Inside Pediatrics Spring/Summer 2026

At that point, medication alone is often not enough.

King teaches her patients to use alarms and visual reminders to improve adherence, and she works with parents to help them understand when to hand over responsibility to their child. Some parents struggle to let go, she said, while others step back too quickly. The goal is a gradual, scaffolded approach. “The parent can still function as the safety net, but the patient is progressively learning the needed skills to become their own safety net.” King tries to see patients in conjunction with their medical appointments. She also follows them when they’re hospitalized and offers telehealth visits. With nearly 1,000 patients in Children’s sickle cell program and just one dedicated psychologist, however, demand far exceeds capacity. Currently, she sees about 20 patients a week, with plans to grow gradually.

So an important focus is boosting patients’ ability to cope with pain. That includes evidence-based strategies such as diaphragmatic breathing and guided imagery to calm the autonomic nervous

system and reduce the intensity of pain signals.

“The parent can still function as the safety net, but the patient is progressively

And it works. Screening tools find patients’ pain scores dropping several points after using such strategies even before receiving pain medication, King said. Equally important is helping kids and their families reframe the pain. Understanding when

learning the needed skills

to become their own safety net.”

pain is severe enough to require escalation to the hospital and when it can be managed while continuing daily activities can reduce fear and help maintain normalcy. Another focus is helping adolescents transition to self-management. This period during adolescence is known for high rates of treatment lapses and worsening outcomes as kids try to become more independent with this complex disease. “They’re managing so many different treatments and medications, so adherence drops,” King said. “It could be forgetfulness, because they can experience cognitive issues related to sickle cell, but sometimes it’s more about not wanting to feel different.”

“My goal is to extend to as many of those as I can,” she said. “But there’s just one of me.”

She’s also focused on tracking data for the program, including barriers and facilitators for care as well as outcomes. She’d eventually like to publish on the program’s experience to help other hospitals start their own. ●

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