Our three year old has a medical condition that will require him to have a number of visits to his doctor’s office and the hospital outpatient clinics. He has had, and will have, lots of procedures and exams and we are dreading it. We feel pretty secure that he’ll be OK once we get through this, but how can we help him get through this without traumatizing him?
Planning ahead—as you are doing—is the key to helping your child. It can be hard for a parent to watch your child go through repeated exams or tests, but you have an important role in helping him to cope. When children are prepared well for medical procedures they are surprisingly capable and resilient—sometimes they bounce back more quickly than their parents do!
It sounds as if you have a good understanding of your child’s medical condition and confidence in his health care providers. When parents are comfortable—usually as a result of getting an opportunity to confer with doctors, ask questions, and to be fully informed of options in treatment—it is much easier to focus on your child’s needs.
The best way to prepare young children for medical procedures is through play and simple explanations. If you don’t have a full set of toy “doctor” exam equipment and a play set of a hospital, now is the time to get these! You may also want to add real equipment that you can usually get from your doctor or the clinic. It’s also helpful to have a teddy bear who can be the “patient” who can be prepared for the experiences your child will have. The teddy bear, being fully prepared, can go with your son to his appointments and be a source of comfort as well as a way to engage his imagination.
Before you begin preparing your child for upcoming procedures, introduce the toys and tell him a story about the little bear and what he does in his regular life. Of course, the bear will have many similarities to your son! After you can see that your child is enjoying the play, tell a story about what has happened to the bear up until now, telling the story of what you think your son has experienced. Watch his reactions and notice if he seems engaged, upset, or if he wants to tell or ask you anything. Take your time with this play. Five to ten minutes is plenty. If you have time, you can bring the bear out to play every day, sometimes telling stories about regular life, sometimes about the medical procedures.
A day before the next procedure, use the little bear to help you tell your son about what is going to happen next to him. Before you do this, find out from the doctors, nurses and technicians exactly what will happen and, if possible, arrange to borrow some equipment from them that will be similar to what your son will see. If your child is going to a new place, arrive in plenty of time to park and allow time to walk around, visit the cafeteria, or play outdoors. This will help everyone arrive relaxed rather than rushed.
Tell your son that the little bear is going to the clinic (or wherever he is going) to have an exam (or whatever he is having) just like he is because they have to do certain things to stay healthy. Even if your child does not have pain or symptoms that he knows about, be very matter of fact about the parts of his body that need to be helped to work better or to be “fixed”. Use simple, concrete terms as much as you can, since young children can’t imagine concepts they haven’t experienced.
Tell your child what will happen after the procedure if there will be a change in his body functions; “After the exam it might feel funny in your throat and you might not feel like eating right away”. “After you are done there will be a bandaid on your arm and we’ll keep it on until tomorrow.”As much as you can, act out the procedures with the bear, getting your child to help if he want. Let him play with the equipment and ask as many questions as he wants to ask.
Tell your child that he and his bear might not like the way the procedure feels and describe how it might feel. Use words like squeeze, prick, pinch or push, rather than more general word “hurt”—the more specific you can be, the better.
If your child will have to be in a certain position for the tests, practice together. If you will be able to hold him, show him how you will do that. If he will have to be in a wrapped restraint, practice that, since the restraint can be as frightening as a procedure to an unprepared child.
The playful approach can seem awkward at first, but you will find that it is an effective and even enjoyable way of helping your child to cope.
It is less threatening for your child to when you communicate to him through the bear. You can talk about the bear’s feelings, or what the bear might be thinking as a way of letting your child know that it is OK to think and feel that way..
Should children be “restrained”?
You know your child best, but find out ahead of time whether there are options for using a wrap or mummy bag to help your child be still during a procedure. It is often comforting to plan for being wrapped up in a cozy bag. However, it is less helpful to wait until a child is upset to use a restraint, even if necessary to get a procedure completed. At that point, the child may perceive the restraint as a punishment and the parents and medical people may be emotionally upset.
Preparation is the key, as well as having reasonable expectations. No child should ever be criticized for acting defensively. Whether your child is in a blanket restraint or not, your arms around him can be the best way of holding him still and helping him to feel safe.
Many medical people who work with children are talented at building rapport so that the procedures go smoothly and the child and his parents feel as though they were helped, not hurt. It actually takes less time to complete a procedure when a child cooperates, so the investment in creating a positive experience is well worth the time. However, you can’t count on everyone being as tuned in as you might wish, so your doing your homework on preparation is the way to go.
And don’t forget ice cream afterwards!