If you have a boy (or girl) with a chronic illness, you may wonder if he can learn to manage his condition by himself. The answer, in most cases, is yes. A recent study looked at how self-management plays a major role in early advances made by children. The authors concluded that although intelligence is generally thought to play a key part in children's early school progress, aspects of children's self-management abilities—including the ability to alternately shift and focus attention and to control acting out--are related to early success and account for greater variation in academic progress than do measures of intelligence.

These findings were not surprising to me. At a children’s treatment center for asthma, we taught children as young as five years of age to take control of their asthma drugs. We started by giving each child his or her week’s supply of drugs. We carefully monitored how well a youngster took the medicines on his or her own. Over time, we gradually checked on the children less and less until we saw that she was taking the drugs as told to by her doctor. We then only monitored occasionally to be certain that the child was doing what she had shown she could do.

Would this same approach work with your child? It probably would, although you need to be the judge of his or her being able to self-manage a chronic illness. The beauty of this approach is that it lets the child know that he or she plays a big role in managing the chronic illness. This results in fewer conflicts within a family but, more importantly, it helps a youngster acquire the self-confidence that he or she can really make a difference in caring for a chronic condition. Do you have any comments or questions about this entry?

Blair C, Razza RP. Relating effortful control, executive function, and false belief understanding to emerging math and literacy ability in kindergarten. Child Development 2007;78:647-63.