Preparing your child for a clinic visit

Whatever the reason for a doctor visit, many children react in the same way–“Aaaahhh!!!” or “No, I don’t want to!!!” They are usually scared and confused, and may feel like going to the doctor is their parents’ way of punishing them for something that they did or thought. There are many things that you, as parents, can do to help make doctor visits easier for you, your child, and the medical staff :

1) BE HONEST

Be honest about what is going to happen during the visit. If your child is going to need to get a needle for any reason, such as immunizations or blood tests, let him or her know that. Most children (and adults) fear needles, but they may cope better if they know what to expect. Many parents think that if they don’t tell their child about the needle (or any other uncomfortable part of a doctor visit) then their child will be less anxious and more cooperative. However, the opposite may occur. Think about those times when you may have dropped your child off at day care and snuck out the door without saying good-bye. It may have been easier for you at first since you didn’t have to see your child upset and crying, but you may have noticed drop-offs becoming increasingly difficult for your child. The same is true with doctor visits; your child may become more and more anxious if he or she is not told what to expect, or is told there will be no needle or “shot” when there will be. Your child may learn to not trust you or what you say. So, it’s best for everyone if you say something to your child like the following: “You will need to get medicine through a small needle to stay healthy. It may feel like a pinch or a sting, but that feeling will go away quickly. Your job is to stay very still so the medicine can go in easier and faster.” During any procedure your child may need, it helps to explain what he or she will actually see, hear, taste, smell and feel. Children experience their world through their senses. When to tell your child about an upcoming doctor visit varies depending upon his or her age; generally, it is best to prepare your child as many days prior to the appointment as his or her age.

2) ROLE PLAY

Along with talking about what will happen during the doctor visit, most young children benefit from role-playing the visit with toy doctor kits. Role-playing gives children a better understanding of the medical experience, and can help them cope more effectively. You and your child can take turns being the doctor/nurse and the patient. You and your child can also role-play with stuffed animals and dolls as patients. While playing, ask your child questions, such as, “What do you think is going to happen to your patient at the doctor’s?” Or, “I wonder why your patient needs to have a shot?” (A topic that will most likely come up) By paying attention to what your child says and does during play, you can get a better idea of what he/she understands and clear up any misconceptions. During role-play, it’s a good idea to continually show your child how the doctor and other medical staff (nurses, medical assistants) want to help your child stay healthy and safe. You can also use this time to teach and practice coping techniques with your child, for example: when it is time for the doll patient to have a shot, you can say to your child, “Should your doll count to five, or should she take a deep breath?” Then, you and your child can practice counting or breathing for the doll. Make sure to comment on what a good job the doll did lying still and counting/breathing. This type of play helps by giving some control to the child, and encourages more positive coping styles. It also helps to role play after the doctor visit so your child can express any anxiety or frustrations he or she may have felt during the visit.

3) READ BOOKS

Read books to your child about going to the doctor, dentist, or hospital. A visit to any of these places may be difficult for your child, and they all involve similar themes, such as unfamiliar equipment and people, loss of control, pain, etc. Reading is something most children enjoy, and it is a fun way for your child to learn about how other children (and animals) deal with their experiences in similar situations. It is helpful to read these types of books with your child as part of your typical reading routine, since medical and dental visits are not always planned! Your older child will benefit from looking at and reading basic anatomy books–school-age children are often fascinated with their bodies and how they work.

4) DO ART ACTIVITIES

Engage children in art activities with medical themes and equipment. Most children enjoy doing some type of art, so this is a great way to help them feel more comfortable and familiar with the people and things they will come in contact with during a doctor visit. You can use items from your First-Aid kit at home, such as bandaids, cotton balls, and gauze; and you might encourage your child to tape or glue them on to paper to create a medical collage. Older children can use medical items to create realistic pictures–bandaids can be used to make flowers (use markers to brighten them up), cotton balls can be clouds, and gauze can be a girl’s dress or grass. There are limitless possibilities! You can also provide your child with coloring pages that include pictures of medical staff and tools, doctor’s office, and waiting area, etc., as well as coloring pages of the dentist and hospital environments.

