Tips for Working with Children

Most of you work with children and, as you know, it can be challenging at times, especially when trying to make a cast for a new brace! We have gathered some of the best ideas from our experienced partners (Bill Kunst, Cindy Diener, Suzanne Davis, Charmayne Ross, Valerie Wondra) on things you can do to help reduce anxiety and calm or distract your child patient. Our contributing practitioners suggest trying these different ideas and see what provides the best results. You can quickly move through different ideas with a patient to find one that works with the specific situation.

If you have any ideas that we have missed, please let us know. We’ll share them in future issues of Dafo Dynamics.

Help from the Parents

• Parents can be very helpful. It is always a good idea to ask the parents what they have found calms the child.
• Some practitioners have actually put a small cast on the parent first in front of the child so that the child can see what to expect and that it did not hurt their parent.
• Children can sense if their parents are anxious and that may complicate the child’s stress. Explaining what you are doing and why, and showing the parent what you will be doing can help with this, especially if it is the first time the family has been through this experience.

Distractions

• Have a video playing, or give the child a toy or book that engages the child and provides a distraction.
• Have child play with the Cascade flipper, and get the child, parent and siblings to all participate in choosing the colorful straps for the brace.
• Get child to be the “helper”; and have the child hold the tape or cut the strip. The participation gives them a sense of control and eases their anxiety.

Calming

• Play calming music or sing nursery rhymes and songs to the child.
• Have calming scents like lavender in the room.
• Explain what you are doing before you do each step to reduce fear or anxiety. Even if you do not think the child understands what you are saying, your confident tone may be enough to help the child stay calm.
• Oral input is often calming for children. Little children may do well with a pacifier or bottle, and older children may like chewing gum, sucking on a lollipop or chewing crunchy foods.
• On occasion fluorescent lighting can be unpleasantly stimulating for some children with sensory issues. Opt for incandescent lighting for these patients.

Position and Contact

• Deep, gentle, firm contact on the skin is calming and organizing for many of these children. You can have the parents help by surrounding the child with a gentle “hug”, or you could also use a blanket and wrap it around the child. Also, whoever is helping to support or hold the child can help calm the child by giving the child gentle compression down into their base of support, generally the hips or bottom.
• Flexion is an organizing and relaxing position. Having the knees bent up a little higher than the hip, when possible, may help the child stay more relaxed.

What to Avoid

• Choose your words carefully. Don’t say “This won’t hurt” because as soon as you use the word “hurt” the child gets anxious. You can say, “This will feel warm, tickly, firm”, etc. Use words that feel safe.
• Avoid wearing a lab coat or any other hospital garb. Many of the children are conditioned to be fearful with most hospital procedures, so avoid making that association in your own clinic.