When Your Toddler or Preschooler Needs a Test, Procedure, or Surgery
(Ages 1 to 5 years)
Your toddler or preschooler is too young to understand everything that is going on right now – but you are likely anxious or upset by what's happening. And your youngster is quite capable of sensing your unease and stress. For you, then, being prepared for the test or procedure will help you stay calm and supportive when your child needs you.
What your child understands
Your toddler or preschooler is able to grasp on some level what is going on if you keep explanations simple and short. Keep in mind that crying is a normal response in young children who are scared, anxious, or under stress. Your child hasn't yet developed coping skills and depends on you for these. Prepare ahead of time to help make the visit to the doctor or hospital less frightening. The more your child knows beforehand, the less "new" it will seem. Studies have shown that children who are prepared experience less anxiety about their medical treatment than children who are not prepared.
Other suggestions to ease the way:
Describe what the doctor's office or hospital is like.
Tell your child if he or she will have to stay overnight at the hospital. Reassure your child that you will be staying, too, if that is the case. You can usually arrange to sleep over.
Inform your child that friends and family are allowed to visit.
Make sure your child understands that the reason for the test, procedure, or surgery is not because of anything he or she has done. Your child needs to know that he or she is not to blame.
Listen to your child. Young children use play to express their joys, fears, and all the feelings in between. Stuffed animals, dolls, and other toys are good aids. So are art supplies since feelings can be expressed through drawing and painting. Your child's storytelling skills can be tapped, too.
Books can help your child understand what's going on. Many preschool books about going to the doctor or the hospital are available at your local library or bookstore, or online. Here are a few examples:
The Berenstain Bears Go to the Doctor by Stan and Jan Berenstain
Going to the Doctor by T. Berry Brazelton
Little Critter: My Visit to the Hospital by Mercer Mayer
Going to the Hospital...What Will I See? by M.S. Jaynie R. Wood and Jo Berkus
Franklin Goes to the Hospital by Paulette Bourgeois and Brenda Clark
Before your child goes to the doctor or hospital, you can:
Role-play with your child. You can be the doctor and your child can be the patient; then switch roles. Older sisters or brothers can also get in the act with their younger sibling. Pets and stuffed animals can help, too.
Have your preschooler help you pack meaningful toys, games, books, pictures, and other items that can provide comfort to him or her in the doctor's waiting room or hospital.
Once in the doctor's office or hospital, encourage your child to do some of these activities to relax:
Breathe in a controlled manner
Look through a kaleidoscope
Play with a bubble blower or pinwheel
Listen to music and stories
Read pop-up books (toddlers) and find the hidden pictures (preschoolers)
Parents need to remember to stay calm and speak in a low, gentle voice. You have to be the role model for your child. Show with your body language and your voice that you believe everything will be fine, and that you have complete trust in your child's doctor and the rest of the health care team. Stay overnight if possible.
Other things you can do:
Find out if you can be with your child during the procedure or surgery. But do this only if you can remain calm. Your presence could be reassuring, but not if you are visibly stressed.
Reassure your child if he or she will be placed in restraints during the test or procedure. (Restraints help keep your child safe and allow the test to be done properly.)
Have your child involved in decisions whenever practical.
Provide family rules and routines as appropriate in the hospital.
Questions to ask your child's health care provider
You are the most important member of your child's health care team – because no one knows your child better than you! Let your child's health care provider know that you want to be a part of the treatment process.
Here are questions to ask before the test, procedure, or surgery:
How long will the test, procedure, or surgery take?
Will my child feel pain or discomfort?
Will restraints be used?
What are the risks involved?
What outcomes have you seen with this medical condition?
Who in addition to you is involved? Can I meet the health care team?
What type of medical equipment will be used?
What does this equipment look, sound, and feel like?
Does my child have to go without eating or drinking beforehand? If so, for how long?
Will my child be awake for the procedure or surgery?
What should I expect just before the procedure?
What do you see as my role?
Will I be allowed to be with my child during and after the procedure or surgery?
How long will my child have to stay in the hospital?
How many follow-up visits do you anticipate?
After the test, procedure, or surgery:
Did my child experience pain? If so, how long is it expected to last?
How is this discomfort or pain managed?
What medications are prescribed for my child? What are the side effects?
If anesthesia was used, how long will it take to wear off?
How should I expect my child to act now?
Do I have to restrict my child in any way or prevent him or her from doing any activities?
How long can I anticipate until my child is "back to normal?"
What to tell your child
Here are suggestions on how to tell your child what will happen:
Provide only the truth. Honest explanations about the test, procedure, or surgery are best.
Break the information into small chunks. Too many details at once will overwhelm your child. About 15 minutes is all a young child can handle.
Delay talking about the procedure or test until the day before it's scheduled. Youngsters at this age have a limited concept of time.
Choose a quiet time to talk.
Use a calm, reassuring voice.
Use simple language and kind words. Use "warm" instead of "burning" for something he or she might feel during a test or procedure. When referring to anesthesia for surgery, use "you will get to blow up a balloon."
Try to focus on the sensory experiences, such as what your child will feel, hear, smell, and see.
Child life program
Many hospitals have child life programs. A child life specialist is usually part of the health care team. When working with you and your child, this specialist can help you:
Understand the medical information presented to you so you have accurate descriptions of what will be done for your child
Enhance your ability to support your child, as well as help you and your family cope with and adjust to your child's illness
Decrease your child's overall anxiety and perception of pain