As part of the diagnosis and treatment, many children with disabilities need to undergo procedures that can be uncomfortable and cause anxiety, such as getting their blood drawn for lab work or having an EEG test. While it’s never a fun task, it can be downright impossible for some kids. With the help of Undivided parents and Rachel Delano, MSW, LCSW, CCLS III, child life specialist at Baystate Children’s Hospital in Massachusetts, we’ve put together tips that will help parents and kids have a less stressful experience.
These strategies can be applied to any necessary maintenance appointments, such as doctor visits, vaccines, haircuts, and nail trims.
Call ahead of time. Rachel Delano tells us that it can be helpful to inform your provider of the challenges you anticipate. “This can also allow them to schedule you with a provider who is more comfortable working with a child who struggles in the medical setting,” she adds.
Ask about using pharmacological aids. For a blood draw or vaccine, numbing medication can be applied at home prior to leaving for the appointment. Delano explains, “You place the cream on your child’s forearm and cover it with the provider sticker so that when the provider finds the best vein, the area is numb.” She says you can also ask if the office has freeze spray, which numbs the skin instantly but is very cold (some children don’t like this sensation). “You can also ask for an anxiolytic such as Ativan. It takes 30 to 45 minutes to work but can help with anxiety around the procedure to take the edge off,” Delano adds.
Have an honest discussion and offer choices. Delano says that “children benefit from honest steps, even when they are resistant or will not like what’s going to happen.” If your child benefits from talking about the plan ahead of time, she says, it’s important to discuss the steps and allow the child to make choices when possible. “If you anticipate that your child will be resistant, tell them the day before and say, ‘We can go today or we can go tomorrow.’ Then you’re able to remind your child about their choice, and they feel more in control.” Other choices you can offer are sitting by themselves or in your lap, and watching the procedure or looking away.
Find a coping strategy. Delano says this can include noise-canceling headphones, listening to music, watching a video, or using a sensory fidget. Ask your child, “Would you like to hold my hand?” or “Would you like it if we count down until it’s over?”
Read a story and watch videos. Social Stories can help present upcoming events in ways that are easy to understand. Make a story of the what, why, when, where, who, and how of getting blood drawn. You can use a template and fill it in with your own pictures, which is often helpful for kids. There are many videos on YouTube showing kids undergoing a medical procedure without crying or resisting. Showing your child someone their age who is calmly going through the same activity can be a good example that everything will be okay. As you’re watching the video, you can pause in different spots and describe what’s happening and how your child might feel. You can mention, “It won’t hurt as much if you are relaxed and don’t move.” Watch as many times as needed until your child feels more at ease.
Schedule a visit to the doctor’s office or the location of the appointment to explain the events and get accustomed to the environment. If you can, meet with the medical professional so your child will recognize the person on the day of the appointment. Explain that on this first trip, it is just a visit to see the office and then go home.
Explain to your child that they have the right to consent. Giving their consent allows children to feel a sense of readiness and control. This process will take time, and it might mean a few failed appointments. You can explain to your child that their body belongs to them and they have the option to say no.
Count down to your child’s appointment and make it seem exciting. Let them know it is in three days, two days, etc. By presenting it as something to look forward to and creating a positive attitude around the event, you can help ease their trepidation.
Plan an activity or a reward that your child can look forward to if they are successful with completing the procedure. This way, you’re combining a fun activity with the appointment.
Allow your child to consent. Parents can sometimes be encouraged by medical staff to restrain their child during a procedure to ensure cooperation. The medical professional may ask that you hold your child’s arms or lock their legs between yours, but restraint can escalate the behavior and may cause more harm than good. If you are asked this, you can explain that you would prefer that your child give consent and that the procedure will not be done until they give permission.
You can also state that you would like to hold your child in your lap. Delano says that if you are advocating for this, it is very important that you hold your child firmly so that no one is injured. “When you provide a tight embrace, you can softly speak into your child’s ear that you are there to keep them safe and explain that the provider is there to help them,” Delano says.