HELPING YOUR CHILD COPE WITH MEDICAL EXPERIENCES

Two examples of coping techniques were mentioned above: counting and taking deep breaths. Your child will benefit greatly from learning and practicing coping strategies with you that he or she can use during stressful times–from getting weighed to getting a shot (whatever your child considers hard or stressful). Being able to successfully get through a distressing procedure may give your child confidence that he or she can master other challenging situations.

Here are some coping/distraction techniques you can use with your child by age level:

Infants (birth-one year)

* Rocking and patting
* Sucking (pacifier)
* Holding for comfort/positioning
* Singing/music
* Rattles

Toddlers (one-three years)

* Bubble-blowing or pinwheel
* Singing/music
* Holding for comfort/positioning
* Light up toys
* Holding favorite object (blanket, doll)
* Pop-up picture books/sound books
* Medical play (playing with real and toy medical equipment; beginning role-play by 2 ½ or 3 years)

Pre-school (three-five years)

* Light-up toys
* Bubble-blowing/pinwheel/party blower
* Picture books/ pop-up books/ sound books
* Singing/music
* Holding for comfort/positioning
* Medical play (playing with real and toy medical equipment–playing “nurse” or “doctor”)
* Counting
* View Finders
* Magic wand (tube with glitter, oil, water, sequins)
* Stroking, touching
* Talking about favorite stories, pets, places
* Videos

School-age (five to twelve years)

* Relaxation i.e.: pretending to be Raggedy Ann or Andy
* Books (I Spy), puppets
* Magic wand
* Bubble-blowing/pinwheel/party blower
* Deep breathing
* Holding a squeeze ball
* Procedural rehearsal, Medical play
* Holding for comfort/positioning
* Music
* Guided imagery–stories about place child would rather be
* View Finders
* Videos
* Hand-held electronic games
* Brain teasers; spelling, etc.
* Positive self-talk

Adolescence (twelve to eighteen years)

* Relaxation
* Deep breathing
* Music
* Guided imagery
* Medical play
* Massage
* Bubble-blowing/pinwheel/party blower
* Videos
* Positioning/comforting touch/hold
* Holding a squeeze ball
* Positive self-talk

Websites to find other ideas/resources on preparing children for a doctor or hospital visit:

1) http://kidshealth.org/parent/system/doctor/dr_visits.html– This site has many great ideas for preparing your child for a doctor visit. Kidshealth.org is also a great resource on other topics related to children’s health and development, such as Nutrition and Fitness and Emotions and Behavior

2) http://www.awareparenting.com/answer10.htm – This article is titled, “Making doctor visits a pleasant experience for children” by Aletha Solter, Ph.D.–Dr. Solter gives advice on preparing children for doctor visits in both non-emergency and emergency situations

3) Toddler’s Today Kids’ Today Age-by-Age Doctor Guide

4) Contemporary Pediatrics – “Books for the child afraid of doctors, hospitals, and medical procedures.” Book suggestions for infants through adolescents.

***Please feel free to ask for our Child Life Specialist if you have any further questions or concerns regarding preparing your child for a doctor or hospital visit. You may also request to speak with them if you know your child will need extra preparation and/or support for a procedure (such as an IV, blood draw, immunization, etc.), or for a hospital admission and/or surgery. If a hospital admission and/or surgery is planned, you are encouraged to schedule a hospital tour for you and your child so that your family will know more about what to expect at the hospital.

Child Life Specialist: Jessica Claspill-Garcia, Hayward Inpatient Pediatrics: 510-784-4219

Your child is also invited to participate in arts and crafts, and other fun activities, at the activity table located in the Sleepy Hollow lobby across from the injection room and next to the Health Education Desk. There is also storytelling at the activity table and in the waiting areas at unscheduled times throughout the week, and there will be more of that in the near future!

I hope the above suggestions will help you and your child have more positive experiences during your future doctor and hospital visits!