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In order to optimize psychosocial and cognitive development and family function of chronically ill patients who are acutely stable in a pediatric intensive care unit, the philosophy of care was changed. Psychosocial development was enhanced by practices that develop trust in caregivers, including change in visiting policies and consistency in caregivers. Cognitive development was enhanced by increasing interaction with the environment outside of the Pediatric Intensive Care Unit bed. Family function was maintained by communication and family participation.