Encourage autonomy

What is autonomy?

Autonomy is the ability of a person to act on their own free will. When a child has autonomy, even in small ways, it helps build his confidence, self-esteem and independence.
Autonomy is a critical part of learning for all children.

In most children (even toddlers and preschoolers), key ways to encourage autonomy include:

explicitly role modeling desired tasks,
encouraging your child to try tasks that he/she has not done before,
offering realistic choices,
respecting their efforts to complete the task.

But what about the child who has special medical needs?

Building autonomy is especially important for the child with chronic health issues or care needs. This child may feel powerless because he/she has to follow so many “rules” set by others, like his/her parents, nurses and doctors. If we let this child participate in his/her care, he/she has the chance to learn and understand the care better. This helps him/her feel more in control and helps build self-esteem. Ultimately, these are the characteristics of a resilient child, one who can face new challenges in a positive way.

For the child that must have certain regular care (eg, tracheostomy or gastrostomy care), you can offer choices related to the care (see table below for more details) and perhaps, just as importantly, you can offer your child lots of reasonable choices in the other areas of their daily life (eg, which toy do they wish to play with, which pair of socks to wear, etc).

Some children do have limited autonomy, usually because they are unable to understand or because they do not have the motor control or strength to carry out tasks; even so, these children can be offered realistic choices in a way that matches their abilities.

Have a look at some of the examples below to get you started. Talk to your health care team to find specific suggestions for your child.

Encouraging autonomy: some examples by developmental stage

Adolescents

Role modelling tasks

Demonstration of tasks and reinforcement of information with written or visual materials works well in many adolescents. Peer learning/mentorship from an older adolescent can be especially powerful in this age group.

Encouraging participation in tasks

Adolescents naturally struggle with independence and a search for autonomy as they move towards becoming adults. Those that have experiences of chronic illness and restricted autonomy may be especially challenged during this developmental stage.

Some adolescents can be sad, frustrated or angry about having care needs. If your previously collaborative teenager is now refusing care or struggling in another way, please speak to your health care team.

Offering reasonable choices

Again, offering realistic choices are the best way to build autonomy; this is true in adults also!

Adolescents who have had experience with making choices (and experiencing the consequences!) are better prepared for the turbulence of puberty.

We recommend that all families of adolescents with chronic medical conditions talk to their health care team (with their adolescent!) about navigating this stage and preparing for the transition to adult care.

https://complexcareathomeforchildren.com/prepare-your-child/encourage-autonomy/

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