Society of Pediatric Psychology Presidential Address: Toward a Social Ecology of Pediatric Psychology

Although pediatric psychologists have contributed much to the clinical and research literature regarding the effects of chronic illness on children’s cognitive and social development, unfortunately we have been less productive in examining the reciprocal influence of children’s illness on other systems including peer relationships, schools, and health care providers. There are distinct reciprocal interactions between children with chronic illness and systems surrounding them. In this article, I argue that cultural systems, family systems, peers, schools, and health care providers influence the adjustment and adaptation of children with chronic illness and that children with chronic disease also have reciprocal influences on these systems. For the purpose of this article, I will draw primarily from my own program of research, as well as the programs of research from close colleagues. The literature reviewed here does not represent an exhaustive review of social ecology; rather, the purpose of the article is to provide exemplars to illustrate the notion regarding reciprocal influences of systems on pediatric populations and pediatric populations on systems. I argue for a greater systems approach in pediatric psychology. We should consider in our future research agenda the reciprocal interactions of children’s illness on systems and systems’ issues on children’s adjustment and adaptation to illness. The scope of the article is limited to family systems, broader social