When Your School-Aged Child Needs a Test, Procedure, or Surgery
(Ages 5 to 12 years)
Your school-aged child will understand some aspects of what is going on right now – and you are likely anxious or upset by what's happening. Being prepared for the test or procedure will help you stay calm and supportive when your child needs you.
What your child understands
By age 7 or 8, school-aged children are starting to develop coping skills as they think more logically and begin to understand cause and effect—if this happens, then that may happen. This way of thinking helps them find ways to cope with scary or stressful experiences. They also:
Start to experience more than one point of view
Can learn from one situation and apply it to another
Have increased awareness of their own body
Fear loss of control
May cry as a response to anxiety or stress
Prepare ahead of time to help make the visit to the doctor or hospital less frightening. 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 if that is what your child desires. Separation from parents is less of a worry as a child gets older.
Inform your child that friends and family are allowed to visit. Peers start to gain importance in a child's life at 7 to 11 years of age.
Make sure your younger school-aged 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.
Be patient with your child. He or she may try to gain mastery over the situation by attempting to understand the medical treatment. Answer your child's questions to the best of your ability. Use online resources, as well as books from the library or bookstore to arm you with age-appropriate explanations. Arrange for your child to ask the doctor questions.
Before your child goes to the doctor or hospital you can:
Take your child on a hospital tour
Attend "pre-op" classes if they are offered
Have your child meet his or her health care team
Make sure your child packs 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
Listen to music or a story through headphones
Rehearse behavior with a parent through role-play
Watch favorite DVDs
Model by observing another child experiencing the test, procedure, or surgery on a DVD. Your child can demonstrate the behavior to help him or her master it.
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.
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.
Stay overnight if you and your child agree that this is best.
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?
What are the risks involved?
Will my child feel pain or discomfort?
Will restraints be used?
What outcomes have you seen with this medical condition?
Who in addition to you is involved? Can we 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 chunks. Too many details at once will overwhelm the younger school-aged child.
Talk with your child no earlier than one week before a test, procedure, or surgery. Older school-aged children can usually handle receiving such information even earlier, as much as two to four weeks, depending on the child's age and personality.
Choose a quiet time to discuss, and use a calm, reassuring voice.
Choose your words carefully to prevent misunderstanding and extra stress. For example, if you refer to receiving anesthesia for surgery, be careful about telling children that it puts them to sleep because they might have experienced putting a favorite pet to sleep.
Try to focus on the sensory experiences, such as what your child will feel, hear, smell, and see. Older school-aged children can handle more direct information, gently delivered.
Role-play with a sibling or a doll to briefly demonstrate the procedure or test.
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
Teach your child distraction techniques
Decrease your child's overall anxiety and perception of pain