What concerns do most teenage girls have when a physical deformity like scoliosis is first diagnosed? How about their parents?Dr. Cantor: Both parents and teenagers will have concerns related to the type of treatment that will be necessary and the prospect of progressive disability. The need to make decisions about treatment will be stressful, and the possibility of major surgery generally raises a high level of anticipatory anxiety. Teenagers may be particularly concerned about the effects of scoliosis on physical appearance and the effects on their attractiveness to the opposite sex. Teenagers confronted with the prospect of wearing a brace will worry about the possibility of restrictions on activities, social stigma and discomfort.
How do most girls make themselves feel comfortable in participating in an activity (PE, swimming, prom) that makes their deformity obvious?Dr. Cantor: Developing a positive self-image is the key to being comfortable in a variety of life situations. In a society obsessed with beauty where we are constantly bombarded with images of the "ideal," people who deviate significantly from that "ideal" are confronted with even greater challenges in developing a positive self-image. The process in developing a positive self-image is not really different, however, for those with an obvious physical condition that affects appearance or function than it is for the rest of the human race. Everyone struggles at some level with his or her self-image. Fashion models who supposedly personify society's ideal of beauty often question their physical attractiveness. If secure regarding their appearance, they probably feel insecure about other aspects of themselves such as their intellectual abilities. Beauty truly is not simply skin-deep. It is not easy for any of us to develop a positive self-image, but this is the key to coping with many of the challenges confronting us in life, including living with scoliosis.
What advice do you have for someone who is resistant to the idea of wearing a brace to school? What are some possible strategies for improving compliance with brace wear?Dr. Cantor: Teenagers, like adults, may sometimes have trouble appreciating the long-term implications of choices they make about their health care. Offering external incentives to them for initially trying the brace may be a helpful strategy. If the brace does not have to be worn full time, setting up schedules for wearing the brace at times that are least disruptive to their lives will also improve compliance. Helping them learn to deal with the social stigma of wearing a brace will go a long way towards increasing compliance. Some teenagers prefer to wear their clothes over a brace and choose clothes that make the brace less obvious.
How can parents help their teenager cope with a physical deformity?Dr. Cantor: As with any problem their child might face, parents can first help by listening. Listening means trying to truly understand how your child feels before attempting to solve the problem or to give advice. Don't tell your child how he or she should feel. How you would feel is not necessarily how your child feels. Accept your teenager's feelings and communicate that you understand.
Nancy L. Cantor, Ph.D.Primary Children's Medical Center
100 N. Medical Drive
Salt Lake City, UT 84113