Better relationships for teenagers with chronic illness

Associate Lecturer Anne McMaugh.

Kids with visible physical health conditions like spina bifida, cerebral palsy and cystic fibrosis often struggle making friends at school. But one academic’s research and teaching aims to help.

How teenagers handle friendships, rejection and bullying is the focus of Anne McMaugh’s research. An Associate Lecturer in the School of Education at Macquarie University, McMaugh has focused on typical developmental processes such as social cognition, peer relationships and making friends.

As part of her research, she has studied and talked with 12 to 14-year-olds with chronic physical health conditions that are visible and disabling, concentrating on how they formed and negotiated relationships at school. None was intellectually disabled.

The results

McMaugh was able to divide the students from the study into three main groups, the first of which were well adjusted to their peers.

“These students are very aware of what others are likely to think of them, and so pre-emptively try to overcome this by strategically self-disclosing or hiding aspects of their condition,” she says.

This group also displayed the best strategies for dealing with rejection.

“They draw on their friends for social support, on the similarities between them, their sense of kindness and empathy and good humour,” McMaugh says. “These students are confident and gregarious.”

A second group is “doing OK”, she says, while a third is adjusting poorly, having been actively rejected by their classmates. Especially vulnerable were those with conditions related to the central nervous system, which made them look different and have problems with verbal communication.

Taking action from the top down

McMaugh believes that all schools need to do a lot more to monitor student interactions and look out for anyone likely to become a target of victimisation or bullying. Those with poor adjustment are often disenfranchised within the school system, and feel their teachers don’t help them enough.

What she’s found will not only feed into the Education as Social Development course she will co-ordinate from next year, but has already informed her teaching of Macquarie’s education students.

“I give students examples of stories teenagers recount of their experiences,” says McMaugh. “For instance, one child told me he started to avoid maths classes because the teacher yelled at him to ‘try harder, try harder’ in front of all his classmates. He was in a typical suburban high school. He said to me: ‘What is that? What is trying harder? I’m already trying hard enough’.

“I need to explain to the uni students that we have to make learning meaningful and help the teenagers out with productive strategies. The teacher has to sit down with the student and find out why he’s finding learning so hard. Then the work can be broken down into small and manageable tasks. And the curriculum has to be appropriate.”

Students can find the support of a teacher’s aide helpful or embarrassing. Aides might be advised not to hover around a sensitive adolescent. Disclosing information about a particular student’s disability should also be carefully handled. It can further stigmatise, and lead to an even worse response from peers.

While assertiveness training of individuals can be effective, McMaugh says schools need to take on the responsibility to remove the need for the teenagers to adapt in the first place.

“It comes down to addressing tolerance as part of the school culture from the top down,” she says.

For further information, contact Anne McMaugh at anne.mcmaugh@mq.edu.au. The Australian Centre for Educational Studies website is at www.aces.mq.edu.au/educ_home.asp

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