just for kids

december 97

We left off last month at the beginning of adolescence, and my saying that I for one, am happier looking back at my teenage experience, rather than living it again. The first fact that we all must understand is that adolescence is divided into three phases: early (ages 11 to 14), middle (ages 14 to 17) and late (ages 17 to 20). These are arbitrary as we all develop along a continuum that varies from person to person. One must distinguish physical changes and growth from the cognitive and personality development of adolescence. Hopefully these mature on parallel planes, but when they don't, the adolescent has to deal with this imbalance as an added stress. The end of adolescence is young adulthood. Your child should then have a firm sense of who he or she is, will have long term goals, and will be able to form meaningful relationships leading to marriage and family. For us, the most important marker of our son's passage was a phone call from college in which he told his father how proud he was of his own morals and ethics. Voila! Three months before they were still having heated conversations about social issues and you know who was the one who didn't have a clue about the "truth." There are certain givens that occur and reoccur in adolescents as our children wrestle with becoming young adults. Cognitively, thinking becomes abstract, conceptual, and future oriented. This is a time of creativity. If you are aware of this you can use these facts to help your child continue to care for himself/herself. It is also a time of"trying on "hats" of identities. Most don't last very long, so don't despair. Negativism raises its head again, must like the terrible twos, but with sharper teeth. Here we see different clothes, hair styles, and friends at the beginning of the process, but as time passes, bits and pieces from many sources, including you, will help form a value structure which may surprise you as being very close to yours. Risk taking may also be a part of adolescence. The good news is that this too abates, and more responsible decision-making activity begins to surface. How do all of these processes affect the diabetic adolescent? For one thing, that perfect child may wake up one morning and decided that with his or her newly found narcissism and peer support that they can be just fine if you would just let them alone. This is the time to expect the worst. Cheating on record keeping, neglecting testing blood, binging, drinking, etc. To make matters worse, hormonal changes can play havoc with tight control even if your child continues what they had been doing before. What to do? It's the holiday season. Parties abound, your daughter wants to lose a few pounds to fit into a tight dress, your son feels left out of his peer group when they cruise and he has to stop and eat at regular times, and you are just plain worried. For one thing, understand where your child is in terms of cognitive development. You can't talk to a young adolescent the same way you talk to an eighteen year old. Also understand, that teens work on the supposition that spontaneous activities are better than planned ones. This is difficult because the only way to be able to enjoy these activities is to be in control of your diabetes. This discussion is an important one to have allowing your teen to have more independence as they prove that they can handle freedom in an age appropriate manner. As your teen matures they can begin to use the very skills they have needed to master diabetes to master other parts of their lives, a fact that they will probably not see. It is this mastery of self and environment that they are seeking to develop. Help your teen to control this holiday time by reminding them of these facts. Once is enough. The second time you become the wicked witch of the north, south, east, and west combined into a cartoon like character not to be believed. Now the hard one. As your children become older and more mobile, we lose control. We can help, have discussions, never let them self-destruct, but ultimately, we must let the diabetes become their disease, not ours. Before you intervene, make a decision about how significant the behavior is on a scale of one to ten, with ten being the most self-destructive. You don't want to react to the one through fives as they may be a bother, but are part of "trying on those hats." More importantly, you don't want to respond to a four with the same intensity that you react to a nine. You will lost your credibility as someone who might be trusted to understand. These years are the time that the health-care-team can be of great importance. Seeing the doctor and dealing with the results of blood work disallows cheating and denial, but more importantly, allows your teen to discuss important issues with someone outside of the family. Learning how to use insulin to control glucose levels during parties, discussing fears about sexual issues, and having an interested impartial adult confront behavior leaves parents the leisure to praise successes, and bake Christmas cookies. One last suggestion. At the beginning of adolescence, try to get your child involved in a peer diabetes support group that can help get all of them through the trials of becoming independent young adults. Bribes will no longer work. Paying them off has less value, but intelligent discussions, and compromise as you wean them from relying on others and watch them develop into young adults, may well help you get a similar phone call one day as my husband got from our son. My husband smiled for a full week.

Holidays invariably means cookies to children of all ages. Here's a recipe that will satisfy their desire for something chocolate, but won't make their blood sugar levels sky-rocket. Remember, moderation is always necessary when eating a food containing sugar. These are for a special treat only when blood sugars are under control, and not meant to take the place of a piece of fruit for everyday dessert. (For additional holiday baking recipes, see Cooking Tips.)