Barbara, Is a 12-year-old capable of taking her daily meds on her own? No reminder from Mom!?? No double check from Mom! I think it NEEDS to be supervised!!
From: Honeymoore, Granville
Dr. Cora Breuner, an adolescent medicine specialist atf Seattle Children's Hospital and the University of Washington tends to agree with you, but it's not a clear-cut issue. Here's why:
1. Are these meds for a chronic disease, such as diabetes, or for a time-limited illness like an ear infection?
''With something like diabetes, we teach kids to monitor their own medicine beginning as young as 9,'' says Breuner who is also a member of the American Academy of Pediatrics Committee on Adolescence. ''This child typically would be considered responsible because she has lived with and learned the process of her disease - in this case, of taking her blood, reading the numbers, giving herself the shot.'' That sense of autonomy gives her a sense of control over her illness.
But this only works with some chronic conditions. ''You wouldn't want a kid dosing herself for ADD,'' says Bruener.
Breuner also would not be comfortable handing meds over to the same age child to dose herself for an ear infection. ''That child isn't used to remembering to take something every day. It hasn't been part of her routine,'' she says.
2. Bruener asks, ''Is her judgment solid enough -- are the frontal lobes pruned enough - for her to know what to do if she misses a dose? To document the dosage? To know how to keep it out of reach of a younger sib and never slip up? To know the side effects? To know she's experiencing side effects and to tell you about them?
"This is a ridiculous amount of information for a kid who sometimes is barely able to remember to brush her teeth,'' Bruener says.
3. Developmentally, she might not be able to help herself from forgetting, ignoring, or denying the need for her meds.
Between 14 and 16, teens typically go through a stage called the Imaginary Audience where they imagine all their peers see them all the time, as if they live their lives on stage. That's fine when you fit in. But if you think you are different from everyone else, if you stand out in some way that makes you potentially unlikeable, that's a huge problem. Kids with chronic disease? They stand out big time, at least in their own minds.
''What they want most is to just like everyone else,'' Bruener says. ''It's why a 15-year-old with cystic fibrosis can say to himself, 'Yeah, I know I have cystic fibrosis, but I can have some cigarettes with my friends.'''
It's that potential for poor judgment that can most get a teen in trouble when it comes to self-dosing.
On the other hand, you don't want your child to be so dependent on you or fearful about her meds that she cannot develop autonomy around her disease. So here's what to do:
Let her know that you recognize her need for autonomy, you recognize how important it is, and you want to help facilitate it. Then brainstorm with her age-appropriate ways for her to be more independent that include some aspects of taking control of her disease - Diet? Exercise? Sleep? Keeping up on the literature? - but not the meds. At least not now.
There's one notable exception and that's when a child has already had a good deal of responsibility for herself, for instance, she's made her own lunch every day since she was 8. Some kids, like in ''Matilda'' or ''Home Alone,'' are resourceful and able to manage.
In the end, Bruener concludes, ''When it comes to medicine, it's never wrong to supervise, even to micro manage. I'd want to get her through a couple more years.''
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