ABSTRACT
Childhood sickle cell anemia is conceptualized as a particular form of stress to which the black extended family adapts. Successful adaptation is assumed to be indicated by overt behavioural manifestations of child competence during the middle childhood years. The chapter describes the extended kin relations used, more or less successfully, by three types of urban families to cope with caring for middle school-aged black children with sickle cell disease. These are female-headed, single-parent families, with highly restricted extended kin contact, nuclear families, generally natural mother and father families, with restricted extended kin contact and multigenerational families, frequently spanning more than one household, with extensive kin contact. The three types of families were inductively identified during a larger study using two criteria: the primary caregiver's identified secondary caregivers and if intergenerational relations were invoked to assist in child care. Families potentially provide the cognitive, social, and emotional bases for children's eventual competence.
