Taking the anxiety out of children's doctor visits

Katie Scarlett and Sara Fisher, certified child-life specialists at Children's Hospital of Philadelphia, wrote this for the "Healthy Kids" blog: www.philly.com/healthykids.

Nearly everything about health care - hospitalization, vaccination, even routine visits to the pediatrician - can be stressful for kids (and adults, too).

"We're going to the doctor," may be a phrase your children are not happy to hear. It is common among children of all ages to have a fear of visiting the doctor. This fear alone can cause your child not to respond well to the doctor - and, most important, can affect his or her emotional response to the medical experience.

As child-life specialists, we work to empower children and families in a health-care setting through mastery of challenging events. When children know they are going to see the doctor, they often worry about what is going to happen.

Every child approaches stressful situations differently. Following these suggestions, however, could help your child cope more effectively - in this case, with an outpatient clinic appointment.

Ask ahead. Find out what blood work, tests, or procedures to expect at your child's appointment. Then you can have a discussion with your child beforehand about what is likely to happen. Use honest yet gentle language about where your child is going, what will happen, and why. If he or she asks a question you do not know the answer to, it's OK to say you don't know - and that you will learn together at the appointment.

Develop a plan together. Work with your child to come up with a coping plan before the appointment. Providing your child with realistic choices - say, holding your hand, sitting in your lap, taking deep breaths, or looking at a book - will maximize his or her sense of control. Parents may act as a "coach" for their children by helping them to remember these coping techniques.

Rehearse. It is often helpful for children to rehearse the anticipated sequence of events for their appointment. This can include the coping plan you established. For example, allowing your child to play with a toy doctor's kit can foster exploration and familiarization with unfamiliar medical equipment. Practicing the coping plan can help develop confidence and a sense of mastery in a new situation.

Make it feel familiar. Bring activities or comfort items. Familiar items from home can provide a sense of comfort and normalization for your child - as well as a great distraction from long wait times or unfamiliar medical situations or discussions.

Don't be shy. Ask questions and seek advice during your appointment. Children of all ages can have an active role in medical discussions, decisions, and procedures. You know your child best, so it's important for you to be an active participant.