When Your School-Age Child Needs a Test, Procedure, or Surgery

What your child understands

By age 7 or 8, school-age children are starting to develop coping skills as they think more logically and start 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 have more than one point of view

• Can learn from one situation and apply it to another

• Have more 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 healthcare provider or hospital less frightening. Studies have shown that children who are prepared are less anxious about their treatment than children who are not prepared.

Other suggestions to ease the way:

• Describe what the healthcare provider's office or hospital is like.

• Tell your child if an overnight stay at the hospital is possible. Reassure your child that you will be staying, too, if that's the case. You can usually arrange to sleep over if that is what your child needs. Separation from parents is less of a worry as a child gets older.

• Tell your child that friends and family can visit. Peers start to gain importance in a child's life at 7 to 11 years of age.

• Check that your younger school-age child understands that the reason for the test, procedure, or surgery is not because of anything they have done. Your child needs to know that they are not to blame.

• Be patient with your child. They may try to gain mastery over the situation by attempting to understand the medical treatment. Answer your child's questions as best you can. Use online resources and books from the library or bookstore to arm you with age-appropriate explanations. Arrange for your child to ask the healthcare provider questions.

Before your child goes to the healthcare provider or hospital, you can:

• Take your child on a hospital tour

• Attend "pre-op" classes if they are offered

• Have your child meet their healthcare team

• Have your child pack meaningful toys, games, books, pictures, and other items that can give comfort to them in the healthcare provider's waiting room or hospital

Once in the healthcare provider's office or hospital, encourage your child to do some of these activities to relax:

• Take deep breaths

• Listen to music or a story through headphones

• Rehearse behavior with a parent through role-play

• Read

• Watch favorite DVDs

• Model by observing another child having the test, procedure, or surgery on a DVD. Your child can show the behavior to help them 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 healthcare provider and the rest of the healthcare team.

Other things you can do:

• Find out if you can be with your child during the procedure. Many hospitals allow a parent to go with a child to the operating room until the child is asleep. 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 they will be restrained during the test or procedure. (Restraints help keep your child safe and allow the test to be done correctly.)

• Have your child involved in decisions whenever practical.

• Stay overnight if you and your child agree that this is best.

• Enforce family rules and routines as appropriate in the hospital.

Questions to ask your child's healthcare provider

You are the most important member of your child's healthcare team. No one knows your child better than you! Let your child's healthcare 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 health condition?

• Who, in addition to you, is involved? Can we meet the healthcare 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 have pain? If so, how long is it expected to last?

• How is this discomfort or pain managed?

• What medicines 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 them from doing any activities?

• How long will it be until my child is "back to normal?"

What to tell your child

Here are suggestions on how to tell your child what will happen:

• Tell 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-age child.

• Talk with your child no earlier than 1 week before a test, procedure, or surgery. Older school-age children can usually handle receiving such information even earlier, as much as 2 to 4 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 what your child will feel, hear, smell, and see. Older school-age 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 healthcare 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

• Help 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 methods

• Decrease your child's overall anxiety and perception of pain