What to tell your child

You can ask your child's nurse or a Child Life Specialist to assist you in preparing your child for an upcoming procedure. Listen to and observe your child's cues concerning his needs for preparation. If your child will be conscious during a medical procedure, it is a good idea to prepare them in advance. It is important to tell your child what they will sense (see, hear, feel, taste, smell) before, during and after the procedure. For example, what will the environment look like, will you be there and, if so, where will you be. This will help your child feel less vulnerable.

The best time to prepare your child depends on their age. You will not be able to accompany your child into the operating room, but your presence is often welcome during other procedures.

Helping your child cope: age-appropriate guidelines

• Infants (newborn to one year old)
  • At this age, being separated from parents provokes the most anxiety. Be present with your child, hold, comfort and talk to him.
  • Your infant can often sense your worries and anxieties; therefore it is important you try to remain calm.
  • Talk to your child. The sound of your voice can be very soothing. Talking will also stimulate your child and promote their development. Tell them what is happening, name things or tell them a story.
  • Play peek-a-boo. Through this game your child learns to trust he will see you again. At this age, infants cannot comprehend that what is not visible still exists.
  • As much as possible, try to maintain your child's regular schedule (feeding, sleeping, etc).
  • Create a stimulating environment. Place a mobile and brightly-coloured toys in the crib.
  • Play soft music, lullabies or sing to your child.
  • Bring familiar items from home such as toys, stuffed animals or a favorite blanket.
  • Encourage rolling, kicking, crawling and reaching for toys by placing them in the crib.
  • Ask for help from family and friends to relieve you for short periods of time.
  • Ask the nurse or a Child Life Specialist for a volunteer to stay with your child while you run errands or take a break.
• Toddlers (one to three years old)
  • Stay with your child as much as possible; if you have to leave tell them in concrete terms when you will be leaving and when you will be coming back (i.e. after lunch, after nap, before the TV show ends).
  • Bring familiar and favorite toys and objects to the hospital
  • Offer your child as many choices as possible, only where real choices exist. This provides them with some sense of control in a world where they have little choice of what happens to them. ("Where will you sit during procedure? Which game would you like to play? What would you like to eat, watch etc...")
  • Tell your child what will be happening to them. The best time to prepare a toddler is just a few minutes before the procedure. Any sooner and they are likely to forget.
  • Allow your child to express anger, fear and sadness. These feelings are normal and acceptable.
  • During a procedure, you may try to distract your child by engaging in a fun activity. This will take the attention away from the procedure thus reducing anxiety and negative feelings. You can distract your child by reading a book, blowing bubbles or using any toy that has sounds and lights. If distraction does not work, you may simply explain what is happening to them and what they can do to help. You may not be able to take away the fear or pain, but you can let them know you are there to help support them.
  • If your child is mobile and you have the nurse's permission to take them off the ward, you may bring them to the playroom (or the terrace during the summer). They will have the opportunity to be in a non-threatening environment where they can play and socialize. Play is a safe, natural and universal tool in which children can find refuge, work through feelings, grow, learn and have positive experiences. These positive experiences are especially important during a stressful and frightening experience.
• Preschoolers (three to five years old)
  • Preschoolers tend to view their hospitalization as punishment for something they have done. Reassure your child it is not their fault and they are not being punished.
  • Stay with your child as much as possible. If you need to leave, tell your child when you will be leaving and when you will be coming back. Since preschoolers cannot understand the concept of time, it is important you use concrete terms (ex. after lunch, before your favorite TV show, after your nap).
  • Children at this age need to have things explained to them in honest and simple terms. The best time to prepare your child is a few hours before the treatment.
  • Explain what they will see, hear, feel and smell. Preschoolers are good at using their imaginations. Knowing what to expect will reduce the likelihood of threatening fantasies.
  • During a procedure, you may try to distract your child by engaging them in a fun activity. This will take the attention away from the procedure, reducing anxiety and negative feelings. You can distract your child by reading a book, blowing bubbles or using any toy that has sounds and lights. If distraction does not work, you may simply explain what is happening to them and what he can do to help. You may not be able to take the fear or pain away, but you can let them know you are there to help support them.
  • Encourage play opportunities for your child. Check with the nurse to make sure your child can leave the ward. If this is possible, you may take them to the Family Resource Centre (C-542). This will provide a change of environment and a safe place to play. If your child is admitted to the sixth floor, there is a playroom there. Please be sure to advise the nurse of where your child will be.
  • Encourage your child to express their feelings by playing doctor/nurse. They can pretend their favorite doll or animal is the patient and they are the doctor or nurse.
  • Read books together about going to the hospital.
• School-age children (six to 12 years old)
  • Prepare your child a few days in advance. Explain what they will see, hear, smell and feel. Also explain changes that may occur in their body as a result of treatments and medications. A child at this age may reflect on what will happen and may come back with questions related to the procedure.
  • You can explain to your child in more detail why they need a particular treatment.
  • Talk to your child and answer questions openly and honestly.
  • Allow them to pack their own bag/suitcase with favorite items.
  • Encourage them to keep in touch with friends.
  • Encourage friends to come and visit and encourage your child to meet and socialize with other children in the hospital.
  • Encourage your child to engage in pleasant activities (arts and crafts, games, using the computer in the Family Resource Centre - C-542).
• Adolescents (12 to 18 years old)
  • Adolescents tend to be concerned with body image and changes. It is important to inform your child about what will happen and how they will look afterwards.
  • Include your adolescent in discussions and decisions about treatment and encourage them to ask questions. Legally, a child over fourteen years old can make medical decisions and request their medical information be kept confidential.
  • Encourage them to talk and express feelings, but understand they may want to keep certain things to themselves.
  • With emerging independence, adolescents may feel they are being treated like children. Foster independence by allowing them to make choices and respect their need for privacy.
  • Encourage friends and peers to visit them in the hospital. Socialization plays an important role in adolescence, and especially in the hospital where teens are at a higher risk for social isolation. Please also understand and respect that your adolescent may not want their peers to see them due to bodily changes.