Early research on child adjustment to chronic illness assumed that each condition had a unique impact. Recently researchers have suggested that all chronic conditions influence adjustment in similar ways. To compare these models, data were collected on 165 adolescents having chronic conditions with and without brain involvement, and 49 healthy controls. Adolescents with brain-based conditions had more behaviour problems, less autonomous functioning and poorer school achievement. Children with conditions having no brain involvement differed from controls only in reporting less work experience and having lower math achievement scores. These findings support a modified perspective that involves both general factors and effects specific to brain-based conditions.