Education Chronic<unk>  often interferes with children's ability to attend and succeed in school. Children with severe disorders are particularly likely to miss school because of debilitating<unk> , as well as for medical appointments. High rates of school absence are associated with poor adjustment and psychosocial wellbeing among children with chronic illnesses. For children with severe chronic<unk>  disorders, school districts may provide a variety of services, including inpatient, homebound, and special education. Inpatient education Some hospitals employ or contract tutors to assist children in inpatient care with their schoolwork. Hospital teachers are typically certified to teach a wide variety of ages and subjects. At the same time, in a study by Steinke et al., around one-third of hospital teachers reported teaching ages or subjects beyond their areas of certification. The number of hospital teachers is declining due to reduced hospitalization and shorter hospital stays. Homebound education In many school districts in the United States, homebound education is offered to students who miss more than 15 days in a row. Homebound education typically consists of 45 minutes of instruction per day in the child's home. Other nations, including Australia and Belgium, have implemented programs to use technology to include chronically ill students in their regular class sessions, and these programs have generally had positive results. Many critics of homebound education believe that it is not a sufficient substitute for classroom learning. Additionally, many children with chronic<unk>  have intermittent rather than extended absences, which makes them ineligible for homebound education services. Even when homebound education is an option, it is often difficult for students from low-income or otherwise disadvantaged backgrounds. Programs typically require a computer, Internet connection, a quiet and well-lit space, and parental supervision, demands that may prove burdensome for economically disadvantaged families. Special education services While children with chronic<unk>  are typically not placed in special education classrooms, they may receive health-related accommodations. Such accommodations may include shorter school days, exemption from requirements like physical education classes, arrangements to deliver medication and other treatments, and programs to educate classmates about their disorder. These measures require extensive communication between teachers, doctors, and school nurses. Family impacts Paediatric chronic<unk>  often impacts quality of life for the families of children affected, with mothers having particularly low health-related quality of life on average. Parents of children with chronic<unk>  conditions allocate considerable physical, financial, and emotional resources towards health care for their child. For example, a study by Ho and colleagues found that primary caregivers for chronically ill children spent an average of around $8800 and 28.5 hours on medical appointments in the past three months, causing them to miss an average of 4 days of work. Mental health<unk>  often exists alongside mental health conditions like anxiety disorders, depression, and post-traumatic stress disorder (PTSD), with elevated rates of these disorders lasting into adulthood. There are a variety of theories that address this relationship. Chronic<unk>  is emotionally stressful both to the child affected and to his or her family, which may increase their risks for mental illness. Chronic<unk>  and PTSD can also be "mutually maintaining", with cognitive, behavioural, and affective patterns creating a cycle of worsening physical and mental symptoms. Under this model, depressive symptoms (such as reduced activity and increased physiological arousal) aggravate<unk>  symptoms, and unhealthy coping strategies (such as catastrophic thinking) worsen mental health. Many mental health disorders also share neurobiological mechanisms with psychological disorders, such as activating the HPA axis and increasing the production of stress hormones. Chronic<unk> , anxiety, depression, and PTSD are also all associated dysfunction involving serotonin and brain-derived neurotrophic factor. New research has also linked both chronic<unk>  and mental illness to inflammation. Quality of life In a study of patients at a paediatric<unk>  clinic, researchers found that chronic<unk>  had a significant negative impact on quality of life. Depression was also prevalent, and was correlated with functional disability. Additionally, psychosocial adjustment is a better predictor of school attendance than<unk>  severity, which suggests that it is an important variable in examining outcomes of children with chronic<unk> . The psychological consequences of chronic<unk>  may be exacerbated with the stigma associated with it. Many people do not typically associate chronic<unk>  with children, and so may minimize or dismiss its impact.
Childhood chronic pain
History of dental treatments
Childhood chronic illness
History of dermatology
History of psychosurgery
History of medical diagnosis
History of neurology and neurosurgery
History of surgery