Responding to children’s needs as they grow older
We have already discussed the idea that children have different needs at different ages. The concept of ‘evolving capacities’ was introduced in Study Session 2 of this module. It recognises that as children grow, they are able to take increasing responsibility for their own health in line with their physical, emotional, cognitive and social development. For example, a pre-school child has only a limited understanding of cause and effect and will need adults to set safe limits. By adolescence, he or she is capable of engaging in abstract reasoning and should therefore be allowed greater independence in decision-making.
It is important to note that these changes do not take place at the same age and same rate for all children. Children’s talents, their environment, the level of support they receive, opportunities for creative and active involvement, as well as cultural expectations will all influence their capacities for decision-making and taking responsibility for their needs.
Other factors, such as, for example, gender or disability, will have a significant effect on how children’s needs must be met. It will also often affect the extent to which they are met.
How might the needs of a 15-year-old blind boy who is a wheelchair user be met differently from those of a non-disabled child?
Privacy, respect for confidentiality and capacity for decision-making are needs that become more and more important to older children. As children experience puberty, they may become sexually active and develop emotional attachments beyond the family. They need information relating to sexual and reproductive health. Very often young people look to their peers to obtain information and they develop their own ideas about relationships through observing others. Some of this may be helpful, but some of it may be based on myths or stereotypes. Parents, caregivers and teachers should be a source of age-appropriate information about sex, relationships and growing up to help young people become more self-aware and better informed, and allowing them to make healthy choices. However, too often they fail to provide young people with the information they need. They may provide incorrect information or are simply in denial that children are sexually active. A consultation with young people undertaken for the development of this curriculum highlighted widespread concern that they are not provided with the information they need.
One girl’s experience
I got pregnant at the beginning of Form 2. I had a boyfriend and because I did not know anything about my menstrual cycle we had sex without using a condom, and I got pregnant that first time. I didn’t realise it until I missed my period, and I was vomiting every morning. When my pregnancy reached four months, I was ashamed of going to school but when I told my boyfriend he refused point blank that he was responsible. My mother asked me who made me pregnant. I told her and also that the boy had refused responsibility. She told me this was the gift from my prostitution.
In summary then, when working with children and young people, you need to take account of their changing needs – for information, for advice, and for recognition of their emerging capacity to be involved in decisions affecting them, including their health care. These needs are equally important for boys and girls. They are also as important to children with disabilities as they are to all other children: while other children are developing greater capacity for independence, the need to be able to ‘grow up’ can be particularly difficult for an adolescent with disabilities, for example, who is necessarily reliant on others.