LIKE OTHER INVISIBLE symptoms, cognitive symptoms associated with MS may be particularly difficult for children to understand. The most common cognitive impairments include problems with memory and concentration and an overall slowing of thought processes. Specific functions that are likely to be affected include learning and remembering new information, verbal fluency, maintaining attention for sustained periods (concentration), and executive functions (e.g., organizational and problem-solving).
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| Multiple Sclerosis Causes And Symptoms |
Children as well as adults frequently misinterpret these symptoms. For example, it is not unusual for a parent's forgetfulness to be interpreted as "not listening" or "not caring." As a result, the child feels hurt and angry and the parent feels frustrated and misunderstood. Children may begin to wonder if their parent is "becoming stupid," not paying attention, or simply not trying hard enough, especially when the parent has difficulty helping the child with homework.
Cognitive impairments can also interfere with usual parental responsibilities such as maintaining a child's schedule of appointments and activities. Consider the example of Stacy, who was angry and disappointed about missing an anticipated field trip with her fourth-grade class. Stacy's mother, whose impaired memory and organizational skills caused her to misplace things around the house, had forgotten to return her daughter's permission slip on time. Thus, common cognitive problems can interfere with planning and family communication, resulting in frustrating misunderstandings and conflict.
Emotional And Behavioral Symptoms
EMOTIONAL ADJUSTMENT TO MS is an ongoing process that begins at diagnosis and continues over the course of the illness. Considering the unpredictability and potential disability that accompany MS, it is not surprising that depression is very common. Untreated depression can have a significant impact on a parent's ability or motivation to carry out the daily activities and responsibilities of parenting.
Ms. B, a 30-year-old, single mother with progressive MS, had become socially isolated since having to give up her secretarial job. As she became increasingly depressed, Ms. B relied more and more on her school-aged daughter for companionship, often restricting the child's after school play time to watching television with her. Her daughter became resentful and emotionally torn, wanting both to spend time with her friends in the neighborhood and to please her mother.
The mood swings, outbursts of temper, and general irritability that sometimes occur with MS can also interfere with parent-child interactions. Children often have particular difficulty understanding a parent's intense and unpredictable emotional state, particularly when they become the easy and available target for these frustrations.
When Sarah G came running into the house to ask her father if she could go to the movies with a friend, her father reacted by yelling loudly at her to stop interrupting him. Mr. G's problems with attention, concentration, and memory had been interfering with his efforts to balance his check-book and pay the monthly bills. When Sarah came into the room, she inadvertently interrupted her father's efforts to concentrate and complete a task that would once have been simple for him. The anger and frustration he felt spilled over to his surprised young daughter, who went back and told her friend she could not go to the movies. This kind of misplaced anger often leaves the parent feeling guilty and the child feeling resentful, hurt, and confused.
Social Consequences
IT IS NOT unusual for a family to renegotiate roles and responsibilities in response to changes in physical or cognitive abilities that result from a chronic illness. Some of the most profound consequences of MS involve the reconfiguration that occurs within the family as its members try to cope with the disease. For example, the breadwinning spouse with MS who becomes unable to continue working may stay at home and take on new parenting responsibilities while the well-spouse returns to the workforce.
Other families may find themselves facing the necessity of sharing parenting responsibilities with individuals from outside the family (e.g., home health workers). In its most dramatic form, reconfiguration within the family may involve divorce or separation. Less obvious reconfigurations involve the emotional withdrawal of one or both partners from each other and/or from their parenting roles. Single parents who have MS seem to be particularly at risk for increased role-related stress because they often have no partner with whom they can share financial, household, and parenting responsibilities.
Some parents assume that, because of their MS, they can no longer be as involved in their children's social, recreational, and athletic activities. MS symptoms, transportation problems, and architectural barriers may indeed prevent a parent from participating in the way he or she once did. However, it is important for parents to assess each situation carefully, pursue all their options, and seek assistance before depriving themselves and their children of their participation.
Another common assumption made by parents is that their children will be embarrassed to be seen with a parent who uses a cane or a wheelchair. In fact, the supportive presence of the parent usually outweighs any embarrassment, and many children are proud of parents who have overcome difficulties associated with their MS.
Younger children are particularly interested in having their parent come to school to talk to the class about physical disability or give the children a demonstration ride in a wheelchair or scooter. Adolescents (who may be embarrassed by their mothers and fathers whether they have MS or not) often engage their parent's help to write a research paper about MS for one of their classes. To find out more, you can check out Multiple Sclerosis Causes And Symptoms.