Risk and resilience among children and youth with disabilities
J. Patterson and R. W. Blum
Maternal and Child Health Major School of Public Health, University of Minnesota, Minneapolis, USA.
OBJECTIVE: To review the literature on risk and protective factors as
applied to children with chronic and disabling conditions so as to assist
the health care professional in developing clinical strategies and
interventions. DESIGN: Literature review. MAIN OUTCOME VARIABLES: Risk
factors (eg, emotional problems, school failure) and protective variables
(eg, family cohesion, school involvement). RESULTS: Both risk and
protective factors can be identified at multiple levels: the condition, the
child, the family, and the community. Conditions that are invisible have
remitting-relenting courses, and where the prognosis is uncertain, these
conditions are associated with the greatest emotional problems. Males with
chronic conditions appear to have more emotional sequelae than do females.
Likewise, personality characteristics of sociability and flexibility and
physical characteristics of attractiveness are protective. Families with
clear boundaries and a capacity to balance competing family needs, maintain
flexibility, and ascribe positive meanings to life events all are
protective. CONCLUSIONS: As increasing numbers of children with chronic
conditions survive through adolescence to adulthood, the creation of
environments where children can optimally develop becomes ever more
pressing. It is evident that a range of factors, many amenable to
interventions, can influence outcomes for these young people.
Social support processes and the adaptation of individuals with chronic disabilities.
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