Special and Wonderful Needs -Supporting children with additional needs through healthcare encounters

Going through health care encounters and medical experiences can be very overwhelming and challenging for all children. They are often faced with fear and uncertainty in a world that is foreign to them. New people, places, expectations and experiences, test a little person’s ability to cope and adapt. If your child has additional needs, this process can be almost unbearable. The sights, sounds and other sensory experiences can overload their systems. While it is impossible to mitigate all the potential triggers that a child may face during their healthcare encounters, there are ways that we can support them to reduce the impact with planning and preparation.

Planning

Knowing your child’s triggers ahead of time can help your medical team plan for a more positive experience. If you are working with a Child Life Therapist or Occupational Therapist, they can create a Behavioural Support Profile to help identify potential triggers that may be challenging in the hospital or medical environment.

Communication

It is important that your medical team know the best way to communicate with your child. Every child has different and preferred means of communication.

· Does your child have expressive and receptive language skills?

· Is talking the best way to communicate or is it better to use visual schedules or board makers?

· Should they use full sentences or short phrases?

· Does your child sign with Auslan or Makaton?

· Is it best to provide extra processing time or to break tasks down into small steps?

Having an understanding of your child’s preferred communication methods, allows those working with them to tap into their strengths and ensure that your child feels heard and understood.

Sensory and Environmental Triggers

Being in the hospital can result in sensory overload for many children. Bright lights, loud noises, strange smells and people touching them to complete observations or procedures can be very overwhelming. Additionally, breaking a daily routine, the time of day, transitions, rushing and lots of new people can be incredibly triggering for children, in particular, those with additional needs.

Ideas that might be appropriate to support your child through their health care encounter might include:

· Bringing in noise cancelling headphones

· Phoning ahead to organise a quiet space to bypass waiting rooms

· Requesting a room where lighting can be altered

· Allowing your child to play outside while awaiting their appointment

· Finding a space that allows room to pace

· Advocating for the hospital band or sticker to be placed out of sight or not directly on the child

· Bringing in comfort items –comfort blankies or pillows, toys, devices, food, chew toys, music, weighted blanket etc

· Requesting minimum people in the room

· Considering appropriate comfort positioning for procedures

· Using visual schedules or board maker to explain the steps of procedures

· Creating a ‘First and Then’ chart to support clear expectations

· Creating a social story around your health care encounter

· Using glad wrap around EMLA/Angel Numbing cream prior to blood tests rather than stickers to hold it in place

· Utilising resources such as the Royal Children’s Hospital: ‘A Child’s Guide to Hospital’ to help prepare your child to understand the procedures that might be required to complete

(RCH TV : A child's guide to hospital)

It might be a good idea to call ahead of time prior to your appointment and see whether your health care team can assist you in planning and setting up these proactive strategies. Remember that you know your child best and it is okay to advocate for them to have the most positive health care experience possible. It is likely that your child will require ongoing medical reviews, if not procedures or hospitalisations. By establishing a plan, you are more likely to set your child up for success, leading to a more positive experience and less resistance to future health care encounters.

Kate Strickland has a background in Occupational Therapy and Education and has been a Child Life Therapist working with infants, children and young people in the cardiac space for many years at the Royal Children’s Hospital. Seeing the gap in service provision pre and post hospital, she started the organisation Healing Hearts Beyond to provide a community-based Child Life Therapy service to support infants and children along with their families in managing the stresses associated with procedures, hospitalisations and medical trauma.