Quality of substitute care as an influence on separation responses

Sick child care: a developmental perspective

Sick child care programs provide an alternative when mildly ill children are excluded from their regular child care program. Although infectious disease implications have been addressed, little attention has been directed to the potentially negative consequences of care by unfamiliar providers in unfamiliar settings. Appropriate options for care during illness must be based not only on the physical but the emotional and developmental needs of young children.

Emotional reactions of children to isolation in a cancer hospital

Emotional reactions of 123 hospitalized children and their mothers were evaluated during standard isolation with limited visitation and during peninsula isolation with visitation only through glass partitions. Self-report surveys and behavioral observations by nurses indicated that (1) patients and parents in both isolation facilities had overall high levels of hospital-related anxiety and depression which varied with the patient's chronologic age; and (2) parents of preschool children had more negative opinions toward peninsula isolation than did parents of older children. These results confirm the need for psychologically supportive programs for the families of children being treated for catastrophic diseases.

Intellectual and social development following prolonged isolation

A patient with severe combined immunodeficiency required protective isolation for the first year of life. He was discharged after an effective treatment program was developed and has remained well. Developmental testing at 14 and 16 months revealed near age level social and intellectual functioning. Optimal nursing care, frequent and prolonged maternal contact, and the patient's adaptive capacities permitted rapid adjustment to normal life following prolonged isolation.