Health professionals should recognize that children with COPD have a high prevalence of psychosexual maladjustment and these professionals must assume a role in promoting young patients' sexual health. Respiratory therapists can help parents understand the importance of confidently handling their ill children and understand that oral gratification is essential in psychosexual development. Therapists can help parents of toddlers with COPD learn to grant autonomy to the child, to use correct terminology for body parts, to accept masturbation as normal. Therapists can help preschoolers with COPD by providing factual answers to questions about sex and by encouraging parents to do the same. Guidance by a therapist can help the ill child identify with the same-sex parent without excessive attachment. Therapists should caution parents against prohibiting and punishing school-age children's sexual behavior. Therapists can find peer and support groups and social activities for the child, can alert nurses to needs for sex education, and can alert physicians to obsessive sexual behavior or exclusive homosexual interest. Chronically ill adolescents should be helped to develop a sense of intimacy, in order to avoid isolation. Other problems of ill adolescents may include prolonged dependence, sexual misinformation, self-image problems, and delayed secondary sex characteristics development. CF adolescents need genetic and birth-control counseling, and asthmatic female adolescents should know the risks of pregnancy.
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