Compassionate Care

A Guide To Discussing Medical Care With Kids

By Lydia Barhight, Ph.D., Psychologist
Shriners Hospitals for Children — Chicago

Discussions around medical care can be sensitive and emotional, especially when kids are facing a new illness or injury. Parents might wonder how to tell a young child that he will be having surgery. A teenager with a new spinal cord injury might ask her parents if she’ll be able to walk again.

There’s no “right” or “wrong” way to approach these conversations; however, it can be helpful to think about your child’s age and developmental level. Here is an age-by-age guide to having these discussions.

Very young children (0-2) and preschoolers (3-5)

Lydia Barhight, Ph.D.

Even very young children pick up on the emotions, behaviors and language of adults around them. Showing a full range of emotions is normal and healthy, but it helps to be aware of the cues that you are sending.

  • Use simple, direct language. Tell them what to expect during doctor’s visits and treatments.
  • For older preschoolers, share simple facts such as the name of their medical condition, and help them learn the terminology about their care. Be honest, but filter out what is not necessary or too complex.
  • Young children are comforted by routines. Keep things consistent when you can.

Middle childhood (6-12)

Some school-age children are curious about their medical condition. Others might not even think about it on a daily basis. It’s important to meet children where they are and follow their lead.

  • Talk to children about how to answer questions they might get from peers. Planning ahead and coming up with a script can give them confidence to answer difficult questions.
  • Seek out stories of others. It can be powerful for children to know about others who have similar conditions.
  • Continue to be honest. Providing inaccurate information to make a child feel better can have lasting consequences.
  • Let them know that it is good for them to ask questions or share their feelings. Explain that sometimes, things are just hard, and remove the pressure to find the “bright side.”

Teenagers and young adults (13-18)

It’s typical for teenagers to give great weight to peer relationships. So it’s particularly important to have discussions with teens about changes in appearance, physical differences and self-esteem.

  • Discuss how their injury or condition might affect their daily activities, such as sports, school activities and spending time with friends.
  • Give direct information about their treatment, procedures or diagnosis. This age group is typically better able to understand more complex information about their medical care.
  • Consider having them keep a journal for questions that might pop up when they’re at home and bring them to medical appointments.
  • If they don’t want to talk at a certain time, let them know that they can always come back to you later.
  • Lead by example and model healthy coping, such as exercising, socializing and getting good sleep
FOR MORE ADVICE Every child has his or her own needs, depending on cognitive level, personality strengths and weaknesses. Never hesitate to ask your health care team for individualized help, visit apa.org/helpcenter/talking-to-children .