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Preparing preschoolers for test/procedure; Test/procedure preparation - preschooler
Proper preparation for a test or procedure reduces your child's anxiety about the situation, encourages cooperation, and helps the child develop coping skills.
Preparation can effectively reduce distress in children who are undergoing medical tests, minimizing crying and resistance to the procedure. Research finds that lowering anxiety can actually decrease the sensation of pain felt by people during uncomfortable procedures.
Before the test, understand that your child probably will cry. Preparation may not change the fact that your child will feel some discomfort or pain. You can try demonstrating what will happen during the test in advance to learn about your child's particular fears and concerns. Using a doll or other object to act out the test may help reveal worries that the child may not be willing to discuss directly.
This may help reduce your child's anxiety. Most people are more frightened of the unknown. It helps if the child knows what to expect. If a child's fears are unrealistic, you may want to explain what will actually happen. If the child is worried about an unavoidable part of the test, do not minimize this concern. Reassure the child that you will be there to help as much as you can.
Make sure your child understands that the procedure is not a punishment. Children at this age may believe that the pain they feel is a punishment for something they did.
The most important way you can help your child is with proper preparation, and with your support and comfort around the time of the procedure.
PREPARING BEFORE THE PROCEDURE:
Keep your explanations about the procedure to 10 or 15 minutes, because preschoolers have a limited attention span. Preparation should take place directly before the test or procedure so that the child doesn't worry about it for days or weeks in advance.
Here are some general guidelines for preparing your child for a test or procedure:
Play can be a wonderful way of demonstrating the procedure for your child and identifying any anxiety. Tailor this technique to your child. Most health care facilities for children use similar techniques to prepare children for procedures.
Many young children have a favorite toy or other important object that can be a tool for a process called third-party communication. It may be less threatening for your child to express concerns through the toy or object instead of directly. For example, a child who is about to have blood drawn may be better able to understand if you discuss how her doll might "feel" during the test.
Toys or dolls can help you explain the procedure to your preschooler. Once you are familiar with the procedure, briefly demonstrate on the toy what your child will experience. Using the toy, show your child:
After your demonstration, allow your child to play with some of the items (except for needles and other sharp items). Watch your child for clues about concerns or fears.
No matter what test is performed, your child will probably cry. This is a normal response to a strange environment, unfamiliar people, and separation from you. Knowing this from the beginning may help relieve some of your anxiety about what to expect.
Your child may be restrained by hand or with physical devices. Young children lack the physical control, coordination, and ability to follow commands that older children and adults usually have. Most tests and procedures require limited or no movement to ensure accuracy.
Restraints may be used during a procedure or other situation to ensure your child's safety. For example, to get clear results with x-rays there must not be any movement. Radiological and nuclear studies require that all staff temporarily leave the room. In these situations, restraints may be used for your child's safety.
If a puncture is done to get a blood sample or start an IV, restraints may be used to protect your child. If the child moves, the needle could cause an injury.
Your health care provider will use every method to ensure your child's safety and comfort. Besides restraints, other measures include medications, monitors, and observation.
Your job as a parent is to comfort your child.
DURING THE PROCEDURE:
Your presence may help your child during the procedure, especially if the procedure allows you to maintain physical contact. If the procedure is performed at the hospital or your health care provider's office, you may be given the opportunity to be present. If you are not sure whether you are allowed to be present, ask.
If you think you may become ill or anxious, consider keeping your distance but remaining in your child's line of vision. If you are not able to be present, leaving a familiar object with your child may be comforting.
Avoid showing your anxiety. This will only make your child feel more upset. Research has suggested that children are more cooperative if their parents have taken measures (such as anxiety reducing acupuncture) to reduce their own anxiety.
Khan KA, Weisman SJ. Nonpharmacologic pain management strategies in the pediatric emergency department. Clin Ped Emerg Med. 2007;8(4):240-247.
Yip P, Middleton P, Cyna AM, Carlyle Av. Non-pharmacological interventions for assisting the induction of anesthesia in children. Department of Paediatric Anaesthesia, Starship Children's Hospital, Auckland, New Zealand. Cochrane Database Syst Rev. 2009 Jul 8;(3):CD006447.
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