Communicating with Children

Why include children in counseling sessions?

Increases patient/caregiver satisfaction, children benefit from knowing what is expected of them, promotes independence, increases adherence, and encourages questions

What do children want and need to know?

Information about the dosage form, how it will make them better, dosing frequency, duration of treatment, and side effects (what do they need to tell their parents?)

What are the four cognitive development stages in children?

1. Sensorimotor

2. Pre-operational

3. Concrete operations

4. Formal operations

Sensorimotor stage

Typically occurs from birth to around 2 years old. During this stage, infants and toddlers learn about the world primarily through their senses and physical actions

Is it possible to learn about medications in the sensorimotor stage?

No

Pre-operational stage

Typically occurs in children 2-7 years old, where the child is learning language and more advanced mental processes. However, they only consider 1 aspect of a situation at a time and can't relate cause and effect relative to health

Concrete operations stage

Occurs from 7-12 years. Children become more capable of logical thinking and can reason about real-world situations, but their reasoning is still grounded in the present and in things they can see and touch. They learn that diseases can be prevented

Formal operations stage

Occurs from 13-adulthood where they develop the ability to think abstractly and hypothetically. They begin to understand complex cause-and-effect relationships. Takes a more directive role in care

Assign the correct Piaget stage to this statement:

Do not understand cause and effect relative to health

Pre-operational stage

Assign the correct Piaget stage to this statement:

Able to take a more directive role in care

Formal operations stage

Assign the correct Piaget stage to this statement:

Can learn cause and effect relative to health

Concrete operations stage

Assign the correct Piaget stage to this statement:

Learning about medications is not possible

Sensorimotor stage

Assign the correct Piaget stage to this counseling excerpt:

This medicine helps your kidney. Your mom or dad will give it to you when you wake up and before you go to bed. It tastes good and I think you will like it

Pre-operational stage

Assign the correct Piaget stage to this counseling excerpt:

Tacrolimus prevents rejection. It will keep your immune system from attacking your new kidney. Take it at 8am and 8pm every day.

Formal operations stage

Assign the correct Piaget stage to this counseling excerpt:

Counsel parents only

Sensorimotor stage

Assign the correct Piaget stage to this counseling excerpt:

This medicine will keep your body from harming your new kidney. Work with your parents to take the medicine at 8am and 8pm every day

Concrete operations stage

Gaining rapport: Start with Comfort

Sit at their level or below, keep eye contact, and introduce yourself clearly

Gaining rapport: Know the circle

Know the accompanying adult's relationship to the child, use a normal voice, remain calm, and focus on them

Gaining rapport: Child focuses approach

Find something of interest to them, and try to keep the parents from speaking ill of the child

Gaining rapport: Make it interactive

Involve them, let them look at devices, and ask them questions

Gaining rapport: Support Expression

Give them time to respond, allow them to share fears or concerns, and clearly explain their role in what's happening

Tips for speaking to infants

Speak in a soft tone

Do not lean over them

If they reach out, they want to play

When they stop interacting, stop trying

Tips for speaking to toddlers

Have distractions ready

Offer choices if available

Dont help them with a task unless they ask

Use open-ended questions

Deliver basic information

Give them time to respond

Tips for speaking to school-age children

Ask them questions and give information

Give straightforward responses

Use examples of other children to get them talking

Provide more details on how medication works

What is some general information to know about speaking to adolescents?

You should listen more than you talk

Find something that interests them

Focus on them and let parents supplement

Talk to them alone if conversation is sensitive

What are some sensitive topics to discuss with adolescents?

Alcohol with Flagyl, teratogenic medications, smoke exposure, and recreational drug use

Tips for speaking to adolescents

Watch their body language

Remain calm and not judgmental

Understand their viewpoint

Ask questions differently if needed to get information

Involve them in decisions

Information given should be similar to info given to adults