Five Valuable Tips to Help Anxious Children Cope with Healthcare Procedures

By Dr. Priti P. Desai, PhD, MPH, CCLS

AROUND THE GLOBE TODAY, INFANTS, CHILDREN, AND ADOLESCENTS FACE A VARIETY OF STRESSFUL SITUATIONS. WHEN RELATED TO HEALTHCARE, THESE EXPERIENCES CAN OFTEN LEAD TO FEELINGS OF FEAR, CONFUSION, AND ISOLATION AND CAN NEGATIVELY AFFECT PHYSICAL AND EMOTIONAL HEALTH AND WELL-BEING IN CHILDREN OF ALL AGES. FOR PARENTS AND FAMILY MEMBERS, THESE SITUATIONS CAN BE EQUALLY CHALLENGING TO MANAGE. CHILDREN ARE PARTICULARLY VULNERABLE WHEN THEY DO NOT RECEIVE ADEQUATE INFORMATION AND REASSURANCE, AND PARENTS OR OTHER RESPONSIBLE ADULTS MAY FEEL UNSURE OF THEIR ABILITY TO HELP CHILDREN SUCCESSFULLY UNDERSTAND AND MANAGE THESE EXPERIENCES.

The role of a Certified Child Life Specialist (CCLS) is to help children and their families ease the anxiety and stress that often accompany illness, injury, and hospitalization and help them to clearly understand their diagnosis and relevant medical or surgical treatment. A CCLS’s goal is to help normalize the healthcare environment and build confidence in children and their families to manage their healthcare experience.

As a CCLS with the global surgical nonprofit Operation Smile, I have been given the opportunity to help families around the world. Operation Smile provides free reconstructive cleft surgery and related care to individuals in areas of the world where it is needed most. Operation Smile leans on the help of volunteer child life specialists and other psychosocial care providers to help patients and their families navigate through their medical journey, which can often be emotionally overwhelming. Child life specialists are certified professionals who provide psychosocial care by building trusting relationships, normalizing the environment through play and activities while educating patients and their families about the entire healthcare experience.

Through my experience as a CCLS with Operation Smile, I have seen children gain the confidence they needed and go into surgery with a look on their face that says, “I’ve got this.” I have observed several families surmounting difficult situations together, learning and growing from the experience. This is what I love most about the work I do. I am honored to be able to provide this service for children and families worldwide. Here, I am excited for the opportunity to share these tips for parents on how to help prepare children for medical/ surgical procedures.

1. Be aware children of different age groups, temperaments, and other factors will have different fears, misconceptions, and questions about the upcoming experience.

The way CCLSs would speak and explain surgery to a five-year-old is very different from the way they would talk with or explain a surgical experience to a 13-yearold. As children get older, they have different understandings of their diagnosis and different perceptions about the upcoming experience. It is important to be aware that depending on their age, temperament, past healthcare experiences, and other factors, children will have different ideas and concerns about what to expect, hence leading to unique needs for explanations and resources for boosting their psychological safety.

2. Parents should learn about the diagnosis and procedure themselves so they can better support the child.

It is beneficial for parents to learn about their child’s diagnosis and upcoming procedure. Being equipped with the facts can help parents and family members better understand and accept the situation. Parents or responsible caregivers should be mindful of using reliable sources of medical information, including having honest conversations with their child’s medical provider or child life specialist. The CCLS will be able to clearly break down the information so parents and children can better understand what to expect during the treatment or procedure. The CCLS will even practice coping strategies with children to help them manage their otherwise difficult experiences.

3. Be truthful with your child about the diagnosis and the procedures. Communicate with them as honestly and simply as possible.

As mentioned in tip number two, learning about the child’s diagnosis and the upcoming procedure is very important for both the parent and child. Children are often curious and may have questions about what will happen during a procedure. It is essential for parents to be honest with their children about their diagnosis and

treatment plan. While it may mean having difficult conversations, keeping children from the truth does not help. Based on the child’s coping style, one should vary the detail provided regarding the procedure. Therefore, discussing this with a child life specialist is extremely useful. These professionals understand how to talk with children of all ages and with different coping styles and can help to clearly and simply break down complex medical terms and procedures to reduce the child’s anxiety. This includes what children will see, feel, hear, taste, or smell during procedures, and rehearse how children can play a more active role to help the procedure go smoothly.

4. Parents should acknowledge their feelings about the upcoming experience while learning about and pursuing appropriate ways to cope.

While this experience revolves around the child, the situation can be difficult for parents and family members to comprehend and accept. It is important for parents to acknowledge their feelings surrounding the event and spend some time finding their unique way to cope.

It can be easy for parents to spend all their energy focusing on their child’s needs. However, it is necessary for parents to care for themselves so they can better support the child. Examples of different coping tools for parents include being informed about the healthcare situation, seeking social support, taking the time for self-care such as being mindful about diet, exercise, sleep, or relying on spiritual resources.

5. Try to remain as calm as possible. Often, visible distress from parents or family members can trigger distress in a child.

It is not uncommon for children to look to their parents for clues on how to feel or respond. Seeing a calm expression on their parent’s face or an overall calm demeanor during visits with the doctor or when waiting for their procedure will help a child to relax. If parents show signs of worry or distress, children can pick up on this, and it could make them feel the same way. This is another example of how parents taking time to acknowledge their own feelings can help them better support the child when they need it most.

Although they are an extremely valuable resource for parents and children, child life specialists are not very commonly known healthcare providers. Many parents and family members do not realize this professional resource exists in most children’s hospitals across the United States. Generally, child life services are included in the cost of the child’s hospital stay, and at this time, there is not a separate billing code for their services. Parents can ask for a consultation with a child life specialist, especially if their child has a new diagnosis, is exhibiting fear, or needs help developing a coping plan. By talking more about the child life profession and sharing this information with friends and family, we can raise awareness about child life specialists and the role they play in helping children and their families overcome difficult healthcare situations.

In many of the countries we serve with Operation Smile, the child life profession is a completely new concept. It is rewarding to have this experience through Operation Smile to bring psychosocial care to children and families in other parts of the world. To learn more about Operation Smile and its transformative healing work, you can visit https://www.operationsmile.org/. More information about Certified Child Life Specialists and the child life profession can be found at https://www. childlife.org/.

SOURCES

Association of Child Life Professionals: https://www.childlife.org/ the-child-life-profession

Dr. Priti P. Desai, PhD, MPH, CCLS, is an East Carolina University (ECU) Associate Professor in the Department of Human Development and Family Science in the College of Health and Human Performance. Dr. Desai was selected to receive the 2020 ECU Achievement in International Service and Engagement Award based on her work to expand ECU’s global reach and establish ECU as an internationally impactful university. Her activities as a teacher, researcher, and leader have been critical to ECU’s national and international reputation. Dr. Desai began her clinical child life career at the Johns Hopkins Children’s Center and Kennedy Krieger Institute in Baltimore before spending a decade at Children’s Healthcare of Atlanta. She joined ECU’s faculty in 2002. In addition to her contributions to ECU, Dr. Desai has served as a Certified Child Life Specialist (CCLS) for global surgical nonprofit Operation Smile since 1992. Shortly after she began volunteering with Operation Smile, Dr. Desai’s talents as a CCLS were recognized. She was nominated to represent the CCLS’s role in cleft care as a member of Operation Smile’s Speakers Bureau. In 2003 she was invited to be a member of the Operation Smile Child Life Advisory Group of the Medical Advisory Council (MAC). As a member of the MAC, she serves as an advocate for child life’s psychosocial care provider role on surgical programs around the globe.