If your child reacts negatively while in the chair, such as flinching or screaming, ask your child if they can be brave, but give them the option to say no. If the final answer is no, leave the appointment and reschedule for a different day so you can try again. This may happen a few times before your child consents. For many children, having a sense of control over the process will greatly reduce their fear and anxiety, which will increase their ability to be brave.
Distract your child. Getting your child to focus on you rather than the procedure can be difficult. You can watch this video, which explains how you can put methods of distraction into action.
Discuss how the appointment went. Having a discussion with your child about how the appointment went and how your child felt can help encourage calm, patient behavior for future appointments. If they decide to say no and leave without completing the procedure, this can allow you to understand their fear and hesitancy. If they were able to have a successful appointment, discussing the events and saying something like ‘Next time won’t be as scary’ can reinforce how well they did and add positivity surrounding the event.
Reward your child. After your child successfully completes the procedure, reward them with verbal affirmations and the activity or item you talked about. This can include letting them hear how proud you are and what a great job they did, or asking if they’d like to call a loved one to tell others how brave they were.
Be patient. Reconditioning any event is an ongoing process that will take time. You might go through all of these recommendations and still get unwanted behavior. This process should be repeated for every appointment or routine event for months or years, and over time, the procedure will be conditionally known to be stress-free for your child.
Rachel Delano also recommends the tips for parents in this flyer, which focuses on vaccines but can be used for any procedure that a child is nervous about.
Ask to make an appointment with a pediatric phlebotomist, as they can be more flexible and cooperative about your child needing more time and guidance than at general locations. If you are going through Labcorp, you can select locations that have a pediatric phlebotomist. Many pediatricians can also conduct blood draws in their office.
Here are some examples of stories to read and videos you can watch together to prepare for the blood draw:
Practice for the appointment with pretend play. Many kids have difficulty tolerating tactile sensations, such as others touching their heads. Parents can help their children build a positive relationship with touch through play. This can include games and songs such as “head, shoulders, knees and toes,” Simon Says, dressing up with hats or headbands, dance parties, and giving more kisses and gentle touches to your child’s head. The most important thing is that we never force unwanted sensory input to a child.
Playing hairdresser can help your child get used to having someone touching their hair with hands, combs, and tools. You can recruit a toy to have their hair done, or you can take turns with your child running the barber shop. Practice wearing an apron or cape, and tickle your child’s neck with a makeup brush to simulate the tickle of falling hair.
See more practical advice in 10 Tips for Making Haircuts Easier for Kids with Sensory Processing Issues.
Practice good oral care between dental visits. Cavities aren’t just expensive to fix; they can lead to serious health problems and, of course, lead to even more anxiety around dental visits. Here are some tips to make everyday oral care easier for you and your child:
It can also be helpful to have visual instructions. This video shows how to brush teeth with a breakdown of each of the steps written in the video description, and here’s a free visual printout of the steps to teeth brushing that you can post in the bathroom.
Check out 10 Tips for Making a Dentist Visit Easier for Kids with Disabilities for more information about preparing for the appointment itself.
For a child, it can be very scary to have wires glued to your head, so it is important to discuss what will happen before the test. For example, telling your child, “Some sticky, goopy gel will be put on your head to help keep the stickers in place, which have some rainbow colored wires attached to them. Then you'll have something like a ‘funny hat’ put on your head.” You may want to create a Social Story or show a YouTube video like this one from Boston Children’s Hospital to prime your child as much as possible so that they know what will happen before you even enter the hospital. Also, your child may benefit from acting the procedure out with a doll. The “unknown” can cause a child anxiety, whereas knowing exactly what will happen can help ease fears for some children.
During the few hours or even days for the EEG, it is important that your child is comfortable and has fun things to do as distractions, such as board games, favorite dolls or action figures, coloring books, books, snacks, and electronic devices if they don’t interfere with testing.
You can also ask family members to call or FaceTime, so your child knows that everyone cares and is cheering them on throughout the testing.
Save your favorite resources and access a custom Roadmap.
Get Started
