Even Mary Poppins could learn a thing or two from child life specialists


Every parent has been there – frustrated by the child who is afraid of shots, refuses to take her medicine or just won't sit still long enough to get his temperature taken.

In honor of "Child Life Month," Akron Children's Hospital asked its certified child life specialists to give parents their best advice. After all, if these techniques work at the hospital when kids are preparing for surgery, radiology exams and other procedures, they surely should work at home.

Child life specialists, whose education and training focus on child development and psychology, are an integral part of the Akron Children's Hospital experience. Child life specialists calm children and their parents, explain to them what's about to happen and, yes, sometimes distract kids with a book, a song or a wand of bubbles.
Here are their best tips when:

Your child doesn't like going to the doctor – "Reframe the experience positively, emphasizing that the doctor is working to 'keep you well,' and 'helping you to feel better so that you can play and have fun again," said Laura Leiendecker, a child life specialist on Akron Children's school-age inpatient floor. "You can also read books about going to the doctor and purchase or make a 'doctor's bag' to use in role playing."

Leiendecker also suggests planning a stop after the appointment to get a treat. Don't present this as a reward, but over time this can help the child develop a more positive association with doctor visits.

Your child won't sit for a temperature reading – "I would encourage the child to sit on her parent's lap so she can be more comfortable," said Krista Saraniti, a child life specialist in the surgery department at Akron Children's Mahoning Valley. "If your child is competitive, make it a race against the clock to see if she can sit still until the thermometer or stopwatch beeps."

Your child needs surgery – "Honesty is the best policy," said Megan Flaker, who works with children undergoing outpatient surgery. "But always offer information that is age appropriate for your child."

For example, if the parent tells a 3-year-old he is "going to the doctor" when he is actually having his tonsil removed, he may develop an unnecessary fear of the doctor.

"This child may experience throat pain he was not prepared for," said Flaker, "'Expected' stress is better handled than 'unexpected' stress."
Akron Children's offers pre-surgery tours that allow children and their parents to see the hospital and ask questions. The child life specialists typically prepare children for surgery by focusing on the five senses, such as seeing surgeons and nurses in masks and the smell of their anesthesia, in addition to the sounds, tastes and feelings they may experience.

Your child hates needles – Be honest with your child if he is due for immunizations or lab work, said Betsy Cetnarowski, a child life specialist in Radiology.

"Numerous studies show children who are prepared for a health care experience feel less anxiety," said Cetnarowski.

The goal is to not set up an expectation for pain, while acknowledging that pain is possible.

"If a child asks if something will hurt, say something along the lines of 'Some people feel it hurts while others think it's not painful at all. Let's see what you think," said Leiendecker.

Younger children who are especially fearful of needles may feel more empowered on the other end of a "play" syringe, playing doctor with a doll or stuffed animal. Older children who are especially fearful may benefit from deep breathing exercises, muscle relaxation techniques or listening to music.

Your child is en route to ER – "Children pick up our anxieties, so the more calm and confident parents can be, the better their children will do," said Michelle Peterson, a child life specialist in surgical services.

Saraniti said the ride to the ER is a good time to explain that the child will be meeting a lot of new people who are all there to help him.
A children's hospital ER team is well suited to get kids through stitches, casting to treat a broken bone, and other common procedures.

"Parents can help children through just about anything by offering a hand to squeeze, singing a song, and allowing for tears," said Melissa Mares, a child life specialist in Akron Children's pediatric intensive care unit. "If you think about it, grab a book or a favorite blanket or stuffed animal before you leave home. Older kids, of course, may prefer distraction that comes in the form of music, a hand-held electronic game set, cell phone apps or a laptop computer."

Your child hates taking medicine – "If your child must take medicine for an extended period, a chart is always helpful," said Saraniti. "You can establish guidelines such as offering a sticker for every time the child takes the medicine without a fight and so many stickers can lead to a reward."

Inform but don't overwhelm kids with information. For example, while it is important to tell young children what to expect before and after surgery, it probably isn't necessary to include details of what is happening while they are under anesthesia.

According to child life specialist Amy Lee, drawing, keeping a journal or making a scrapbook can help some children process a new or difficult experience.

"Children are smart and parents need to give them a chance to learn to cope with new experiences," said Alisa Mills, who works in surgical services. "Don't be afraid of those tears. Children will look to you to see if your response is strong and steady."

Just like other aspects of life, parents are role models for their children when it comes to health care.

"We want children to master their experience and become good consumers of health care," said Peterson.

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