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Young people taking responsibility for self-management: when is the ideal time?
  1. Line Caes
  1. Division of Pyschology, Faculty of Natural Sciences, University of Stirling, Stirling, UK
  1. Correspondence to Dr Line Caes, Faculty of Natural Sciences, University of Stirling, Stirling FK9 4LA, UK; line.caes{at}

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This article summarises a recent EBN Twitter Chat on the challenges involved with determining the right time and approach to support adolescents in taking more responsibility for their disease management. The Twitter-Chat was led by Line Caes (@LineCaes) from the University of Stirling and moderated by Roberta Heale (@robertaheale). The pre-chat Blog can be found at:


Adolescence is a stage in development characterised by rapid changes in physical, cognitive, emotional and social functioning.1 All of these changes are preparing the adolescents to lead an independent, fulfilling life. For adolescents with a chronic illness this requires overcoming an additional challenge of gaining independence in their disease self-management. Indeed, successful transfer from parent-led to adolescent-led self-management is key to adaptive management of the chronic illness into adulthood, thereby preventing continued disability. Across several chronic illnesses, it has been found that optimal executive functioning within the context of a supportive parent–child relationship is essential for a smooth transfer of self-management.2 3 Executive functioning is defined as the capacity to coordinate our thoughts and behaviours, with three core components: inhibition, working memory and cognitive flexibility.4 Optimal executive functioning skills are assumed to be pivotal to successful self-management of chronic illness and associated quality of life.5 6 For example, considerable parent–child agreement on who takes responsibility for diabetes-related tasks and increased levels of executive functioning were positively associated with greater self-management and adherence. This in turn considerably improved their quality of life.6–8

However, adolescence has been identified as a sensitive and vulnerable period characterised by an erratic growth in executive functioning skills,9 which might partially explain why adolescence represents the developmental stage with the worst ratings for engagement with self-management.6 10 11 Such erratic growth in critical skills for …

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  • Funding Dr Line Caes held the Twitter chat and wrote this article while being funded by the Royal Society of Edinburgh/Scottish Government Sabbatical Research Grant 2019.

  • Competing interests None declared.

  • Provenance and peer review Commissioned; internally peer reviewed.