Supporting development of children with chronic conditions: from compliance toward shared management

Children with chronic conditions can meet the overall health outcomes articulated in Bright Futures (1994), a model outlining a continuum of social, developmental, and health outcome achievements that help shape an independent, healthy adult. These outcomes begin with the development of a therapeutic alliance between families and providers and end with an independent, healthy functioning adult. The achievement of these outcomes does not come without the support of providers, however. Health care providers ideally merge multiple models of practice to provide an anticipatory guidance approach throughout the child's life to assist the family in this important task. Three models have been found useful: developmental, leadership, and changing foci, which families can merge into every day life.