| The focus of this handbook is the delivery of pediatric psychological services in schools, but
in this introduction the focus is on the broader context of pediatric psychology and health care.
To understand changes in the provision of health care to children and adolescents, it is helpful
first to understand the several natures of childhood illness. These aspects are both physical
and psychological. Chronic illnesses are conditions involving a protracted course of treatment.
Chronic illnesses can result in compromised mental, cognitive, and physical functioning and
are frequently characterized by acute complications that may result in hospitalizations or other
forms of intensive treatment (Thompson & Gustafson, 1996). Included in chronic illnesses
are such conditions of childhood as developmental illnesses like mental retardation and diseases
like cystic fibrosis. A condition that persists for more than 3 months within 1 year and
necessitates ongoing care from a health care provider is considered to be chronic.
By the age of 18 years, 10% to 15% of children have experienced one or more chronic
medical conditions (Tarnowski & Brown, 2000). Approximately 1 million children in this
country have a chronic illness that may impair their daily functioning, and an additional
10 million children have a less serious form of chronic conditions (Thompson & Gustafson,
1996). Prevalence of chronic conditions in children has nearly doubled over the past several
decades. This increased prevalence has been attributed to several factors, including advances in
health care reflecting improved early diagnosis and treatment, the survival of infants of extreme
prematurity or low birth weight, and new diseases like prenatal drug exposure and AIDS. |
