Children With Chronic Illness

Asthma

Asthma is currently the most common childhood illness, affecting approximately 5 million children under the age of 18 in the United States. Asthma is a respiratory condition characterized by an obstruction of the airway; it can result in wheezing, coughing, shortness of breath, chest tightness, and fatigue. Attacks may be triggered by allergens, environmental conditions, exercise, or stress. The severity and timing of asthma attacks vary. They can result in limitations on physical activity and increased frequency of medical visits. Treatment varies depending on severity and may consist of self-administered inhalers, nebulizer treatments, or hospitalization. Side effects of these medications can include hyperactivity, anxiety and depression, drowsiness, and impairment in memory and attention.

Diabetes

Diabetes mellitus (DM) is an autoimmune disease affecting metabolism. There are two different types—type 1, which is insulin-dependent or juvenile diabetes, and type 2. Type 1 DM affects approximately 1 in 400 to 600 children and results in permanent insulin deficiency. Treatment for type 1 DM involves regular blood glucose monitoring and daily self-administered insulin injections or the use of an insulin pump.

Type 2 DM is found in 10% to 20% of newly diagnosed cases of juvenile DM. The recent increase in the incidence of childhood obesity is likely responsible for recent increases in type 2 diagnoses. Type 2 DM is characterized by insulin resistance, resulting in chronically high levels of insulin in the body. Treatment of type 2 DM involves strict management of diet and exercise and the administration of oral medication or insulin injections. Based on the nature of the disease and required treatments, diabetes has been found to affect the learning process, mood and attention, and social interactions.

Juvenile Rheumatoid Arthritis

Juvenile rheumatoid arthritis (JRA) is an autoimmune condition affecting approximately 200,000 children in the United States under the age of 18. There are three subtypes of JRA: pauciarticular (least severe), polyarticular, and systemic (most severe). Symptoms include stiff and swollen joints, limited mobility, pain, and occasional fevers and rash. Severe JRA can impact bodily organs as well. Treatment for JRA includes medication, limiting activity, and participating in therapeutic exercise programs. Pain and stiffness associated with JRA can affect writing, physical activity, and school attendance.

Cancer

Cancer is the uncontrolled spreading of abnormal cells that can affect various parts of the body. The most common childhood cancers are leukemia (blood cancer), lymphomas (cancers of the lymphatic system), and brain tumors. Because cancer treatments are very intense, both the disease and treatment can have severe impacts. Treatments for cancer often include some combination of surgery, chemotherapy, radiation, bone marrow transplants, and immunosuppressants. Symptoms of the disease and treatment may include nausea and vomiting, fatigue, muscle weakness, and significant changes in appearance (e.g., facial swelling, hair loss, temporary weight gain or [Page 76]loss). Particular attention should be paid to social adjustment, peer relationships, and the emotional well-being of the child.

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