Developmental Issues

The emotional care of the child and their family is just as important as the physical care rendered by the health care professionals. When the child and family are able to trust in their health care provider, there is better compliance with health care regimens and procedures.

The provider must take into account the developmental/chronological age of the child - and the parents - as this will significantly impact how they respond to the provider's care. The provider must understand the emotional needs of the patients, and adapt their delivery of care appropriately.

During the acute phase of treatment, the provider has a dual role to play in the care of this child. Anxiety will be heightened for all persons while the child's basic physiological needs are met. The provider should include the appropriate emotional support and understanding of the pediatric patient's unique needs while performing essential life-saving steps.

While each age group has specific characteristics, there are many similarities which are easy for the caregiver to remember. The provider must understand that during times of stress, children may regress in their developmental stage. Don't assume that a child's chronological age dictates their developmental stage.

For those children who range in age from birth to pre-adolescence (about 10 years of age), the caregiver should remember these significant characteristics:



For the pre-adolescent & adolescent age patient, the caregiver should remember these significant characteristics:



For the long term care of a patient with PSVT, the child and parent(s) should continue to receive support and understanding from their health care team. Children with long-term illnesses are at a greater risk for developing associated psychological problems. These children must deal with a condition that may be here to stay and can occur without any warning at all. These children may experience a wide range of feelings, from denial to guilt to anger.

The parents also must deal with the uncertainty of PSVT. While often considered to be a non-life threatening arrhythmia by health care providers, it may be a constant source of special concern for the parent. Arrangements for care must be made with every caretaker the child may be with - from school activities to visiting at friend's houses. The parents must feel confident that the child can care for him/herself should an episode of PSVT occur. The parent must also feel confident that the adult in charge will take special care to assist the child as needed, and to refrain from hazardous snacks including chocolate and cola drinks.

Young children are unable to understand "why" they have PSVT, and may assume it is a punishment for being "bad". They may exhibit anger towards their parent and health care team for not being able to cure this arrhythmia. The child may further become bitter and withdrawn while reacting to dietary restrictions and uncomfortable treatments (i.e. blood draws, follow-up EKGs, etc.).

Pre-adolescents and adolescents may feel pulled in opposite directions. They may feel the need to be dependent upon their parent or health care provider for the ongoing treatment of this arrhythmia, while they would prefer to be independent from the adults and be more similar to their peers. This age group may decrease or stop taking their prescribed medications without the knowledge of the provider, or choose to consume or use chemicals which can stimulate PSVT. These actions are the result of a normal desire to take charge of their own body.

Children of all ages, and their parents, should be encouraged to learn as much about PSVT as possible. It is also helpful for both parents and children to meet with other families that have gone through this problem, to see how successfully it can be dealt with.

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Whenever possible, it is best to prepare patients honestly for procedures that may be painful.