How a child becomes more independent

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Learn about different factors that affect how your child is able to take on more responsibility for their self-care.

Key points

  • As a parent of a child with a health condition you want them to learn self-care and to make smart decisions about their health.
  • For your child, learning self-care is a process that takes time and it should be started when they are quite young.
  • Factors that affect how your child is able to take on more responsibility for their self-care include their brain development and hormonal changes.
  • Parenting style also affects how your child is able to take on more responsibility for their self-care. Different parenting styles include authoritarian, authoritative, permissive, and absent or withdrawn.

As a parent, you are the most important person in your child’s life. You nurture your child, keep them safe and teach them the skills to become a confident, happy and healthy young adult who can take care of themselves and function well in the world around them.

Parents of children with a health condition have the same goals as other parents but with extra challenges. Not only do you want your child to function well generally, you also want them to truly embrace the concept of self-care and make smart decisions about their health.

Learning self-care is a process, not an event. A child or teen with a health condition has more to learn to stay healthy, so it makes sense to start teaching self-care when they are quite young. This gives them time to learn and practise these skills.

As your child grows through the teen years into adulthood, many factors will affect how well they can take more responsibility for their care. These include:

  • brain development and hormonal changes
  • your parenting style

Your teen’s brain development and hormonal changes

Why is it so difficult for most teenagers to consistently make good choices and act responsibly? While it might seem sometimes like your teenager is acting unpredictably and immaturely just to drive you crazy, there is likely much more going on.

Scientists have discovered two reasons why teenagers often struggle with making ‘adult’ decisions and choosing to act responsibly:

  • brain development
  • hormonal changes.

Brain development

Teenagers may learn some new skills rapidly, but some parts of their brains do not develop as quickly as others. This affects the rate at which a teen can learn specific skills.

Brain scans have shown that a person’s brain continues to change until 25 years of age. These changes help explain the sometimes unpredictable behaviour of teens (for example how your teen can act like a calm, rational adult one minute and an over-emotional child the next).

The pre-frontal cortex is the part of the brain that controls “executive functioning” – the skills involved in showing good judgment and acting responsibly. The pre-frontal cortex is also one of the last parts of the brain to develop. Until it is fully developed, your teen is still learning the skills they need to plan ahead, set priorities, organize thoughts, suppress impulses and think about the consequences of their choices.

Hormonal changes

As an adolescent’s body develops, it produces and releases sex hormones to cause the physical changes of puberty. During the teen years, sex hormones become very active in a part of the brain called the limbic system. This part of the brain helps us regulate our emotions. It also helps us recognize and interpret people’s emotions.

Since this part of the brain is not yet fully developed, teens often misread or misinterpret the emotional signals of others. This can help explain why a teenager often reads too little or too much into a parent’s facial expressions, for example. It can also explain why teens might experience emotional outbursts and seek stimulation, which can lead to risky and thrill-seeking behaviour.

While your teenager’s brain is still growing, the ‘rational’ part, which helps them make good decisions, is not fully developed. At the same time, the ‘emotional’ part of their brain is overactive. It is no wonder then that your teenager is not consistent in how they behave!

Referring to the teen brain, an article in Time magazine once stated, “It’s like turning on the engine of a car without a skilled driver at the wheel.” The teen will eventually learn to drive, but there will likely be some ‘fender benders’ along the way as they get used to handling more responsibility for their care.

When it comes to your child’s health, you, your child and your child’s health-care team can work together to minimize the number and damage of these ‘fender benders’.

Parenting styles

Your child’s ability to gain responsibilities and skills depends in part on your parenting style. In turn, your approach to parenting is affected by many factors such as how your parents raised you, the larger culture in which you grew up and your attitude to issues such as discipline.

There is no perfect recipe as to how to effectively parent, but the literature cites several parenting styles that may resonate with you. These include:

  • authoritarian
  • authoritative
  • permissive
  • absent or withdrawn


An authoritarian approach focuses on obeying rules and does not allow for negotiation between parent and child. For example, a parent who is authoritarian would say “Your curfew is 10pm. That’s the rule and there is no discussion about this.”


An authoritative approach focuses on rules as well, but it also allows some negotiation between parent and child. For example, an authoritative parent would say “You want to stay out until 11, but I want you back home much earlier, so let’s set your curfew at 10pm for now and we’ll see how it goes for the next few weeks.”


With a permissive parenting style, there are either no rules or there are no consequences for breaking the rules. A permissive parent would say either, “You can come home whenever you want to.” or “You were supposed to be home at 10pm, but you didn’t come home. Oh well, I’m glad you’re home now.”

Absent or withdrawn

When a parent is absent or withdrawn, there are no rules and no discussion about rules. This is because the parent is emotionally absent, usually because of substance abuse problems or severe mental health problems. In these cases, and using the examples above, the parent may not know where the child is, much less decide on a curfew.

Adapting your parenting style

The teenage years can be especially difficult as teens test limits and challenge things they used to accept, such as family rules and parents’ authority. You and your teen likely have different ideas of what is considered “fun” and “safe” and this can lead to many heated arguments. This can be extremely difficult for you as a parent and may cause you to revert to a style of parenting you received when growing up. This may or may not be helpful to your teen.

A more helpful approach is to imagine your child as an adult and think about the kind of skills they will need to have to stay healthy and manage themselves in an appropriate and responsible manner. Once you have an idea of the skills you want your teen to learn, you can consider how your parenting style supports or hinders your child in developing these skills. Then, you can work at making some changes in your parenting if necessary.

The result of successful parenting is a young person who has the skills and knowledge to function well in the larger society. There are many rules in our society, but there is also some negotiation around many of these rules (for example working flex time at one’s job). Parents who are authoritative and help their children learn to negotiate are most able to prepare their children for success in our larger society.

How an effective parenting style makes a difference

Children who learn valuable skills from successful parenting can apply them when negotiating their health care with their medical team. Have a look at the example below and a teen’s possible responses depending on how they were raised.


A doctor prescribes a medication that must be taken three times a day, but your teenager does not feel that taking medication this often is reasonable or realistic.

Possible responses:

  • If your teen was raised by authoritative parents with opportunities to learn how to negotiate, they are more likely to be honest with their doctor and ask if the medicine dosage or scheduling can be changed or if there is any alternative option.
  • A teen from an authoritarian home is more likely not to question the medicine instructions but then struggle with taking the medication properly. They may fail to some degree, or worse, totally stop taking the medication.
  • A teen whose parents are permissive or absent is more likely to take the medication only when they want to, which likely will not coincide with how it was prescribed.
Last updated: March 3rd 2021