Managing ADHD, diabetes and other chronic conditions in teens

Children diagnosed with chronic illnesses and other long-term conditions such as ADHD, diabetes, severe allergies, asthma and more spend their childhoods with treatment generally managed by their parents or other caregivers in their lives. As those children grow, having them take a more active role in understanding their condition and handling treatment can help in their ongoing care.

How can chronic conditions change as children age, and what should parents do to help keep their kids safe as they transition into adulthood? Pediatrician Hannah Hulsey-Comer, MD, explained what you need to know about managing ADHD in teens, along with other chronic conditions.

How do chronic illnesses or conditions like diabetes or asthma change as children age into adolescence?

“One of the first and simplest answers to that question is that medication requirements, from the type of medicine to the dose amount that is most effective may change as your child’s body changes during puberty and into early adulthood,” said Dr. Hulsey-Comer.

What symptoms they experience may increase or decrease over time. Your child’s care team may need to make adaptations or adjustments to their treatment plan based on their activities as well.

Essential care for chronic conditions in teens while supporting their growing independence

“During adolescence, teens start to become more independent and have increased control over their day-to-day routines,” said Dr. Hulsey-Comer. “Many of them have relied their whole lives on having parents or caregivers who are handling all the details of their ongoing care. Working with your child to ensure they know how to manage their chronic conditions and keep track of their medications is essential for them to be able to have that autonomy and to move safely into adulthood.”

For some people, ADHD symptoms may lessen over time, but for over half of children and adolescents with ADHD, their symptoms persist in adulthood. Medication regimens may need to be adjusted depending on work schedules or their continuing education.

“When it comes to asthma, severe allergies and diabetes, what may seem like an inconvenience to a child whose caregivers are managing their condition well could become seriously dangerous if they don’t have the knowledge they need or rescue medications available when they’re on their own,” said Dr. Hulsey-Comer.

It’s crucial that they know how to obtain and use their medications and know the importance of having medications readily available. It may be helpful for them to make sure some of their friends are aware of their condition and what steps may need to be taken in the event of an asthma attack, low blood sugar for a diabetic or a strong allergic reaction.

Chronic conditions like ADHD, asthma and diabetes all need routine follow ups and check-ins with the provider to make sure their symptoms are well controlled and their medicine is at the right dosage. Teens need to know how to make these appointments and how to navigate the healthcare system to receive their much needed follow ups, especially as they transition from pediatric to adult care.

How can I help my teen child to be more in control of their health needs?  

“I advise parents and caregivers to help their child learn how to advocate for themselves in a healthcare space, and to make their health a priority as they grow,” said Dr. Hulsey-Comer. “Teens should be taking on more responsibility as they get older, and that includes having a better understanding of and agency over their own body.”

Don’t just throw these new responsibilities at them all at once. Start early, speaking with them about how to access healthcare when they need it and offering assistance without taking over the process completely. Navigating the healthcare system can be complicated. Teens need to know who and how to reach their doctor’s office, how to obtain their medications from the pharmacy and how to access MyChart. Teens who can utilize technology to meet their health needs are more likely to be able to manage their chronic conditions when away from caregivers.

Offer your teen time alone with their healthcare provider

“For many teenagers, the idea of asking questions or talking to a doctor about their concerns with their parent in the room may feel so painfully embarrassing that they’d rather just remain silent,” said Dr. Hulsey-Comer. “This leads to very important questions not being asked at all.”

Make sure your teen has the option during their annual well child visit or other visit with their pediatrician to have time without you in the room. It’s just as simple as letting them know that you’ll be stepping outside, and they can let you know when they’re ready for you to return.

Letting the teen take these small steps can help them prepare for transitioning to adult care. Besides spending time alone with their healthcare provider and practicing the process of scheduling an appointment, this can include the process of checking in and writing a list of priorities or concerns to discuss during their health visit.

“I recommend Got Transition®, a national resource that has very helpful information for teens, caregivers and health providers related to the important process of healthcare transition from childhood to adulthood,” said Dr. Hulsey-Comer. “They have great tools to help with preparation for taking ownership of your health as you get older, as well as a readiness assessment to help with pointing out areas that may need improvement.”

What should I make sure my teen knows before they take over their own care?

The process of healthcare transition from a pediatric model of care to adult healthcare takes effort and planning. It’s important that this process is done well, and one key way to help ensure success is to start early.

“Does your teen know what to expect at the doctor’s office? Are they prepared for the way their care will change as their needs change? Do they have the skills to navigate the healthcare system when it comes to managing a chronic condition? These are all crucial pieces of knowledge to have when you’re looking to avoid missing out on important parts of care,” said Dr. Hulsey-Comer.

Having an ongoing primary care home is essential to the transition from pediatric to adult healthcare, especially for teens with chronic health conditions. This may mean transitioning from a pediatric to adult provider. In some cases, like sickle cell disease, your child may end up staying with the same medical provider, through a program like the Sickle Cell Lifespan Center, but the care they receive is adjusted to a more adult model.

During this time, make sure you speak openly with your teenage child on their healthcare needs, the steps you take to manage them and what they’ll need to handle moving forward. This can be done through a transition summary created by the provider that highlights the key aspects of the patient’s medical record.

“For teens with chronic health conditions, especially if entering a new environment like heading off to college or moving out into an apartment or other living space for the first time, it may be beneficial for them to carry a completed medical summary or emergency care plan,” said Dr. Hulsey-Comer. “You’ll want a plan that details their health conditions, medications and what to do in an emergency.”

Speak with your child’s pediatrician on the specifics of what should be on that document and make sure your child is involved in putting it together and aware of all the information it contains.