In this section
There are a many differences between children, adolescents and
adults- physiological, anatomical, cognitive, social and emotional-
which all impact on the way illness and disease present in children
and young people, as well as the way healthcare is provided.
Although adults continue to develop psychosocially, their
values/behaviour/social circles are generally far more defined and
stable, whereas children and adolescents are rapidly
developing and using the world around them and picking up cues from
their environment to aid in that development.
It is essential to be mindful of the way clinicians interact &
communicate with children, adolescents and their families as they
play a role in this development, and to be well aware of the
broader context of a child or adolescent's life, as this has a much
more significant impact on the way they experience and recover from
illness or injury.
Unlike adult, children and
adolescents are still in a period of social development which
involves learning the values, knowledge and skills that enable them
to relate to others. The goal is for children and adolescents to
build a positive sense of their own identity and their role in
relationships with people around them.
These social skills and lessons can be learnt from those who care
for them, as well as indirectly through negotiating social
relationships with family or with friends, and through
participation in the world around them e.g. coming to
hospital. Not of these relationships and experiences are
positive, and the impact of negative influences also shapes social
behaviours. Hospitals and their staff can be part of a
child/families social environment and therefore it is important for
clinicians to be mindful of how they conduct themselves in
their social or professional relationships with a child's family
and toward the child and adolescent themselves, as this has an
impact on learning and development of their own social
identity. It is also important to be mindful of different
circumstances which shape social skills during the developmental
process and influence behaviours and interactions with other
Children, and to a lesser extent adolescents, typically present
more explicitly with their immediate social circle shown to the
clinician- with the presentation of parents, grandparents, aunts
& uncles etc at appointments.
Children and adolescents are still developing their ability to
recognize and manage their emotions or feelings, and this can be
influenced by many social and environmental factors.
For infants and young children, their emotional bond of affection
or 'attachment' to their caregivers is crucial to their emotional
Effects of Secure Attachment
Clinicians in a pediatric setting should be mindful of the
disruption to this bond that may result in separation anxiety which
is emotional distress seen in many infants when they are separated
from people with whom they have formed an attachment.
They should also be mindful that not all children and adolescents
will come from an environment where they will have the consistency
and stability in their everyday lives to allow them to form secure
attachments, and this may be reflected in their coping and
The growth of thought in children
More so that in an adult environment, a clinician must be mindful
of how they communicate with a patient, taking into account a child
or adolescent's level of cognitive development.
It is important to not only acknowledge the differences in a
child vs adult population but also adolescence and the specific
developmental challenges that it presents.
Adolescents are generally more able to participate in
decision-making about their own care, and have opinions and views
which can challenge those of their families and/or health care
providers so it is necessary to find the most appropriate way to
work with each adolescent on an individual basis. This is the
case in a paediatric or adult setting, as adolescents can often be
seen in adult environments and can feel overwhelmed or
insignificant without the opportunity to participate in their own
Adolescents can be more inclined to be experimental and take
part in high-risk behaviours which impact on their health and their
response to intervention. Adolescents and children are also
more vulnerable as a result of their reliance on others to meet
their different needs, and they can be more susceptible to
the negative impacts of complex social situations and
exploitation as they are not yet fully developed or
independent. These factors can have a major impact on their
presentation and behaviours, and are also a major factor in
planning for discharge/ future healthcare and wellness.
Adolescents will eventually transition to adult health-care
environments, which can be a vastly different environment with new
challenges and staff. It is important to help adolescents
prepare for this transition by taking more responsibility for their
own healthcare and enable them to negotiate their way through
this new environment.
Why is specialist paediatric training important?
Children, adolescents and adults
As well as the more obvious physiological and cognitive differences
between childrena dn adults, working with children and adolescents
requires the consideration of future development- physical, social,
emotional cognitive- as of primary importance. The need to be
aware of the context in which a child or adolescent lives and
functions is crucial for both the provision of appropriate
management as well as planning for future healthcare.
Protecting Children is Everyone's Business
National Framework for Protecting Australia's Children