Background: The advances of the past 50 years in pediatric medicine resulted in many children surviving into adulthood who otherwise would have died earlier in childhood. Vaccines, antibiotics, and injury prevention efforts have resulted in “the new morbidity” where pediatrician spend up to half of their time caring for children with chronic illness, behavioral health conditions, and developmental disabilities, instead of acute infections. This presentation will describe the role of pediatric consult-liaison research in understanding the epidemiology of “the new morbidity” and reframing the discussion from a focus on morbidity to the promotion of Positive Youth Development.
Methods: This presentation will focus on three frameworks used to study adaptation to pediatric chronic illness, 1) Epidemiological approaches examining Children with Special Health Care needs (CSHCN); 2) Psychological Adaptation to Illness; and 3) the Positive Youth Development (PYD) framework.
Results: Studies using CSHCN approach demonstrate that CSHCN as compared to peers without illness have similar higher rates of anxiety and depression, but long-term have positive social outcomes with similar rates of independent living and marriage. Studies examining adaptation to chronic illness have found specific characteristics related to illness characteristics, treatment intensity, and parental adjustment that affect youth outcomes. The PYD framework focuses on the context of each child’s environment and internal and external resources that promote positive outcomes and growth.
Conclusion: This is an exciting time for Pediatric Consult-Liaison research to be a part of addressing “the New Morbidity” and improving the health and well-being of children and their families.
References: 1. Maslow, GR, Haydon, A, McRee, AL, Ford, CA, Halpern, CT. Growing up with a Chronic Illness: Social Success, Educational/Vocational Distress. Journal of Adolescent Health, 2011; 49(2): 206-212. PMID: 21783055 2. Maslow, GR, Hill, SN, and Pollock, MD. Comparison of Positive Youth Development for Youth with Chronic Conditions with Healthy Peers. The Journal of Adolescent Health. 2016; 59(6): 716-21. PMID: 27693130 3. French, A., Jones, K. A., Bush, C., Greiner, M. A., Copeland, J. N., Davis, N. O., Heilbron, N, & Maslow, GR.(2022). Racial and ethnic differences in psychotropic prescription receipt among pediatric patients enrolled in North Carolina Medicaid. Psychiatric Services, 73(12), 1401-1404. 4. Wong CA, Ming D, Maslow G, Gifford EJ. (2020) Mitigating the Impacts of the COVID-19 Pandemic Response on At-Risk Children. Pediatrics. Jul;146(1). PMID: 32317311. 5. Maslow, GR, Banny, A., Pollock, M., Stefureac, K., Rosa, K., Walter, B. K., Hobbs Knutson, K., Lucas, J., Heilbron, N. Preliminary Outcomes from an Integrated Pediatric Mental Health Outpatient Clinic. Child and Adolescent Psychiatric Clinics of North America. 2017: 26(4): 761-770. PMID: 28916012
Learning Objectives:
Describe the challenges facing children and youth with chronic physical illness and factors associated with poor adaptation and positive outcomes.
Describe different theoretical approaches to studying the experience of chronic physical illness among pediatric patients.
Describe ways in which the field of Pediatric Consult-Liaison research can help improve the lives of children and youth with chronic illness.
