The stars of the show

How do we tell if pediatric patients are anxious?

Do you remember your childhood drawings? It turns out there’s a lot more going on in your drawings than we might think!

Masters student Silvia Ortiz has completed a study in the pediatric clinic at the School of Dentistry. She was studying how the young patients felt about their treatment.

She asked the children to draw everything about their experience at the dentist that day, and then interviewed them about their drawings. To analyze the drawings, she used an instrument called “Child Drawing: Hospital.” This tool has been used in many pediatric healthcare studies to analyze child experiences.

The goal of the study was to help our dental students incorporate holistic treatment. Ortiz says, “It’s not just how good they are at completing the procedure. It’s also about making that relationship with the child so that the child learns that dentistry is not scary.”

Overall, the study showed that the patients had more positive experiences than negative. Dr. Minn Yoon, one of Ortiz’s supervisors, says, “That’s great to know, but both positive and negative experiences can be used to better our students’ learning. This study gives us data to open discussions.”

One recurring feature in the drawings was the room’s lights. Children with mostly positive experiences drew lights that were sized proportionately, whereas those with more negative experiences drew larger lights.

Ortiz says, “If the children focus on the lights, it is often a sign of anxiety.”

“The light is an analogy for a child’s overall experience,” Yoon says. “It can ‘illuminate’ — pun intended! — whether a student was able to connect with a child enough so that the child understood what was going on in their environment.” Anxiety in child patients is most often resolved through connection with the dentist. “The child is the star of the show in pediatric dentistry. So if you can explain everything to them — yourself, your partners, the setting, the instruments — it goes a long way to create that connection and reduce their anxiety.”

Ortiz has a bachelor’s of mathematics. She says, “I didn’t know what I wanted to do with math when I graduated. I didn’t want to be a pure mathematician and I was interested in healthcare. I really liked the idea of patient experience and I love children. I came up with this idea and here we are.”

Yoon says, “This study is about understanding what the needs and perceptions are in the community, so we can ensure we’re meeting our motto of being vital to the community.”

Left: Overall positive experience. Right: Overall negative experience

This child (left) had an overall positive experience. In the analysis, things that are important to note are that everything is detailed, the child is proportionate size to everything else, the details of the people were exact. This shows she made a deep connection with her dentist, even though she had a traumatic procedure done (she had a tooth removed). Notice that the light is proportionate to the child.

This child (right) had an overall negative experience. She drew a monster underneath it all, and herself very small on the chair, to the point where she had to label herself. And the light is a prominent feature. Then she drew the ceiling lights as well (the five blue spots).

Both drawings are by 6 year old girls.