lose 15 minutes of computer time. You’re not punishing her for having diabetes, you’re punishing her for not doing what she needs to do to manage her diabetes.
- Don’t let diabetes talk and issues dominate your family – for everyone’s sake. Remember that your child is a child first, and a child with diabetes second. When your toddler wakes up in the morning, cuddle him first, check his blood glucose second. When you pick up your child at school, ask first how her day was, next how her blood glucose was. When your teen gets home in the evening, ask first how the basketball game was, later if he had any lows.
As with any challenges, if your family is facing serious obstacles to good mental health and social functioning, please contact a professional who can help you sort it all out. Many pediatric diabetes teams include a psychologist and/or social worker, so contacting your child’s diabetes health care team is a good place to start. Also, you could arrange a consultation with a mental health professional that you seek out on your own – you could check the registry for licensed psychologists or social workers in your province, or reach out to a diabetes expert who is also trained in your family’s area of need (teenagers, behaviour change, eating disorders, anxiety, etcetera).
This article was compiled from the following sources:
- Presentation by Dr. Carol Huang (Assistant Professor, U of C Dept of Pediatrics) at JDRF Outreach Event, March 19, 2011
- Parenting workshop by Michael Watts (Medical Social Worker) at the Alberta Children’s Hospital, March 26, 2011
- Presentation by Joe Solowiejczyk (Diabetes Nurse Educator and Family Therapist) at the Alberta Children’s Hospital, February 10, 2011
- Alberta Children’s Hospital Handouts “Tips for Toddlers with Diabetes” and “Pointers for Preschoolers with Diabetes”
- Presentation by Dr. Tracy Vaillancourt (Associate Professor, Educational Psychology) for the Alberta Centre for Child, Family & Community Well-Being, November 3, 2008
The above information was reviewed for content accuracy by clinical staff of the Alberta Children’s Hospital Diabetes Clinic.