WHAT DOES THE EVIDENCE SAY? Children with additional needs accessing hospital and emergency departments.
Through each developmental stage, children interpret, comprehend, and process the world in a variety of different ways. Children and adolescents having to be treated in hospital, especially children with additional needs, can find the experience of being poked and prodded by strangers quite confronting. Additionally, it can be developmentally appropriate for children to experience anxiety related to separation or body integrity whilst in hospital. As such there has been a relatively recent push by medical and allied health professionals to take into account the psychological needs of children on an individual and age-appropriate basis. In particular, the need for a calming and minimally disruptive environment that reduces anxiety and allays fear.
Research indicates that in addition to taking into consideration a child’s age, developmental level and temperament when children are hospitalised, there are a number of other techniques that can be used to promote a minimally disruptive environment. These can include:
· Giving the child developmentally appropriate information regarding the medical procedure
· Encourage children to ask questions
· Developing distraction techniques (i.e. books, iPad apps, etc.)
· Developing relaxation skills (i.e. guided meditation, progressive muscle relaxation, etc.)
· Encouraging positive self-talk through coping statements (i.e. “I am strong”)
· Enhancing parent support
· Swaddling for infants
· Maintaining home routines while in hospital (i.e. wake and sleep times, school work, photos)
· Creating a predictable schedule for the child
· Providing choices for the child so as to create a level of control
· Incorporating consistent play into the child’s day
The available literature indicates that the benefits of professionals taking the time to incorporate these strategies range from decreasing anxiety, decreasing sensations of pain, and decreasing recovery periods.
DeMaso, D. R., & Snell, C. (2013, August). Promoting coping in children facing pediatric surgery. InSeminars in pediatric surgery (Vol. 22, No. 3, pp. 134-138). WB Saunders.
Moore, E. R., Bennett, K. L., Dietrich, M. S., & Wells, N. (2015). The Effect of Directed Medical Play on Young Children’s Pain and Distress During Burn Wound Care. Journal of Pediatric Health Care,29(3), 265-273.
Murtagh, J. E. (2006). Managing painful paediatric procedures. Australian Prescriber, 29(4), 94 – 96.
Okado, Y., Long, A. M., & Phipps, S. (2014). Association between parent and child distress and the moderating effects of life events in families with and without a history of pediatric cancer. Journal of pediatric psychology, jsu058.
Tobin, D. P. (2013). The Future of Child Life in Pediatrics and Its Implications for Health Care Professionals (Doctoral dissertation, Oakland University William Beaumont School of Medicine Oakland).