DiSH-MT: Empowering Autonomy in Students - A Developmental Approach

In this session, Amy Rohyans Stewart, MS, CCLS, provided participants with an overview of child life services and support of the pediatric population and included a review of the Child Life Stress Potential Assessment as it relates to creating and bolstering coping and resilience in the school setting, particularly for students with Diabetes.

Consider a tool to understand the student experience: Stress Potential Assessment (SPA)
Child Variables: Chronological and developmental age; Responses to previous separations from home and family; Response to current and previous healthcare experiences; Ability to communicate and function independently; Understanding, fears, and concerns; Coping styles and resources; Cultural values and beliefs; and other life stresses
Family Variables: Availability to child; Support systems and resources; Other family needs and commitments; Cultural beliefs and values; Anxiety level and emotional status; Other life stresses; Responses to current and previous health care experiences; Understanding of child’s needs and concerns; Ability and opportunities to communicate with healthcare providers
Healthcare Variables: Diagnosis; Anticipated treatment and procedures; physical response to illness, injury and treatment; Previous healthcare experiences; Number, personality, and values of healthcare professionals involved
Support students in understanding the WHY behind the WHAT about diabetes to help motivate the day-to-day work of diabetes.
Give students autonomy when safe, e.g. can they check sugars, manage diabetes care in the classroom rather than leaving/missing class to go to the health office?

Try to understand the student’s perspective and experience. Keep in mind the many variables (see above): child, family variables, factors that affect coping with diabetes, child development, temperament, parenting & coping styles, what the family is already juggling, healthcare and school variables, the trauma of diagnosis process, communication, and autonomy.
When building relationships and trust with students and families, try to take into account each person’s experience and perspective, where they are coming from, and how different actions, moments, and conversations may feel.
Finding and encouraging a healthy balance is a challenge and each moment or decision feels like a lot of pressure.
Early and often: reinforce and normalize the benefit of counseling in families with diabetes. To find resources: diabetes clinics should have a social worker or mental health provider. Also, you can look on PsychologyToday – to help find a local provider.

How do you support a student and family when parents/guardians are extremely protective and do not want “others” involved in their child’s care, management, and support?

Starting the trust and relationship building with both the student and the family/guardians right away helps reinforce the “normalcy” and integrated care and support abilities of the school nurse and staff. Try to communicate common goals so there’s mutual understanding you and the family both want the best for the child. Try taking into account each student and family’s experiences and perspectives, and how managing and supporting diabetes can be challenging combined with normal, daily stressors of students and families.
Resources?