Medical trauma in children - Children's National

Medical procedures can cause anxiety at any age. But children are especially vulnerable to medical trauma, which is lasting anxiety triggered by painful needles, noisy machines or other parts of medical care. Here's how parents and caregivers can support children and reduce lasting trauma.

Which children are most at risk for medical trauma?

The risk for medical anxiety and post-traumatic stress disorder (PTSD) can be higher in:

• Children with anxiety or other mental health conditions
• Emergency situations, such as sudden illness or injury
• Long-term illnesses that need repeated treatments
• Children facing other stressors, such as housing instability

What should I tell my child about a medical procedure?

You know your children best and can gauge how much they can understand. Experts recommend:

• Use your instincts to help your child understand what is happening and when.
• Answer kids' questions with short, honest replies.
• Ask the child if they want more information.
• Use pictures to help explain what to expect.
• For planned procedures, prepare your child without leaving too much time to worry.

How can I support my child who's going through a painful or scary procedure?

Every parent knows that watching your child feel pain or fear is awful. As tempting as it is, psychologists advise against telling your child "It won't hurt" when it definitely will. Likewise, resist the urge to convince your child "It's OK" when to them, it is anything but. Instead, you can tell your child that the procedure is temporary and that you'll be with them and go through the process together.

Try these five strategies:

1. Offer choices: Like adults, children under stress do better when they have some control over what's happening:

• Practitioners can let the child choose which arm they prefer for a vaccination.
• You can let your child decide if they want to sit on a lap or hold on to a favorite toy.
• You can offer the child a choice of reward after the procedure, such as their favorite activity, snack or meal.

1. Model calm: Your child picks up on your emotions, so appearing centered and calm helps them feel safer.
2. Use distraction: Experts suggest acting as a distraction coach, engaging your child's mind with:

• Favorite books and toys
• Blowing bubbles
• Counting backward from 100
• Grounding practice: "Can you name all the blue things you can see in this room?"

1. Give praise: When the procedure is finished, you can say things such as:

• "You finished the puzzle!"
• "You controlled your breathing!"
• "You were brave!"

1. Get support: Some hospitals, such as Children's National, have child life specialists who can help engage and distract your child and reduce the impact of a painful or frightening procedure.

When should I worry about medical PTSD in my child?

It's natural for children to be on edge after a painful or frightening medical procedure. They may seem jumpy, angry or tearful. They might have nightmares or express anxiety about future treatments.

It may be time to talk to a health care professional if you notice signs of medical PTSD:

• Fear or other negative feelings persisting weeks after the procedure
• Intrusive memories of the event
• Struggles with or lack of interest in regular school or play
• Lasting problems with motivation, eating or sleeping
• Refusing follow-up or further medical care

If your child is struggling in school, working with their teachers can help keep communication open. Your pediatrician can recommend more support or refer you to a mental health professional.