THE CHRONICALLY ILL CHILD: A Guide for Parents and Professionals

Improvements in the treatment of many chronic childhood diseases have increased the life span of those affected, so McCollum has expanded her 1975 Coping with Prolonged Health Impairment in Your Child to include a chapter on the onset of adulthood--an appropriate addition to a sensitive, knowledgeable text. Specific diseases are not on McCollum's agenda (though case studies take in cystic fibrosis, leukemia, kidney disorders, and others); rather, she discusses the general needs of those children--ten percent of all children, we learn--afflicted with physical disorders lasting three months or longer. Quality of life is the top consideration: ""even one whose life span must be relatively brief can leave a significant imprint on human history."" To this end, families must understand the maturing, changing child--the tasks of growth which affect, and are affected by, chronic illness. What the tasks are, what they mean practically to parents and siblings, is beautifully explained as McCollum discusses each developmental group--noting, for instance, how children's anxieties change from fear of death to fear of loss of a limb, or of a loved one. At the onset of adulthood, she points out, the normal developmental tasks--achieving a sense of independence from the family, entering intimate relationships (and perhaps beginning a family), finding an occupation--are complicated by physical handicaps, questions of genetic involvement, and societal pressures. A separate question for parents is whether they should have another child; here, McCollum explores the considerations pro and con, and the special precautions to be taken. Then, in the book's second major section, she covers sources of help--from physicians, genetic counseling, psychotherapy, support groups, and financial aid to social action. Comprehensive, up-to-date guidance that retains a comforting personal tone.