The pediatrician and care of chronic illness

Abstract

The prevalence of chronic illness in children in this country has been estimated to be 10% to 20%. (Chronicity, by definition, refers to any condition that persists for longer than three months.)1 Furthermore, the prevalence figures that identify at least one of every ten children as having chronic disease include only physical disorders and exclude mental or emotional handicaps and other conditions now classified as the "new morbidity." This group of problems, which encompasses preschool behavior and learning disorders as well as other school dysfunctions and adolescent adjustment problems, represents a significant additional class of chronic disabilities. Primary physicians now find themselves with responsibility for (1) the earliest possible identification of any child with chronic disease; (2) assessment of various physical, emotional, and social needs including referral to specialty services such as consulting physician-specialists and other helping agencies and resources; and finally (3) provision of continuity and coordination of care for medical problems such as childhood cancer or a psycho-educational problem such as a severe learning disability.