This is one of the most common questions child life specialists get when working with parents who want to know how and when to talk to their child. When is the right time to tell my child that a procedure, shot, or doctor’s visit is happening soon?
Regardless of the child’s age, it’s important for parents to understand to recognize what their previous experiences are with themselves and also their child.
Understand your own triggers
Taking a few moments to do some “internal work” and think about what some of their own triggers are around medical experiences is a key part of having the conversation. Once it is clear what their own triggers are, it is easier to recognize those signs if they begin to bubble up during a conversation.
Here’s an example:
Susan’s daughter is scheduled for an MRI scan next week. The last time Susan had any experience with an MRI was when she was in high school and was in a traumatic car accident. Susan’s recollection of the experience is upsetting, confusing, and painful. Recognizing that this is Susan’s experience and that it is separate from what her daughter is about to experience will be important before preparing her daughter.
Learn from past experiences
Unless this is an infant’s first shot or vaccine, it is likely that the parent and child have been through some sort of medical or stressful experience together before. What worked best? What didn’t go well? Pulling on previous experiences can help parents identify things to include and try to avoid.
Here’s an example:
The last time Lam had a preoperative appointment, the surgeon pretended to look for monkeys in his ears when using the stethoscope. Before the day of surgery, Lam’s father told this to the pre-op nurse and the care team embraced the “pretend play” and joked about monkeys with Lam to help him feel comfortable.
Allow the child to have a say
Including children in the preparation is key to having a successful conversation. Whether the child is old enough to tell you, “don’t tell me until the day before something happens,” or “give me as much notice as possible,” even young children can give verbal cues about how much information they want. When you notice your child changing the conversation, protesting, or becoming visibly upset, it’s time to take a break and develop another strategy.
Here’s an example:
The last time Diego was in the hospital, he had a really difficult time with the tape coming off of his PICC line. He struggled, yelled, and took a like time to recover from the dressing removal. Before Diego’s next hospital experience, his mother gauges his recollection of the event to understand what stuck out to him. After she understands his memory of the events, she asks questions like, “if you ever had to go through something like that again, when would you want to know it was going to happen?”
Start with digestible information
Beginning a conversation without a frame of reference almost never works. When we allow children to understand the context of a conversation, it can help them feel engaged. Lead with the facts that the child already knows and use a combination of questions and statements to guide the rest of the conversation.
Here is an example:
Tanisha’s daughter is having tonsil and adenoid surgery next week but is scared to bring it up because the last time they were at the hospital, it was for an overnight sleep study that was difficult for both of them. Tanisha brings up the conversation by validating her daughter’s experience. “The last time we were at the hospital overnight, we both really struggled to get sleep, and I remember how you felt about the nasal cannula. I was talking with your doctor today, and they told me that we need to go back to the hospital next week, but this time will be much different than the last time. We will go in the morning instead of at night.”
Trust yourself and ask for help, if necessary
As parents, our responsibility is to learn as much as we can to guide our children through difficult experiences. Spoiler alert, we won’t always get it right! Parents fumble over words and children will undoubtedly get nervous and upset about difficult information. The job of a parent is to sit with their children when those feelings bubble up and let them know they won’t navigate it alone.
The Child Life On Call podcast is a place where parents share stories about what it’s like to have a child who has an illness or diagnosis for the purpose of helping other families feel less isolated. Podcast episodes that relate to preparation that may be helpful to listen to on this topic are this one, this one and this one.
If you know a parent who would like support in navigating these conversations with their children, you can make a virtual visit with a child life specialist here.