School age test/procedure preparation
Alternative names:
preparing school age children for test/procedure; test/procedure preparation - school age
Information:
Definition:
Proper preparation for a test or procedure that can reduce your child's anxiety, encourage cooperation, and help develop coping skills.
Research has shown that preparatory interventions are effective in reducing some signs of distress in children such as crying or resisting the procedure; this led to other findings suggesting that with preparation children report less pain and exhibit physiologic signs showing less distress.
Before the test, know that your child probably will cry, and restraints may be used. You can try the use of play in demonstrating what will happen during the test and in discovering your child's concerns. If your child is older, you can use videos, where their peers do the teaching. Explaining the procedure will also be of value in reducing your child's anxiety. Let your child participate and make as many decisions as possible. Focus on the pleasurable things that will happen after the test. With age and independence, your child may or may not wish you to be present during the procedure, and his or her wishes should be respected. In these years, privacy is of increasing importance and should be protected.
PRE-PROCEDURE PREPARATION:
Limit your explanations to 20 minutes each, in several sessions if necessary. School age children have a good concept of time, allowing for preparation in advance of the procedure. The older your child, the earlier in advance you can begin preparation.
Here are some general guidelines for preparing your child for a test or procedure:
- Explain the procedure in correct medical terminology.
- Use anatomical and physiological drawings and diagrams to illustrate the part(s) of the body that will be involved.
- To the best of your ability, describe how the test will feel.
- Allow your child to practice different positions or movements that will be required for the particular test or procedure, such as the fetal position for a lumbar puncture.
- Save topics or subjects that you think will cause your child the most stress for last.
- Be honest with your child about discomfort that may be felt, but don't dwell on the topic, since this could instill undue concern in your child.
- Stress the benefits of the procedure and anything that the child may find pleasurable afterwards, such as feeling better, or going home.
- To the best of your ability, describe the operation of equipment that will be involved in concrete (literal) terms.
- Suggest ways for maintaining control:
- counting
- deep breathing
- relaxation (thinking of pleasant thoughts)
- Allow your child to participate in simple tasks.
- Include your child in the decision-making process, such as the time of day or the body site where the procedure is performed (these depend on the time constraints of your health care provider and the type of procedure being performed, but where possible, let your child make some decisions).
- Encourage participation during the procedure, such as holding an instrument, if allowed.
PLAY PREPARATION:
Play and third-person communication can be wonderful and revealing ways of demonstrating the procedure for your child, and identifying his or her concerns. For younger school age children, this technique is very appropriate. Older school age children might view this approach as childish. Consider the intellectual needs of your child before implementing this type of communication. Older children may better benefit from films that show peers explaining, demonstrating, and undergoing the same procedure. Ask your health care provider if such films are available for your child's viewing.
This technique needs to be individualized for each child, and most health care facilities that are oriented towards children, such as a children's hospital, use this same technique to prepare your child. This type of communication can take some practice.
Children asked direct questions about their feelings often are avoidant and elusive. Of course, some children are more than happy to share their feelings with you, but as anxiety and fear increase it is not uncommon for the child to withdraw.
Most young children have an object of importance they keep close to them. This object or toy can be a tool for a type of interaction called third-party communication. It is less threatening for your child to communicate concerns through the toy or object than to express them directly. For example, consider a 7-year old girl who is clearly afraid, has a doll named Karen, and is going to have her blood drawn. You could look at the girl and tell her that Karen looks like she might feel afraid. Your child may or may not share those feelings at this point, and additional questioning along this line may be necessary.
The same object or doll can be a productive tool for explaining the procedure. Young school age children continue to manifest concrete thinking. Concrete thinking involves taking everything literally, and an inability to make deductions or generalizations. For example, if you say you feel fine to a concrete thinker, he or she may interpret that by thinking your feeling or touch sensation is intact. Once you are familiar with the procedure through information obtained from your health care provider and this software, briefly demonstrate on the toy or object what your child will experience during the procedure. For example, show positioning, bandages, stethoscopes, cleaning the skin, how incisions are made, injections are given, or IV's are inserted Medical toys are available, or you can ask whether your health care provider can share some of the noninvasive items you need for the demonstration and play period. After your demonstration, allow your child to play with some of the noninvasive items. The way he or she plays can also give you clues regarding concerns and fears.
Drawing is another way for children to express themselves. Ask your child to draw the procedure after you have explained and demonstrated it. You may be able to identify concerns or misconceptions through your child's artistic expression.
DURING THE PROCEDURE:
If the procedure is performed at the hospital or your health care provider's office, you will most likely be given the opportunity to be present. Your child may or may not desire your presence, and it is best to honor his or her wishes.
If you are not asked to be by your child's side and would like to be, ask your health care provider if this is possible, and ask your child if he or she would mind your presence. Out of respect for your child's growing need for privacy, do not allow peers or siblings to view the procedure.
Other considerations:- Ask your health care provider to limit the number of strangers entering and leaving the room during the procedure, since this can raise anxiety.
- Ask that the care provider who has spent the most time with your child perform the procedure.
- Ask that anesthetics be used where appropriate to reduce the level of discomfort your child will feel.
- Ask that painful procedures not be performed in the hospital bed or room so the child does not come to associate pain with these areas.
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The information provided herein should not be used for diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Copyright 2000 adam.com, Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
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