Children who have medical needs that are not easily met by routine medical care, and have one or more diagnoses that include terms like chronic, congenital, severe, and complex are considered to be “children with medical complexity (CMC);” however, there is not a commonly accepted universal definition of CMC  (Children With Medical, 2011). 


CMC is identified using four main components:


  1. The child’s needs

  2. The child’s functional limitations

  3. The child’s chronic conditions

  4. The child’s health care use

  (Children With Medical, 2011)


The needs of a medically complex child will

significantly impact family functioning.  In some cases

in Connecticut, should the child need to be removed

from their home due to safety concerns, and services

within the home are not sufficient, the Department of

Children and Families may file an “Uncared for: Specialized

Needs” petition with the Superior Court for Juvenile Matters.




                                                                                                                                         (Cohen et al, 2011)



Children with complex medical conditions not only include disorders with a high morbidity rate, but also include emotional and behavioral disorders.  For these children, treatment may need to include medication intervention, cognitive therapy, behavior modification approaches, therapeutic services, and additional support services for the individual and the family (Medications Used For, 2010). 


Cognitive Behavior Therapy (CBT)    

Cognitive Behavior Therapy is a combination of therapeutic techniques that explore a person’s thoughts, feelings, and belief system as the impetus for their emotional and behavioral experiences, asking questions that force the individual to consider the truth of deeply held beliefs (Field et al, 2015).  This evidence-based practice is among the most commonly used therapeutic approach today, and has led to interesting findings in the field of neuroscience.  Scans have shown positive physiological changes in brain functioning during CBT (Field et al, 2015), specific to the areas in the brain that involve decision–making. 



Much of the treatment that children receive for their medical needs includes one or more medications.  It is important for advocates to understand the need and use of a child’s medication to better campaign for the child’s needs.  The CT Department of Children and Families provides parents/guardians, foster parents, families, youth, and social workers with a list of questions to consider when exploring medication use (Medications Used For, 2010). 


In certain situations, advocates should ask health care professionals the following questions:


  1. What is the name of the medication being prescribed?

  2. Why is this medication being used?

  3. What is it supposed to do for this child?

  4. How long should it take to work?

  5. When and how should the child take this medication?

  6. Will this medication interact with anything (foods, drinks, other medications)?

  7. What are the side effects of the medication?

  8. What should the parent/ guardian/ child do if the side effects occur?

  9. How will I know that the child is getting better on this medication?

  10. What are the signs that the child is getting worse?

  11. Is there any information that the parent/ guardian/ child should read about this medication?

  12. Are there any blood tests or any other testing that needs to be done before the child begins taking the medication?

  13. Will any tests need to be done while the child is taking the medication? If so, why?

  14. What does the child's school nurse need to know about this medication?

  15. How long will the child need to take this medication?

  16. How will we decide to stop this medication?




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