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Juvenile Arthritis.

Last updated Wednesday, December 22, 2004

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Coping

What are some strategies for coping with juvenile arthritis?

Your child may feel angry or sad about having arthritis.

But be aware that you as parents, siblings, and other family members may also have troubling feelings about the disease and its effect on the family. However, acceptance and settling into a routine will benefit everyone in the family.

When you are first told your child has arthritis, you might feel shocked, numbed, or disbelieving. You might also feel guilty, and ask yourself if something you did or didn't do caused your child's arthritis. While these thoughts are common to all parents whose children are ill, work hard to put such thinking into perspective. Remember: you are not the reason for your child's arthritis.

The child with arthritis may feel many different emotions. Children can feel "hurt" by an illness that isn't their fault, blame parents for the illness, adopt a "why me?" attitude, engage in self-pity or become angry because of restrictions on activities. They may also resent other children who are well, including brothers and sisters.

Other children in the family may feel left out and resentful because of the amount of time and attention the child with arthritis requires. Or they may feel guilty, as if their normal "bad thoughts" towards their brother or sister had somehow caused the illness.

Children may over-identify with the brother or sister with special needs. Some feel a pressure to achieve or make up for what their brother or sister can no longer do. Others want to involve themselves in care giving--to the point where they give up their own normal activities. In these cases, try to help siblings find other ways to deal with their feelings. Whenever possible, let brothers and sisters settle their own differences. Encourage siblings to talk with peers who live in homes with similar concerns. The key to dealing with all these emotions is to talk about them with one another.

Talk to your child's brothers and sisters about arthritis--let them express their feelings about the disease. Encourage the family to treat the child with JRA as they did before she became ill--but at the same time, do remember that she will need some special attention.

Talk to your child about how she feels about the illness. Allow your child to express her anger about arthritis from time to time.

Encourage your child to develop her special talents.

Expect your child to behave as well as other children--do not give her special privileges, like avoiding light household chores that she is physically able to do, just because she has arthritis.

Encourage your child to learn as much as she can about arthritis and about her treatment program. Older children can be responsible for taking medications on time, reporting any medication side effects to you, and following an exercise program. Prepare them for the change to adult health-care.

Remember: Your attitude toward arthritis will affect the way your child feels about arthritis.

Try not to overprotect your child. Your child might become too dependent if you do everything for her or if you keep her from tasks which she is capable of doing. Don't be manipulated into allowing activities that shouldn't be done, but compromise when you can. Being as consistent as possible will help your child learn what is expected. Plan special time to spend alone with your spouse, or with the entire family. When your child first becomes ill, you may set aside relationships with other family members. It is important, however, to continue to talk and spend time with all family members.

The child with arthritis may develop emotional or behavioral problems that you cannot deal with alone. Other family members may feel overwhelmed. Fortunately, help is available.

Education

Children with arthritis should nearly always attend a regular school. They should not be isolated from other children of the same age. But because of JRA, your child may need some special materials and services to help her get along in a regular school.

It is important to educate your child's teachers, the school nurse, and the principal about arthritis and its effects on your child. In general, teachers are cooperative and understanding about JRA. In a few cases, it may be necessary to ask your child's physician or a member of her health-care team to intervene.

Federal laws which give your child rights by barring discrimination against children with disabilities in public schools, and requiring private schools to be accessible, include:

  • Section 504 of The Rehabilitation Act of 1973. It bans discrimination against disabled persons in programs that receive federal funds.
  • Public Law 101-476-The Individuals with Disabilities Education Act (IDEA), formerly the Education for All Handicapped Children Act, PL 94-142. It says that every child has a right to a free, appropriate public education, whether or not the child has a disability.
  • Part H of the IDEA Act. It provides money to states to identify infants and toddlers with developmental disabilities, and to offer them and their families early intervention services until they reach the age of three.
  • The Americans With Disabilities Act. It requires private schools, daycare centers and nurseries to be accessible to children with disabilities, and bans discrimination in hiring and employment.

For more information on these laws, contact the Special Education Director in your state's Department of Education.

Who can help patients and families cope with juvenile arthritis?

Many Arthritis Foundation chapters and some pediatric rheumatology centers have AJAO family support groups that provide resources, avenues for sharing ideas and feelings, and a place to meet and learn from other families who truly understand what your child is experiencing. If emotional stress becomes too great, it may be helpful to seek professional counseling. The doctor, nurse, or medical social worker may be able to help you, or may be able to refer you to other sources of help. AJAO National Family Conferences, held each year in a different region of the country, give parents the opportunity to meet others and to learn from experts about many aspects of managing JRA, while children enjoy special activities. Regional juvenile arthritis conferences may also be offered by local chapters.

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